All You Need to Know About Mesothelioma, Mesothelioma is a type of cancer that most commonly affects the lining of the lungs, and more rarely, the lining of the abdomen, heart, or testes. Mesothelioma is a rare cancer, with 3000 cases being diagnosed yearly in the US. It is caused by past exposure to asbestos, most often in the workplace. Mesothelioma is usually diagnosed late and has a poor prognosis, but there are treatment options available that can improve quality of life or even bring about remission.
Types of Mesothelioma
By far the most common type of mesothelioma affects the lining of the lungs, and is called pleural mesothelioma. Pleural mesothelioma represents approximately 70% of all diagnosed cases of mesothelioma. Peritoneal mesothelioma, the second most common type, originates in the lining of the abdomen, and represents 20% of all cases of mesothelioma. Very rarely, mesothelioma may affect the lining of the heart, or pericardium, or the lining of the testes. These two forms together account for only 2% of cases.
Symptoms of Mesothelioma
This cancer causes different symptoms depending on its location.
♦ Pleural mesothelioma causes mainly respiratory symptoms, including the following:
- Chest pain
- Shortness of breath and reduced chest expansion.
- Abnormal breath sounds
- Dry cough or coughing up blood.
- Blood clotting disorders
- Night sweats and fever
♦ Peritoneal mesothelioma usually manifests with digestive symptoms, such as:
- Loss of appetite and weight
- A feeling of fullness
- Bowel obstruction
- Abdominal pain and swelling
- Nausea and vomiting
Diagnosis of Mesothelioma
Mesothelioma symptoms usually appear insidiously and intensify slowly, so patients tend to only see a doctor once the tumor is large enough to cause significant discomfort. Even then, general practitioners may initially misdiagnose mesothelioma as a less serious complaint such as irritable bowel syndrome or pneumonia. Therefore it is important, if you suspect you might have a mesothelioma, to discuss with your doctor if you had a history of exposure to asbestos in the past.
Once the treatment plan for the misdiagnosed illness fails, a doctor may request imaging studies to be done of the affected area. The imaging may be done by X-ray, MRI scan, CT scan or PET scan. The current gold standard is to use a combined CT-PET scan, which gives a detailed overlay of the body, while lighting up highly active cells that might suggest cancer.
Additional Tests and scans
Once a tumor has been identified on scans, it will be necessary to take a sample of it to identify the tumor type. Taking a small tissue sample is called biopsy. This is most often done through thoracoscopy, a surgical procedure that involves inserting a small tube with a camera into the affected area to guide sample taking. A thoracoscopy usually requires a three-day stay in hospital, and is considered a minor surgery.
The tissue sample will be examined and tested to determine the origin and cell type of the tumorous mass, and whether it is cancerous or benign. The vast majority of mesotheliomas are cancerous, although a small minority of peritoneal cases may be benign and without apparent cause.
Once mesothelioma is confirmed, the doctor may order additional tests to stage the cancer in order to discover how far it has spread. There are usually four stages to a cancer, with stage I being the least serious, and stage IV being the most advanced. The staging of the tumor has an important role in deciding on the right kind of therapy to use.
From the first doctor’s appointment to diagnosis, identifying a mesothelioma may take three months or more.
Causes of Mesothelioma
The leading cause of mesothelioma is exposure to asbestos. Although the use of asbestos has been minimized in recent decades, people still get mesothelioma today since it takes 20-50 years after exposure for mesothelioma to develop. Asbestos exposure may occur when you live or work near an asbestos mine or processing plant, since there will be a high concentration of fibers in the air. The construction, military and automotive industries also carry a high risk of exposure. Since many older houses were built using asbestos products, home renovation may also carry a risk.
Some minerals with similar properties to asbestos, and high radiation exposure, are among the lesser causes of mesothelioma. Answering your questions about ASBESTOS!
Treatment for mesothelioma usually consists of surgery, radiation, chemotherapy or a combination approach called multimodal therapy.
- Surgical Procedures:
Aggressive surgery to remove mesothelioma is usually indicated if the tumor is not very advanced, or is localized to a small area. Curative surgery is most often followed by radiation therapy and chemotherapy to destroy any remaining cancer cells. When the tumor has spread or if the patient is very weak, surgery may no longer be an option to remove the entire tumor, but partial surgery may be performed to remove sections of the tumor that are compressing nerves or blood vessels, or causing particular pain. This is called palliative surgery, and although it may not cure mesothelioma, it can greatly improve the quality of life of persons affected by advanced mesothelioma.
- Radiation Therapy:
Radiation therapy uses non-invasive, high-energy beams to destroy cancerous cells. Although it does not have very severe side-effects, it does damage and destroy normal cells in the area too, so it is used sparingly, and often only on specific types of mesothelioma.
Chemotherapy involves treating mesothelioma with drugs that are designed to destroy cancerous cells. These drugs are usually injected or delivered through a drip into the bloodstream. Since the drugs also damage normal cells throughout the body, chemotherapy has very severe side-effects, but over time, the patient may experience great improvement in their condition.
- Multimodal Therapy:
Although all these treatments have their benefits, patients are usually treated using a combined approach called multimodal therapy, which involves using all the different treatment options in different ratios according to the patient’s needs. Using multimodal therapy, may patients can achieve control of their mesothelioma, and some may enter long-term remission or be cured.
Although the prognosis for mesothelioma is generally poor, with only ten percent of mesothelioma patients surviving past 5 years, it can be improved by early detection and treatment. So if you or your loved ones have been exposed to asbestos in the past, don’t wait for symptoms to develop. Be proactive and see your doctor for an early diagnosis and treatment.