Mesothelioma is an aggressive cancer that develops in the tissue surrounding the mesothelium, the protective covering that covers the lungs, chest wall, heart, and abdomen. Most cases of this cancer are caused by asbestos exposure. Asbestos is a mineral found in many building, industrial, and household products. Contact with asbestos increases the risk of this cancer, but mesothelioma is a rare type.
Symptoms of mesothelioma vary depending on severity and which part of the body is affected. Unfortunately, most people with mesothelioma are diagnosed at a later stage, which can make treatment difficult. Nonetheless, there are a variety of treatment options that can improve the outlook for this condition.
There are two ways health care providers classify mesothelioma, based on location and type of tumor. Mesothelioma can appear in the following areas of the body:
- Pleura: lining of the lungs
- peritoneum: abdominal tissue
- pericardium: lining of the heart
- Vaginal capsule of the testicles: To vaginal or testicular tissue
There are three types of mesothelioma tumors and they are classified based on their cellular composition. These include:
- Epithelial Mesothelioma: Epithelial mesothelioma, which accounts for 80% of cases, affects the epithelial cells that make up the outer layer of the internal lining of organs, body cavities, and blood vessels. This type often appears first in the lungs (pleural mesothelioma) and is the most treatable.
- Sarcomatoid Mesothelioma: It is a mixture of two major cancer cell types: carcinoma and sarcoma. This type causes distinctive spindle-shaped cells and accounts for about 10% of all mesothelioma cases. The rarest of the three types, but also the most aggressive and fastest.
- Mixed mesothelioma: Also known as biphasic mesothelioma, this cancer occurs when both epithelioid and sarcomatoid types are present.
Mesothelioma primarily affects the lungs and may spread to the abdominal wall, heart, or other organs. Symptoms depend on the exact part of the body that is affected.
systemic symptoms
Systemic symptoms are symptoms that affect the entire body. All types of mesothelioma can cause:
respiratory symptoms
Most cases of mesothelioma are pleural or affect the lungs. As a result, the following may occur:
abdominal symptoms
If the cancer spreads to the inner abdominal wall (known as peritoneal mesothelioma), symptoms may include:
heart symptoms
Pericardial mesothelioma affects the tissue surrounding the heart (part of the cardiovascular system). When this type of cancer develops, symptoms may include:
- Chest pain (known as angina)
- irregular or fast heartbeat
- heart murmur
Mesothelioma occurs when cancer cells form in the mesothelial tissue that lines organs or cavities in the body. The DNA (genetic code) of these cells is abnormal. As a result, they divide faster than healthy cells and can quickly spread to other parts of the body.
More than 80% of mesothelioma cases are the result of asbestos exposure. Asbestos is an ingredient in hazardous building and industrial materials and certain products. Inhaling or ingesting asbestos can cause damage and inflammation to cells, which can lead to cancer. This is a delayed process. Mesothelioma usually develops 20 to 40 years after exposure.
risk factors
Asbestos exposure through construction, industrial work, and handling certain products or building materials is a major risk factor for mesothelioma. Other factors also play a role, such as:
- Older people, usually over 45 years old
- radiotherapeutics
- Assigned male at birth
- Genetic mutations that may increase the risk of mesothelioma
- smoking
If you have symptoms of mesothelioma or may have been exposed to asbestos, it is important to see a health care provider for a proper diagnosis. Your provider will first ask you about your medical history and perform a physical examination. They will also try to rule out other potential causes of your symptoms, such as other types of lung cancer, lung infections, medication side effects, or pulmonary fibrosis.
Several diagnostic tests may help your healthcare provider detect mesothelioma, including:
- Fluid Testing: A sample of fluid from the chest (thoracentesis), abdomen (paracentesis), or around the heart (cardiocentesis) is tested for signs of cancer.
- Blood tests: Check for elevated levels of fibulin-3 and soluble mesothelin-related peptide (SMRP) in the blood, which may be signs of mesothelioma.
- Biopsy: A sample of tumor tissue is taken using a syringe or surgery to check for the presence of cancer cells.
- Chest x-ray: Detects lung wall thickening, calcium deposits, fluid build-up, or other signs of lung damage.
- Computed tomography (CT) scan: It creates a three-dimensional representation of tissue for further evaluation to locate a tumor, determine if cancer has spread, or for treatment.
- Magnetic resonance imaging (MRI) scan: Detailed images of soft tissue are made to locate and evaluate tumors.
Stages of Mesothelioma
After evaluating the scan and biopsy, if you test positive for mesothelioma, your health care provider will determine the stage of the disease. The steps are as follows:
- Stage 1: There is a tumor in the pleural tissue of the lungs, diaphragm, or other tissues, but there are no signs that it has spread to lymph nodes or other parts of the body.
