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Thursday, 12 September 2019

Mesothelioma Types ,Treatment and Other Mesothelioma Related.

Mesothelioma Types ,Treatment and Other Mesothelioma Related.

Mesothelioma can either be malignant (cancerous) or benign (non-cancerous) in nature. Mesothelioma affects the mesothelium, hence mesothelioma.

What is the mesothelium?

The mesothelium is a type of tissue lined with special cells referred to as mesothelial cells. The mesothelial cells typically line the abdominal cavity, heart cavity, chest cavity, and the outer surface of most internal organs. Each cavity has a specific name for the mesothelial covered cavity which is:

Peritoneum: abdominal cavity
Pleura: chest cavity
Pericardium: heart cavity

The mesothelium has a specific purpose in the body. The mesothelium produces a lubricating fluid that allows easy movement of the organs. The pleural mesothelium for example, allows the lungs to move easily with each breath that is taken. Without this, breathing would be a difficult and possibly painful process.

Many refer to malignant mesothelioma as simply, mesothelioma. There are three main types of malignant mesothelioma ranked from less likely to more commonly seen:

Sarcomatoid
Mixed/Biphasic
Epithelioid

Malignant mesothelioma more commonly begins in the chest cavity (pleural mesothelioma). Approximately 10-20% of the cases of malignant mesothelioma will begin in the abdominal cavity (peritoneal mesothelioma). Malignant mesothelioma rarely begins in the cavity surrounding the heart (pericardial mesothelioma).

Malignant Mesothelioma Statistics:


Mesothelioma is a very rare cancer estimated to affect 2,000-3,000 newly diagnosed cases annually in the U.S. The United States reported an increased rate of mesothelioma from 1970 to 1990, which has currently stabilized and possibly decreased. However, European countries continue to see an increase in the rate of mesothelioma.

Mesothelioma is commonly seen in the ages 65 years and older but increases with age. Mesothelioma is 5 times more likely to affect men than women. Mesothelioma is more common in the Caucasian nationality than African American.

Mesothelioma is a very serious cancer. Symptoms commonly do not appear early which causes mesothelioma to be diagnosed at an advanced stage. For this reason, mesothelioma has a low survival rate that is about 1-2 years. However , cancer research is slowly changing the statistics.

Difference Between Pleural Mesothelioma and Peritoneal Mesothelioma


Pleural Mesothelioma is the most common form of mesothelioma. The pleura are nothing but the thin membrane located between the chest cavity and the lungs. They prevent the lungs from chafing with the chest walls by providing a surface that is lubricated. So, therefore pleural mesothelioma is also referred to as lung cancer.

Another common form of this cancer is peritoneal mesothelioma. This peritoneal membrane helps in the enclosure of the organs in the abdomen. Even though peritoneal mesotheliomas are less common than pleural mesotheliomas, they are more invasive and may cut down the life expectancy of the patient. Mesotheliomas have been previously found in the abdominal and stomach areas.

The understanding of the treatment process is a must for the patient after diagnosis. The oncologist or your doctor will provide more information on the various treatments available. The know-how of your legal rights is also very important. If you are diagnosed with asbestos related cancer or mesothelioma in particular, you are most likely affected by asbestos. Manufactures have always known of asbestos insulation devices available yet they decided not to reveal the information that asbestos was hazardous. So if you have been a victim of such a, you have the right of recovery against the manufacturers which can further help in reducing the costs of treatment and provide a little if not full compensation for your suffering.

All the difference in the world in treatment can be made by choosing the right doctor that suits you. Doctors with good international reputations on works on mesothelioma patients must be chosen. A checklist has been provided by the American Cancer Society on what to question your doctor before which may help you to get the right doctor or another opinion.

Pleural Mesothelioma Fact

There are two main types; 1] the localized mesothelioma{benign and malignant types} 2] the diffuse malignant mesothelioma
Causes There is a strong correlation between asbestos exposure and the development of mesothelioma, although a history of exposure is not always obtainable in patients who have mesothelioma. There are 2 types of asbestos fibres based on crystalline structure; a-serpentine {chrysolite} and b-amphibole. Included within the amphibole are amosite, tremolte, crocidolite and anthophyllite. The most harmful is the crocidolite or better known as blue asbestos.

