Mesothelioma is a cancer that forms around the lining of the lungs or abdomen. Asbestos exposure is the primary cause, accounting for approximately 80-90 percent of cases.
Most cases of mesothelioma grow and spread quickly. The cancer doesn’t begin to cause symptoms until it spreads beyond the mesothelial lining, usually around stage III or IV.
Symptoms of pleural mesothelioma, which forms around the lungs, include chest pain, difficulty breathing, hoarseness and dry cough. Symptoms of peritoneal mesothelioma, which develops around the abdomen, include abdominal pain, distention, abdominal swelling and digestive issues such as constipation.
Anti-cancer treatments, including surgery, chemotherapy and radiation therapy, can control symptoms and extend survival, but no cure for mesothelioma is available yet.
The average survival rate for mesothelioma is around one year. People diagnosed early who qualify for surgery and other aggressive treatments often live three or more years. For example, around half of peritoneal mesothelioma patients who undergo surgery and heated chemotherapy live longer than five years.
Hospice care is a valuable resource and source of support for people with mesothelioma who have run out of effective treatment options. Hospice is known for excellent palliative care, which aims to control symptoms and maximize quality of life.
“We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being,” says Atul Gawande, author of the award-winning book “Being Mortal,” surgeon at Brigham and Women’s Hospital and professor at Harvard Medical School in Boston.
Hospice has much to offer for people with mesothelioma to improve their well-being including skilled nursing, prescribing medication, mental health counseling and support groups.
Benefits of Hospice Care for Mesothelioma Patients
Nurturing well-being and boosting quality of life are the primary end goals of hospice care.
Hospice medical professionals achieve these goals by using palliative care principles to control symptoms, occupational therapy to minimize challenges and mental health counseling to address emotional health.
As mesothelioma tumors expand and spread they affect important bodily systems and functions. People with pleural mesothelioma, which accounts for 75 percent of all mesothelioma cases, eventually develop pulmonary dysfunction. Hospice staff can help by teaching patients breathing techniques and finding positions for sitting and sleeping to promote better breathing. Hospice can also prescribe medicines that work to improve shortness of breath and relieve chest pain.
Pleural and peritoneal mesothelioma patients develop digestive issues and difficulty swallowing, whether directly from the cancer growing or indirectly as side effects of cancer treatment. These complications get in the way of eating and drinking enough to obtain adequate nutrition and fluid intake. Hospice nurses are equipped to help patients troubleshoot eating and drinking challenges by offering advice on what to eat and how to prepare it, and can prescribe medicine to increase appetite.
Late-stage mesothelioma can lead to pain that requires use of potent pain relievers such as morphine, which hospice can prescribe without a hospital visit. This leads to less hospitalizations, better pain control and higher quality of life. Morphine is particularly effective at calming breathing difficulties such as shortness of breath and chest pain. Hospice also offers other pain relievers aside from morphine and hospice nurses are skilled at reviewing a patient’s medication list to avoid drug interactions.
Social, spiritual and emotional support is also available through hospice to patients and their loved ones. Patients and caregivers can benefit from support groups and mental health counseling provided by hospice. Nondenominational spiritual counseling is also available. Support groups, counseling and bereavement services are available to family members for a year after their loved one passes away.
Finding Hospice Care
Hospice is available to anyone diagnosed with a terminal disease with a prognosis of six months or less.
To enter hospice a referral is not required from the patient’s primary physician. A referral or order from the primary care physician does support the six-month prognosis. This referral is often provided by the mesothelioma patient’s oncologist. Often, patients or their loved ones need to speak up about hospice because many oncologists are reluctant to mention it for fear of upsetting a patient and their family.
However, electing hospice doesn’t mean you’ve given up. Rather, hospice is associated with longer life because palliative care can maintain or improve overall health and make health obstacles easier to overcome.
A 2010 study of lung cancer patients at Massachusetts General Hospital reported 25 percent longer life among those who received palliative care like that offered by hospice.
Most people receive hospice care at home. Hospice care is also available in hospitals and through hospice in-patient facilities, which resemble a skilled-nursing facility.
Insurance, Medicare and Medicaid all offer coverage for hospice care. Patients may be responsible for the cost of prescription medications that are not for symptom management of the terminal illness the patient was accepted into hospice or for medications for illness that do not support or contribute to the prognosis of six months or less.
To find a hospice provider near you, visit HospiceDirectory.org.
Author bio: Michelle Whitmer has been a medical writer and editor for Pleural Mesothelioma Center since 2008. Focused on the benefits of integrative medicine for cancer patients, Michelle is a certified yoga instructor, member of the Academy of Integrative Health & Medicine and graduated from Rollins College in Florida.