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| Diffuse Pleural Mesothelioma (Photo Credit: Wikipedia) |
Pleural mesothelioma occurs when the pleural sac surrounding the lungs, abdomen and ribs becomes malignant or cancerous due to asbestos exposure. The pleural sac, or plainly known as the pleura, contains a thin membrane called the mesothelium. It is the job of the mesothelium to secrete fluids that permits the lungs to expand and contract when breathing.
What Causes Pleural Mesothelioma?
Asbestos inhalation is the major culprit of Pleural mesothelioma. When a person inhales asbestos fibers, a build up of these fibers occurs in the lungs. Because these fibers are microscopic, they can very easily penetrate through the walls of the lung and into the pleural cavity, and the abdominal cavity. As these asbestos fibers travel from the lungs into the pleural cavity, they destroy the mesothelium. As asbestos fibres attack the pleural cavity, malignant tumors can develop. These tumors stop the lungs from functioning normally. Any malignant tumors can choke the lungs and press on the ribcage which causes the sufferer a great deal of pain. Because they are so minute and thin, they can beat the body's natural defenses. They build up in the narrow airways thus causing scarring and inflammation. This can lead to chest pain and chronic cough. Also, since the lungs are responsible for oxygenizing the blood, it is very possible for cancerous cells to move to other parts of the body through injection of malignant tumors into these cells, that move through the bloodstream.
Diagnosis of Pleural Mesothelioma
Symptoms of Pleural Mesothelioma at a Glance
- Chest pain
- Shortness of breath
- Hemoptysis (coughing up blood)
- Loss of appetite, weight loss
- Cough and fever
- Dysphagia (difficulty swallowing food)
- Pleural effusions (fluid buildup in the abdomen)
- Swelling of the face and arms
- Sensory loss
- Nausea
- Back pain
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytopathology if this fluid is aspirated with a syringe. For pleural fluid, this is done by thoracentesis or tube thoracostomy (chest tube).
Here is a video of a woman who is sharing her husband's experience as he went through pneumonectomy for mesothelioma diagnosis:
Pleural mesothelioma is typically fatal within 1 year of diagnosis. However, understanding and recognizing key risk factors, like asbestos exposure, will typically lead to early detection of the cancer. Those who are fortunate to receive an early diagnosis are likely to be more eligible for life-sustaining treatments such as surgical resection of the cancer. This type of treatment can extend a patient’s life years beyond that of a typical mesothelioma patient.
Treatment of Pleural Mesothelioma
Nearly all patients diagnosed with pleural mesothelioma are able to receive some form of treatment for their illness. While there is currently no cure for mesothelioma, patients have been able to extend initial prognosis through advanced mesothelioma treatment regimens currently being developed at clinics and cancer centers across the United States.
Surgery
Surgical resection is difficult in pleural mesothelioma patients when the disease is diagnosed in later stages because at that time the tumor has typically metastasized to other areas of the body like the abdominal cavity and lymph nodes. However, in early stage diagnoses, surgery can absolutely be utilized to slow the advance of mesothelioma disease.
Common surgical procedures utilized in the management of malignant mesothelioma are pneumonectomy and extrapleural pneumonectomy. Pneumonectomy is a general procedure utilized not only in patients of malignant mesothelioma, but also for those battling lung cancers or related lung conditions. Pleurectomy involves the removal of a either a portion of or the entire affected lung in patients. Extrapleural pneumonectomy is a more comprehensive procedure that is more tailored to mesothelioma patients and involves the removal of the entire affected lung, the pleura, the diaphragm, and the pericardium, which is the mesothelial lining that surrounds the heart cavity.
Chemotherapy
Chemotherapy is likely the most prevalent treatment utilized by patients of malignant pleural mesothelioma. While several different chemotherapy drugs have been utilized to varying degrees of effectiveness for the management of malignant pleural mesothelioma, only one has been approved by the Food and Drug Administration as a prescribed therapy for the treatment of malignant pleural mesothelioma. A combination of Alimta(Pemetrexed) and Cisplatin is currently the only drug combination in approved status. However, several other clinical trials are currently active attempting to determine the effectiveness of other drugs including Gemcitabine, Navelbine, and Onconase.
Radiation Therapy
Radiation therapy has been utilized in the treatment of many types of cancer and pleural mesothelioma is no different. Often, radiation is not able to manage cancer by itself so it is combined with either surgery, chemotherapy, or both to augment the treatment plan as a whole. Radiation therapy for pleural mesothelioma utilizes external beam radiation to mutate tumor cells within the body and slow their growth and spread.
Alternative and Complementary Therapies
A growing school in cancer care involves integrative approaches to the treatment of cancer. Integrative oncology utilizes not only the conventional therapies discussed above, but also untraditional therapies such as acupuncture, massage, and reflexology to assist the patient in managing pain, anxiety, and restlessness. Patients battling pleural mesothelioma have effectively utilized alternative therapies like these to increase the effectiveness of their treatment program overall. Generally, patients who are able to withstand the difficult side-effects of more potent chemotherapy and radiation treatments will be best able to extend their prognosis. Patients of pleural mesothelioma who have utilized alternative therapies have been able to do just that. However, most of these therapies are preferential and will depend on the health of the patient as to whether or not they will be able to engage in them. As with any treatment, patients should seek the consultation of their oncologist or cancer specialist before engaging in any alternative therapy.
Sources: 1, 2, 3