Side Effects of Treatment

Most of the cancer patients claim that the after effects of the treatments are more difficult to bear rather than the cancer itself. Mesothelioma is one of the cancers whose treatment side effects are awfully painful and difficult to endure. Because of this reason, I have gathered some resources that explain you the some most common side effects associated with the treatment, it surely will help you.

Pain Management

The most critical and important part of a patient care plan is pain dependency and management. The pain tolerance and pain itself varies with their experience. The first step is to assess where is the origin of pain? Where is the pain coming from? When is the pain start? Is it chronic or is it acute? Whether the pain has changed from acute to chronic? What relieves the pain? If the pain changes from acute to intolerable or chronic pain it means that cancer is advancing. You have to report immediately to your physician.

The most common and helpful practice for pain management is to maintain a daily pain journal where you can note down the origin of pain, variation or fluctuation of pain and what alleviates the pain.

Pain Clinics

In United Sates there are many clinics located for the pain management. They are assisting people who are diagnosed with mesothelioma or any other cancer. So, that they can learn different strategies to manage the pain effectively and can experience a piece of mind with comfort. There are number of clinics which offer in-home or in-hospital consultations, they will check the pain regularly and also assist family members that how they can administrate pain medicines.

Sleep Apnea or Sleep Disorders

The disturbance in sleep may delay the effectiveness of mesothelioma treatment. So how can you combat this issue? First you have to keep up with a very positive attitude. Then to promote a sufficient sleep the following actions must be taken:

•   A couple of hours before going to bed have a high protein snack.
•   Avoid caffeine.
•   Wear comfortable clothes when going to sleep like pajamas.
•    Before bedtime have a massage and back rub for relaxation and to ease the pain.
•   Sleep on your own pillows, sheets and blankets.
•   Set up a schedule for bedtime and wake up time to train your body.
•  Avoid night time visitors and also limit the number of visits of nursing staff to check the blood pressure.

Anorexia and Cachexia

Cancer treatment routines are linked with loss of appetite and reduction in strength and vitality of mind and body. To prevent anorexia is to set up good nutrition and eating habits. A patient must be check by a nurse or nutritionist during meals and should strictly follow the diet plan. Additionally, a patient may be prescribed by anti-depressants and may attend support group meetings with the people who are suffering from anorexia.

Hair Loss

After chemotherapy treatment hair loss is a very common side effect. For most of the cancer patient it is really painful especially for women watching their hair falling day by day in large clumps, as indeed our hair is part of our identity. Therefore, many people take destiny into their hands and shave their head. If, on the other hand you didn’t choose to shave your head then during chemotherapy you should treat your hair gently. Wash your hair when necessary will slow down the hair fall. Avoid chemicals and sprays as your scalp becomes more exposed. To cover thinning of hair and baldness you can also wear a wig. When taking a step to buy a wig, you will find different types of wigs according to your need. While shopping for the wig you can find Synthetic wig which is light-weight, comfortable and really simple to take care and the other type is made up of real human hair which can be washed and conditioned just like real hair but you have to follow the manufacture’s instructions. If you do not feel comfortable in wearing a wig, you can cover your head by a cotton or silk scarf, some sort of hat or it can be soft turban too.

Vaccinations for Flu

In mesothelioma patients, immune function is usually compromised. Regardless of type or stage of mesothelioma there is a high risk of catching the flu. Not only for mesothelioma but for all cancer patients, they are at higher risk infecting with flu. That is why flu vaccinations are highly recommended for cancer and mesothelioma patients. In United States swine flu or H₁N₁ has become more common other than risk of influenza is usually associated with mesothelioma. If it is not treated properly it will complicated the ongoing treatment, extend the stay in hospital or even cause death.

