Mesothelioma: Definition, Causes, Symptoms, Treatment and Prognosis

Mesothelioma is one affecting thousands of people yearly. May Patients diagnosed with mesothelioma are leading a difficult life since they fail to determine a treatment. Much research and findings are carried out every day to determine more method of treatment and methods that might one day lead to a cure for mesothelioma.

Mesothelioma symptoms are rarely noticed at the early stage, making it hard mesothelioma hard to detect. Many of the early symptoms of mesothelioma are more likely to be caused by other conditions that are non-life-threatening which make many fail to run a check on themselves.

Mesothelioma definition symptoms, causes, treatment, prognosis and some recent development on how the ailment can be treated effectively will be discussed in this article.

What is Mesothelioma

Mesothelioma is a type of cancer that grows from the thin layer of tissue that protects most of the internal organs (the mesothelium). The areas that are most affected is the lining of the lungs and chest wall.  The lining of the abdomen and the sac surrounding the heart, or the sac surrounding the testis are also affected but less commonly and rarely respectively. some of the common symptoms of mesothelioma include shortness of breath due to fluid around the lung, chest wall pain, feeling tired, a swollen abdomen, cough,  and weight loss. These symptoms usually come on slowly. This disease is an aggressive and rare cancer. It is caused by asbestos and develops on the protective tissues that cover’ the lungs, abdomen, and heart. The treatment that combines surgery, radiation, and chemotherapy increases survival and life expectancy at a great percentage.

The American Cancer Society records up to 3,000 new cases of mesothelioma every year in the U.S. This disease is seen to affects people who worked with asbestos and products that contain asbestos mostly. It should be noted that although there are treatments that control the growth of the tumor, researchers have not yet found a definitive cure for cancer. After being exposed to asbestos, mesothelioma symptoms start to appear after about 20 – 50 years. The life expectancy for mesothelioma patients is very low since the is no cure for the disease.

The stage of the disease, cell type, and location of the tumor(s) are the most important factors that determine a patient’s survival. The patient’s overall health, age, and how wide they cancer has spread are also factors that considered for prognosis.

After being diagnosed with mesothelioma, there are a number of critical and important decisions that must be made. Sportandhealthgist is dedicated to providing patients with vital information on current treatment, stories of survival and hope, and financial assistance that are available worldwide.

Causes of Mesothelioma

Major Causes of Mesothelioma

Mesothelioma is rare cancer caused mainly by exposure to asbestos. In general, Mesothelioma cancer starts when a series of genetic mutations happens within a cell, causing the cell to grow and increase beyond control. When a person ingests asbestos,  it causes changes to the person’s DNA, since our genes, is made of DNA, and it controls how cells multiply, grows and die. Changes in our genes cause our cells to divide out of control which will lead to cancer.  Researchers have identified factors that may increase the risk factor. It’s likely that cancers form because of an interaction between many factors, such as inherited conditions, environment, one’s health conditions, and lifestyle choices. Working with asbestos is the most common risk factor for mesothelioma. However, some individuals without any known exposure to asbestos have been diagnosed with mesothelioma.

Asbestos exposure

Asbestos is a mineral that occurs naturally in the environment. Asbestos fibers are strong and have great resistance to heat, therefore there are useful in a wide variety of applications, including insulation, brakes, shingles, flooring and many other products. When asbestos is broken up, during the mining process or when removing asbestos insulation, dust could be created. If the dust is inhaled or swallowed by an individual the asbestos fibers will settle in the lungs or in the stomach of the person, this will cause irritation which has a tendency of leading to mesothelioma.  The incidence of mesothelioma is found to be higher in populations living near naturally found asbestos. In areas that mining or road construction is been done, or where the asbestos-containing rock is naturally weathered, people could be exposed to naturally occurring. Another way that people are mostly exposed to asbestos is through the asbestos-containing soil, used in whitewashing, plastering, and roofing houses in Greece.

Personal history of asbestos exposure.

Exposure to asbestos fibers has been found to be an occupational health hazard since the early 20th century. Numerous epidemiological studies have connected occupational exposure to asbestos with the development of pleural plaques, diffuse pleural thickening, asbestosis.  Asbestos has been largely used in many industrial products, such as cement, brake linings, and gaskets. So, been directly exposed to asbestos fibers at workplaces or at home, increases the risk of mesothelioma greatly.

