What keeps mesothelioma patients from using much-needed painkillers?Besides having surgery, chemotherapy or radiation for palliative reasons, many patients with mesothelioma receive prescriptions for painkillers. These medications can help individuals cope with the aches and discomfort associated with the disease. However, a study has shown that not all patients adhere to their medication regimen all that closely.
Why would a person with mesothelioma only intermittently take their painkillers? That is what a team of radiation oncologists at the University of Pennsylvania asked in a survey, and patients gave a variety of answers in return.
Researchers began by recruiting 90 adults with severe lung malignancies, including nine individuals with mesothelioma. Nearly all patients (92 percent) reported experiencing serious pain, most of which they chalked up to their illnesses.
However, a full one-third of respondents said that they avoided using analgesics, opioids or painkillers. Their reasons for doing so appeared in a report published in the Journal of Opioid Management.
The team immediately noticed that patients were more likely to use analgesics after chemotherapy or radiation than after surgery. Among people with malignant pleural mesothelioma (MPM), this trend can be explained by looking at why these procedures are performed and what their side effects are.
All three are intended to provide pain relief by shrinking or removing tumor masses. However, while surgery immediately eliminates growths and drains fluid, chemo and radiation take time to reduce tumors and, in the meantime, lead to more discomfort or nausea.
Yet surgical relief wasn't the only factor that led to patients avoiding painkiller use. Three-quarters of all patients who did not use analgesics said that they did so out of fear of addiction or abuse. Other common reasons included doctors recommending avoiding painkillers (71 percent) and difficulty paying for prescriptions (56 percent). Likewise, some patients looked to alternative forms of relief, like physical therapy or complementary methods.
While many of these reasons are valid when looked at out of context, they do not hold up very well under scrutiny. Most medical experts agree that MPM can cause pain so serious that it may interfere with treatment or quality of life. This is one reason why palliative care is so vital for patients with mesothelioma.
The research team agreed. They concluded that "medical professionals...should make pain management a priority and regularly discuss pain symptoms and pain management with patients."
The American Cancer Society notes that most people with MPM get effective relief from painkillers without addiction or excess drowsiness.
Can taking aspirin reduce the risk of mesothelioma?, http://pressroom.cancer.org/aspirinreview2012 , 8/27/12
Drug for mesothelioma fails to pass Phase II trial, http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=102&abstractID=79337, 8/28/12
Mesothelioma patients learn to overcome breathlessness, http://www.macmillan.org.uk/Cancerinformation/Livingwithandaftercancer/Symptomssideeffects/Breathlessness/Managingbreathlessness.aspx, 8/20/12
Years later, Australian victims of asbestos exposure still feel powerless, http://www.ingentaconnect.com/content/maney/oeh/2012/00000018/00000002/art00007 , 8/9/12
Doctor suggests buprenorphine for pain from mesothelioma, other cancers, http://www.oncologypractice.com/fileadmin/content_images/jso/PDF/AIP_Burprenorphine_Review.pdf, 8/8/12
Occasionally, mesothelioma mimics benign tumor, http://www.ncbi.nlm.nih.gov/pubmed/21106421 , 8/7/12
New orphan drug will be tested on mesothelioma, http://www.press.bayer.com/baynews/baynews.nsf/ID/9381432A93F2096AC1257A3F0026ACDB?OpenDocument, 8/2/12
Before passing away, pipefitter with mesothelioma describes the 'terrible consequences' of asbestos exposure, http://www.hse.gov.uk/asbestos/videos/cmorganlong-trans.htm, 7/24/12
Study looks at asbestos exposure, mesothelioma and the typical course of the disease, http://www.springerlink.com/content/083666262g0j6073/, 7/20/12