Webinar Recap: Managing Symptoms and Treatment Side Effects

The Mesothelioma Center recently hosted a webinar on managing mesothelioma symptoms and treatment side effects. Attendants learned tips and strategies for dealing with the most commonly reported symptoms of mesothelioma such as fatigue, as well as standard side effects of common treatments. 

Our featured speaker was Dr. Andrea Wolf, a thoracic surgeon and director of the New York Mesothelioma Program at Mount Sinai in New York. The panel included Kim Madril and Micahel Cole who are both pleural mesothelioma survivors.

Kim Madrill is a former nurse who was diagnosed with pleural mesothelioma in July 2019, just 4 months after receiving a breast cancer diagnosis. She underwent an extensive 8-hour surgery and then radiation. 

Michael Cole was diagnosed with pleural mesothelioma in 2015. He opted for aggressive multidisciplinary treatment. 

The panelists addressed the causes of top-reported symptoms and treatment side effects. For each, they reviewed medications, procedures and lifestyle changes that can improve them. Kim and Michael also shared personal stories and strategies for managing symptoms and side effects. 

Managing Fatigue and Other Common Symptoms

Dr. Wolf explained fatigue is one of the most common symptoms because there are many things mesothelioma patients experience that contribute to it. She noted the diagnosis itself, evaluations and treatment can all cause fatigue.

“Fatigue in and of itself is sort of a manifestation of everything that’s going on,” Dr. Wolf explained. “From sleeplessness to the mental use of cognitive resources to deal with all this to the physical fatigue of what patients are undergoing.” 

She added, “Sleep, good nutrition and recognizing that this is a long haul and that it’s normal are essential.” 

Kim shared her experience dealing with fatigue. She said, “The way I deal with it is I try to get sleep. I try to eat a healthy diet.” 

“But sometimes, I like junk food and want to stay up and do a movie marathon,” Kim said. “But I suffer from it. It’s just a matter of being disciplined about managing the tiredness.”

Shortness of breath is another common issue for pleural mesothelioma patients. Doctors can prescribe steroid medication or drain fluid from the chest. However, it can be more difficult to resolve after surgery. 

“To give you some idea, they have this test where I had to blow into a tube, and you were blowing out these virtual candles,” Michael explained. “There were 100 of them, and I could blow out about 98 of them before my surgery. After they removed my lung and part of my diaphragm, I struggled to blow out 3 of them.” 

Nausea is a common reaction to treatments such as chemotherapy. To alleviate nausea, Dr. Wolf suggests medication and avoiding triggers. 

“Zofran is a great medication, probably one of the most commonly used ones in this setting, and it’s very effective,” she said. “Minimizing the things that you notice may contribute to it is also helpful.” 

Dr. Wolf warns that dehydration can be a serious complication of nausea. “One of the most important things with nausea, especially if it’s accompanied by vomiting or lack of being able to keep yourself hydrated, is getting medical attention and avoiding dehydration,” she said. 

Doctors should take care not to over-treat some symptoms, Dr. Wolf noted. She said cough is a key example. 

“Coughing is important. You don’t always want to suppress it,” Dr. Wolf explained. “You want to be able to expectorate it. You want to make sure mucus is coming out so that you’re not developing a risk of pneumonia.”

Managing Brain Fog and Other Complications of Treatment

A common side effect of chemotherapy is “brain fog” or chemo brain.” These terms describe a general cognitive dysfunction that can affect memory or cause confusion. 

Michael shared his experience: “It’s very frustrating struggling with that more than anything. I couldn’t remember the simplest things. I’d be talking, and then I couldn’t think of a word or somebody’s name. It was almost like I was groping around trying to find these things while talking or trying to think.”

“Something would remind me of something, and then it was like starting to open drawers. Finding memories connected to that memory rebuilt my memories,” he recounted. “I don’t believe I have ever returned to where I was before. I’ve had to accept that I can’t mentally function like I did before.” 

He shared, “For a while, I took methylphenidate, and that seemed to help my mental acuity some. It helped give me some energy. Other than that, I try to get proper nutrition, get enough exercise and all these things. The healthier I can keep my body, the better my mind works.”

Skin irritation is a common effect of mesothelioma treatment such as radiation and immunotherapy. “Initially, I thought I was going to escape any skin issue, but toward the end, I had 5 weeks of radiation with itching and sensitivity,” said Kim.

“My skin turned black, and then it was peeling. I was sensitive to the sun and clothes,” Kim recounted. “I was scratching myself, so the nurse at the radiation center recommended a certain kind of cream I bought online. That helped. I switched to all cotton clothing. And I stayed out of the sun.”

Serious complications of mesothelioma treatment include infection or organ dysfunction. Kidney issues are also a concern for some patients. 

“Having the tumor and having the lung involved in any process can increase the risk of pneumonia. Anytime you can’t expectorate mucus, you can develop an infection,” said Wolf. “Cancer itself doesn’t usually cause kidney problems directly for pleural mesothelioma, but dehydration can, in more advanced cases.” 

She explained, “Certain platinum-based chemotherapies can cause kid kidney problems. Sometimes, NSAIDs can cause kidney problems. It’s something to be aware of. If this manifests as a decreased amount of urine or sort of fluid retention, swelling, it can result in sort of swelling of the legs or even it can sometimes result in trouble breathing.”

Talking to your doctor about any new or worsening symptoms or side effects is the best way to ensure you don’t develop complications. Record any details about your symptoms for your next appointment, and ask your doctor for advice on managing them.