Sometimes cancer causes no pain. Symptoms may even be subtle until the cancer is advanced. But with mesothelioma, pain in the chest — where the tumor is usually found — painful coughing, and pain as the cancer spreads and presses on organs are common. The good news: Cancer pain is one thing you don't have to tolerate. Pain management methods for mesothelioma are often successful. Mesothelioma Pain: What to Expect "It's not uncommon to have chest pain," says David Rice, MD, associate professor and director of the mesothelioma program at the University of Texas M.D. Anderson Cancer Center. "Probably 30 to 40 percent of people will have chest pain at some point during their disease," he says, and that percentage may even be as high as 50 percent. Mesothelioma develops in the abdomen or the chest. About 75 percent of mesothelioma cases occur in the chest, called pleural mesothelioma. As this tumor in the chest grows, chest pain, as well as frequent and painful coughing, can occur. "Not everyone who has mesothelioma experiences pain," says Dr. Rice. However, as the cancer spreads, pain becomes more likely as it affects other areas of the body and presses on surrounding organs. Bone metastases are also likely to cause pain, he says. Pain may also occur in the lower back, or, in the case of peritoneal (abdominal) mesothelioma, in the abdomen. Mesothelioma Pain: What It's Like Glynn Kron, 57, of Ponchatoula, La., didn't experience pain from his mesothelioma at first. In fact, he didn't experience any symptoms at all. "I went to a pulmonologist to receive help to quit smoking," says Kron, who says he probably was exposed to asbestos while working on cars, and as a teen, when he worked on construction jobs. When the doctor evaluated his health before prescribing him medication, she found a collapsed lung on the X-ray. After it wouldn't re-inflate, he says, the medical team took a look inside and found the tumor. It was diagnosed as mesothelioma in October 2007. He had major surgery in January 2008, which left a huge scar. "They cut a lot of nerves and muscle," says Kron. He lost his whole lung, part of the chest wall, the chest wall lining, and the heart lining. Today, he says, while he is cancer-free, he still has a lot of numbness — and pain. Kron is still trying to find the right way to manage his pain post-surgery. He's taking medication, but doesn't want to keep taking it forever. "I tried some over-the-counter [OTC] pain medication but it's not strong enough — and you have to take so many of them," he says. Plus, the cost of those OTC medications gets too high too quickly, since insurance won't pay for them. He's considering seeing a pain management specialist for better control. "It certainly has an impact," Kron says of his daily life with mesothelioma. He has problems bending over and even has difficulty tying his shoes. "Between the pain and the loss of the lung, it's reduced and changed my activities quite a bit." Mesothelioma Pain: Management Techniques Narcotics are the most common, and successful, way of treating pain from mesothelioma, says Rice. But a thorough evaluation is important to make sure pain management is being handled correctly. “[Chest] pain is usually controllable with narcotic medication," says Rice. "In patients who do have chest pain that is related to tumor, it is important that they be evaluated by a pain specialist early on in their treatment so that if the pain worsens, medications can be [adjusted] upward." Palliative chemotherapy is also an option to manage pain from tumors, says Rice. Palliative chemotherapy doesn't have a goal of curing the cancer, but rather eliminating pain and keeping an individual comfortable. Reducing tumor size may also decrease coughing or your provider can prescribe medications to stop the coughing. Mesothelioma is a challenging diagnosis, and treatment can be difficult — leaving you feeling worse after the surgery than before it. But pain management is an important part of every cancer treatment plan, and there are many options to try until you find what relieves your pain.