Medical Procedures Mesothelioma

The chance of recovery (mesothelioma prognosis) depends on the size of the cancer, where the cancer is, how far the cancer has spread, how the cancer cells look under the microscope, how the cancer responds to mesothelioma treatment, and the patient's age and general health. Standard mesothelioma treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered.

There are a number of mesothelioma treatment options available to mesothelioma patients. Extrapleural pneumonectomy in selected patient with very early stage disease may improve recurrence-free survival, but its impact on overall survival is unknown. Pleurectomy and Decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and pain caused by invasive tumors. The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients treated. Unfortunately, the duration of symptom control is short-lived. Single agent and combined chemotherapy have reported higher response rates in STAGE II patients, but the toxicity reported is also higher, and there is no evidence that combination treatments result in longer survival or longer control of the mesothelioma symptoms.

Standard Treatments

There are treatments for all patients with malignant mesothelioma.

Three kinds of treatment are used:

chemotheraphy (using drugs to fight the cancer).

surgery (taking out the cancer).

radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells) chemotherapy (using drugs to fight the cancer).

Surgery is a common treatment of malignant mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. Depending on how far the cancer has spread, a lung also may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). If fluid has collected in the chest or abdomen, the doctor may drain the fluid out of the body by putting a needle into the chest or abdomen and using gentle suction to remove the fluid. If fluid is removed from the chest, this is called thoracentesis. If fluid is removed from the abdomen, this is called paracentesis. The doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. In mesothelioma, chemotherapy may be put directly into the chest (intrapleural chemotherapy).

Intraoperative photodynamic therapy is a new type of treatment that uses special drugs and light to kill cancer cells during surgery. A drug that makes cancer cells more sensitive to light is injected into a vein several days before surgery. During surgery to remove as much of the cancer as possible, a special light is used to shine on the pleura. This treatment is being studied for early stages of mesothelioma in the chest.

Side Effects

Cancer treatments all have side effects. It is hard to kill cancer cells at the same time as keeping all healthy cells safe. Side effects of treatment depend on the type of treatment and the person's overall health when treatment starts.

Experimental Treatments

Not all patients are cured with standard therapy, and some standard treatments may have more side effects than are desired. Clinical trials, therefore, are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in many parts of the country for many patients with malignant mesothelioma.

Mesothelioma cause

The only recognized cause of mesothelioma is exposure to asbestos, though other factors such as smoking can make the disease more or less likely in some individuals. Industrial laborers were widely subjected to asbestos exposure on the job, as the material was widely used throughout the 20th century. Few of these workers knew they were being exposed to asbestos, however, despite the fact that many manufacturers were aware the material was hazardous. In most cases, mesothelioma symptoms will not appear in an individual exposed to asbestos until many years after the exposure has occurred. Those who believe they may have been exposed to asbestos should fill out our form to receive a free mesothelioma information packet, detailing treatment options, emerging therapies, and jobsite exposure information.

The mesothelium is a target of the toxic and carcinogenic effects of asbestos fibers. Fibers greater than 8 mu in length and less than 0.25 mu in diameter have been found to be highly tumorigenic in rodents, while shorter asbestos fibers or spherical mineral particles have not been shown to produce mesotheliomas. For investigation of early mesothelial reactions associated with the development of mesotheliomas, C57BL/6 mice were given intraperitoneal injections of 200 micrograms of short or long crocidolite asbestos fibers, toxic silica particles, or nontoxic titanium dioxide particles. At intervals between 3 hours and 21 days after a single injection, the mesothelial surface of the diaphragm was examined by stereomicroscopy, scanning electron microscopy, and autoradiography. Within 6 hours after injection of asbestos fibers, mesothelial cells in the lacunar regions of the diaphragm retracted opening stomata 10.7 +/- 2.3 mu in diameter leading to the submesothelial lymphatic plexus.

Short asbestos fibers (90.6% less than or equal to 2 mu in length), silica, or titanium dioxide particles (less than or equal to 5 mu in diameter) were cleared through these stomata without provoking an inflammatory reaction or mesothelial injury. In contrast, long asbestos fibers (60.3% greater than or equal to 2 mu in length) were trapped at the lymphatic stomata in the lacunar regions on the peritoneal surface of the diaphragm. At these sites, an intense inflammatory reaction developed with accumulation of activated macrophages and a 5.5-fold increase in albumin recovered in the peritoneal lavage fluid after 3 days. As early as 12 hours after injection of long asbestos fibers, the adjacent mesothelial cells were unable to exclude trypan blue and lost their surface microvilli, developed blebs, and detached. Recovery of lactate dehydrogenase activity in the peritoneal lavage fluid was increased 5.8-fold after 3 days and returned to normal levels after 14 days.

