Pain management in patients with malignant mesothelioma: challenges and solutions

J Saunders,1 M Ashton,1,2 C Hall,3,4 B Laird,3,4 N MacLeod1 1Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK; 2Institute of Cancer Sciences, University of Glasgow, UK; 3Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XR, UK; 4St Columba’s Hospice, Edinburgh EH5 3RW, UK Abstract: Malignant pleural mesothelioma (MPM) is an aggressive cancer with a considerable symptom burden and poor prognosis. Focus on maintaining patients’ quality of life and pain control is therefore paramount. Pain management in MPM is complex due to its multifactorial etiology resulting from direct tumor infiltration of the surrounding soft tissue, bone, and encasement of the intercostal nerves. A variety of treatment modalities, including pharmacological and non-pharmacological options, are often required to achieve adequate pain control in this challenging disease. This review article examines the current challenges and solutions available for pain management in MPM. Keywords: malignant, pleural, mesothelioma, pain, radiotherapy