- Step 2: A tumor has developed in the pleural tissue of the lung, diaphragm, or other tissue and has begun to spread to the lymph nodes, but there are no signs of cancer cells elsewhere in the body.
- Step 3: The tumor began to spread locally and moved to the abdominal wall, pericardium, chest wall, or lymph nodes.
- Step 4: The tumor has spread locally and to distant parts of the body.
The exact treatment plan for mesothelioma will depend on the severity of your condition and the symptoms you are experiencing. Current options include surgery to remove the tumor, chemotherapy or radiation therapy to stop the spread of cancer cells, and medications or other procedures to manage symptoms.
surgery
Mesothelioma tumors can be removed through several surgeries. A surgeon may remove them from the pleura and other lung tissue. Pleurotomy/decorative surgery (P/D). In more serious cases Extrapleural lung resection (EPP) may help eliminate damaged lungs.
chemotherapy
Chemotherapy involves repeated doses of drugs taken intravenously (IV) to prevent the cancer from growing or spreading. For mesothelioma, common chemotherapy drugs include a combination of Alimta (pemetrexed) and Platinol (cisplatin), which can be taken every 21 days as needed or as much as you can tolerate.
radiotherapeutics
Radiation therapy, which sends radio waves (often x-rays) to the tumor, is not as effective as other treatments for mesothelioma itself. However, oncologists may use this treatment in conjunction with surgery to relieve pain associated with tumor growth.
immunotherapy
Immunotherapy, a relatively new approach, involves taking certain drugs that trigger the immune system to attack cancer cells. For mesothelioma, a combination of Opdivo (nivolumab) and Yervoy (ipilimumab) may be part of your treatment plan if you have mesothelioma stages 2 to 4.
mitigation procedures
Palliative procedures aim to relieve pain and discomfort associated with fluid accumulation in the lung cavity. These treatments include:
- Pleurodesis: The surgeon makes small incisions in the chest and inserts a tube to drain fluid that has built up in the chest cavity and reduce symptoms.
- Shunt placement: A shunt is a small pump-like device that moves fluid from one body cavity to another through a small opening. This relieves pain and pressure in the abdomen or other body cavities.
- Catheter placement: Excess fluid buildup is drained out of the tube (or catheter) through small incisions in the body to limit pain and pressure.
pain management
In addition to other treatments, your doctor may prescribe painkillers to relieve severe pain. These drugs may include opioids, such as OxyContin (oxycodone). Remember: Opioids have serious side effects and can be addictive, so they are only a short-term solution.
The most important way to prevent mesothelioma is to limit or completely avoid exposure to asbestos. Until 1978, asbestos was frequently used as an insulation and fire retardant in construction. Asbestos was also an ingredient in widely used building materials such as shingles, siding, and roofing or floor tiles until 1989.
If you work on a construction site or are at risk for asbestos exposure, it is important to protect yourself by wearing a mask and following other safety precautions. If your home was built before 1979, consider having it professionally tested for airborne asbestos. It may also be helpful to talk to your health care provider about preventive screenings, as early detection radically improves outcomes.
Unfortunately, mesothelioma increases the risk of developing several other diseases. Some conditions or complications may also occur as a result of chemotherapy and surgery. Relevant conditions are as follows:
- Chronic Obstructive Pulmonary Disease (COPD): It affects your ability to breathe and blocks airflow.
- coronary artery disease (cad): heart disease that damages blood vessels in the heart
- High blood pressure: High blood pressure
- diabetes: It is often caused by a side effect of chemotherapy or surgery, which makes it more difficult for the body to use insulin properly.
- Epidemic: This can occur in surgical areas, especially if they have not been cleaned properly.
- Organ failure: It may interfere with or stop the function of the kidneys, lungs, or heart.
Mesothelioma is an aggressive and serious type of cancer. Unfortunately, this condition is usually discovered at a later stage and is difficult to treat. Without treatment, mesothelioma has a life expectancy of only 4 to 6 months. With treatment, people with this condition can live an average of 18 months longer. However, some people continue to live with it even after five years or more.
Early detection improves the prognosis. If you think you may have been exposed to asbestos or are experiencing symptoms, it is important to get tested as soon as possible. Fortunately, researchers are developing promising new treatments that may help improve outcomes, including targeting specific genes or stimulating immune responses.
Living with cancer or caring for someone with cancer can take a serious emotional toll, often leading to depression or anxiety. Consider the following strategies to help you better manage the emotional effects of mesothelioma.
- Rely on your loved ones for support
- Meeting with a mental health professional for treatment and coping strategies
- Join a support group for others with mesothelioma or a loved one who serves as a caregiver for someone with mesothelioma.
- Participate in clinical trials for new treatments
- Making our home a safe and comfortable environment
- Find fun things to do when you can, like watching a fun show, enjoying a favorite hobby, or spending time with people you love.