Regenerating mesothelial cells appeared at the periphery of asbestos fiber clusters 3 days after injection. Maximal incorporation of 3H-thymidine by mesothelial cells occurred after 7 days, followed by partial restoration of the mesothelial lining after 14-21 days. As late as 6 months after a single injection of crocidolite asbestos fibers, clusters of fibers remained in the lacunar regions, partially covered by mesothelium but surrounded by macrophages and regenerating mesothelial cells. The anatomic distribution and size of lymphatic stomata on the peritoneal surface of the diaphragm account for the selective accumulation of long asbestos fibers in these regions

Peritoneal mesothelioma

Peritoneal mesothelioma is a malignant mesothelioma that forms in the peritoneum, the portion of the mesothelium that surrounds the stomach and the intestines in the abdominal cavity.Mesothelioma of the abdomen, like all types of mesothelioma, is caused by asbestos exposure. Though it can take many years for a patient to demonstrate symptoms of peritoneal mesothelioma, the cancer develops when the asbestos fibers become lodged in the spaces between the mesothelial cells.The principal question is how the asbestos fibers are getting into the peritoneum, since it is not connected directly to the lungs.

Some researchers believe that peritoneal mesothelioma is caused when asbestos fibers are ingested in water or (more rarely) food, and then migrate through the stomach or intestinal wall. Other researchers believe that the asbestos fibers must be coming in through the lungs and then migrating into the peritoneum via the lymph system or the bloodstream. It is even possible that asbestos fibers might be present in sputum which is coughed up and then ingested.

A patient with peritoneal mesothelioma may not demonstrate symptoms of the cancer for 20 to 50 years after initial asbestos exposure since it often takes years for mesothelioma to manifest. In the case of peritoneal mesothelioma, asbestos fibers travel into the peritoneal layers where they cause irritation and inflammation and the development of cancerous cells which divide and grow uncontrollably. The cells cause thickening of the peritoneum and fluid build-up in the peritoneal layers. As the cancerous cells continue to divide overtime, tumors start to form. Most peritoneal mesothelioma symptoms are caused by this membrane thickening, fluid build-up, and eventual tumor development, all of which put pressure on internal organs.

There is an extremely rare form of peritoneal mesothelioma in which the testicles of a male patient develop tumors. The covering of the scrotum is actually an outgrowth of the peritoneal mesothelium. It is believed that fibers from the stomach may migrate to the scrotal covering and that a typical mesothelioma can form there. This is exceptionally rare, however.

Surgical Treatment for mesothelioma

Surgery is commonly used in the treatment of malignant mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed. Depending on how far the cancer has spread, a lung also may be removed (pneumonectomy). The following are some of the most commonly used surgical treatments of mesothelioma:


Pleurodesis


Pleurodesis is a treatment administered through a thoracoscopy or existing chest tube. Pleurodesis creates inflammation effectively eliminating the pleural space. The elimination of this space then inhibits the accumulation of a pleural effusion. Generally used when the pleural effusion is symptomatic. Talc is used most commonly and effectively for this procedure, thus it is often referred to as "talcing" or as a patient having been "talced."


Pleurectomy

Surgery to remove part of the chest (pleura) or abdomen lining (peritoneum) and some of the tissue surrounding it. This procedure is performed for a variety of disorders including pleural effusion, malignant pleural mesothelioma, and trauma.


Pleurectomy/decortication

Surgery to remove part of the chest (pleura) or abdomen lining (peritoneum) and as much for the tumor mass as possible. This procedure may be performed to reduce pain caused by the tumor mass or to prevent the recurrence of pleural effusion. For peritoneal mesothelioma, surgery is generally aimed at relieving symptoms, such as recurrent ascites or bowel obstruction. As with pleural mesothelioma, complete surgical removal of the entire tumor is unlikely.
Pneumonectomy (new-mo-NEK-to-me)

Surgery to remove a lung.
Extrapleural pneumonectomy (or EPP)

Surgery to remove the pleura, diaphragm, pericardium, and entire lung involved with the tumor.

