Pleural Mesothelioma

Pleural Mesothelioma is typically categorized into two types: malignant (cancerous) and benign (non-cancerous).
Benign pleural mesothelioma is generally not life threatening, and can be surgically removed. Benign mesothelioma is not usually a result of asbestos exposure, and with prompt treatment benign mesothelioma is easily curable.

Malignant pleural mesothelioma affects the mesothelium lining between the lungs and the ribs. The only known cause of malignant pleural mesothelioma is exposure to asbestos fibers, such as chrysotile, amosite and crocidolite. Malignant mesothelioma accounts for about 75% of all pleural mesothelioma cases, and is typically not diagnosed until symptoms appear, about 20-30 years after infection occurs.

Symptoms of pleural mesothelioma include the following: shortness of breath, weakness, weight loss, chest pain, loss of appetite, back pain, coughing and difficulty swallowing. While mesothelioma has been diagnosed in patients before symptoms appear, most people with mesothelioma are not aware of the cancer until symptoms become present.

Pleural mesothelioma is first detected typically through a chest X-Ray and CT ( or CAT) scan, followed by a bronchoscopy, or a small scope used to look at the inside of the lungs. Diagnosis of the actual cancer requires a small biopsy of affected tissue. There are several different ways to obtain biopsies, such as using a small needle, an open cut, or through a tube and camera, called a thoracoscopy. The thoracoscopy can detect if there are abnormalities in the mesothelium and can take a tissue sample simultaneously, using the same small tube. Obtaining biopsies usually requires the patient receive anesthesia, but the procedure is not typically painful. While mesothelioma can be detected through X-Rays, CT scans, and even simply listening for fluid build up in the lungs of the patient, the only way to know if mesothelioma is present through pathological testing on a biopsy.

Once a sample of tissue has been tested, the pathologist can determine how advanced the mesothelioma is, and what treatment should be given. Factors such as the patient.s medical history, age, weight, where the cancer is located and if the cancer has spread are all taken into account. Treatments for all the varieties of mesothelioma are generally the same, only targeted to the infected areas. Fortunately, treatment options for people with mesothelioma have vastly improved, especially when the cancer is diagnosed in its early stages. Additionally, many people who have been diagnosed with mesothelioma are treated with a combination of therapies, a plan known as multimodal therapy. Treatments include:

Surgery: Surgery is usually performed in the initial stages of mesothelioma. The extent of surgery depends mostly upon the stage the cancer is in. Surgery may require moving part of the lung and surrounding tissue in order to remove the cancerous tumors. Additionally, fluid build up may be drained in order to make the patient more comfortable.

Chemotherapy: This procedure uses oral or intravenous drugs that travel through the blood stream killing cancerous cells and shrinking tumors.

Radiation Therapy: Radiation uses high energy x-rays. Radiation is administered either outside of the body (external radiation), or internally (internal radiation) to shrink the tumor and kill cancer cells. Internal radiation is performed through a plastic tube which can dually administer drugs.

Additionally, treatments such as photodynamic therapy, gene therapy, angiogenesis inhibitors and immunotherapy are currently undergoing clinical trials. Complimentary and alternative therapies can help to increase the lifespan and comfort for those affected with mesothelioma. Pain control medications have also become easier to administer to patients suffering from mesothelioma-related pain.

Unfortunately, mesothelioma does not have a known cure, and has a 100% fatality rate. As the tumor spreads over the pleura it causes pleural thickening, which reduces the flexibility of the pleura, and causes the lungs to be enclosed in an increasingly restraining cavity. As the lungs become more restricted, they become less functional as they get smaller. As a result, breathing becomes more difficult as the disease progresses. The tumor then spreads to surrounding tissue, constricting the lungs further. As the tumor spreads outward it invades the chest and ribs, typically causing intense pain and constant shortness of breath in the infected person. While most mesothelioma victims survive for about 12-24 months, there have been several documented cases of victims living in the range of a few months to 5-10 years.

While medical science does not know why or how asbestos fibers cause mesothelial cells to become cancerous, we do know that asbestos fibers in the pleura can start a tumor as well as promote its growth. The tumor relies on no other process for its development. Therefore, the main preventative measure against mesothelioma is to avoid contact with asbestos.

Last modified: April 14, 2009