Pleural Mesothelioma

Pleural mesothelioma is one of the four types of mesothelioma and accounts for 75 percent of the diagnoses of diseases related to asbestos exposure. The disease develops in the pleura, the protective lining of the lungs that can be attributed directly to a strong or consistent occupational exposure or inhalation of asbestos fibers.
Once these fibers are inhaled, they migrate directly into the pleural membrane, where they lodge.The body of the person exposed to asbestos have difficulty disposing of the needle-like fibers. Over the years, the fibers are staying irritating the pleural and as a result this causes chronic irritation and scarring in some cases can cause pleural mesothelioma. For this type of cancer, asbestos penetrates directly into the pleural cells. If these cells are cancerous, they multiply uncontrollably and form tumors.
The life expectancy of a patient suffering from this disease is between 4-18 months and 80 percent of people who get pleural mesothelioma are male seniors who have had exposure to asbestos at work, and with a certain period of time when the disease soon appeared. The first symptoms presented by a patient is coughing and shortness of breath. This is mainly caused by reduced lung capacity and fluid retention on the sides of the pleura.
Anatomy and Function of the Pleura
Pleura coating comprises two layers provide protection and support to the lungs or other vital structures such as the breast. Additionally it produces lubricating fluid for the cavity between the two layers so they can help the expansion and contraction of the lungs when we breathe. The outer layer is the parietal pleura lining the chest cavity and while the inner layer also known as visceral layer covers the lungs.
It is extraordinary that the two layers of the pleura are affected by cancer. Generally pleural mesothelioma develops in a layer of the pleura and quickly invade nearby destinations such as the diaphragm, the look of the breast or lung. If the cancer reaches the lymph nodes, can reach metastasize or spread to different parts of the body.
Symptoms Pleural Mesothelioma Associates
Someone who has been affected by pleural mesothelioma may have one or more symptoms related to the presence of tumors or thickening of the pleural membrane. Unfortunately, most of the symptoms associated with the disease do not appear until the cancer in its final stages - stage III or IV. The thickening can cause pleural effusion, this is an accumulation of fluid in the space between the layers of the pleura. This fluid puts pressure on the lungs and results in chest pain and disability to breathe naturally. These complications occur due to a number of factors including:
Continuous and dry cough
Cough with bleeding (hemoptysis)
Shortness of breath
Pain in the rib area or lower back
Painful breathing
Development lumps under the skin in the chest area
Shortness of breath
Night sweating or fever
Unexplained weight loss
Fatigue
During the first consultation with a doctor, more than 60 percent of patients with pleural mesothelioma pain in the chest and has a fairly short breath. Weight loss and fatigue are not among the most common symptoms and the time in which they appear means that the disease is in its final stages. Less than 30 percent of patients with pleural mesothelioma report these symptoms before being diagnosed.
Learn more about symptoms associated with pleural mesothelioma
Diagnosis of Pleural Mesothelioma
Like many other diseases, cancer, pleural mesothelioma can be difficult to diagnose . Symptoms come to light long after the first exhibition took place. Additionally, by the fact that many other respiratory conditions cause similar symptoms, pleural mesothelioma can be confused with a much less severe disease like influenza or pneumonia. All this comes together it is quite difficult for experts to define the difference between this cancer and adenocarcinoma, a common type of lung cancer.
Scan diagnostics
The X-ray or CT scan are commonly used to diagnose pleural mesothelioma.
A diagnosis of pleural mesothelioma can be made based on the patient's symptoms, additionally this can be confirmed by tests to diagnose the presence of cancer. To ensure the best option to treat the patient and their health in general, a diagnosis at an early stage is crucial. After a medical and occupational history together with physical examinations, patients undergo scanning tests to determine cancerous tumors. An X-ray examination may reveal pleural effusion and in some cases the presence of staying in the pleura masses, however, a CT scan provides the doctor with the image normally reveal exposure to asbestos.
With the introduction of PET scan in the 60s, doctors can have the facility to distinguish between benign cancer and malignant mesothelioma. Additionally, a PET scan can detect signs that a mesothelioma tumor is spreading to the lymph nodes, which the CT scan can not detect, which can be very beneficial to determine the status of the disease. A combination quite promising, known as PET-CT scanning, emerged in 2000 and many of the experts in the field say that this technique help predict more clearly if the patient will react in a better way to chemotherapy or PET and CT scan applied separately. However, many studies have to be carried out to make this something official.
