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What is Mesothelioma

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Malignant mesothelioma (me-zoe-thee-lee-O-muh) is a type of cancer that occurs in the thin layer of tissue that covers the majority of your internal organs (mesothelium).

Causes of Mesothelioma

Asbestos is the only confirmed cause of mesothelioma. When inhaled or ingested, asbestos fibers become lodged in the linings of the lungs, abdomen or heart and may eventually lead to tumors.

Many of the early symptoms of mesothelioma are more likely to be caused by other conditions, so at first people may ignore them or mistake them for common, minor ailments. Most people with mesothelioma have symptoms for at least a few months before they are diagnosed.

Symptoms of pleural mesothelioma (mesothelioma of the chest) can include:

  • Pain in the side of the chest or lower back
  • Shortness of breath
  • Cough
  • Fever
  • Excessive sweating
  • Fatigue
  • Weight loss (without trying)
  • Trouble swallowing (feeling like food gets stuck)
  • Hoarseness
  • Swelling of the face and arms

Symptoms of peritoneal mesothelioma can include:

  • Abdominal (belly) pain
  • Swelling or fluid in the abdomen
  • Weight loss (without trying)
  • Nausea and vomiting
  • Constipation

These symptoms can be caused by mesothelioma, but more often they are caused by other conditions. Still, if you have any of these problems (especially if you have been exposed to asbestos), it’s important to see your doctor right away so the cause can be found and treated, if needed.

Pericardial Mesothelioma

Pericardial mesothelioma affects the protective lining of the heart. It’s the rarest location where mesothelioma occurs, and accounts for about 1 percent of all cases. Because it’s rare, doctors don’t get to treat many patients with mesothelioma in this location, and haven’t had many chances to create effective treatments.

Pericardial Symptoms
    • Chest pain
    • Heart murmurs
    • Excessive palpitations
    • Labored breathing
    • Fatigue
    • Night sweats

 

Diagnosing Mesothelioma

Being diagnosed correctly is the first and most important step you’ll take towards getting treatment. If you’ve been exposed to asbestos in the past, and are feeling ongoing symptoms, see an experienced doctor. He or she will order an imaging test — like an x-ray, CT scan, or PET scan — to find visual signs of cancer. If the imaging scan shows anything that looks like a tumor or buildup of fluid, a doctor may order a blood test to make sure the next step in the diagnostic process, a biopsy, is necessary.

A biopsy helps your doctor determines the cell type of the disease — information he or she will use to create an effective treatment plan that can improve your prognosis.

Getting a biopsy is the only way to confirm that you have mesothelioma.

Stages of Mesothelioma

Your cancer stage is an important part of your diagnosis. Along with its cell type, the stage of mesothelioma determines how effective treatment will be. Doctors haven’t created a staging system that’s specific to mesothelioma just yet, because the disease is rare. Instead, they use a number of systems—TNM, Butchart, and Brigham—specific to other cancers. Using different criteria, each system divides the spread of cancer into 4 stages. Generally speaking, the earlier the stage, the less mesothelioma has spread, and the easier it is for surgeons to remove.

Stage 1

  • At stage one, the tumor only affects the area in the mesothelium where it originated; it hasn’t yet spread to other organs.
  • If you’re diagnosed with stage–one mesothelioma, you’ll respond well to treatment, and will enjoy a better prognosis than patients with advanced–stage mesothelioma.

Stage 2

  • At stage two, the tumor has grown larger and may have spread to organs outside the area of where it first appeared in the mesothelium.
  • Depending on your overall health, curative surgery is still an option for you–there’s not a substantial difference in prognosis between stage–one and stage–two patients.

 

Stage 3

  • At stage three, the tumor has spread throughout one side of your body, and may have spread to other areas, including nearby lymph nodes, the esophagus, the chest wall, ribs, or heart.
  • Tumors at this stage do not respond well to curative treatments, but surgery may still be an option. Your doctors will likely use palliative treatment to improve your quality of life.

Stage 4

  • At stage four, the tumor has spread to both sides of the body. It may have invaded the brain, bone cells, far away lymph nodes, and other organ tissues.
  • Most curative treatments, such as surgery and chemotherapy, are not effective in removing stage–four mesothelioma because it has spread so far. Doctors will instead use palliative treatment to relieve discomfort caused by symptoms. They may also enroll you in a clinical trial, where they’ll use new treatments to try and improve your prognosis.

Treatment Options

If you’ve been diagnosed with mesothelioma, you have a number of treatment options, including surgery, chemotherapy, and radiation therapy. Broadly speaking, your treatment will fall into 2 categories: curative or palliative.

Curative Treatment

With curative treatment, doctors extend your survival time by removing as much of the mesothelioma as possible. They often combine multiple curative treatments to achieve amazing results.

Palliative Treatment

With palliative treatment, doctors treat the symptoms of mesothelioma rather than the cancer itself. Its purpose is to improve your quality of life by easing symptoms like chest or abdominal pain.

Doctors don’t treat mesothelioma with a one-size-fits-all approach, because the disease affects each patient differently. How your doctor uses surgery, chemotherapy, or radiation therapy depends on your diagnosis—the cancer stage, cell type, and location of the mesothelioma all play an important role in your treatment.

Additional Treatment Options

Multimodal Therapy. This is a combination of two or more treatments. Doctors have greatly increased the life expectancy of patients with pleural and peritoneal mesothelioma with multimodal therapy.

New Treatments in Clinical Trials. Researchers are also developing new treatments, like immunotherapy and gene therapy, in clinical trials. Emerging treatments can benefit patients diagnosed with any stage of mesothelioma; if you’ve been diagnosed with advanced–stage mesothelioma, you may find an option to improve your prognosis.

 Prognosis

It  is an estimate your doctor makes on how your diagnosis will affect you in the future; they base it on how diagnoses similar to yours affected other people in the past. The location, cell type, and cancer stage of the mesothelioma play a role your doctor’s estimate, and helps them decide which treatment options will work best for you.

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