What Is Mesothelioma, Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. More At http://www.mobilityaid.info/what_is_mesothelioma.html
==== ====What Is Mesotheliomahttp://www.mobilityaid.info/what_is_mesothelioma.html==== ====Mesothelioma . What is mesothelioma?Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos.In this disease, malignant cells develop in the mesothelium, a protective lining that covers most ofthe bodys internal organs.Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may alsooccur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac thatsurrounds the heart).Most people who develop mesothelioma have worked on jobs where they inhaled asbestosparticles, or they have been exposed to asbestos dust and fibre in other ways, such as by washingthe clothes of a family member who worked with asbestos.Unlike lung cancer, there is no association between mesothelioma and smoking. Compensationvia asbestos funds or lawsuits is an important issue in mesothelioma. There are mesotheliomalawyers who specilize Just in these cases.The symptoms of mesothelioma include shortness of breath due to pleural effusion (fluid betweenthe lung and the chest wall) or chest wall pain, and general symptoms such as weight loss.The diagnosis can be made with chest X-rays and a CT scan, and confirmed with a biopsy (tissuesample) and microscopic examination. A thoracoscopy (inserting a tube with a camera into thechest) can be used to take biopsies. It allows the introduction of substances such as talc toobliterate the pleural space (called pleurodesis), which prevents more fluid from accumulating andpressing on the lung.Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carriesa poor prognosis. Research about screening tests for the early detection of mesothelioma isongoing.Signs and symptomsSymptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos.Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleuralspace are often symptoms of pleural mesothelioma.Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling andpain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritonealmesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever.If the cancer has spread beyond the mesothelium to other parts of the body, symptoms mayinclude pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.Mesothelioma that affects the pleura can cause these signs and symptoms:chest wall pain, pleural effusion, or fluid surrounding the lung shortness of breathfatigue or anemia. Wheezing, hoarseness, or coughing blood in the sputum (fluid) coughed up(hemoptysis)In severe cases, the person may have many tumor masses. The individual may develop apneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts ofthe body.Tumors that affect the abdominal cavity often do not cause symptoms until they are at a latestage. Symptoms include:Abdominal pain, ascites, or an abnormal buildup of fluid in the abdomen, a mass in the abdomen,problems with bowel function and weight loss.In severe cases of the disease, the following signs and symptoms may be present:Blood clots in the veins, which may cause thrombophlebitis, disseminated intravascularcoagulation, a disorder causing severe bleeding in many body organs, jaundice, or yellowing ofthe eyes and skin, low blood sugar level,pleural effusion, pulmonary emboli, or blood clots in the arteries of the lungsand severe ascites.Mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors areusually found only on one side of the lungs.Diagnosing MesotheliomaDiagnosing mesothelioma is often difficult, because the symptoms are similar to those of a numberof other conditions.Diagnosis begins with a review of the patients medical history. A history of exposure to asbestosmay increase clinical suspicion for mesothelioma.A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increasessuspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed.If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid isaspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with
an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis.While absence of malignant cells on cytology does not completely exclude mesothelioma , itmakes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis,heart failure).If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm adiagnosis of mesothelioma . A doctor removes a sample of tissue for examination under amicroscope by a pathologist. A biopsy may be done in different ways, depending on where theabnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy.In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tubecalled a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to lookinside the chest and obtain tissue samples.If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue forexamination, the doctor makes a small opening in the abdomen and inserts a special instrumentinto the abdominal cavity. If these procedures do not yield enough tissue, more extensivediagnostic surgery may be necessary.Risk factorsWorking with asbestos is the major risk factor for mesothelioma . Mesothelioma is now known tooccur in those who are genetically pre-disposed to it. A history of asbestos exposure exists inalmost all cases. However, mesothelioma has been reported in some individuals without anyknown exposure to asbestos. In rare cases, mesothelioma has also been associated withirradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, suchas erionite.Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexiblefibers that can be separated into thin threads and woven.Asbestos has been widely used in many industrial products, including cement, brake linings, roofshingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air,especially during the manufacturing process, they may be inhaled or swallowed, and can causeserious health problems.In addition to mesothelioma , exposure to asbestos increases the risk of lung cancer, asbestosis(a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx andkidney.The combination of smoking and asbestos exposure significantly increases a persons risk ofdeveloping cancer of the airways (lung cancer, bronchial carcinoma). The Kent brand of cigarettesused asbestos in its filters for the first few years of production in the 1950s and some cases ofmesothelioma have resulted. Smoking modern cigarettes does not appear to increase the risk ofmesothelioma.Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development ofmesothelioma.
TreatmentTreatment of malignant mesothelioma using conventional therapies has not proved successfuland patients have a median survival time of 6 - 12 months after presentation.The clinical behaviour of the malignancy is affected by several factors including the continuousmesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells,invasion to underlying tissue and other organs within the pleural cavity, and the extremely longlatency period between asbestos exposure and development of the disease.SurgerySurgery, either by itself or used in combination with pre- and post-operative adjuvant therapies,has proved disappointing. A pleurectomy/decortication is the most common surgery, in which thelining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in whichthe lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. Itis not possible to remove the entire mesothelium without killing the patient.RadiationWikibooks has a book on the topic ofRadiation Oncology/Lung/MesotheliomaFor patients with localized disease, and who can toleratea radical surgery, radiation is often given post-operatively as a consolidative treatment.The entire hemi-thorax is treated with radiation therapy, often given simultaneously withchemotherapy.This approach of using surgery followed by radiation with chemotherapy has been pioneered bythe thoracic oncology team at Brigham & Womens Hospital in Boston. Delivering radiation andchemotherapy after a radical surgery has led to extended life expectancy in selected patientpopulations with some patients surviving more than 5 years.As part of a curative approach to mesothelioma , radiotherapy is also commonly applied to thesites of chest drain insertion, in order to prevent growth of the tumor along the track in the chestwall.Although mesothelioma is generally resistant to curative treatment with radiotherapy alone,palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth,such as obstruction of a major blood vessel.Radiation therapy when given alone with curative intent has never been shown to improve survivalfrom mesothelioma. The necessary radiation dose to treat mesothelioma that has not beensurgically removed would be very toxic.ChemotherapyIn February 2004, the United States Food and Drug Administration approved pemetrexed (brand
name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given incombination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.==== ====What Is Mesotheliomahttp://www.mobilityaid.info/what_is_mesothelioma.html==== ====