The best preventative measure for influenza is vaccination. It is recommended that friends and family members of the patient must take more preventative measure against influenza. The people who are regular in touch with mesothelioma patient must receive a vaccination and can also use nasal spray. The nasal spray is not suggested for mesothelioma patients. The most primary preventive measure is vaccination and other measures may include:

• Wash your hand thoroughly with soap and water
• Avoid contact with family members and friend who have been exposed to flu
• Used tissues should be disposed
• When coughing and sneezing cover your mouth and nose
• Get sufficient rest
•  Keep yourself hydrated
• Wear mask in the presence of the person who is showing symptoms of flu and also while traveling outside.

Memory Loss or Chemo Brain

After going through treatments like chemotherapy, hormone or radiation most of the patients suffer from Chemo brain which includes loss of memory, lack in concentration and difficulty in doing multiple works at a time. Oncologists just have an idea that why this happens? May be it is the disease itself cause a memory loss or it can be due to prescribed anticancer drugs. Generally when the treatment is ended the symptoms of chemo brain are gone but in few cases it is not.  It is really frustrating for a person having these symptoms but it can be managed if he consults with his physician to help him out in this matter. Following steps can be taken to manage these symptoms:

•    Add vegetables in your diet which improve your brain and memory function
•   Record your daily events, appointments, telephone numbers, medication in a daily planner
•  You can also post your daily routine on your room’s door in your hospital to provide reference to your doctor and other staff  
•   Discuss the problem with your team of doctors and ask for help so they can plan your treatment and assist you when you forget something
•  After taking approval from your doctor you can also do exercises to improve your mood, improve functioning of brain and for better sleep

In fact there is no specific treatment for chemo brain but the better way to manage is to discuss your issues with your doctor to find a most appropriate way out.

Physical Intimacy

Most of the cancer patients experience sexual problems after being diagnosed which may include depression, early menopause, erectile dysfunction and issues regarding body image. A patient should not feel embarrassed in facing these problems as it is very common in cancer. If you are having any of these issues you can honestly deals with your spouse through discussion. The most common issue related to sex is image of body. After going through such painful treatments, the body of cancer may have bruises, gain or loss in weight or hair loss. These are the reasons patient usually stay away from being sexually intimate. You can ask your doctor and talk about the issues regarding sexual intimacy. Many doctors consider that sex can be healing force for the patient. You have to think positive, touch, hug, kiss and discover new ways to get close to your partner.

The best way to combat with the disease is to be optimistic! There is no way you won’t succeed.

Mesothelioma Treatment

As an individual what will be your treatment options?

When choosing the best treatment option or which is right for you depends on many factors like generally your health condition, age, your cell type (which find out the aggressiveness of cancer), stage of cancer and what is your will. You will have a MDT (multidisciplinary team) of doctors to help you in choosing you the right treatment option for you. These team members comprise a medical oncologist, cardiothoracic surgeon, a pain management specialist, a radiation oncologist and a palliative care specialist, who will study and discuss your case and recommend you the best treatment approach. 

Before making any final decision for your treatment first discuss with your multidisciplinary team of doctors. Although there are so many treatment options for mesothelioma, you should discuss each option with your doctor. You should be well informed about each option which may includes treatment side effects, risk factors, prognosis and quality of life.

Surgery

 

There are two surgical procedures for mesothelioma, pleurectomy/decortication and extrapleural pneumonectomy. These surgeries require highly expertise, as not every thoracic surgeon has expertise in these types of surgeries.  Eventually, the intention or aim of these surgeries is to eliminate the disease with keeping in mind that there must be some remaining of the disease is left. Therefore, for the removal of remaining of the disease can be done by adjuvant therapy. Chemotherapy and Radiotherapy are the most common types of adjuvant therapy.

Pleurectomy/decortication

Pleurectomy/decortication involves the removal of lining of lungs (pleura), it has nothing to do with the eviscerating the lung. You can say that this type of approach is less radical but in few cases the diaphragm and pericardium are removed, but it depends on the extent of tumor. A patient who cannot bear the extrapleural pneumonectomy(EPP) approach and also the recovery time is far quicker than other procedures are the advantages of this approach. Now when we consider about the disadvantages the first thing should comes in our mind that since, from this procedure the tumor is not completely removed so there may be a chance of recurrence of the disease, and inability to use high amount of adjuvant radiation because of possible damage to the lung.

