Mesothelioma is a rare and aggressive cancer primarily caused by exposure to asbestos. It develops in the mesothelium, the thin layer of tissue covering most internal organs, with the most common type affecting the lining of the lungs (pleural mesothelioma). Other types include peritoneal mesothelioma (abdominal lining), pericardial mesothelioma (heart lining), and testicular mesothelioma. Early detection can be challenging as symptoms often appear in the disease’s advanced stages.
Pleural Mesothelioma Symptoms:
Pleural mesothelioma, the most common form, affects the lining of the lungs. Symptoms include persistent chest pain, shortness of breath, and a chronic cough. Patients may also experience difficulty swallowing, swelling of the face or arms, fatigue, and unexplained weight loss. Pleural effusion (fluid buildup in the lungs) is another common symptom, causing further breathing difficulties and chest discomfort.
Peritoneal Mesothelioma Symptoms:
This type affects the abdominal lining and is characterized by symptoms such as abdominal pain, swelling, or tenderness. Other signs include nausea, vomiting, bowel obstruction, and loss of appetite. Unexplained weight loss and fluid accumulation in the abdomen, known as ascites, are also frequent.
Pericardial and Testicular Mesothelioma Symptoms:
Pericardial mesothelioma, affecting the heart’s lining, is extremely rare. It presents symptoms like chest pain, irregular heartbeats, and shortness of breath. Testicular mesothelioma, even rarer, may cause testicular lumps or swelling.
Diagnosing mesothelioma can be challenging due to its symptoms’ resemblance to other respiratory or gastrointestinal conditions. The following tests are used to confirm diagnosis:
Imaging Tests: Chest X-rays, CT scans, PET scans, and MRIs help identify abnormal masses or fluid buildup.
Blood Tests: While blood tests cannot confirm mesothelioma, certain biomarkers (e.g., mesothelin) can suggest its presence.
Biopsy: A biopsy is necessary to confirm mesothelioma. A tissue sample is taken from the affected area using methods like:
Thoracoscopy (for pleural mesothelioma)
Laparoscopy (for peritoneal mesothelioma)
Mediastinoscopy or fine-needle aspiration may also be used.
Histopathology and
Immunohistochemistry: After a biopsy, the cells are examined under a microscope to determine cell type (epithelioid, sarcomatoid, or biphasic), which affects treatment options and prognosis.
Treatment depends on the mesothelioma type, stage, patient’s health, and tumor cell type. Common treatments include:
Surgery: Surgical options are used to remove as much cancer as possible, often combined with other treatments:
Extrapleural Pneumonectomy (EPP): Removal of a lung, pleura, diaphragm, and part of the pericardium in pleural mesothelioma.
Pleurectomy/Decortication (P/D): Removal of the pleura around the lung, leaving the lung intact.
Cytoreductive Surgery: Often used for peritoneal mesothelioma to remove cancerous tissue in the abdomen.
Chemotherapy: Systemic chemotherapy, such as cisplatin combined with pemetrexed, is standard for mesothelioma, especially in advanced cases.
Radiation Therapy: Radiation is used to shrink tumors or reduce symptoms. It is often used post-surgery to eliminate remaining cancer cells.
Hyperthermic Intraperitoneal Chemotherapy (HIPEC): A heated chemotherapy treatment applied directly to the abdominal cavity during surgery. HIPEC is primarily used for peritoneal mesothelioma.
Immunotherapy: Drugs like pembrolizumab and nivolumab boost the immune system to target cancer cells. Immunotherapy is promising for mesothelioma, especially for patients who don’t respond well to other treatments.
Targeted Therapy: Research is ongoing, but targeted drugs focus on specific cancer cell mutations or proteins.
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