One of the main ways by which mesothelioma pain can be treated is with the use of proper medication.

However,the type of medicine and the way the medicine is given depend on the type and cause of pain. For example, chronic pain is best relieved by methods that deliver a steady dose of pain medicine over a long period of time, such as a patch that releases medicine through the skin or slow-release oral tablets. On the other hand, breakthrough pain {Breakthrough pain is flare of pain that happens even though you are taking pain medicine regularly for persistent pain. It’s called breakthrough pain because it “breaks through” the pain relief you get from the regular pain medicine schedule}is best treated with medicines that work fast (quick release), but stay in the system only for a short time.

Below is an overview of the types of medicines used to relieve pain.

For mild to moderate pain

Non-opioids: Acetaminophen (Tylenol®) and non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen are often used.

You can buy many of these over the counter (without a prescription). For others, you need a prescription. Check with your doctor before using these medicines. NSAIDs can slow blood clotting. This may be a problem if you are having surgery or getting chemotherapy.

For moderate to severe pain

Opioids (also known as narcotics): Morphine, fentanyl, hydromorphone, oxycodone, and codeine may be used.

You need a written prescription for these medicines. Non-opioids may be used along with opioids for moderate to severe pain to get the best effect.

For breakthrough pain

Rapid-onset opioids: Fast acting oral morphine; fentanyl in a lozenge or “sucker” form (these forms of fentanyl absorb directly from your mouth as you suck on them, they are not swallowed)

You need a written prescription for these medicines. A short-acting opioid, which relieves breakthrough pain quickly, is often used with a long-acting opioid for chronic pain.

For tingling and burning pain

Antidepressants: Amitriptyline, nortriptyline, and desipramine.

You need a prescription for these medicines. Antidepressants are also prescribed to relieve some types of pain. Taking an antidepressant does not mean that you are depressed or have a mental illness.

Anti-convulsants (anti-seizure medicines): Carbamazepine, gabapentin, and phenytoin

You need a prescription for these medicines. Despite the name, anti-convulsants are used not only for convulsions, but also to control burning and tingling pain.

For pain caused by swelling or pressure

Steroids: Prednisone, dexamethasone.

You need a prescription for these medicines. They are used to lessen swelling, which often causes pressure and pain.

How is pain medicine given?

Some people think that if their pain becomes severe, they will need to get injections or “shots” of pain medicine. In fact, shots are rarely given to relieve cancer pain. There are many other ways you can take pain medicine.

* Oral — means the drug is taken by mouth, either by being swallowed or melted in the mouth. Medicine is given as a liquid, pill, capsule, or in transmucosal form (lozenge or “sucker” where the drug absorbs directly from the mouth).

* Skin patch — a clear, bandage-like patch placed on the skin, which slowly but continuously releases the medicine through the skin for 2 to 3 days. This form of medicine is less likely to cause nausea and vomiting.

* Rectal suppositories — medicine that dissolves in the rectum and is absorbed by the body.

* Injections

Subcutaneous (SC) injection — medicine is placed just under the skin using a small needle.

Intravenous (IV) injection — medicine goes directly into the vein through a needle, port, or catheter.

Intrathecal and epidural injections — medicine is placed directly into the fluid around the spinal cord (intrathecal) or into the space around the spinal cord (epidural).

* Pump, or patient-controlled analgesia (PCA) — with this method, you can help control the amount of pain medicine you take. When you need pain relief, you can press a button to get a pre-set dose of pain medicine through a computerized pump that is connected to a small tube going into your body. The medicine is injected into a vein (intravenously), just under the skin (subcutaneously), or into the area around the spine.

What are the side effects of pain medicine?

All drugs have side effects and pain killers are no exception.Each type of pain medicine however has its own peculiar side effects, even those that you can buy over the counter.

-Some, such as aspirin or ibuprofen (and others in that family of drugs) can cause stomach irritation, or even bleeding from ulcerations, and should be taken with food.

-Many side effects from opioid pain medicine can be prevented. Constipation, for instance, is easier to prevent than to treat. Most doctors will start you on a plan to prevent constipation at the same time they start your opioid pain medicines. Some mild side effects such as nausea, itching, or drowsiness, often go away without further treatment after a few days, as your body adjusts to the medicine. Let your doctor or nurse know if you are having any side effects and ask for help in managing them.

-More serious side effects of pain medicine are rare. As with the more common ones, they often happen in the first few hours of treatment. These serious side effects are: difficulty in breathing,dizziness, and rashes. If you have any of these side effects, you should call your doctor right away.

You should avoid taking medicines to calm you down (sedatives or tranquilizers), alcohol, or take sleeping pills, when you are on opoids as you raise your risk of serious side effects from opioids.Taking opoids and these other drugs has led to the deaths of some people. Make sure you discuss with your doctor before you start taking opioids for pain.

Also the use of aspirin, ibuprofen, and other NSAIDs are contraindicated{should be avoided totally} when you are having chemotherapy. If you are on mesothelioma chemotherapy make sure you discuss with your doctor before you take non-prescription pain relievers.



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