The Treatment Mind Game: How to Feel Better During Chemotherapy

When fighting a battle against cancer, finding ways to feel uplifted and motivated to move forward is crucial. While treatment is meant to create a path towards healing, the actual process and resulting side effects can be painful and emotionally difficult to manage. For example, chemotherapy often causes nausea, vomiting, loss of appetite, fatigue, and depression.

Many options for managing these side effects focus on the body and lessening physical discomfort. However, during this journey, believing in the power of the mind and the thoughts you have can also really make a difference. Here are some ways to help manage the emotional toll treatment can take.

Read more: How Chemotherapy Fights Mesothelioma?

Positive Post-Its

Staying positive can sometimes feel like an insurmountable task. To help shift your mindset towards the self-supportive end, surround yourself with positive affirmations and behaviors. This includes the people you allow around you. Take some notes from this Do Great campaign and share it with your loved ones. Keep a gratitude journal and read it often. Try putting sticky notes all around your house that say things like, “you will get better, you will do great.”

Breathe Better

Rather than trying to meditate, which can quickly become a frustrating and counterintuitive chore, spend some time with your breath. This subconscious process can be used as a tool against feelings of anxiety and also bouts of nausea. Look around and see what kinds of breathing exercises seem to help you. Try counting your breath, or simply breathing deeply and focusing on or visualizing those physical sensations.

Similarly, when having a treatment, visualize the chemo killing the bad cells. Visualize your body healing.

Uncensor Yourself

To say you’re going to feel a lot of different things on your treatment journey is an understatement. Feelings of guilt may trick you into a mode of suffering in silence. Don’t. Staying positive is important, yes, but so is allowing yourself to be in a bad mood. You’re going to want to cry, yell, scream. Let yourself, then move on.

Read Stuff Not About Cancer

It’s easy to find yourself constantly in a cancer-this-cancer-that rabbit hole. It’s important to know what it is you need to, but beyond that, pull yourself out of the hole and read other things you enjoy. Perhaps a magazine, a comic, an old favorite book, or a new one you’ve been meaning to check out. Take the opportunity to get away from the computer screen and visit your local library. If it’s nearby, opt for the walk.

Find Your Funny Bone

Don’t underestimate the power of laughter. Know someone who can always make you laugh? Invite them over. Have a favorite comedy show? Set up a Netflix binge. Do the same for things you find beautiful, and for things that make you feel good about yourself. Seek out the good.

Look To Your Superheros

Who do you admire? This could be an author, a celebrity, a friend. Chances are, they have some pretty great things to say that you’ll believe in. Write them down or recite them in your head. Some cited favorites of cancer survivors include:

“You must do the thing you think you cannot do.” – Eleanor Roosevelt

“Courage does not always roar. Sometimes courage is the quiet voice at the end of the day saying, ‘I will try again tomorrow.” – Mary Anne Radmacher

“When you come to the end of your rope, tie a knot and hang on.” – Franklin D. Roosevelt

Also, become your own superhero. Walk like the warrior you are and soon you’ll believe it.

Multimodal Therapy Improve Survival For Mesothelioma Patients

Multimodal therapy, or multimodality therapy, is the combination of several cancer treatments (or modalities), including surgery, chemotherapy, and radiation. Multimodal therapy may also include certain experimental treatments. For mesothelioma patients, multimodal therapy has been clinically shown to possibly improve survival. While a single treatment may not be effective on its own, a combination of treatments may be more successful at destroying cancer cells. Multimodal treatment is considered one of the standard treatment options for stage II, III, and IV malignant mesothelioma and may be considered in stage I disease.

Treatment Components of Multimodal Therapy

Surgery

Surgery may be palliative or potentially curative, though options are limited for mesothelioma patients. Multimodality therapy including surgery has become a standard treatment of mesothelioma in patients with surgically removable tumors.

Radiation Therapy

Radiation is used in all stages of mesothelioma and can reduce symptoms and disease recurrence. As a multimodal therapy, intraoperative radiation is often used after a pleurectomy/decortication surgery.

Chemotherapy

The main chemotherapy treatment used in multimodal mesothelioma treatment is the combination of cisplatin and pemetrexed. Chemotherapy alone is only modestly effective in treating malignant pleural mesothelioma. However, adding a chemotherapeutic regimen to other treatment modalities, such as radiation therapy and surgery, improves survival.

Emerging and Experimental Treatments

There are a number of emerging and experimental treatments that are used in multimodal therapy. These are treatments that are currently being tested during clinical trials and include immunotherapy, gene therapy, photodynamic therapy, and more.