Pleural Mesothelioma Symptoms

Some of the symptoms of pleural mesothelioma (mesothelioma cancer of the lung lining) include:

1. pain in the lower back or the side of the chest
2. shortness of breath
3. a persistent cough
4. difficulty swallowing food
5. fever and sweating
6. fatigue
7. weight loss.

These symptoms are also common to many minor ailments and, therefore, may not cause a doctor to suspect mesothelioma.

Pleural Effusion-fluid in the Lungs

One of the most common and specific symptoms of pleural mesothelioma is the accumulation of fluid between the lungs and chest cavity. This generally causes shortness of breath, and requires a doctor to drain the fluid, called fine-needle aspiration, to make breathing easier and relieve chest pain. This symptom is more unique to mesothelioma, making it more likely that you may have the disease.

Mesothelioma symptoms

Mesothelioma symptoms are not specific to the disease; that is, many mesothelioma symptoms are also symptoms of other medical problems. Most studies show that the symptoms of mesothelioma usually begin to appear 30 to 40 years after exposure to asbestos. Thus, many mesothelioma patients are unaware that the symptoms they are experiencing are related to something that happened much earlier in their lives. This allows the disease to further progress, which is one reason most patients’ mesothelioma prognosis is very grim. Even a short period of asbestos exposure (as little as a few months) can create the conditions for a disease that erupts much later in life.

Mesothelioma affects the lining of various cavities in the body. Over time, the growth of cancerous tumors causes these tissues to expand and gather fluid. The presence of excess fluid is typically what causes the symptoms to occur. Mesothelioma symptoms also depend on the location of the tumors.

Common signs and symptoms of Mesothelioma include:

• * A cough that does not go away
• * Chest pain, often aggravated by deep breathing
• * Hoarseness
• * Weight loss and loss of appetite
• * Bloody or rust-colored sputum (spit or phlegm)
• * Shortness of breath
• * Fever without a known reason
• * Recurring infections such as bronchitis and pneumonia
• * New onset of wheezing

Symptoms of Mesothelioma Types

• Symptoms of pleural mesothelioma:
• Chest pain
• Fluid in the lungs
• Shortness of breath
• Sustained cough
• Hoarseness
• Wheezing

• Symptoms of peritoneal mesothelioma
• Abdominal pain
• Fluid in the gastrointestinal tract or abdomen
• Lumps in the abdomen
• Bowel movement difficulties
• Weight loss
• Nausea

• Symptoms of pericardial mesothelioma:
• Persistent cough
• Chest pain
• Heart palpitations
• Shortness of breath

Mesothelioma and Cell Mutations.

Mesothelioma causes the cells of the mesothelium to mutate and multiply infinitely. This mutation causes tumors that can prevent proper lung and heart function. Because the cells of the mesothelium are responsible for providing fluid lubrication for the body’s internal organs, mesothelioma is particularly insidious because it can affect multiple organs simultaneously, usually without major symptoms or pain. Mesothelioma can also invade parts of the immune system, including bone marrow, lymph nodes, and spleen, where it continues to mutate and destroy healthy cells.

Development Time of Mesothelioma:

The cancerous cells also lie dormant for many years, and it is not uncommon for the first effects of mesothelioma to appear 20 to 30 years after initial exposure. Unfortunately, there is no cure for mesothelioma, and treatment ranges from preventive surgery to chemotherapy and radiation treatments. By the time symptoms manifest, it is quite often too late. Because mesothelioma lays dormant for so long, post diagnosis survival ranges from 1-5 years depending on the stage of the cancer and the age and condition of the victim.

Other Studies of Mesothelioma and Numbers of Asbestos Related Deaths:

Studies show that there are 10,000 asbestos-related deaths in the United States every year. These 10,000 people are not just a statistic; they are grandfathers and grandmothers, mothers and fathers, friends and neighbors. Very often asbestos companies knew the risks involved with their products, but chose to ignore the danger for the sake of profits. If you or a loved one has contracted Mesothelioma because of negligent use of asbestos, then you have a duty and obligation to seek restitution for your loss. Knowledgeable attorneys in your state are ready to take your case. Contact one today.

Mesothelioma prognosis

Pleural mesothelioma is a difficult cancer to treat because it can spread so extensively and it is generally not diagnosed until it is in the more advanced stages, making surgical removal of all the cancer difficult or impossible. Because it is a relatively rare cancer, mesothelioma has not been studied as much as more common forms of cancer. The stage at which treatment for mesothelioma is begun has a tremendous impact on the patient’s prospects for long-term survival.

