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Mesothelioma is an aggressive cancer that is difficult to diagnose and challenging to treat. The cancer causes uncomfortable symptoms, as do the treatment methods. For most mesothelioma patients, prognosis is not good. Mesothelioma is incurable and patients rarely go into remission.
Additionally, mesothelioma can cause numerous complications ranging from pleural effusions to emotional distress. It affects the family unit as a whole. Treatments can also cause serious complications. Complete care for mesothelioma patients must consider all possible complications. There are many ways to reduce or mitigate complications, but it requires the coordination of the patients’ complete medical team.
Pleural mesothelioma is the most common type of mesothelioma cancer. It impacts the tissue surrounding the lungs and the chest cavity. Many of the complications of pleural mesothelioma are related to the lungs and breathing, but may also affect the diaphragm, the heart, and the spine. Complications can come from the cancer itself or the treatment, and usually comes from a combination of both.
Also fairly common for patients with pleural mesothelioma is pleural effusion. Pleural effusion occurs when fluid accumulates in the chest cavity. This fluid compresses the lungs, making breathing difficult or even painful. Draining accumulated fluid is the only treatment, although the problem is likely to recur even with treatment. Pain is common with mesothelioma. Tumors of the pleural tissue can place pressure on the spine and nerves, causing pain. Surgery or painkillers may help manage pain.
More serious complications may occur as the cancer progresses, including lung collapse. Tumors around the lungs can lead to pressure changes and unusual accumulation of air. This can ultimately cause a collapse. Over time, the cancer may also metastasize. When tumors develop in other parts of the body, these tumors may cause other complications.
Complications of Chemotherapy
Chemotherapy is a common treatment strategy for most mesothelioma. This treatment involves the administration of drugs to target fast-growing cells. Because this is a non-specific treatment, it some healthy cells will also be affected. The death of healthy cells leads to side effects. It can affect your immune system and put you at higher risk for having life threatening infections. If your platelets decrease to a dangerous level, you can be at higher risk of bleeding.
Chemotherapeutic treatment causes a number of immediate side effects. Side effects include nausea, vomiting, hair loss, diarrhea, weight loss, fatigue, mouth sores, constipation, bruising and pain. There are also potential long-term complications. These include damage to lung tissue, heart function, kidneys, liver, nerves, as well as infertility.
Another treatment often used for mesothelioma patients is radiation. Radiation involves a beam of high energy radiation aimed at the tumor site. Like chemotherapy, radiation can cause some short-term side effects. For treating tumors in the chest, potential side effects include skin rashes and burns, shortness of breath, cough, chest pains, weakness, and fever.
Radiation therapy may also cause long-term complications. As the high-energy beam penetrated the body to reach the tumor, it also damages normal, healthy cells. Because healthy cells are affected, radiation can cause serious, lasting damage to organs. Each organ will have certain lifetime total limits, and some will have higher potential rates of complications. While radiation technically carries the possible risk of causing secondary cancers, this process takes several years and patients will die from mesothelioma before this happens.
Complications of Surgery
Not all mesothelioma patients are good candidates for surgical treatment. A tumor may be difficult to reach or may have spread to distant sites. For those who choose to undergo surgery, there are risks and complications to consider. Any surgery can lead to complications like bleeding, infections, blood clots, and tissue damage. With surgery targeting the lungs, pleura, and chest cavity, there are risks of pneumonia and loss of lung function.
These complications are a concern for any surgery in this area. However, risk of complications are high for an extrapleural pneumonectomy, or EPP. EPP is a radical type of surgery sometimes used to treat mesothelioma. It involves removing an entire lung, with the pleural tissue, part of the diaphragm, and some lymph nodes. While radical and invasive, this type of surgery gives some patients a chance at remission.
Emotional, Mental, and Social Effects of Mesothelioma
In addition to the physical complications of mesothelioma and its treatments, there are also other consequences. A diagnosis of an incurable cancer with a poor prognosis has serious effects on mental well-being. Patients with mesothelioma often experience fear, anger, anxiety, depression, and stress. This can affect the whole family or support unit structure.
Complications related to mental health are as important as those that affect physical health. Depression and anxiety can lower a patient’s quality of life. Additionally, patients may suffer social consequences. While living with mesothelioma, it is easy to feel isolated. Because mesothelioma is such a rare disease, it can feel lonely not knowing others who are experiencing the same devastating illness.
Mental and social complications should be addressed for patients with mesothelioma. Doctors should be prepared to include mental health professionals as part a patient’s treatment team. Patients should also have a strong support network to help reduce feelings of loneliness, sadness, and anxiety. A support group of other cancer patients can make a big difference in reducing feelings of isolation, stress, and depression.
The effects of mesothelioma go well beyond the immediate symptoms. Tumors can cause serious complications, as can treatments used to reduce or eliminate them. In addition to physical complications, mesothelioma takes a mental and emotional toll. Patients with mesothelioma need medical teams willing to address treatment of the cancer as well as potential physical, mental, and emotional complications.
Page Medically Reviewed and Edited by Anne Courtney, AOCNP, DNP
Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.