Trimodal Therapy

Malignant mesothelioma is difficult to completely remove with surgery alone. Because the tumor invades such sensitive structures as the diaphragm, esophagus, and heart, surgeons cannot remove a sufficient margin of healthy tissue around the tumor to make sure that all cancer cells have been removed. Therefore, additional cancer fighting treatments are needed.

Trimodal therapy for malignant pleural mesothelioma is the use of all three standard mesothelioma treatments—surgery, radiation therapy, chemotherapy—in some order. It is now widely accepted by oncologists and cancer researchers that more than one treatment modality is better than any single treatment for mesothelioma. A number of studies have shown that a trimodal approach provides the greatest benefit in terms of survival in select patients who can tolerate all three treatments. Indeed, most clinical practice guidelines for malignant pleural mesothelioma recommend trimodality therapy.

Given the relative rarity of malignant pleural mesothelioma, clinical practice guidelines also recommend that anyone undergoing trimodal therapy should be enrolled in a clinical trial whenever possible.

Choosing The Best Order of Treatment

While trimodal therapy is widely accepted as a standard treatment for malignant pleural mesothelioma, the order of treatments is a matter of debate.

Any of the treatment options can be what’s called the primary therapy, an adjuvant or a neoadjuvant therapy.

• Neoadjuvant Therapy — Any treatment given before primary therapy to improve results.
• Primary Therapy — Considered the most effective treatment option. This will most often be surgery.
• Adjuvant Therapy — Any treatment administered after primary therapy to alleviate symptoms and prevent cancer from returning.

In most cases, trimodal therapy will begin with chemotherapy followed by surgery (i.e., extrapleural pneumonectomy) and will finish with external beam, hemithoracic radiation therapy. Second most commonly, the patient first undergoes surgery followed by chemotherapy and radiation therapy. Less common approaches combine surgery with intracavitary chemotherapy followed later by radiation therapy. In some trimodal treatment combinations, hemithoracic radiation is replaced with intensity-modulated radiation therapy (IMRT).

Survival Rates

There is no clearly superior order of treatments in trimodality therapy. When surgery comes first, median survival ranges from 17 months to 28 months, and 39% to 81% of patients complete all three phases of treatment. When chemotherapy is administered before surgery, median survival ranges from 14 to 25.5 months and 32% to 69% of patients fully complete trimodal therapy.

Recent clinical trials have focused on pleurectomy with decortication in trimodality therapy. This surgical approach is associated with fewer complications than extrapleural pneumonectomy and, perhaps, better overall survival when incorporated in a trimodal therapy regimen. Moreover, 84% to 94% of patients were able to complete trimodal therapy when pleurectomy with decortication was used. One small clinical trial reported median survival of 30 months using this surgical approach. While the type of surgery used in trimodal therapy should be individualized to the patient’s circumstances, initial reports of a higher completion rate with pleurectomy and decortication are promising.

The course of therapy is different for each patient. A multidisciplinary team of cancer specialists decides on the best order of treatments based on patient preferences and circumstances.

Creating a Treatment Plan

Not everyone with malignant pleural mesothelioma is a candidate for multimodal therapy. Prior to this treatment, several diagnostic tests need to be run to determine a patient’s suitability for surgery, whether it is extrapleural pneumonectomy or pleurectomy with decortication. At a minimum, patients will undergo the following examinations:

• Physical examination – If other health problems are present, is the patient healthy enough to undergo major surgery?
• Pulmonary function testing – Will the patient have enough lung function in the remaining lobes of the lung after the diseased lung has been removed?
• Cardiac function testing – Does the patient have a strong enough heart to maintain blood pressure after some of the pulmonary blood vessels have been removed? Is the patient’s heart strong enough to undergo major surgery?
• Radiological studies – Radiological studies such as CT, MRI, and PET scans may be used to determine whether cancer cells have extended well beyond the affected lung to distant sites. If they have, trimodal therapy may not be successful.
• Histological examination – Patients do better if their mesothelioma is of the epithelial type rather than sarcomatoid. Because of the aggressive nature of sarcomatoid mesothelioma, doctors may decide not to use multimodal therapy. A third cancer cell type called biphasic mesothelioma has both epithelial and sarcomatoid cells. The prognosis for biphasic mesothelioma is not as good as epithelial mesothelioma, but multimodal therapy can still proceed with this cancer type.

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Mesothelioma Survivor Remains Strong 10 Years After Diagnosis

Virginia Beach spent four years researching and writing hundreds of pages of family history.

She began her memoirs with her ancestors' voyage to America on the Mayflower in 1620, and then across generations, including the birth of her children, grandchildren and great grandchildren. Her move into hospice care in 2014 because of a malignant pleural mesothelioma diagnosis is also part of the tale.

But her story doesn't end there because mesothelioma did not win.

