Health Desk- Mesothelioma cancer is caused by exposure to asbestos. It usually forms in the lining around the lungs or abdomen. Average life expectancy is 18 – 31 months. Symptoms may include chest pain, shortness of breath, and fatigue. Treatment plans with surgery, chemotherapy, and radiation can help improve the prognosis.
What is mesothelioma ?
Mesothelioma, a rare and aggressive form of cancer, develops in the level of certain tissues. Pleural and peritoneal are the two most common types of mesothelioma. These types develop in the lining around the lungs or abdomen, respectively. Other types are pericardial mesothelioma and testicular mesothelioma. There are also different mesothelioma cell types.
Mesothelioma develops after exposure to asbestos. Mica is a fibrous mineral that often forms a dust or powder. If inhaled or ingested, the fibers can accumulate in the internal organs and subsequently lead to the development of tumors. People with occupational asbestos exposure have a higher risk of developing mesothelioma.
Survival of mesothelioma ranges from 18 to 31 months with treatment. In general, treatment can help improve factors such as quality of life and survival. Treatment plans may include traditional methods such as chemotherapy or newer methods such as immunotherapy. Multimodal plans, which are plans combined with different treatments, are common.
What are the causes of mesothelioma ?
Asbestos is the only definite cause of mesothelioma. When asbestos fibers are inhaled or ingested, they can accumulate in the lining of the lungs, stomach, or heart. Over time, the fibers can become inflamed and cause scarring. This irritation can later lead to the development of mesothelioma tumors.
Types and Locations of Mesothelioma-
How does mesothelioma develop ?
- A person comes into contact with asbestos fibers, which are easily inhaled or swallowed.
- Asbestos fibers become lodged in the level of internal organs including the lungs (pleura), abdomen (peritoneum) and heart (pericardium).
- Embedded fibers irritate and damage the surrounding tissue.
- Over time, tumors begin to form in the damaged tissue.
Before the 1980s, many industries used asbestos. As with other industries, the construction and automotive industries often expose workers to asbestos.
Who is at risk of developing mesothelioma ?
- People who are frequently exposed to asbestos are most at risk of developing this disease. However, any amount of asbestos exposure can cause mesothelioma.
- Workers in asbestos industries generally experience high rates of exposure. These workers may have experienced asbestos exposure at their workplace. Veterans also faced higher risk exposure. Asbestos can be a danger even to those who have not worked with it.
- For example, workers may bring home the tiny fibers on their clothing, hair, and skin. As such, it can expose workers’ families and loved ones to asbestos. This is called secondary exposure or secondhand exposure. Secondary exposure is a risk factor for anyone living with asbestos workers.
Occupations at high risk for exposure include-
- Aircraft mechanics
- Auto mechanics
- Boiler worker
- Construction workers
- Fire Fighting
- HAVC worker
- Industrial workers
- Machine operator
- Mine worker
- Oil refinery worker
- Shipyard worker
- Textile mill worker
The elderly are also at greater risk of exposure to asbestos. For decades, the military used asbestos in various branches. As a result, many veterans of the Air Force, Army, Coast Guard, Marine Corps and Navy may encounter asbestos during their time in active service.
What are the symptoms of mesothelioma ?
It can take 10 to 50 years for mesothelioma symptoms to present after initial asbestos exposure. When symptoms do appear, they can easily be mistaken for less serious diseases. Similar symptoms can occur with the flu, pneumonia, or intestinal discomfort.
This latency period and delay in symptom reporting can complicate the mesothelioma diagnosis process. If you or a loved one has a history of asbestos exposure, it may be helpful to disclose that exposure to a doctor who may perform periodic checkups. This can help lead to an earlier diagnosis and treatment plan.
With an earlier diagnosis, patients may have different treatment options. In some cases, early detection can improve the prognosis of mesothelioma.
What are the common symptoms of mesothelioma ?