Extrapleural pneumonectomy (EPP)

This procedure involves the eviscerating of lung, the pericardium (lining of heart), pleura (lining of lung) and part of the diaphragm. A Gortex-like material is used during surgery to reconstruct the diaphragm and pericardium. For this surgery only those patients are eligible who are at a certain stage of cancer and can demonstrate sufficient cardiac and pulmonary function so that they can bear the procedure.

Chemotherapy

 

Anti cancer drugs are used in chemotherapy which helps in stopping the cells of cancer to multiply. Combination of drugs can be used in some cases to boost the effectiveness. Mainly chemotherapy is used to forcefully shrink the size of the tumor and to relieve from the symptoms like pain and breathlessness. Chemotherapy may be supervised as an oral medication, using injection into muscle or vein or may be directly into peritoneal (lining of the abdominal cavity) or pleura. Chemotherapy drugs for mesothelioma may include

•  Gemcitabine
•  Navelbine
•  Paclitaxel
•  Cisplatin
•  Carboplatin
•  Doxorubicin
•  Onconase
•  Cyclophosphamide
•  Pemetrexed

Radiotherapy

 

In radiotherapy high energy x-rays are used to shrink tumors and kill cancer cells. It may be used with the combination of surgery to eliminate the remaining of the disease through which the disease can reoccur and also to treat the pain cause by tumor.  

Clinical Trials

 

The basic idea of the clinical trials is to find a better and new treatment for the disease by involving the patients. There are different objectives of different clinical trials which may comprise comparing a variety of ways to treat a disease or the testing of so many different techniques for cancer prevention, testing of new drugs. There are three phases in clinical trials, which are discussed below:

Phase I Trials

This is the initial phase of clinical trials. In which testing of drugs takes place in the laboratory, that what is the effect of these drugs on cancer cells? In this phase there are few participants are enrolled and are only available at restricted cancer facilities. The objective of this phase is to obtain the utmost tolerated dosage of the drug without getting any severe side effects when treated to humans. If the drug is confirmed to have an effect on cancer at a safe level of dosage, then in Phase II the drug will be tested.

Phase II Trials

In this phase the testing of the safety of drugs carry on, not only that it started to look more precisely at their effectiveness on cancer cells. These trials accommodate more participants than the previous phase and are available at more cancer facilities. Randomly participants are chosen by a computer, rather than by a doctor.

Phase III Trials

In this phase, the comparison between the new procedures or drugs with the existing standard of treatment is being done. Lots of participants are enrolled in this phase. They received a standard treatment or a new treatment. The main objective of this phase trial is to find out that if the cancer slowed or reduced by the drugs. It also determines how the drug is affecting the patient’s quality of life and how long the patient will be stable without the development of the disease?

Palliative Care

 

Palliative care is a procedure that enhances the quality of life of not only the patients but also their families facing the problems related with this life-threatening disease. Palliative care can be given along with the other treatments like surgery or chemotherapy or can be used to control the symptoms in those patients who are not going through or doesn’t want an aggressive treatment. 

There are some patients who are not willing to endure an aggressive treatment, may be because of their age or disease has developed to the point where palliative care is a better option.

At early stage of mesothelioma diagnosis there are two symptoms which are very common can be dealt by palliation:

•         Wound Seeding
•         Pleural effusion

Other symptoms which can also handled by palliative care are:

•         Depression and anxiety
•         Pain
•         Skin problems
•         Dry mouth
•         Loss of appetite
•        Fatigue
•         Breathlessness
•         Gastrointestinal problems

Hospice Care

 

If the palliative measures are taken, it is also referred as hospice care. The training is given for the workers of hospice are same as that of any medical specialty. Hospice care is given to patients as well as to their families too.

