Written By: David Statman
Mesothelioma is a rare cancer that develops in the lining of the lungs, abdomen, or heart. Growth and spread of tumors can lead to varying degrees of pain, ranging from mild discomfort to severe pain that impacts quality of life. Effective pain management includes types of mesothelioma treatment and can improve daily life for patients.
Medically reviewed for accuracy by
Dr. Stephen Williams
Precision Oncology Scientist
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There are several types of pain caused by mesothelioma. They have unique characteristics and different management approaches:
Acute pain – Sudden and sharp pain, that typically lasts for a short period of time, resulting from tumor growth, diagnostic procedures, or treatments
Chronic pain – Persistent, long-lasting pain, ranging from mild to severe, often caused by ongoing tumor pressure, inflammation, or treatment-related side effects
Breakthrough pain – Intense, sudden flare-up of pain, occurring even when a patient is on regular pain medication and often requiring adjustments in medication dosage or additional fast-acting pain relief
Neuropathic pain – Caused by irritation or damage to nerves from tumor growth, surgery, or chemotherapy and is often described as tingling, burning, shooting, or electric shock-like pain
Pain related to mesothelioma requires comprehensive pain management techniques that include a combination of medications, treatments, and complementary care.
Pain can arise from both mesothelioma symptoms and side effects of treatment. The most common causes of pain include tumor growth, fluid buildup, nerve damage, and treatment-related complications.
Pain management for mesothelioma can involve a combination of different medication options. Pharmacology, or medication, management of cancer pain may include the use of opioids (narcotic pain medication), nonsteroidal anti-inflammatory drugs (NSAIDS, like Ibuprofen), or antidepressants, or a combination of some of these medications.
The addition of drug-free or alternative treatments – including physical therapy, massage therapy, and acupuncture – can provide a more comprehensive relief of symptoms and ways to manage pain.
Opioid pain relievers, also known as narcotic pain medications, are commonly prescribed for moderate to severe pain caused by mesothelioma. These medications work by binding to opioid receptors in the brain and spinal cord, effectively blocking pain signals and providing relief.
While opioids are effective in managing pain, they can also cause side effects, including:
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to relieve mild to moderate pain in mesothelioma patients by reducing inflammation and swelling caused by tumors or treatment-related side effects. They can be used alone or in combination with opioids to enhance pain relief while potentially lowering opioid dosage requirements.
While NSAIDs are effective, they can cause side effects, especially with long-term use:
Antidepressants, commonly used for mood disorders, are effective in managing nerve-related pain associated with mesothelioma. They serve as an alternative or complement to opioid pain medications, particularly for patients experiencing neuropathic pain (nerve pain), which can feel like burning, tingling, or electric shocks.
According to the Mayo Clinic, antidepressants help increase levels of neurotransmitters in the spinal cord, which reduces the intensity of pain signals sent to the brain. This makes them particularly useful for chronic pain conditions related to nerve damage from tumors, surgery, or chemotherapy.
There has been a surge in support of marijuana for mesothelioma as a viable treatment to manage pain. Marijuana is also seen as a viable complementary therapy to help patients manage other mesothelioma symptoms and the side effects from standard treatments.
There is no scientific evidence supporting marijuana as a cancer-killing treatment. Experts believe in it purely for managing pain and symptoms, which can improve quality of life. This can be true for both “medical marijuana” and marijuana purchased without a medical prescription in states with legal recreational use.
There are things to consider with using marijuana as a treatment for mesothelioma pain. There are both legal risks and potential side effects. Speak with your doctor before using marijuana for pain management:
Pain management is a way to help mesothelioma patients maintain their quality of life throughout their cancer journey. This treatment option should be offered at every stage of the disease and as part of a comprehensive treatment plan.
Methods of pain management for mesothelioma include medications, treatments, and supportive care. Fluid buildup is a primary mesothelioma symptom and a common source of pain. Removing the fluid from around the lungs, in the abdomen, or around the heart is one way doctors can help decrease pain and related symptoms.
Pleurodesis is a surgical procedure that can help to alleviate pain for patients with malignant pleural mesothelioma, which forms in the lining of the lungs (pleura). As tumors grow and spread, the fluid around the lungs can no longer drain normally, causing fluid to accumulate and press against the lungs and chest wall. The buildup of fluid is called pleural effusions.
During pleurodesis, the fluid is drained from the chest cavity, and the pleural space is permanently closed, eliminating future pleural effusions. Doctors use a talc-like substance to seal the two linings of the pleura together. A thoracoscopy, which is a thoracic scope with a camera attached, is used to perform the pleurodesis.
Fluid is drained from the thoracic cavity to relieve discomfort and difficulty breathing.
A talc-like substance or other chemical agent is introduced into the pleura to bind, or seal, the pleural linings together, preventing further fluid accumulation.
A thoracentesis, also called pleurocentesis, is a procedure to drain fluid from the pleural space and chest cavity. It is similar to a pleurodesis but does not permanently close the pleural space. The procedure temporarily resolves pleural effusions, but fluid accumulation may occur again.
In some cases, thoracentesis can be used as a diagnostic procedure to test for cancerous cells in the pleural fluid, aiding in mesothelioma diagnosis.