The amount, severity, and type of symptoms of mesothelioma vary from patient to patient. Common signs and symptoms of mesothelioma include-
- Stomach ache
- Pain in chest
- Cough or wheezing
- Difficulty breathing (dyspnea)
- Fever and night sweats
- Fluid formation
- Loss of appetite
- Muscle weakness
- Difficulty breathing
- Unexplained weight loss
Types of mesothelioma-
There are four main types of mesothelioma, each based on the location of the tumor. The most common type is malignant pleural mesothelioma. These main types of mesothelioma fall into categories based on the types of cells in the tumor. There are three main mesothelioma cell types:
1. Epithelioid mesothelioma-
Tumors consists of epithelioid cells that look similar to epithelial cells found in skin and other normal tissues. This is the most common mesothelioma cell type. Compared to other cell types, epithelioid mesothelioma responds well to treatment.
2. Sarcomatoid mesothelioma-
The tumor consists of epithelioid cells that look similar to the epithelial cells found in the skin and other normal tissues. This is the most common mesothelioma cell type. Compared to other cell types, epithelioid mesothelioma responds well to treatment.
3. Biphasic mesothelioma-
The tumor consists of a combination of epithelioid and sarcomatoid cells. In general, this type occurs in the pleura (the lining of the lungs) or the peritoneum (the lining of the abdomen). The percentage of each cell type can affect what treatment options are available.
Prognosis, symptoms, and treatment options vary depending on the cell type. These factors also affect where in the body the mesothelioma occurs.
Recommended treatment methods vary depending on the mesothelioma cell type and location. Doctors can create customized treatment plans based on each individual case.
Diagnosis of mesothelioma-
It is important to diagnose mesothelioma as early as possible. After recognizing the symptoms, the doctor will confirm the mesothelioma diagnosis with a biopsy. Biopsy is the only way to definitively diagnose mesothelioma. Other diagnostic tools can help determine location and staging.
Common Tests to Diagnose Mesothelioma-
Before performing a tissue biopsy to diagnose mesothelioma, doctors may check for abnormalities. This procedure may involve various tests such as bloodwork and imaging scans.
1 .Imaging scan-
Doctors often use imaging scans in the early stages of mesothelioma diagnosis. These tests usually include a CT scan, MRI, and X-rays. The scan, like a chest X-ray, can help doctors determine the extent and location of a tumor. Doctors may also use imaging to see how far the disease has progressed.
Each scan has different benefits and limitations. Depending on each case, the doctor may recommend more than one type of imaging scan. After diagnosis, doctors may again use these tests to help determine the stage of the disease, monitor spread, and check for any fluid buildup.
Biopsy is an important step in the diagnosis and treatment of mesothelioma. A biopsy, which removes tissue or fluid for testing, is the only way to diagnose mesothelioma. Imaging scans and other tests may play a role in the diagnosis process, but only a biopsy test can be conclusive. A biopsy can also help determine important disease factors such as cell type.
Biopsies are often done with a needle that removes a sample of fluid or tissue. After the procedure, a pathologist will analyze the sample. Some biopsy methods are less invasive than others.
3 .Blood test-
Blood tests measure indicators of mesothelioma, called biomarkers, in a blood sample. Doctors may combine bloodwork with a biopsy to confirm a mesothelioma diagnosis. Blood tests alone cannot diagnose mesothelioma.
Mesomark® is a blood test approved for certain mesothelioma surveillance. While other tests can identify general cancer indicators, Mesomark is specific for mesothelioma indicators. Advances in blood test methods may support a mesothelioma diagnosis someday earlier.
Staging is another important step in the initial diagnosis process. After confirming a mesothelioma diagnosis, doctors often estimate its stage. The most common mesothelioma staging method is the tumor node metastasis (TNM) staging system. Stages range from the early stages (1 and 2) to the later stages (3 and 4).