The idea of hospice is that it a care for the person which handles his emotional, physical, social and spiritual necessities. Hospice care may include:

•   Symptom relief
•   Pain control
•   Physical therapy
•   Nursing care
•   Mourning services
•   Counseling for the patients and their families

Hospice care provides a good alternative treatment, which helps a person and his family in difficult times who is diagnosed by mesothelioma and make him feel that he is not alone.

A loved one who is diagnosed by mesothelioma creates difficult times not only for him but for everyone who are related to him!

 

Stages of Mesothelioma

When we are talking about the stages of Mesothelioma, it means that these are the evaluation levels which doctors use to find out that how much the cancer extent inside the body. The stages of Mesothelioma are from 1 to 4 according to severeness. For instance, when we are talking about stage 1 mesothelioma is restricted to a particular area and tumor has an impact on a limited area and organ tissues. While when we are talking about another extreme side, the stage 4 at this point mesothelioma is a widespread disease, which has spread far beyond the tumor actually was which has an impact on bone or blood cells and other organ tissues.

The staging categorization only exists for pleural mesothelioma which affects the lining of chest and lungs. At diagnosis the stage of cancer is determined with different testing methods or procedures. By using imaging scans the basic stage can be determine, that provides oncologists a visual representation of how much the tumor is extent inside the body. But if the tests are not conclusive or it appears that the disease is not restricted to small area then doctor advice the patient to go through surgical biopsy through which physicians determine how much the tumor have metastasized to the lymph or blood nodes.

Staging Systems of Mesothelioma

 

Now, let discuss three primary staging systems of Mesothelioma. These systems are used to determine the development of cancer at all the four stages of cancer.

1.   The most common and the oldest technique or system use is Butchart staging system. This system only focused on the location of cancer, so it determines only where the tumor is present. It does not determine how big is the tumor and how many cancer cells are present within the body.

2.   TNM Staging System determines the characteristics of tumor, also find out lymph nodes is involved or not and whether the cancer is spread to the other area of the body or not.

3.   Brigham Staging System is very much similar to TNM staging system but in addition it also determines the location of tumor along with its characteristics. It also makes sure the involvement of lymph node and find out how much the cancer is spread within the body. This system also helps to evaluate for the effectiveness of surgery at every stage.

As noted above, let us discuss now the four stages.

Stage 1 Mesothelioma 

In this stage tumor is restricted, there is no involvement of lymph and the cancer is not spread in the other tissues or organs. The cancer is localized to one side of pleura and through it can be removed easily.

Stage 2 Mesothelioma

In this stage the tumor is larger and has occupied diaphragm or lungs and there is also the involvement of lymph nodes. The cancer is likely to metastasize to both sides of pleura and surgical intervention may be possible.

Stage 3 Mesothelioma

In this stage, the mesothelioma cancer spread in a single area like esophagus, chest wall or lymph nodes and surgical intervention is usually precluded as a successful treatment.

Stage 4 Mesothelioma

In this stage, the cancer is spread out in numerous areas like pericardium, different regions of chest wall. Involvement of Lymph glands is also there and the cancer is metastasizing to other organs. At this stage the surgery is of no use or value.

  

Unusual Facts about Mesothelioma

I am sharing some very unusual facts about that how this cancer can assist in contributing to destruction upon the patient.

• Mesothelioma cancer is almost always linked with the exposure of asbestos. Asbestos is a fire- resistant material that can be integrated into consumer and industrial products. It is made up of tiny fibers that can enter into the body and implant themselves in mesothelium tissues. When the fibers are there, they will trouble the nearby cells, making them to duplicate hysterically and randomly to develop into tumor. Basically the first fact I want to tell about this disease that more or less 70-80% cases have been drew to the exposure of asbestos. While in the rest of cases the exposure of asbestos is suspected but they are not confirmed. The use of asbestos in Unites States has been strongly regulated ever since 80’s.But the asbestos still present in earlier constructed buildings, ships and factories that still causing a problem for the people who are working there.

