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NCCN Guidelines for Patients



Malignant Pleural Mesothelioma, Version 1.2016

What is supportive care?

For most patients with cancer, their main concern

is that treatment works. However, having cancer is

complex and brings many physical and emotional

challenges. It is important to know about these

challenges and get the support you need.

Supportive care is treatment given to relieve

the symptoms of mesothelioma, side effects of

mesothelioma treatment, and other health issues

related to the cancer. It is important to talk openly

with your treatment team during this time. Let the

team know how you are feeling and if the care is

working. Ask questions and reach out if you need

more information about your next steps.

This section explains some of the challenges you

may face as well as ways to manage them with

supportive care.

See Guide 9.

When is it needed?

Pleural effusion

Pleural effusion is the buildup of extra fluid in the

pleural cavity. This can result in shortness of breath

and make it hard to breathe. A pleural catheter can

be used to drain the fluid buildup. Another treatment

is talc pleurodesis. Talc pleurodesis involves putting

talc powder into the pleural cavity. The powder

irritates the tissue and causes the two layers of

pleura to grow together while healing. This seals the

pleural cavity and stops fluid buildup. It is important

that a PET/CT scan is done before talc pleurodesis

because talc causes pleural inflammation, which can

look like cancer on the scan.

Chest pain

Chest pain may be caused by cancer growing into

the chest wall. Radiation therapy may be used to

ease chest pain. However, there are other ways to

manage chest pain such as with pain medications

or chemotherapy. For more information about chest

pain and management, talk to your treatment team.

Bronchial or esophageal obstruction

Cancer can grow and cause an obstruction

(blockage). Mesothelioma can grow and block your

bronchial tube (airway path) or esophageal tube

(digestive path). If this happens, radiation therapy

may be used to try and shrink the tumor. To learn

more about radiation therapy for an obstruction,

ask your treatment team. See page 25 for more

information on radiation therapy.

Nausea and vomiting

Nausea and vomiting are two of the more common

side effects a person with cancer can have. It can

happen from the cancer itself, health problems

caused by cancer, and from cancer treatment. Some

chemotherapy drugs and radiation therapy (to the

upper abdomen) can cause these unwanted side

effects. Your doctors may prescribe anti-nausea

and vomiting drugs. You can also find other ways

to cope like eating smaller meals, drinking plenty of

Guide 9. Conditions for supportive


Side effects

Pleural effusion

Chest pain

Bronchial or esophageal obstruction

Nausea and vomiting

Smoking cessation



Supportive care

What is supportive care?

When is it needed?