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Mesothelioma and chest wall pain 

Mesothelioma and chest wall pain
Chapter:
Mesothelioma and chest wall pain
Author(s):

Manohar Sharma

and Sanjeeva Gupta

DOI:
10.1093/med/9780199661626.003.0007
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date: 18 June 2021

Approximately 1800 new cases of mesothelioma are diagnosed each year in England. Most people who develop mesothelioma have worked in jobs where they inhaled asbestos, or were exposed to asbestos dust and fibres in other ways. The large majority of patients will die within a year of diagnosis. Mesothelioma incidence is still rising and is expected to peak between 2010 and 2015. Between 2006 and 2020 up to 30,000 people will die of the disease in the UK. Patients with mesothelioma frequently suffer distressing symptoms including breathlessness, chest pain, fatigue, and weight loss. Intractable pain in particular is a key issue. Pain is caused by tumour compressing on the remaining lung, pleural effusion, infiltration of tumour into chest wall and neural structures. Often the pain can be as a result of surgery to resect the tumour or take biopsy. Pain can be often controlled with simple analgesic and strong opioids in line with the World Health Organization analgesic ladder. However, in a number of cases pain is refractory and severe. In these cases pain management options including nerve blocks, intrathecal neurolysis, spinal infusions, and cordotomy must be accessible and considered early.

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