Mesothelioma Study Reveals Need to Step Up Pain Control

Healthcare providers should make pain control a higher priority for their patients with mesothelioma and other lung-related cancers.

That is the message of a recent University of Pennsylvania study on pain management.  The study gathered information on pain and pain control from patients with mesothelioma or lung cancer between 2005 and 2008. Participants were asked to fill out an Internet-based questionnaire that included 22 questions designed to assess their symptoms, evaluate their pain, and appraise their attitudes toward pain medication.

Of the ninety people who filled out the survey, nine percent had mesothelioma, a rare cancer of the lining of the chest or abdominal cavity.  The other 91 percent had either small-cell or non-small-cell lung cancer. Most were men and 89 percent were Caucasian.  Almost half of the survey respondents had undergone surgery for their mesothelioma or lung cancer, 58 percent were treated with chemotherapy and 44 percent had had radiotherapy.

When malignant mesothelioma starts in the pleural cavity around the lungs, patients often report mild pain in the chest or back. Mesothelioma in the abdominal cavity may trigger pelvic pain. Mesothelioma pain often progresses and can become severe and chronic in the later stages of the disease. Ninety-two percent of the patients in the University of Pennsylvania study reported pain. Fifty-two percent attributed their pain to their disease while 38 percent said the treatment was the cause. Sixty-seven percent of respondents said they were unsure of the primary cause.

But the most disturbing news for the pain researchers was that, among the patients reporting pain, a full third were not using pain medications to control it.  When asked why not, 76 percent said they were worried about becoming dependent on them and 56 percent said they were not able to pay for the medication.  But in 71 percent of cases, patients said their healthcare providers had not even recommended medication.  Many mesothelioma and lung cancer patients were using physical therapy or other alternative therapies to manage their pain.

The study’s authors say their findings suggest inadequate provider concern for symptom palliation, even though multiple studies have cited uncontrolled cancer pain as having a detrimental effect on quality of life. They recommend that providers caring for patients with mesothelioma or lung cancer “make pain management a priority and regularly discuss pain symptoms and pain management with patients” since pain control needs may change over time.

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