mesothelioma: Causes, symptoms, Diagnosis and Treatment

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Mesothelioma Overview

Mesothelioma is an aggressive and deadly form of cancer. Mesothelioma treatments are available, but for many people with mesothelioma, a cure isn’t possible.

Doctors that manage the treatment of such disease divides mesothelioma into different types based on what part of the mesothelium is affected. Mesothelioma 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 (peritoneal mesothelioma), around the heart and around the testicles.

Symptoms of Mesothelioma

Signs and symptoms of mesothelioma 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:

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.

Mesothelioma Diagnosis

If you have signs and symptoms that might indicate mesothelioma, your doctor will conduct a physical exam to check for any lumps or other unusual signs.

Your doctor may order imaging scans, such as a chest X-ray and a computerized tomography (CT) scan of your chest or abdomen, to look for abnormalities.

Based on the findings, you may undergo further testing to determine whether mesothelioma or another disease is causing your symptoms.

Biopsy

Biopsy, a procedure to remove a small portion of tissue for laboratory examination, is the only way to determine whether you have the disease. Depending on what area of your body is affected, your doctor selects the right biopsy procedure for you.

Options include:

  • Inserting a needle through the skin. The doctor might remove fluid or a piece of tissue with a thin needle inserted through the skin on your chest or abdomen.
  • Collecting a sample of tissue during surgery. A fluid or tissue sample might be collected during an operation. The surgeon might make a small incision and insert a tube with a video camera to see inside your chest or abdomen. Special tools can be passed through the tube to collect a tissue sample.

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.

Key Risk factors that causes mesothelioma

The primary risk factor for mesothelioma: Most mesothelioma’s are thought to be related to asbestos exposure. Asbestos is a mineral that’s found naturally in the environment. Asbestos fibers are strong and resistant to heat, making them useful in a wide variety of applications, such as in insulation, brakes, shingles, flooring and many other products.

When asbestos is broken up, such as during the mining process or when removing asbestos insulation, dust may be created. If the dust is inhaled or swallowed, the asbestos fibers will settle in the lungs or in the stomach, where they can cause irritation that may lead to mesothelioma. Exactly how this happens isn’t understood. It can take 20 to 60 years or more for mesothelioma to develop after asbestos exposure.

Most people with asbestos exposure never develop mesothelioma. This indicates that other factors may be involved in determining whether someone gets mesothelioma. For instance, you could inherit a predisposition to cancer or some other condition could increase your risk.

Factors that may increase the risk of mesothelioma include:

Personal history of asbestos exposure. If you’ve been directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.
Living with someone who works with asbestos. People who are exposed to asbestos may carry the fibers home on their skin and clothing.
People who work with high levels of asbestos can reduce the risk of bringing home asbestos fibers by showering and changing clothes before leaving work.
A family history of mesothelioma. If your parent, sibling or child has mesothelioma, you may have an increased risk of this disease.
Radiation therapy to the chest. If you had radiation therapy for cancer in your chest, you might have an increased risk of mesothelioma.

Complications

As pleural mesothelioma spreads in the chest, it puts pressure on the structures in that area. This can cause complications, such as:
  • Difficulty breathing
  • Chest pain
  • Difficulty swallowing
  • Pain caused by pressure on the nerves and spinal cord
  • Accumulation of fluid in the chest (pleural effusion), which can compress the lung nearby and make breathing difficult

Prevention

Reducing your exposure to asbestos may lower your risk of get the discussed disease
Find out whether you work with asbestos
Most people with mesothelioma were exposed to the asbestos fibers at work. Workers who may encounter asbestos fibers include:

  • Asbestos miners
  • Electricians
  • Plumbers
  • Pipefitters
  • Insulators
  • Shipyard workers
  • Demolition workers
  • Brake mechanics
  • Selected military personnel
  • Home remodelers

Mesothelioma Treatment

What treatment you undergo for mesothelioma depends on your health and certain aspects of your cancer, such as its stage and location.

it 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 such disease 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.

Chemotherapy

Chemotherapy uses chemicals to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of a aliment 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.

Other treatments

Other treatments include:

  • Immunotherapy. Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process. This treatment might be an option if other treatments aren’t working.
  • Targeted therapy. Targeted therapy uses drugs that attack specific vulnerabilities in cancer cells. These drugs aren’t commonly used for treating mesothelioma, but your doctor might recommend targeted therapy based on the results of tumor DNA testing.
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