Living with someone who works with asbestos.

Family members and others living with people that work directly or indirectly with asbestos have a high risk of developing mesothelioma, and even other asbestos-related diseases This great risk could be because of any of this: exposure to asbestos dust brought home on the clothing and hair of the asbestos workers via washing the worker’s clothes or being in contact with asbestos-contaminated work clothing. To decrease the risk of exposing family members to asbestos fibers, asbestos workers are supposed to shower and change their clothing before leaving the workplace.

A family history of mesothelioma

In a research carried on white American population in 2012, it was discovered that people with a germline mutation in their BAP1 gene are at greater risk of developing mesothelioma.  If your parent, sibling or child has been diagnosed with mesothelioma, then you may be at an increased risk of this disease.

Erionite exposure

Erionite is a zeolite mineral with almost the properties as asbestos and is found to cause mesothelioma. Detailed epidemiological studies have shown that erionite mostly causes mesothelioma in families with a genetic predisposition. Erionite deposits are found in the Western United States, where it’s used in gravel for road surfacing, and in Turkey and also used to construct homes.

In rare cases, mesothelioma has also been in connection with irradiation of the chest or abdomen, intrapleural thorium dioxide (Thorotrast) as a contrast medium, and breathing in of other fibrous silicates, such as talc.

Development of Mesothelioma

  1. When a person breathes in or swallows airborne asbestos fibers.
  2. The asbestos fibers turned to lodged in the lining of the lungs, abdomen or heart.
  3. The embedded fibers destroyed the mesothelial cells and also cause inflammation.
  4. Over time, tumors begin to form on the destroyed mesothelium, which is the lining of the abdomen, lung, heart, and testes.

Tumors also can be benign (noncancerous). But when tumors are cancerous, doctors call the disease malignant mesothelioma.

Symptoms of Mesothelioma

As pleural mesothelioma spreads in the chest, it puts pressure on the framework in that area. Mesothelioma tumors start as very small nodules on the lining of the lungs or abdomen. Cancer does not show signs and symptoms until the tumors have developed and spread. This is normally around cancer stage 3 and stage  4 when tumors start to cause pressure on the chest wall or abdominal cavity. This can produce some complications, which may include:

  • Difficulty breathing
  • Chest pain
  • Difficulty swallowing
  • Pain caused by pressure on the nerves and spinal cord
  • Accumulation of fluid in the chest (pleural effusion), which can compress the lung nearby and make breathing difficult
  • A dry cough or wheezing
  • Shortness of breath (dyspnea)
  • Respiratory complications
  • Pain in the abdomen
  • Fever or night sweats
  • Pleural effusion (fluid around the lungs)
  • Fatigue
  • Muscle weakness

The first sign of mesothelioma is most likely chest or abdominal pain, and shortness of breath and bloating, depending on where cancer developed. Because the first set of signs it shows could be slight, and doctors often mistake them as typical aches and pains or symptoms of an unserious illness. Most timely mesothelioma diagnoses occur accidentally through regular  X-rays or blood tests. By the time the warning signs are identified, cancer most a time has already spread, making it hard for doctors to treat. Making your primary care doctor aware of any history of being exposed to asbestos and requesting cancer screenings could help lead to a timely-than-normal mesothelioma diagnosis and a greater chance of qualifying for life-extending therapy.

Being aware of the symptoms of mesothelioma timely in cancer’s development is almost impossible based on the fact that the disease does not show early symptoms to identify.

Some Common Mesothelioma Treatment

Treatment helps people living with malignant mesothelioma to live longer. Although a treatment that can give a curative outcome is rare, a treatment approach called multimodal therapy could help some patients live longer with cancer. Multimodal therapy combination of treatments to kill cancer cells in so many ways. Specialists take it to the best form of treatment for mesothelioma.

Patients diagnosed in at the timely stage often qualify for a combination of surgery, chemotherapy and radiation therapy. Multimodal therapy for late-stage patients may involve chemotherapy and immunotherapy.

