Cancer of the mesothelium, a membrane that lines the interior of body cavities like the chest and abdomen, is known as mesothelioma. Chest cavities are the site of mesothelioma disease's onset in three out of every four cases. Aside from the chest and abdomen, the heart region can also experience mesothelioma onset.
Malignant cells from the mesothelium can invade and harm nearby tissues regardless of where they come from. Additionally, cancerous cells can metastasize, or spread, to various body regions.
Frequently, mesothelioma is already advanced when it is discovered. A 5-year survival rate of 5% to 10% is typical. Most lung mesothelioma patients pass away from pneumonia or respiratory failure. When a tumour penetrates the muscle that divides the chest and abdomen, the diaphragm, some patients experience a small-bowel obstruction. When the tumour invades the pericardium, a thin sac that surrounds the heart, and the heart itself, fewer people pass away from heart-related complications.
What causes mesothelioma?
Working with asbestos poses the biggest risk for mesothelioma. A class of minerals known as asbestos contains microscopic fibers. Asbestos has been mined and utilized extensively in the construction, automotive, and other industries because these fibers are heat, fire, chemical, and electricity resistant and do not conduct electricity.
Small asbestos fibers can cause serious health issues if they are inhaled or ingested if they are released into the air during manufacturing. Asbestos exposure at work has been linked to up to 75% of mesothelioma cases. There is some evidence that individuals who live with asbestos workers and their family members are more likely to develop mesothelioma and possibly other asbestos-related diseases. This risk could be brought on by contact with asbestos dust that asbestos workers bring home in their clothing and hair. People who live close to asbestos mines have also been diagnosed with mesothelioma in some cases.
Nevertheless, mesothelioma has been reported in some people who have never been exposed to asbestos. Other, less frequent, but potential causes include:
Zeolites. Chemically speaking, asbestos is related to these minerals. According to the American Cancer Society, erionite, one of these related minerals, is frequently found in the soil in some regions of Turkey. The high mesothelioma rates in those regions are thought to be caused by exposure to erionite.
Radiation. Injections of thorium dioxide (Thorotrast), a substance used by doctors in some chest X-rays until the 1950s, or after exposure to high doses of radiation to the chest or abdomen are two instances where mesotheliomas have been reported in the literature, according to the American Cancer Society.
virus SV40. According to the American Cancer Society, some studies in lab animals have suggested that exposure to the simian virus 40 (SV40) may increase the risk of mesothelioma development. Between 1955 and 1963, some injectable polio vaccines were tainted with SV40, potentially exposing up to 30 million Americans to the virus. The largest human studies to date on this subject have not discovered a higher risk of mesothelioma or other cancers in those who received the tainted vaccines as children.
Genetics. Some medical professionals think some people may have a genetic predisposition to mesothelioma. Different populations have different rates of illness.
Mesothelioma signs and symptoms
Commonly, mesothelioma symptoms don't start to manifest themselves for 20 to 50 years after the initial asbestos exposure.
Chest pain and shortness of breath are the main signs and symptoms of mesothelioma of the lungs. If it is significant enough, fluid buildup in the pleura brought on by mesothelioma may also be a factor in the shortness of breath.
Peritoneal (abdominal) mesothelioma symptoms can consist of:
- Loss of weight
- abdomen-related swelling and discomfort
- abnormalities in blood clotting
- intestine obstruction
- Anemia
- Fever
Symptoms of cancer that have spread to other body locations may include pain, trouble swallowing, or swelling in the neck or face.
Having these symptoms doesn't necessarily mean you have mesothelioma because many conditions share them. You should consult your doctor to find out what is causing them.
Physical examination and medical history
Due to its rarity, mesothelioma frequently undergoes initial misdiagnosis. Your doctor will likely take a thorough medical history if you exhibit symptoms that raise the possibility that you have mesothelioma to look for signs and possible risk factors, such as asbestos exposure. The main factor increasing the risk of mesothelioma is asbestos exposure.
Your doctor will also inquire about your general health and perform an examination to look for any potential mesothelioma symptoms. These could include fluid in the pericardium, chest cavity, or abdomen (the thin membrane around the heart).
Your doctor might recommend mesothelioma testing for you based on the results of the examination.
Mesothelioma screenings
The various types of mesothelioma tests are numerous. These consist of:
a blood test. Fibulin-3, osteopontin, and soluble mesothelin-related peptides (SMRPs) blood levels are frequently higher in mesothelioma patients. High levels of these substances increase the likelihood of the disease, even though these blood tests cannot confirm a diagnosis of mesothelioma—further research is required before they can be of dependable use in a clinical setting.
tests on fluid and tissue samples. Your doctor can take a sample of any fluid that has accumulated in your body and may be linked to mesothelioma by inserting a needle under your skin and into the suspected area. The fluid can then be examined for cancer cells under a microscope. Additional tests can determine whether the cancer is mesothelioma if cancer cells are discovered.
Depending on where the fluid is, different names for this test are used:
- chest cavity thoracentesis
- abdominal paracentesis
- Pericardiocentesis — examination of the heart's membrane
It doesn't necessarily follow that you don't have mesothelioma just because your doctor doesn't discover any cells of the disease in the fluid. To diagnose mesothelioma, actual tissue samples (biopsies) are occasionally required.