Localised Benign Mesothelioma

These characteristically arise from the inner layer of the pleura Symptoms and signs;

-chest pain

-shortness of breath

-most of the times there are no symptoms {asymptomatic}, these tumors are usually discovered on routine chest x-ray -hypoglycaemia {low blood sugar} is sometimes associated

Treatment Surgery is the main stay of treatment, the tumor is removed by the surgeon and reccurence is rare and when it happens transition to malignant form of tumor should be suspected.

Localised Malignant Mesothelioma Symptoms and Signs; -

chest pain -cough -fever -shortness of breath Treatment Surgery is also the treatment of choice, although prognosis is very poor

Diffuse Malignant Mesothelioma This type of mesothelioma can arise form any part of the pleura and often extend into the peritoneum as well as into the ribs and chest wall {peritoneal mesothelioma and pericardial mesothelioma}. It also spreads commonly to the liver, brain and adrenal glands. Histologically malignant mesothelioma have both fibrous {sarcomatous mesothelioma} and epithelial {papillary} components.

Investigations


-CT scan of the chest is extremely useful in diagnosing the extent of the tumor.

-Needle biopsy {the surgeon inserts a special needle into the pleura to take samples of the tumor which is taken to the laboratory to see under the microscope} of the pleura is a must.

-Pleural fluid is aspirated and taken to the lab for microsopic examination.

Staging of Malignant Pleural Mesothelioma


-Stage 1:Involvement of ipsilateral pleura and lungs {affecting just one lung either left or right lung}

-Stage 2-Invlovment of chest wall, mediastinum {structure at the middle of the heart}, pericardium or contralateral {opposite side} pleura

-Stage 3-Distant blood spread into other organs eg brain, adrenals
treatment is discouragingly ineffective and survival rarely longer than 2 years with an average of 10-14 months. In selected cases with stage 1 a radical surgery-pleuropneumonectomy may be effective, but long term survival is rare. Primary radiation therapy may be used also. Combination chemotherapy using either single agent or combination protocols have also been used but the outcome remains dismal.

Peritoneal Mesothelioma

Peritoneal mesothelioma occurs in the abdominal lining and is a rare form of malignant cancers affecting lesser number of people than pleural mesothelioma. The peritoneum is made up of two parts such as visceral peritoneum that covers the internal organs and parietal peritoneum that covers the abdominal cavity.

The cells in these two layers secrete fluid that helps in the movement of organs inside the abdomen. However, if the cells become malignant it overproduces causing excess fluid in the abdomen. It is widely believed that, risk factor associated with peritoneal mesothelioma is asbestos. Asbestos particles make their entry into the body either through ingestion or inhalation and reaches peritoneum through the lymphatic system causing malignancy of the cellular lining of abdomen.

The early signs of Peritoneal Mesothelioma include:

* Increased weight loss due to low intake of food
* Night sweats often accompanied with fever
* Increased abdominal girth coupled with bouts of abdominal pain and indigestion
* Extreme fatigue, fever and anemic condition

Tests and Diagnoses:
Based on symptoms doctors cannot ascertain presence of peritoneal mesothelioma but goes for medical investigations ranging from x-rays to CT scans to MRI. These imaging tests and studies help in the detection of the disease and also aids in knowing the stage and metastases of the cancer.
But, it is the biopsy that ultimately confirms the disease- either a fluid aspiration biopsy or a tissue biopsy. If the cancer is detected early it helps to cure it faster because as the cancer advances to diffuse peritoneal mesothelioma the cancer cells invade other body parts as well.

Treatment Methods:

The disease is very difficult to diagnose at early stages. One of the approaches is intra-peritoneal chemotherapy. In this method of treatment, following surgery, drugs are induced directly into the abdomen. In some cases, radiation therapy is done to shrink the tumors before surgery is done.

But, it is the cytoreductive surgery called debulking that is done. Although surgery is considered to be the first line of treatment yet it is not done for all patients. If the patients' physical health is failing, a surgical operation is enervating. In these cases, it is the palliative approach that works best. This therapy, simply works to reduce symptoms and improve the quality of life for the patients with chemotherapeutic drugs.

High-energy radiation is also used to treat peritoneal mesothelioma, but is not used alone. Radiation therapy is mostly followed by surgery and use of palliative Chemotherapy drugs.

Latest Advancements:

There are ongoing clinical trials and experiments such as immunotherapy, gene therapy and usage of antiangiogenesis drugs for treating the cancer. Multi-modality approach often proved to be useful in certain cases and intracavitary chemotherapy and radiation therapy are subjects of further research and tests.

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