Doctors apply a local anesthetic to the skin and superficial tissues to numb the area before the procedure.
A hollow needle is inserted into the chest cavity with the assistance of an ultrasound to ensure precise placement of the needle and location of the fluid.
The doctor carefully extracts the fluid, relieving pressure on the lungs and chest wall.
A paracentesis is a procedure to alleviate pain for people with peritoneal mesothelioma, which forms in the lining of the abdominal cavity (peritoneum), by removing excess fluid accumulation in the abdominal cavity. As tumors grow and spread in the abdomen, an abnormal amount of fluid builds up. This fluid build up in the peritoneum is called ascites.
Since fluid buildup may recur, repeat procedures may be necessary to manage ongoing symptoms.
Paracentesis can be used to diagnose peritoneal mesothelioma by allowing doctors to collect fluid samples or even remove small amounts of diseased tissue for pathology testing.
A local anesthetic is injected into the skin and superficial tissue prior to the procedure to minimize discomfort.
Doctors use an ultrasound machine to identify the fluid location and ensure precise needle placement.
A hollow needle is inserted into the abdominal cavity to remove the fluid.
A pericardiocentesis is a procedure to drain fluid from the pericardium, which is the lining around the heart. This lining is where pericardial mesothelioma forms.
As tumors grow and spread in the abdominal lining, fluid builds up. The excess fluid around the heart can cause pain and prevent the heart from pumping blood at full function.
The doctor uses an echocardiogram (ultrasound of the heart) or live X-ray imaging (fluoroscopy) to visualize the heart structures and locate the fluid.
With imaging assistance, the doctor determines the safest location to insert a hollow needle into the pericardial sac.
A local anesthetic is injected into the skin and superficial tissue to minimize discomfort.
The doctor carefully removes the excess fluid, relieving pressure on the heart.
In addition to medications and medical procedures, drug-free therapies can be a valuable part of comprehensive pain management for mesothelioma patients. These treatment options can help manage pain symptoms and treatment side effects while improving overall well-being and quality of life.
Physical therapy focuses on improving mobility, reducing stiffness, and strengthening muscles.
By enhancing flexibility and endurance, patients may experience:
Massage therapy can help mesothelioma patients by:
Acupuncture is a traditional Chinese medicine practice that involves stimulating specific points on the body using thin needles. This therapy can:
Mesothelioma pain can be caused by tumors creating pressure against the chest wall, lungs, abdominal wall, or abdominal organs. This occurs due to tumor growth within the tissue linings of the lungs or abdominal cavity. The tumors take up space in the linings and cause fluid to build up and cause pressure and pain. This pain is one of the symptoms of mesothelioma.
Fluid buildup is a primary cause of pain from mesothelioma. Doctors can drain excess fluid from the chest or abdominal cavity with procedures using a needle, such as a pleurodesis, thoracentesis, paracentesis, or pericardiocentesis.
Opioids, NSAIDS, and antidepressants are medications doctors use to manage mesothelioma pain. Patients may also find relief from marijuana drug-free options such as physical therapy, massage therapy, and acupuncture. Pain management should be part of a comprehensive plan for mesothelioma treatment at all phases of medical care.
Sources & Author
Seeing a diagnosis of mesothelioma can be overwhelming, especially when considering the many sources and types of pain that may accompany this disease. Mesothelioma is a rare cancer that develops in the lining of the lungs, abdomen, or heart, and as it progresses, it can cause varying levels of discomfort, from mild to severe. Managing this pain is an essential part of treatment, aimed at improving the quality of daily life for patients and their loved ones.
There are different types of pain associated with mesothelioma, including sudden, sharp episodes known as acute pain, persistent long-lasting pain called chronic pain, and sudden intense flare-ups referred to as breakthrough pain. Many patients also experience neuropathic pain, which results from nerve irritation or damage caused by tumor growth, surgery, or treatments like chemotherapy. Understanding these types of pain helps in developing a comprehensive management approach that includes medications, procedures, and supportive therapies tailored to each individual’s needs.
The causes of pain in mesothelioma are diverse. Tumor growth may exert pressure on nearby organs and tissues, leading to discomfort and functional issues. Fluid buildup in the chest or abdomen, known as effusion or ascites, can cause pressure and difficulty breathing, along with swelling and pain. Nerve damage from the disease or treatments can lead to burning or shooting sensations, while side effects from therapies, such as postoperative pain or tissue inflammation, can also contribute to discomfort. Because pain can stem from various sources, personalized treatment plans are vital to effectively alleviate symptoms and enhance comfort.
Managing mesothelioma pain involves a combination of medications and medical procedures. Pain relievers like opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to control different levels of pain, though each comes with potential side effects that require careful oversight. Supporting therapies such as physical therapy, massage, and acupuncture can also help reduce pain, improve mobility, and promote overall well-being. In some cases, procedures to remove excess fluid, like thoracentesis or paracentesis, are performed to relieve pressure and ease symptoms. These treatments are often combined into a comprehensive, patient-specific plan aimed at providing relief and maintaining the best possible quality of life throughout the course of the disease.