Beach, 88, recovered from the cancer miraculously, left hospice care and returned to independent living at the Presbyterian Retirement Community near Lancaster, Pennsylvania. Now she is eagerly awaiting the birth of three more great grandchildren to add to her chronicles and her growing correspondence list.

Last month, she passed the 10-year survival mark for a patient with malignant pleural mesothelioma — a rare moment — stunning doctors with her ability to fight off this incurable cancer.

She also returned to the church choir and her job as a librarian at the retirement community.

"My oncologist doesn't say it's in remission. He says it's in control,'' Beach said recently from her home. "I've been very fortunate. When I was originally diagnosed, they gave me a year and a half to live. That was 10 years ago. Then last year, they said it was time for hospice. The tumors had doubled in size, but after six months, I graduated out."

Miracles happen.

The Power of Prayer

Beach is a pastor's daughter and widowed wife of a pastor. She believes strongly in the power of prayer. Her faith never wavers. Each day starts and ends with a Bible passage. She gives thanks to God.

She mentions mesothelioma only once in her 250-page autobiography. And it's only in passing — nothing more.

"I live with a lot of elderly people here. Everyone suffers from one thing or another. I just don't like to hear sad stories. I'm not going to be one," she said. "It's not a huge part of my life right now, so I don't talk about it. It's not how I want my grandchildren to remember me. I'm an optimistic person who looks at the bright side."

When Virginia was first diagnosed, they put her name in the church bulletin so that everyone could pray for her and the other cancer patients. As much as she appreciated the prayers, she asked church members to remove her name. She believed God would handle it just fine. And he has.

Her father may have died at age 54 from lung cancer, which doctors originally thought she had. But her mother lived to be 104 and gave speeches in her community throughout her 90s.

Virginia inherited her mother's strong genes.

Still Sharp and in Touch

She had fought off malignant melanoma cancer in the late 1990s. Her husband, Roger, suffered through dementia in the final years of his life and died in 2009, leaving her with the fondest of memories.

But there is a clarity, purpose and sharpness to her today that defies her age.

Beach has 20 grandchildren and 13 great grandchildren between her five daughters who are spread across the country in Oregon, New York and Ohio. Some of her grandchildren live as far away as Japan, Thailand and Colombia.

One son-in-law became a minister. One grandson is overseas on a church mission.

She keeps a spreadsheet with everyone's birth dates, wedding anniversaries and addresses. kanaEvery year, she sends each family member Christmas and birthday cards with personalized, handwritten notes.

"It's a wonderful family," she said. "I've been blessed."

Sudden Health Scare

Beach underwent eight rounds of chemotherapy shortly after she was diagnosed a decade ago, and doctors were pleased with the results. Since then, she opted against undergoing any otheraggressive treatment.

But last summer, she became frightened by a sudden shortness of breath, prompting her oncologist to recommend hospice and palliative care.

A nurse and a social worker started visiting her regularly. Her primary care physician also continued to stop by. Even the local chaplain started making house calls. But her health improved, and she waved off much of the help they were offering.

"After a while, the doctor told me my lungs were clear. I didn't need them to do much, but the nurse did help me understand my iPad, and how to use it better," she laughed. "That was a big help to me."

Living an Active and Productive Life

Beach remains active today and takes classes on balance five days a week at a wellness center. She traveled to Oxford, Ohio, earlier this summer for a grandson's wedding and visited Portland the previous summer.

She uses her iPad to send emails to her daughters, grandchildren and great grandchildren. The organizational skills she learned throughout the years as a librarian are evident today in her writing.

Family members help format, edit and create graphics for her memoirs, but Beach maintains full control, amending her story each time another event takes place in her life.

Despite her mesothelioma, Beach has accomplished much in her life, and that's why she has aptly titled her memoirs "Journey to Joy."

Sources: www.asbestos.com/blog/2015/09/02/mesothelioma-survivor-strong-10-years-after-diagnosis

Asbestos is the only confirmed cause of mesothelioma.

While the causes of many types of cancer remain unknown, that is not the case with mesothelioma. Up to 85% of all diagnosed cases of mesothelioma can be definitively linked to exposure to asbestos. For decades, concerned doctors and research scientists speculated about the dangers of asbestos and warned industries to discontinue its use, but a conclusive link wasn’t actually made until 1999, when it was too late for the millions around the world who had already suffered prolonged exposure to the dangerous mineral.

How Asbestos Makes You Sick

Asbestos is a naturally-occurring mineral that possesses excellent insulating and heat-shielding properties. Because of this, it has long been used in a variety of products, including building materials like insulation, gaskets, floor and ceiling tiles, and drywall tape, as well as in automotive products such as brake pads and shoes and clutch plates.