The most common treatment options for mesothelioma are the follows:

  • Surgery
  • Chemotherapy
  • Radiation therapy

New and experimental therapies are available through clinical trials. Some of these therapies include targeted therapy, immunotherapy, and photodynamic therapy. Different types of mesothelioma require specialized treatment. Varying surgeries and chemotherapy drugs are used in malignant pleural mesothelioma treatment compared to peritoneal mesothelioma treatment. Mesothelioma life expectancy without treatment is around four to six months for the average patient diagnosed in stage 3 or stage 4. Electing treatment at these stages often helps patients live at least a year. Those diagnosed in stage 1 or stage 2 who undergo aggressive treatment may live for years with mesothelioma.

Surgery

The following surgical treatments may be used for malignant mesothelioma in the chest:

  • Wide local excision: Surgery to move out cancer and some of the healthy tissue that surrounds it.
  • Pleurectomy and decortication: Surgery to take away some of the covering of the lungs and lining of the chest and part of the outside surface of the lungs.
  • Extrapleural pneumonectomy: Surgery to remove one whole lung and some of the lining of the chest, the diaphragm, and the lining of the sac close to the heart.
  • Pleurodesis: A surgical procedure that makes use chemicals or drugs to make a scar in the space that connects the layers of the pleura. Fluid is at the beginning drained from the space using a catheter or chest tube and the chemical or drug is used to refill the space. The scarring ends the development of fluid in the pleural cavity.

After the doctor takes away all cancer that could be seen at the time of the surgery, some patients may undertake chemotherapy or radiation therapy after surgery to destroy any cancer cells that are left. The post-treatment given after the surgery, to decrease the risk that cancer will come back, is known as adjuvant therapy.

Radiation

For patients with other common diseases, and who can tolerate a radical surgery, radiation can be given post-operatively as a consolidative treatment. The whole hemithorax is treated with radiation therapy, mostly given together with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to longer life expectancy in some patient populations. It can also stop severe side-effects, including destructive pneumonitis. As part of a curative procedure to mesothelioma, radiotherapy is typically applied to the sites of chest drain insertion, in order to stop the growth of the tumor along the track in the chest wall.

Although mesothelioma generally opposes treatment with radiotherapy alone that tends to cure it, palliative treatment regimens are often used to prevent some sign that comes as a result of tumor growth, such as obstruction of a major blood vessel. Radiation therapy, when given alone with intent to cure it, has never been shown to increase survival from mesothelioma. The needed radiation dose to treat mesothelioma that has not been surgically operated would be above human tolerance. Radiotherapy is of few uses in pericardial mesothelioma.

Chemotherapy

Chemotherapy is a cancer treatment which makes use of drugs to end the development of cancer cells, it will either by kill the cells or stop them from dividing. When the intake of chemotherapy is by mouth or injected into a vein or muscle, the drugs go through the bloodstream and can get to the cancer cells everywhere in the body (systemic chemotherapy). When chemotherapy is put directly into the cerebrospinal fluid, an organ, or a body cavity such as the chest or peritoneum, the drugs specifically have an effect on the cancer cells in those areas (regional chemotherapy). Combination chemotherapy means making use of an anticancer drug that is more than one.

Hyperthermic intraperitoneal chemotherapy treats mesothelioma that has spread to the peritoneum (tissue that lines the abdomen and conceals most of the organs in the abdomen). After the surgically removing of all the cancer cells that could be found, a solution that contains the anticancer drugs is heated and injected into and out of the abdomen to destroy the cancer cells that were left. Heating the anticancer drugs may help to destroy more of the cancer cells. The way the chemotherapy is administered relies on the type and stage of the cancer cells that are to be treated.

Mesothelioma Prognosis

Mesothelioma prognosis is mostly very poor. Normal survival even when surgically operated is between 12 and 21 months which actually depends on the stage of the cancer cells at diagnosis with close to 7.5% of people that have survived for 5 years. Women, young people, people with low-stage cancers, and people with epithelioid cancers faces improve prognoses. Factors that act negatively to prognosis include sarcomatoid or biphasic histology, high platelet counts (over 400,000), age above 50 years, over 15.5 white blood cell counts, low levels of glucose in the pleural fluid, low albumin levels, and a great fibrinogen levels.

A lot of markers are under investigation as prognostic factors, including nuclear grade, and serum c-reactive protein. Long-term survival is rare.  A 10-month median survival time is what Pericardial mesothelioma patient has. In peritoneal mesothelioma, high expression of WT-1 protein shows an extremely bad prognosis.

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