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Types of Mesothelioma:
Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. Its only known cause in the U.S. is previous exposure to asbestos fibers, including chrysotile, amosite or crocidolite. This exposure is likely to have happened twenty or more years before the disease becomes evident, since it takes many years for the disease to "incubate." It is the most common type of mesothelioma, accounting for about 75% of all cases.
Benign mesothelioma can often be removed surgically, are generally not life-threatening, and are not usually related to asbestos exposure. Malignant mesothelioma, however, are very serious. Fortunately, they are rare - about two thousand people are diagnosed with mesothelioma in the U.S. each year. Many of the organs in the abdomen are enveloped by a thin membrane of mesothelial cells, known as the peritoneum.
Peritoneal mesothelioma is a tumor of this membrane. Its only known cause in the U.S. is previous exposure to asbestos, but it can be many years after exposure before the disease appears. Peritoneal mesothelioma account for about one-fifth of all mesothelioma.
Pericardial Mesothelioma is a tumor that can occur at any age with a mean age of 46 years at presentation. Patients present with chest pain, dyspnea, cough, and palpitations. Although there appears to be a strong link to asbestos exposure, a definite association has not been established due to the rarity of this lesion. Surgery combined with radiation therapy may provide some palliation, but the prognosis is extremely poor. On CT there is irregular, diffuse pericardial thickening and a pericardial effusion. Pericardium is a thin lining of tissue surrounding the heart.
Symptoms of Mesothelioma:
When the symptoms of peritoneal mesothelioma appear, they typically include abdominal pains, weakness, weight loss, loss of appetite, nausea, and abdominal swelling. Fluid often accumulates in the peritoneal space, a condition known as ascites. Over time the wasting symptoms can become more and more severe.
The growing tumor can exert increasing pressure on the organs in the abdomen, leading to bowel obstruction and distention. If the tumor presses upward, it can impair breathing capacity. If the tumor pushes against areas with many nerve fibers, and the bowel distends, the amount of pain can increase.
Treating Mesothelioma:
The treatment options for people with mesothelioma have improved significantly, especially for those whose cancer is diagnosed early and treated vigorously. Many people are treated with a combination of therapies, sometimes known as multimodal therapy.
Specific types of treatment include:
* Chemotherapy and other drug-based therapies
* Radiation therapy
* Surgery and
* Intra-operative photodynamic therapy.
There are also experimental treatments like gene therapy and immunotherapy, angiogenesis inhibitors, and clinical trials for various new treatments and combinations of treatments.
Treatments that reduce pain and improve lung function, are becoming more successful (although they cannot cure mesothelioma.) Pain control medications have become easier to administer. Debulking is a surgical process of removing a substantial part of the tumor and reducing the pleural thickening; this can provide significant relief. X-ray therapy has also been successfully used to control the tumor and the pain associated with it for a while.
Surgery is a common treatment of malignant mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. Depending on how far the cancer has spread, a lung also may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).