This information helps doctors understand prognosis and treatment options. In stages 1 and 2, patients may have different treatment options. In stages 3 and 4, the cancer has spread, or metastasized. This may mean that patients in these later stages versus earlier stages have different treatment options.
With stage 1 mesothelioma, the cancer occurs only in specific, or localized areas of the body. Invasive treatments such as surgery are often an option. Life expectancy ranges from 21 months to over 5.5 years with treatment.
With stage 2 mesothelioma, the cancer has spread to nearby organs and lymph nodes. Some invasive treatments, such as surgery, may still be an option. Life expectancy with treatment ranges from 19 months to about 5.5 years.
With stage 3 mesothelioma, the cancer has further spread to other organs and tissues. Treatment options may be more limited. Life expectancy ranges from 16 months to about 5 years with treatment.
With stage 4 mesothelioma, the cancer has spread to distant organs and tissues. Most treatment options are palliative and aim to increase patient comfort. Life expectancy ranges from 12 to 26 months with treatment.
Doctors use several factors to estimate prognosis, but a person’s experience may differ from this estimate. Stages 1 to 4 patients have exceeded their original life expectancy. Research advances continue to expand treatment options for early and late stage cases.
Diagnosis of mesothelioma-
Prognosis is a patient’s medical expectation for disease progression. Mesothelioma prognosis includes life expectancy, quality of life, and other aspects of the patient’s experience. Doctors use information such as stage and cell type to estimate survival time and the best treatment option to diagnose prognosis.
When discussing their prognosis, patients will often hear other related terms, including-
Life expectancy- An estimate of how long they will live after diagnosis. It is presented in months or years.
Survival Rate- The percentage of a certain group of people who are still alive at a specific time. It is usually reported in 1-, 2-, 3- or 5-year increments.
The prognosis for each patient will vary based on several individual factors. In general, treatment can help improve the patient’s prognosis. Mesothelioma specialists can create an individualized treatment plan for each patient.
A forecast is a complex estimate and many factors affect it. Treatment usually helps to improve the prognosis. With treatment, some mesothelioma patients are able to exceed their initial life expectancy by months, years, or even decades.
For example, Heather von St. James has been a pleural mesothelioma survivor for more than 16 years. During her diagnosis, doctors said she had 15 months to live. Heather had a multimodal treatment plan that included surgery and heated chemotherapy. Today she supports patients with mesothelioma and advocates for awareness of the disease.
Did you know mesothelioma ?
Advances in mesothelioma treatment have enabled some patients to improve their prognosis for years. In one study, researchers reported that approximately 45% of patients with peritoneal mesothelioma survived for at least 10 years after surgery and HIPEC treatment.
Mesothelioma treatment options-
Treatment is the best way to help improve the prognosis of mesothelioma. This may include improving quality of life and extending life expectancy.
Conventional treatments for mesothelioma include chemotherapy, radiation, and surgery. Immunotherapy is a new, promising treatment method that is frequently used. It may be an option for mesothelioma patients.
These methods will often be combined to create a successful treatment plan. This approach is called multimodal treatment. Multimodal plans have yielded the best known patient survival outcomes.
Chemotherapy drugs kill cancer cells and stop them from multiplying. For mesothelioma, the standard first-line chemotherapy treatment is cisplatin or carboplatin with pemetrexed. It is often combined with other methods.
Immunotherapy helps the body identify and fight cancer cells. It has been successful for patients with moderate or complicated cases. There is approval for pleural cases in combination with Opdivo® (nivolumab) and Yervoy® (ipilimumab). Clinical trials continue to test this method.
Radiation is a standard cancer treatment that uses energy to damage or kill cancer cells. It is commonly used along with other methods such as surgery to treat pleural mesothelioma.
Surgery is the method of manually removing cancerous tissue. It can be used in different stages of cancer. In the later stages, surgery may be more palliative than therapeutic.
Note – This article has been written for educational purpose, for more information consult a qualified medical practitioner. Thank you.