After receiving a diagnosis of mesothelioma, a patient is faced with many challenging scenarios, including overwhelming emotional responses that result from the stressors involved in receiving treatments.  In order to affect the best treatment outcome possible, it is important that the patient with mesothelioma be informed on ways to cope with the changes inherent to the cancer diagnosis.
     Besides the stress involved with a diagnosis of mesothelioma, the side effects and symptoms of the disease will also tend to cause stress for the patient.  Regardless of the source of stress, there are numerous techniques that can be engaged in coping with cancer related stress.

Coping with stress.
While stress is the body’s normal and natural response to this situation, it can also quickly become the body’s enemy.  This is especially true in coping with a cancer diagnosis.  Experts have shown that stress, which causes the release of a hormone called cortisol, can have detrimental effects on the course of recovery in any disease.  Although cortisol is a natural, necessary, and beneficial chemical for normal body functioning, the excess cortisol resulting from physical and/or psychological stress can lead to or exacerbate illness.
Changes in a person’s life after receiving a diagnosis of mesothelioma may extend to interpersonal relationships with family and friends.  While it is of great importance at this time for the patient to have a strong system of support through these types of relationships, depression may cause a negative impact to reverberate throughout all areas of life.  This can result in the patient’s experience of difficult interactions with physicians as well as family.
It is recommended that those people who do not have strong support systems avail themselves of nursing care, counseling, and if possible, support groups.  The necessity for admission to a nursing facility may also be necessary, if only temporarily.  Even patients who have family may find that their loved ones have responded to the diagnosis by enforcing a distance in relationship.  This may be due to the person’s fears, misunderstandings, inability to cope, or possibly the person’s attempt to give the patient privacy.  
Post-surgical scarring and other physical changes may also contribute to the mesothelioma patient’s experience of stress, making coping more difficult.  In the case of very large tumors, painful post-surgical healing and the resulting scar may cause intense suffering.
Sometimes, a patient deals very well with the cancer diagnosis until treatment begins.  Then, the stress of the treatment, which frequently causes increased feelings of discomfort, pain, and illness for the patient, can cause a breakdown in coping skills.

What to expect
The patient’s response to a mesothelioma diagnosis is as individual as the person it pertains to, so each person responds differently.  Some people will develop anxiety, depression, and/or other psychiatric problems in the wake of their mesothelioma discovery, while others may attempt to ignore it completely.       
For a person who has newly received a cancer diagnosis, certain reactions on the emotional and psychological level may be expected.  These include:

1. Anger.  Anger is a natural response to the prospective threat posed by cancer’s physical attack and potential for causing pain.
2. Denial.  Denial may include the inability or unwillingness to make changes in accordance with the implications of the mesothelioma diagnosis. 
3. Depression.  An overwhelming sense of depression can stem from the news of mesothelioma.  For this reason, many healthcare professionals suggest that patients seek counseling and avail themselves of any support groups which may be available and appropriate.  Depressed patients may experience feelings of hopelessness, helplessness, loss of control, and loss of self-esteem.
4. Guilt.  Some patients will respond to the diagnosis by forming the opinion that the disease is a punishment for previous behavior.  Guilt may also stem from the patient’s idea that their disease is inconveniencing family, or from the patient’s feelings of envy toward healthier individuals.
5. Withdrawal and/or isolation.  While coming to terms with a mesothelioma diagnosis, the patient may withdraw completely from family and friends.  Attempts to isolate may also occur.

     Another source of stress for newly diagnosed mesothelioma patients can be the adjustment involved in receiving medical care.  At times, this can be a depersonalizing experience, and even inspire feelings of humiliation, self-hatred, and embarrassment. 
Learning to negotiate the nuances of the medical system is an important skill for the cancer patient to acquire, and gaining an understanding of effective communication techniques can be a valuable resource.  To this end, some experts recommend that cancer patients develop better communication skills through learning to:

1. Ask questions and insist on clear answers.  By owning the right to ask questions about procedures, treatment, diagnosis, prognosis, and other concerns, the patient can gain a better sense of control in this situation.  When a professional seems evasive in answering questions, it is the patient’s right to demand an answer.
2. Communicate needs to medical personnel.  Cancer patients, like all patients, have rights that are to be respected by healthcare providers.  Additionally, patients have the right to communicate their needs to any caregivers, including family members.

Exercise
In some cases and when recommended by a physician, the benefits of exercise can extend to helping patients cope with their mesothelioma.  Exercise increases circulation and causes the release of endorphins, which can result in an increased sense of well being.  Additionally, exercise can decrease the feelings of depression and anxiety experienced by many people dealing with cancer.
Some simple exercises include gardening, walking, golfing, and swimming.  For pleural mesothelioma patients who have had a portion of their lung removed, it may be recommended that physical activity is closely controlled to avoid the risk of overexertion.  There are many exercises that physicians can recommend for individuals who are bedridden that will help the joints remain mobile and allow for muscle stretching.