Asbestos is not dangerous when left undisturbed. In fact, scientists estimate that asbestos occurs naturally in our air and drinking water and that everyone breathes in the mineral at some time or another. However, when asbestos is damaged and becomes “friable” – soft and weak – it is more easily airborne, and hence, inhalation can occur more easily.

People who worked with asbestos that was cut, crushed, sanded, torn, or otherwise manipulated were prone to inhaling these dangerous fibers. Prior to the asbestos warnings of the 1970s, individuals who worked with asbestos were given little or no protective gear, even though it has been proven that experts have known about the dangers of asbestos for more than a century and warned industries of the risks.

Usually, those exposed to asbestos on a regular basis do not get sick immediately. As a matter of fact, asbestos diseases often do not appear for 20-50 years after exposure. However, a handful of workers who were first responders at the World Trade Center disaster in 2001 have already died of mesothelioma due to extreme exposure to the material.

Asbestos fibers that are breathed into the lungs cannot be expelled, so they remain there, embedding themselves in the lining of the lung (the mesothelium) and causing inflammation. Cancerous tumors may develop decades later and require very harsh mesothelioma treatment.

Who Is at Risk?

Individuals who have worked many years at particular jobs where asbestos was in plentiful use are most at risk for developing mesothelioma or any other sort of asbestos-related disease.

One of the highest incidences of mesothelioma is among shipyard workers who were employed during the peak years of World War II, not only in America but also in other countries. Because shipyards often performed overhauls on war ships, workers were exposed to large amounts of friable asbestos and inhaled the mineral on a regular basis for long hours at a time. Shipyard workers and other workers that are consistently at risk include:

Secondary Exposure

In addition, home renovations or other DIY projects can lead to direct exposure to asbestos. Tearing apart walls and ceilings or installing new insulation, for example, can lead to dangerous levels of exposure, especially without proper protective gear. Though experts note that no amount of exposure is safe, prolonged exposure increase susceptibility to the disease.

Others at risk for developing mesothelioma include the families of those who worked with asbestos on a regular basis. While mesothelioma is not contagious, it wasn’t unusual for workers to bring home asbestos dust on their clothing. Numerous cases of this rare cancer have been diagnosed among women who washed asbestos-laden clothing, as well as adults who, as children, enjoyed close contact with their father (or grandfather) when he got home from work, before he changed and showered, never realizing that they were inhaling dangerous fibers as well.

Smoking and Mesothelioma

Though smoking doesn’t directly cause mesothelioma, it does make a person more likely to develop the disease. Reports have shown that smokers who worked with asbestos are up to 90 percent more likely to develop mesothelioma than those who don’t smoke. Furthermore, smokers who already have asbestosis are also more likely to develop mesothelioma. Simply put, smoking and asbestos don’t mix.

Types of Asbestos

Asbestos naturally occurs in six types, which fall into two categories, differentiated by their basic structure.

Sources:
1. American Cancer Society. What are the risk factors for malignant mesothelioma?
2. National Institute for Occupational Safety and Health.
3. National Cancer Institute. Asbestos Exposure and Cancer Risk.
4. https://www.maacenter.org/mesothelioma/causes/

What mesothelioma is

Mesothelioma is a type of cancer that can develop in the tissues covering the lungs or the abdomen. It is a cancer of mesothelial cells. These cells cover the outer surface of most of our internal body organs, forming a lining that is called the mesothelium.

Mesothelioma in the chest

About three quarters of mesotheliomas occur in the chest (75%). They start in the two sheets of tissue known as pleural membranes (or pleura) that cover the lungs. The gap between the pleura is called the pleural space. The pleura are fibrous sheets that help to protect the lungs. They also produce a lubricating fluid that helps the pleural membranes to slide over each other easily when the lungs expand and deflate as we breathe. Mesothelioma of the pleura is called pleural mesothelioma.





The sheet of tissue covering the heart (the pericardium) is very close to the pleura. So in some people pleural mesothelioma may also spread into the pericardium. The diagram below shows the pleural membranes thickening due to mesothelioma.

Mesothelioma in the abdomen

The sheet of tissue covering the organs of the abdomen (tummy) is called the peritoneum. It helps to protect the contents of the abdomen and keep them in place. It also produces a lubricating fluid. The fluid helps the abdominal organs to move smoothly against each other as we move around.


Mesothelioma of the tissues lining the abdominal cavity is known as peritoneal mesothelioma. About a quarter of mesotheliomas occur in the abdomen (25%). So it is much less common than pleural mesothelioma. Peritoneal mesothelioma does not usually spread to other parts of the body.

Benign mesothelioma

A type of non cancerous (benign) mesothelioma can develop in the lining of the lungs, or in the lining of the reproductive organs. It can occur in either men or women. These non cancerous tumours are very rare and we don't cover them in this section.


source:cancerresearchuk.org