Pleural mesothelioma is a ?
Pleural mesothelioma is a rare and malignant cancer caused by asbestos. Mesothelioma tumors form in the pleura, a thin membrane of cells that line the lungs and chest wall.
As the most common type of asbestos-related cancer, malignant pleural mesothelioma accounts for approximately 80 - 90 percent of all mesothelioma cases. Pleural mesothelioma differs from other types in four primary ways:
Location: Pleural mesothelioma is located in the linings of the lungs and the chest wall, known as the pleura.
Symptoms: As the disease mostly affects the lungs, the primary symptoms affect the respiratory system, such as shortness of breath, or the thoracic cavity, such as chest pain.
Treatment: The standard treatment for pleural mesothelioma is surgery, which often includes removal of some or all of the pleura and possibly part of the lung, combined with chemotherapy and / or radiation.
Survival: The prognosis for pleural mesothelioma is poor, with a median survival time of about 1 year. However, there are cases of long-term survival, in some cases as long as 20 years.
What is the Prognosis for Pleural Mesothelioma?
As with all types of mesothelioma, the prognosis for pleural mesothelioma is Very poor. For patients who do not receive treatment, the median survival is only six months; however, certain types of treatment can improve prognosis significantly.
For example, studies have shown that cocktail chemotherapy treatment of pemetrexed (Alimta) and cisplatin have a longer median survival time (12.1 months) than chemotherapy using cisplatin alone (9.1 months).
The biggest factors affecting the prognosis of pleural mesothelioma patients are:
Tumor size and staging
Cell type (histopathology)
Patient's gender and age
Stage of the cancer
In general, patients who are women, younger, or have an early-stage diagnosis (Stage 1 or Stage 2) have a better prognosis than those who are older, or have a late-stage diagnosis.
What are the Symptoms of Pleural Mesothelioma?
Anywhere from 20 to 50 years can pass between the time a person is exposed to asbestos and when pleural mesothelioma symptoms begin to appear. Once symptoms do begin to occur, they may show up in the chest and respiratory system, although some symptoms (like weight loss or fever) can be systemic.
Pleural mesothelioma can also be accompanied by a set of conditions that could display the symptoms of their own. These include:
Pleural plaque - a chalky substance that forms on the lungs due to calcification
Diffuse pleural thickening (DPT) - Gray, fibrous tissue that fills in pleural spaces
Asbestosis - Scarring of the lungs (fibrosis)
These conditions may not have pleural mesothelioma.
How is Pleural Mesothelioma Diagnosed?
Malignant pleural mesothelioma symptoms often present in many cases. The most common way to diagnose the disease is to undergo a series of tests that can rule out other diseases, including various types of cancer.
The first step is to perform one or more imaging scans (x-rays, CT, PET, or MRI) to identify potential tumors. If such a tumor is detected, one or more blood tests may be performed for certain biomarkers (high levels of specific substances in the blood). If these tests point toward the possibility of mesothelioma, the diagnosis will need to be verified through a thoracoscopy, thoracotomy, thoracentesis, or mediastinoscopy.
The most common misdiagnoses for pleural mesothelioma include:
Chronic Obstructive Pulmonary Disease (COPD)
Pneumonia
Asthma
Influenza (the flu)
Other chest cancers, such as lung cancer or adenocarcinoma
What Treatments Are Available for Pleural Mesothelioma?
All types of mesothelioma are treated using a combination of three types of therapy:
Surgery - Cytoreduction surgery (also called "debulking") is often performed with the intent of removing as many cancer cells as possible.
Chemotherapy - A combination of chemotherapy drugs (usually pemetrexed [Alimta] and Cisplatin) are administered to kill remaining tumor cells.
Radiation - A blast of targeted radiation to shrink tumors in the body.
Pleurectomy / Decortication (P / D)
This type of surgery involves removal of the parietal pleura (the outer membrane) as well as a portion of nearby organs and tissue, such as the mediastinum, diaphragm, and pericardium. Although it is not considered a curative operation, and results in recurrence about 80 - 90 percent of the time.
Because P / D is usually less stressful on the body, it is usually offered as a palliative treatment of patients who have a later stage of the disease, or when curative options are not viable.
Extrapleural Pneumonectomy (EPP)
Patients who are in the physical physical condition can undergo EPP, which is a potentially curative treatment of the lung, nearby lymph nodes, and adjacent tissue. It is the only type of surgery associated with long-term survival.
Because it is heavily invasive and stressful on the body, EPP is used almost exclusively for patients who meet the following criteria:
Stage 1 or 2 mesothelioma
Epithelial cell type mesothelioma
Have not previously had coronary bypass surgery or pleurectomy
Cardiac ejection fraction measurement of 45 percent or greater (this measures how well your heart pumps blood)
No cardiac dysfunction and / or arrhythmia
No liver, renal, or similar diseases
Source :mesothelioma.com
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