The patient’s overall health status and age affect the prognosis. The American Cancer Society reports that 75 percent of those diagnosed with mesothelioma are 65 years old or older. Men are five times more likely to have mesothelioma than women are.

When mesothelioma is diagnosed, the doctors look at how far the cancer has spread and several health factors. Pleural mesothelioma patients have a poorer prognosis if they are experiencing chest pain, shortness of breath, inability to perform daily tasks, weight loss, a low red blood cell count, a high white blood cell count, and high blood levels of a substance called LDH. According to the American Cancer Society, most mesothelioma patients who have all these factors present pass away within six months of their diagnosis. It is rare for these seriously ill patients to live two years after their diagnosis. Patients without these serious risk factors at the time of their diagnosis have a better outcome.

What is Mesothelioma?

Mesothelioma is a cancer that affects the lining around the lungs, heart, and abdominal cavities - called the mesothelium - which is primarily caused by chronic exposure to asbestos or asbestos related products. As asbestos fibers enter the body, either by breathing or swallowing, they cause normally healthy cells to mutate into cancer.

This exposure can come directly, such as working in an asbestos processing center, or indirectly by inhalation of residual asbestos particles remaining on clothing or building materials. Studies show that exposure as short as one year can cause a variety of asbestos-related illnesses, including mesothelioma.

Mesothelioma Treatments

Five major approaches to mesothelioma treatments are surgery, radiation therapy, chemotherapy, palliative therapy, and biological therapy. Each method may be used alone, but often they are coordinated in combined programs to improve the overall treatment result. The extent of any treatment is always dependant upon a patient’s physical health condition, their age, the location and stages of mesothelioma (degree) of the disease, and the extent of asbestos exposure.


Surgery - Mesothelioma Treatment

Surgery - Patients diagnosed with pleural mesothelioma can be considered possible candidates for a surgical procedure known as pneumonectomy. This is the surgical excision (removal) of the diseased lung and, if need be, any affected parts of the surrounding diaphragm. In reality, pneumonectomy is considered a high-risk procedure and eligibility is dependant upon the patient’s present state of health and extent of asbestos cancer exposure.



Radiation - Mesothelioma Treatment

Radiation Treatment - Radiation therapy is the mesothelioma treatment of disease using either an external source of high-energy rays (x-rays or gamma rays) or internally implanted radioactive substances. These rays and substances are effective in destroying tissue and stopping the growth of malignant cells. In contrast to chemotherapy, radiation therapy is targeted towards a specific area and can treat the affected area without exposing the surrounding healthy tissue. Radiation can be used as a combination treatment along with surgery, or can be used alone to combat mesothelioma cancer. As with most treatments, a high dose of radiation can cause health complications.



Chemotherapy - Mesothelioma Treatment

Chemotherapy is the use of drugs in the cancer treatment. Standard chemotherapy treatments are either administered in the form of pills or injected medication, and may be used alone or in combination with surgery and irradiation. In chemotherapy, drugs are given according to a written protocol, or plan, that details exactly how the drugs will be given. Once these drugs are distributed in the body, however, both tumor cells and normal tissue cells are susceptible to their lethal effects, often making the patient very ill. Usually drug therapy is continued until the patient achieves a remission, which is the absence of all signs of disease. Common side effects of chemotherapy include nausea, vomiting, diarrhea, bleeding, weight loss, hair loss, and overall physical fatigue.



Palliative Therapy - Mesothelioma Treatment

Palliative therapy is a relieving, but not curative method by which to treat and control the symptoms of mesothelioma cancer. During such therapy, a needle is used to drain and suction excess fluid from the affected tissue. Generally, post-palliative drugs are administered to the patient in order to prevent further accumulation of fluids.
Biological - Mesothelioma Treatment

Biological Treatment - A more recent approach to cancer treatment, including treatment of mesothelioma cancer, is the use of the body’s own defense mechanisms to fight tumor cells. Medical experts are exploring how elements of the immune system can be restored, enhanced, mimicked, and manipulated to destroy cancerous cells. Substances produced by normal cells that either directly block tumor growth or stimulate the immune system and other body defenses are called biological response modifiers. Examples of these substances are interferon (made by lymphocytes which are important in immune response), monoclonal antibodies (derived from mouse cells and capable of binding to human tumors in an immune response), colony-stimulating factors (CSFs) that stimulate blood forming cells, and interleukins that stimulate the immune system.