Psychological, Social & Spiritual Factors in Managing Mesothelioma

Treatment of mesothelioma, and related pain management, must extend beyond the physical complaint. Often many psychological, emotional, social, cultural, spiritual and family factors are triggered with a diagnosis of mesothelioma. The evaluating clinician or medical team responsible for establishing treatment goals should consider the whole person and work from a multifactor approach. The mesothelioma specialist and health care team should not only explore the significance of physical pain with the patient, but also how the cancer and pain impacts functional and emotional status. 

 

In addition to physical complaints, mesothelioma patients also often experience financial worries, concern over loss of independence, family problems, social isolation and fear of death. Anxiety and depression are common factors for those diagnosed with mesothelioma and other forms of asbestos-related cancer. 

 

Caring for the mesothelioma patient should include addressing all aspects of a person: physical, intellectual, social, emotional, and spiritual. Treatment combined with empathy helps the mesothelioma patient feel more cared for, understood and supported despite knowing the gravity of their situation.    

 

When diagnosed with mesothelioma, many patients feel anxiety, fear, confusion and sadness. States of mind and attitude can greatly affect a patient’s perception of pain and can even affect response to treatments and survival times. While there are numerous pharmacological (drug) treatments available to address anxiety and depression, integrating nonpharmacological approaches can improve overall outcomes and give an increased sense of peace in the midst of a difficult journey. 

 

Some complementary, non-drug methods of treating mesothelioma that can also help patients feel some sense of control when so many things are out of their control include:  

 

Many mesothelioma patients report that along with physical pain are accompanying feelings of fear, anger, frustration, disappointment, and hopelessness. By taking advantage of and using alternative forms of palliative care, patients can relieve some of their mental suffering which, in turn, often reduces their level of physical pain and improves their responses to other standard treatments.  

 

Research on the importance of integrating psychological and spiritual elements into palliative care have shown that when these aspects are included, pharmacological interventions have increased in efficacy. Sometimes barriers to adequate pain relief come from the patient’s misconceptions about medications, fear of analgesic use, drug dependency, and potential unpleasant side effects. Also, some patients feel that they should not bother their physicians or oncologists with complaints of pain. 

 

When psychological and spiritual elements are included in the treatment plan, patients are less likely to underreport or delay communicating their pain. Hospice members and empathic members of a multidisciplinary team can help the patient to identify barriers that may be limiting the effect of pharmaceutical measures and causing less than optimal pain relief.

 

Increasing the modalities of treatment is likely to lead to maximum relief of pain and can minimize the use of pharmacological therapies. If the patient desires, including a wider circle of family (partner, parents, children) and close friends can help elevate carers’ psychological and emotional states and ease post bereavement. 

 

The hope is that by including psychological and spiritual elements as part of the treatment plan, mesothelioma patients are helped to end their lives more calmly, with their pain and suffering lessened and their existential pain reduced. Such an approach increases chances that the patient will feel well cared for and understood by their medical team and family members. 

 

Because the time between diagnosis and death is relatively short and curative treatments are not available, mesothelioma patients in particular have a number of psychological factors that may arise. Many patients diagnosed with mesothelioma are in their 50’s to 80’s and are leaving behind partners and a family, and many experience the loss of not being able to enjoy their years of retirement. Many patients feel anger, rightfully so, over having contracted a disease that was caused by factors outside of their control (exposure to asbestos) and due to negligence on the part of their employers. They also feel anger and shock when told that there are no known cures and effective cancer therapies are limited. 

 

Reactions to learning about the disease of mesothelioma can sometimes cause withdrawal and reluctance to engage in any coping strategies that might bring about some acceptance or understanding of their medical situation. In addition to other stressors, many patients are involved in an asbestos lawsuit and ongoing litigation. 

 

For these reasons, it is even more important with mesothelioma patients to include psychological and spiritual interventions alongside pharmacological treatments. Often pain relief can not be achieved until both psychological and physical aspects of the pain are addressed.

 

Early referral to and early intervention by a health care team that is educated and inclusive of psychological and complementary pain therapies, can make a huge difference in improving the quality of life for mesothelioma patients. Mesothelioma specialists that recognize the importance of addressing psychological, somatic, and spiritual influences have a greater chance of engaging with and supporting patients during the last stages of their life with pain under control. This, in turn, helps to support caring family members as well. 

 

If you have recently been diagnosed with mesothelioma, ask your oncologist about palliative care options that include psychological and/or spiritual aspects along with symptom management that can be integrated into a treatment plan for optimal quality of life and pain relief.