Biopsies. Tissue can be removed to be checked for mesothelioma. They consist of:
Biopsy with a needle. To do this, a long, hollow needle must be inserted under the skin and a small portion of the tumour must be removed. To direct the needle into the tumour, your doctor might use imaging tests. In some situations, the sample may be insufficient to make a diagnosis, necessitating a more invasive procedure.
Laparoscopy, mediastinoscopy, and thoracoscopy. In these procedures, the doctor makes a tiny skin incision and inserts a thin, illuminated scope to view any potential mesothelioma areas. Small tools can be used to extract tissue samples for microscopic examination through other cuts. Depending on the area being examined, a specific procedure will be followed:
- The chest wall and lungs are examined during a thoracoscopy.
- The abdomen is examined during a laparoscopy.
- A mediastinoscopy looks at the area of the chest closest to the heart.
surgery for a biopsy. In some circumstances, more invasive procedures might be required to collect a sufficient amount of tissue for a diagnosis. To remove a larger sample of the tumour or the entire tumour in this situation, a surgeon may perform a thoracotomy (opening the chest cavity) or laparotomy (opening the abdominal cavity).
biopsy with endobronchial ultrasound guidance. To check the lungs for tumours, a lengthy, thin, flexible tube is passed down the throat. To help the doctor better identify the tumour and the ideal location for the biopsy, the tube also has an ultrasound. The doctor can take a tiny sample of a tumour through the tube if one is discovered.
image-based tests. With the aid of these tests, your doctor can see inside your body without needing to make any cuts.
The following imaging exams are frequently used to diagnose mesothelioma:
- A chest X-ray. An X-ray of the chest might reveal fluid between the lungs and chest wall, changes in the lungs, or abnormal thickening or calcium deposits on the lung lining, all of which could be signs of mesothelioma.
- Digital tomography (CT). The CT scan is a procedure that produces finely detailed images of the interior of the body using multiple X-rays and a computer. CT scans are frequently used to check for signs of cancer, locate cancer, and determine whether it has spread.
- CT with positron emission (PET). In this test, a shot of a substance containing a radioactive atom is administered, and then images of the body are taken. The radioactive substance is heavily absorbed by cancer cells, which appear brighter than healthy tissue in the images. Doctors then concentrate additional testing on these potentially cancerous areas.
- Imaging using magnetic resonance (MRI). Strong magnets and radio waves are used in MRI scans to create precise images of the body. They might assist your doctor in locating the tumour because they give exact images of soft tissues. MRI scans may be especially helpful for mesotheliomas that affect the diaphragm, a dome-shaped muscle underneath the lungs.
Prognosis for Mesothelioma
The prognosis for mesothelioma and your treatment options are influenced by several factors. These are a few of them:
Cancer's stage or the extent of the disease in the body. The tumor's size, the presence of cancer cells in the lymph nodes, and the extent of the disease's spread are typically used to determine the stage.
The mesothelioma's size
Whether surgery can completely remove the mesothelioma
the volume of fluid in the abdomen or chest
age and general health of you
Mesothelioma cells' subtype
Whether cancer has recently been discovered or has been treated and returned
Mesothelioma treatments
The factors listed above, as well as others, affect how mesothelioma is treated. Surgery, radiation, and chemotherapy are the three common types of treatment. Treatment for mesothelioma frequently consists of two or all three of these methods.
Surgery. The following procedures are frequently used to treat mesothelioma:
Using a broad local excision technique, cancer and some surrounding healthy tissue is removed.
In a pleurectomy and decortication, the surgeon removes a portion of the chest lining and the outside of the lungs.
Extrapleural pneumonectomy, which entails the removal of one entire lung along with a portion of the diaphragm, chest, and sac surrounding the heart,
Pleurodesis is a procedure in which a substance is used to cause the lung lining to scar and adhere to the lung. The scarring prevents fluid accumulation. This is not intended to be a cure; rather, it is used to manage symptoms.
radiation treatment. High-energy X-rays and other forms of radiation are used in this type of cancer treatment to either kill or stop the growth of mesothelioma cells. Both internal and external radiation delivery is possible. In external radiation therapy, radiation is directed toward cancer by a device outside the body. Internal radiation involves inserting needles, seeds, wires, or catheters with radioactive material inside of them directly into the vicinity of the mesothelioma.
Chemotherapy. In this, drugs are used to kill or prevent the division of cancerous mesothelioma cells, thereby halting the growth of the disease. Chemotherapy can be administered orally, intravenously (into a vein or muscle to reach mesothelioma cells all over the body), or topically (directly into the affected area of the body to primarily affect mesothelioma cells there). Doctors occasionally administer multiple chemotherapy drugs. Combination chemotherapy is what this is.
Immunotherapy. To aid your immune system in fighting cancer, this uses specific medications. The FDA has approved the Opdivo and Yervoy drug combination for treating unresectable mesothelioma. That is mesothelioma, which cannot be surgically treated because it has spread to a significant portion of the body.
fields for treating cancer (TTF). Chemotherapy and electric fields with particular frequencies are used in this type of treatment to slow the division of cancer cells.