• Mesothelioma has an exceptionally long latency period. Let me explain what actually is latency period – it is the time between patient’s first asbestos exposure and his/her diagnose. Mesothelioma develop very silently without any noticeable symptoms while other cancers usually develop quickly and make them visible with pain or symptoms, other cancers can easily diagnosed by usual screening or tests. Mesothelioma cancer takes almost 10-20 years to be diagnosed. It is very rare in case of this cancer to be diagnosed at early stages. If truth be told the majority patients of mesothelioma are diagnosed in third or fourth stage when options of treatment are limited. After the diagnosis of the mesothelioma patient, the average life expectancy is 4-18 months.

•  The signs and symptoms of Mesothelioma are vague that is why it is usually linked up with different health problems. Symptoms include breathlessness, persistent cough, weight loss, back pain, chest pain or fatigue. As all these symptoms can be associated with pneumonia, bronchitis emphysema, influenza and chronic obstructive pulmonary disease (COPD) so a doctor can misdiagnose it.  In fact most of the patients don’t even care to go to the doctor because they think they are just having a simple cold. That is why mesothelioma diagnosed in the later stages.

• Mesothelioma is a very rare type of cancer. In United States every year about 3,000 people are diagnosed by this disease and the cause is asbestos. On the other hand the use of asbestos in recent years has been faded so we are expecting that consensus may be drop in later years.

• In contrast with other cancers, mesothelioma has an exceptionally bleak diagnosis. Most of the patients died within eighteen months after been diagnosed by this disease. Some lives about 2 years after learning that they are suffering by mesothelioma. A number of people live only few months or even few weeks. Moreover mesothelioma is very less responsive to the treatment unlike other cancers because it is being diagnosed at very advanced stage. At Stage I remedial surgery is possible but it depends on the location of tumor in lungs. Some patients opt for chemotherapy and radiation. At this stage, pain medication is given to the patient, some of them also pursue for alternative treatments like acupuncture and massage to make them relief from the pain.

Asbestos and its Exposure

The first question may arise in your mind is what actually the asbestos is? Asbestos can generally be described as number of fibrous material which is occurred naturally.

Asbestos are used in these products:

•         Flue pipes
•         Drainage pipes
•         Fibro sheeting
•         Roofing guttering and shingles

All types of asbestos are to be considered as cancer causing (carcinogenic) and continuous exposure to asbestos fibers can cause mesothelioma, asbestosis and lung cancer. That is why in most of the countries the use and also the manufacturing of asbestos are banned.

We can find Asbestos in workplaces, buildings and dwelling built before 90’s. But some of the workplaces, buildings and dwelling which are made recently may also contain asbestos.

The worst part of Asbestos is that through visually examination it is very difficult to spot or confirm its presence. To be sure enough whether the asbestos is present or not we have to take the sample of the material to the certified laboratory.  

If you have any doubt regarding that the sample of the material may contain asbestos, you should not attempt it as it is very hazardous. It should be done by a qualified contractor.

Do you know that the asbestos is in your home too? There are many things in your house which are made up of asbestos cement:

•    Water pipes
•    Gutters
•    Electrical conduit
•    Domestic roofing
•    Vinyl floor tiles
•    Fence panels
•    Interior and exterior walls

Yes, asbestos is a very common thing use in our home. Now we can come across the health threats due to asbestos. Generally the threats occur when we do not the hazards while working with asbestos and we do not take any proper precautions.

When we breathe in asbestos fibers it leads to three respiratory diseases. All of them are may be fatal:

•  Asbestosis
•  Mesothelioma (pleural and peritoneal)
•  Lung Cancer

Now you know which things in your home may contain asbestos and you already know the hazards of asbestos exposure. The first thing you should do, remove the asbestos as early as possible to save your family and have a piece of mind. Just call a qualified and licensed contractor and get it removed from your home and live a healthy life.