ABSTRACT – Mesothelioma is the cancer of mesothelial cells present in pleura or lining of lungs, heart, and abdomen....
Mesothelioma
Mesothelioma is a type of cancer that occurs in the thin layer of tissue that covers the majority of your internal organs (mesothelium).
It is an aggressive and deadly form of cancer. Treatments are available, but for many people with this disease, a cure isn’t possible.
Doctors divide it into different types based on what part of the mesothelium is affected. Its most often affects the tissue that surrounds the lungs (pleura). This type is called pleural mesothelioma. Other, rarer types of mesothelioma affect tissue in the abdomen, around the heart and around the testicles.
Symptoms
Signs and symptoms vary depending on where the cancer occurs.
Pleural mesothelioma, which affects the tissue that surrounds the lungs, causes signs and symptoms that may include:
Chest pain
Painful coughing
Shortness of breath
Unusual lumps of tissue under the skin on your chest
Unexplained weight loss
Peritoneal mesothelioma, which occurs in tissue in the abdomen, causes signs and symptoms that may include:
Abdominal pain
Abdominal swelling
Nausea
Unexplained weight loss
Other forms of mesothelioma
Signs and symptoms of other types of mesothelioma are unclear, since these forms of the disease are very rare.
Pericardial mesothelioma, which affects tissue that surrounds the heart, can cause signs and symptoms such as breathing difficulty and chest pains.
Mesothelioma of tunica vaginalis, which affects tissue surrounding the testicles, may be first detected as swelling or a mass on a testicle.
Causes
In general, cancer begins when a series of changes (mutations) happens in a cell’s DNA. The DNA contains the instructions that tell a cell what to do. The mutations tell the cell to grow and multiply out of control. The abnormal cells accumulate and form a tumor.
It isn’t clear what causes the initial genetic mutations that lead to mesothelioma, though researchers have identified factors that may increase the risk. It’s likely that cancers form because of an interaction between many factors, such as inherited conditions, your environment, your health conditions and your lifestyle choices.
What treatment you undergo for mesothelioma depends on your health and certain aspects of your cancer, such as its stage and location.
Unfortunately, mesothelioma often is an aggressive disease and for most people a cure isn’t possible. Mesothelioma is usually diagnosed at an advanced stage — when it isn’t possible to remove the cancer through an operation. Instead, your doctor may work to control your cancer to make you more comfortable.
Discuss treatment goals with your doctor. Some people want to do everything they can to treat their cancer, even if that means enduring side effects for a small chance of an improvement. Others prefer treatments that make them comfortable so that they can live their remaining time as symptom-free as possible.
Surgery
Surgeons work to remove mesothelioma when it’s diagnosed at an early stage. In some cases this may cure the cancer.
Most of the time, it isn’t possible to remove all of the cancer. In this situation, surgery may help to reduce the signs and symptoms caused by mesothelioma spreading in your body.
Surgical options may include:
Surgery to decrease fluid buildup. Pleural mesothelioma may cause fluid to build up in your chest, causing difficulty breathing. Surgeons insert a tube or catheter into your chest to drain the fluid. Doctors may also inject medicine into your chest to prevent fluid from returning (pleurodesis).
Surgery to remove the tissue around the lungs. Surgeons may remove the tissue lining the ribs and the lungs (pleurectomy). This procedure won’t cure mesothelioma, but may relieve signs and symptoms.
Surgery to remove a lung and the surrounding tissue. Removing the affected lung and the tissue that surrounds it may relieve signs and symptoms of pleural mesothelioma. If you’ll be receiving radiation therapy to the chest after surgery, this procedure also allows doctors to use higher doses, since they won’t need to worry about protecting your lung from damaging radiation.
Surgery for peritoneal mesothelioma. Peritoneal mesothelioma is sometimes treated with surgery to remove as much of the cancer as possible. Chemotherapy may be used before or after surgery.
Chemotherapy
Chemotherapy uses chemicals to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of a mesothelioma that can’t be removed using surgery. Chemotherapy may also be used before surgery (neoadjuvant chemotherapy) to make an operation easier or after surgery (adjuvant chemotherapy) to reduce the chance that cancer will return.
Chemotherapy drugs may also be heated and administered directly into the abdominal cavity (intraperitoneal chemotherapy), in the case of peritoneal mesothelioma.
Radiation therapy
Radiation therapy focuses high-energy beams from sources such as X-rays and protons to a specific spot or spots on your body. Radiation may be used after surgery to kill any remaining cancer cells. It may also help reduce signs and symptoms of advanced cancer in situations where surgery isn’t an option.
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