Smears and biopsies
The cytologies and biopsies help diagnose mesothelioma more accurately.
While technological advances in scanning process has contributed to a more accurate diagnosis, a little more invasive procedures should be doing to make an official diagnosis of mesothelioma. One such process is the thoracentesis in which a needle is inserted in the lungs to collect the pleural fluid.Making to inspect cytology cell samples, doctors look for biomarkers indicating presence of a cancer, examples of such markers are the epithelial membrane antigen, calretinin and WT1. Specialized doctors can make a cytology to diagnose mesothelioma cancer in 80% of cases are successful.
Sometimes the results are inconclusive or simply no presence of pleural fluid. In these cases doctors prefer to biopsy tissue from the pleura. Color dyes are added to the sample in order to help doctors visualize cellular structures. A type of biopsy is often used aspiration of thyroid fine needle although many other doctors have applied thoracoscopy and have received much more favorable results. A thoracoscopic biopsy produces a result that in 98 percent of patients. Current golden rule when diagnosing pleural mesothelioma, you have to take a test cell taken within an electron microscope. If the number of examinations and biopsies can confirm the presence of mesothelioma, doctors can start working on a plan based on results.
Treatment of pleural mesothelioma
Historically, doctors have sought pleural mesothelioma cancer with surgery, chemotherapy or radiation therapy. Depending on how advanced the disease in the patient, these treatments can be curative or palliative. While not many patients are diagnosed early enough to be treated with curative surgery, many palliative treatments exist that can relieve a lot of symptoms, improve quality of life and significantly increase life expectancy. There is research that are evaluating a variety of alternative treatments such as immunotherapy and gene therapy, which may become a common treatment for mesothelioma patients once they are perfected.
Surgery
The surgery remains a primary treatment for patients with pleural mesothelioma. One of the most common procedures is pleurectomy / decortication, where the goal of the operation is to remove the tumor affecting the pleura. A more aggressive treatment is the extra-pleural pneumonectomy, this is safely remove the entire lung, the diaphragm and the pericardium.Only a small fraction of patients have a proper function of your lungs to qualify for treatment as aggressive as this.
Chemotherapy
One of the most common is the palliative therapieschemotherapy in which the use of one or more drugs infected try to eliminate cancer cells and shrink tumors. While a recent study has shown that patients respond better to chemotherapy, the results have been unfavorable. Only 15 to 20 percent of patients with mesothelioma notice a significant reduction of the tumor after the therapy is applied.
However, many clinical studies combine chemotherapy treatment that has shown considerable potential. A multi-center Phase 3 study found that a combination of pemetrexed and cisplatin prolongs median survival 2.8 months compared a single therapy in which only cisplatin is one. 41 percent of patients who were treated with pemetrexed and cisplatin regimen experienced tumor shrinkage of at least 50 percent. While the combination of drugs used for chemotherapy pleura mesothelioma cure has yet been found, this is the main objective of countless researchers involved in clinical trials.
Radiation therapy
Pleural mesothelioma usually resists radiation therapy . In this treatment, doctors give a local radiation to kill cancer cells and shrink the tumor. Although it is a very poor to cure the patient this may be effective for managing symptoms such as chest pain option. One of the most successful techniques of radiation therapy is intensity modulated. It is usually applied to patients at intervals of low doses after radical surgery such as extra pleural pneumonectomy, this technique prevents recurrence of cancer in many cases. While it is effective in preventing the cancer from returning to areas where radiation was applied, is even spreading of the tumor is something that is unresolved.
Multimodal therapy
Currently, there is no universally accepted treatment to treat pleural mesothelioma, most experts can agree that life expectancy can be improved if a combined treatment is applied. This is known as a multimodal therapy and researchers are constantly experimenting with surgery, chemotherapy and radiation to discover the most efficient combination. In one example of multimodal therapy applied to patients with pleural mesothelioma, doctors applied extra-pleural pneumonectomy first. Radiation therapy is then administered to reduce the risk of the cancer coming back in the place where the radiation was applied and that this does not spread from areas near the affected organ, chemotherapy is applied.a