Coping with side effects and symptoms.
There are several common side effects that a patient can expect to confront as a result of the treatments for mesothelioma; additionally, some patients may have symptoms stemming from the mesothelioma itself.  The most common side effects include:

1. Loss of appetite.  The waning of a cancer patient’s appetite can be a symptom, side effect, or the direct result of depression.  Regardless of the cause, stimulation of the diet is an important mechanism in coping with this side effect.  To boost the appetite, one should eat small meals frequently, eat meals with others, and ask that preferred foods be prepared.
2. Dry mouth.  To combat the side effect of dry mouth, the patient should drink plenty of fluids and increase fluid intake at mealtime. 
3. Diarrhea.  Coping with diarrhea can be especially trying for cancer patients.  In this case, it is important to remain hydrated with clear liquids until a significant period of time has lapsed since the last bout of diarrhea.  At this point, a bland meal of bananas, rice, skinned poultry, or farina can be consumed.
4. Nausea.  To cope with nausea, stay away from common triggers like the scent of cooking food.  Rest after eating but remain upright, and eat foods at room temperature instead of hot.
5. Vomiting.  Wait until vomiting has ceased before trying to eat or drink anything.  In severe cases, your physician may recommend an anti-emetic. 

Coping with pain.
Cancer pain can be one of the most intense challenges for patients struggling to cope with their new situation.  Fortunately, innovations in both treatments and attitudes have provided healthcare professionals with improved resourced for the alleviation of pain symptoms.
The experience of pain is unique to each individual, so that what may not cause discomfort for one person may cause extreme pain for another.  For this reason, no one treatment can be recommended for all patients in any given situation.
The pain associated with cancer has several different sources.  The tumor site can cause intense pain; the body may also produce a pain response to the invasion of cancer as a way to communicate a disruption in the normal state of physiological affairs.  Pain can also be the result of the surgical or radiotherapy treatment for cancer.
Effective pain control is best achieved through the cooperation of a team of professionals.  This may include oncologists, nurses, and primary care physicians, as well as therapists, social workers, family members, and the patient.  This team will coordinate the determination of treatment and dosage, and the patient and others will have a role in delivery and adherence to the prescribed method of pain alleviation. 
Because there are several different types of pain, there are also several types of treatments corresponding with those pain types.  These include:

1. Somatic pain.  Somatic pain is caused by the body’s pain receptors reacting to a perceived threat.  This pain results in a dull or aching sensation that is localized.
2. Visceral pain.  Visceral pain is the result of changes to the viscera, or tissues in the abdominal cavity.  This results in a less localized expression of pain than is experienced in somatic pain, and may feel like pressure and squeezing.  Intense visceral pain can cause nausea, vomiting, and sweating.
3. Neuropathic pain.  Neuropathic pain is the direct result of nervous system damage.  Depending on the type of mesothelioma, the cancer itself may cause nerve damage, or the treatment may damage nerves.  In either case, neuropathic pain is a severe and shooting type of pain.

Pain treatments.
Most people dealing with cancer pain use analgesics for pain relief.  These are drugs that allow for alleviation of pain without causing a loss of consciousness.  There are several levels of pain relief treatment available for treating the various levels of pain.
The first level of pain relief treatment is through a non-opioid analgesic, which is used for mild to moderate pain.  These include medications like aspirin, ibuprofen, and acetaminophen.  The advantage of non-opioid analgesics is that they have few side effects.  On the other hand, their effects are only felt for three to four hours. 
The next level of pain relief involves opioid analgesics.  These are stronger medications than the non-opioids, and have more side effects and risks attached to their use.  Opioids are controlled substances and are addictive.  For this reason, physicians are very careful in prescribing these drugs.  However, opioid pain relievers are not nearly as addictive as most people think they are.  Additionally, patients suffering from severe pain do not experience the euphoric “high” that drug abusers seeking opioids for pleasure have.
One commonly prescribed opioid is codeine, which ranges from mild to strong depending on the dosage.  Morphine is a very strong opioid pain reliever, as is oxycodone and dilaudid.  Physicians generally prescribe opioids at a lower dose to begin with and gradually increase the dose as treatment continues and the patient proves the tolerability of the drug.
Analgesics may be administered via pill or injection, intravenously or epidurally, in rectal suppositories, transdermal patches, or other delivery methods.  Common side effects in opioids include constipation, decreased appetite, and nausea.  Additionally, drowsiness and dry mouth are commonly experienced in patients receiving opioid treatment. 
Some medications are used in conjunction with pain relievers to enhance the analgesic effects.  These include antidepressants like amitriptyline and imipramine, anti-convulsants like carbamazepine, and corticosteroids such as dexamethasone. 

Alternative pain treatments.
Acupuncture is a common alternative method for unconventional pain relief.  In this procedure, long, thin needles are placed into the skin in a specific location.  This causes the stimulation of nerves; stimulation may be enhanced through the twirling, heating, or electrical charging of the needles.
Physical therapy is also recommended in cancer pain alleviation, depending on the type and location of cancer.  The use of physical therapy can help patients cope with muscle and joint pain.  Hypnosis, biofeedback, music therapy and yoga are other alternative methods available to cancer patients suffering from intense, chronic pain. 

Pain and mental health.
The toll that pain takes on a person can have a strong psychological effect.  This may result in exacerbation of depression or other psychiatric illnesses.  For this reason, it is often necessary that chronic pain sufferers receive counseling or psychotherapy when dealing with constant pain.  Psychopharmaceuticals may also be indicated and prescribed in cases of severe psychiatric distress.