Continue Pain Management

Fatigue

Cancer-related fatigue may be the result of the general progression of the disease, the effects of medication, or the after effects of treatments such as surgery, chemotherapy, or radiation therapy. The following symptoms are usually associated with fatigue:

• Diminished energy level disproportionate to activity
• Diminished activity associated with physical or intellectual performance
• Diminished motivation; lack of interest in activities
• Exhaustion, apathy, or lethargy
• Generalized tiredness
• Sleep abnormalities
• Irritability, impatience, or changes in mood

The treatment of fatigue is based on first identifying, and then managing, the underlying cause of the fatigue. Once that is accomplished, interventions such as medication, exercise, stress management, and nutrition are used. More on fatigue in mesothelioma patients.

Dry Mouth

Dry mouth, or xerostoma, is another symptom addressed in palliative care. Causes may be dehydration, depression or anxiety, or may be a side effect of medications such as pain relievers, antidepressants, diuretics, or tranquilizers. Chemotherapy treatments or radiotherapy may also be a cause.

Relief of dry mouth can often be achieved by:

• Drinking plenty of fluids
• Sucking on ice chips or Vitamin C tablets
• Chewing sugarless gum
• Maintaining good oral hygiene
• Providing humidified air

Loss of Appetite

Patients with life-threatening illnesses often lose their appetite, and subsequently, lose weight. If the condition becomes too severe, it is called cachexia. Doctors uniformly agree that nutrition plays a vital role in the patient's well being. Causes of weight loss include inadequate intake of nutrients because the patient can not or does not want to eat, poor absorption of the food that is eaten, and changes in the patient's metabolism.

Weight loss may be managed by:

• Eating smaller, more frequent meals
• Eating high calorie, high protein foods
• Receiving nutritional counseling

There are also medications which may help depending on the patient's desired goal. Some of these medications stimulate appetite, but do not usually increase weight, some stimulate appetite and cause slight weight gain, and still others help prevent nausea and vomiting.

Gastrointestinal Problems

Gastrointestinal problems may be associated with the disease process itself, or as a side effect of treatments or medications the patient is receiving. These may include nausea, vomiting, constipation, and diarrhea.

As mentioned above, there are medications which can help with nausea and vomiting. Your doctor or a nutritionist may also be able to provide eating hints and/or special diets tailored to fit the patient's individual needs. More on diarreah in mesothelioma patients.

Skin Problems

There are a variety of skin problems which may accompany cancer, including dryness, itching, rash, sores, and ulcers. It is important to treat these conditions as quickly as possible in order to reduce discomfort and the risk of infection.

• Dryness may be lessened by adding baby or mineral oil to warm bath water, and by applying moisturizers. It is also important to drink 8-10 glasses of water per day.
• Itching and rash may be lessened by adding baking soda to cool bath water, or by applying a cool, moist cloth to itchy areas. Avoid harsh laundry detergents, and change sheets and towels daily.
• Keep skin clean and dry and check skin daily for pressure sores or ulcers which may become infected.

Anxiety/Depression

Anxiety is a hallmark of a life-threatening illness. Feelings of fear, worry, or apprehension may lead to long-term generalized anxiety, or short, intense panic attacks. Causes may include difficulty in coming to terms with the illness, fear of isolation and separation, poorly controlled pain, or side effects of medication.

Treatments to control anxiety may include stress management techniques, counseling, support of family and friends, and control of pain or side effects from medication.

Depression, while less common, often affects family members as well as the patient themselves. Depression may be related to loss of the ability to function, changing family roles, limited social and financial support, pain, or other symptoms such as shortness of breath.

Control of the above symptoms is accomplished through antidepressant medication, support and counseling, pain management, and stress management.

More on palliative care and hospice for mesothelioma patients.