Health & Wellness

Everything You Need to Know about Malignant Mesothelioma Cancer

0 Shares

Malignant mesothelioma is a disease in which malignant (cancer) cells form in the lining of the chest or abdomen.

The malignant mesothelioma is a type of cancer found in the pleura (thin layer of tissue lining the cavity thoracic and covers the lungs ) or the peritoneum (thin layer of tissue lining the stomach and covers most of their organs ). Malignant mesothelioma also forms in the heart or testicles, but this is very rare.

Malignant Mesothelioma Risk Factor

Anything that increases the likelihood of having a disease is called a risk factor. The presence of a risk factor does not mean that you will get cancer, but the absence of risk factors does not mean that you will not get cancer. Check with your doctor if you think you are at risk.

Most people with malignant mesothelioma have worked or lived in places where they inhaled or swallowed asbestos. After exposure to asbestos, it usually takes a long time until a malignant mesothelioma forms. Living with a person who works near asbestos is also a risk factor for malignant mesothelioma.

Signs & Symptoms of Malignant Mesothelioma

Sometimes, malignant mesothelioma cancer causes fluid to accumulate in the chest or abdomen. The signs and symptoms occur because the liquid, malignant mesothelioma or other conditions. Check with your doctor if you have any of the following signs or symptoms:

  • Difficulty breathing.
  • Cough.
  • Pain under the ribs.
  • Pain or swelling in the abdomen.
  • Masses in the abdomen.
  • Constipation.
  • Problems with blood clots (unexpected clots).
  • Weight loss for no known reason.
  • Feeling very tired.

Malignant Mesothelioma Cancer

How to Diagnose Malignant Mesothelioma

In some cases, it is difficult to differentiate malignant mesothelioma that is found in the chest from lung cancer.

The following tests and procedures are used to diagnose a malignant thorax or peritoneum mesothelioma:

  • Physical exam and history: An exam of the body to check the general state of health and identify any signs of illness, such as masses or anything else that seems abnormal. Data are also taken on health habits, asbestos exposure, history of illnesses and previous treatments.
  • Chest x-ray: X-ray of the organs and bones inside the chest. An X-ray is a type of energy beam that can pass through the body and be captured in a film that shows an image of areas inside the body.
  • Computed tomography (CT): a procedure for which a series of detailed images of the chest and abdomen are taken from different angles. The images are created with a machine connected to a computer ray X.injected one dye into a vein or swallowed to the organs or tissues show more clearly. This procedure is also called computed tomography, computed tomography (CT) or CT scanning.
  • Biopsy: removal of cells or tissues from the pleura or peritoneum for a pathologist to observe under a microscope and determine if there are signs of cancer.

The procedures used to collect cells or tissues are as follows:

  • Lung biopsy by fine-needle aspiration (AAF): removal of tissue or fluid using a fine needle. A procedure with images is used to find abnormal tissue or fluid in the lung. Sometimes a small incision is made in the skin where the biopsy needle is passed to the abnormal tissue or fluid and a sample is taken.
  • Thoracoscopy: procedure for which an incision (cut) is made between two ribs and a thoracoscope is inserted into the thorax (a thin tube-shaped instrument with a light and a lens to observe).
  • Thoracotomy: procedure for which an incision (cut) is made between two ribs to determine if there are signs of disease inside the chest.
  • Peritoneoscopy: procedure for which an incision (cut) is made in the wall of the abdomen and a peritoneoscope (a thin tube-shaped instrument with a light and a lens to observe) is inserted into the abdomen.
  • Open biopsy: procedure for which an incision (cut) is made in the skin that allows you to see and remove tissues to determine if there are signs of disease.

The following tests may be done on cell and tissue samples:

  • Examination Cytology: An examination of cells under a microscope to determine if there is something abnormal. For mesothelioma, fluid is drawn from the chest or abdomen. A pathologist examines the fluid to determine if there are signs of cancer.
  • Immunohistochemical test: test to identify certain antigens in a tissue sample through the use of antibodies. Usually, the antibody binds to a radioactive substance or a dye so that the cells light up under a microscope. This type of study is used to determine the difference between different types of cancer.
  • Electron microscopy: A laboratory test by which the cells of a tissue sample are observed with a high power microscope to detect certain changes in the cells. Small details look better with an electron microscope than when using another type of microscope.

Factors Affecting Prognosis & Treatment Options

The prognosis (chance of recovery ) and treatment options depend on the following aspects:

  • The stage of cancer.
  • The size of the tumour.
  • If possible remove the tumor completely by surgery.
  • The amount of fluid in the chest or abdomen.
  • The patient’s age
  • The degree of activity of the patient.
  • The general state of health of the patient, such as the health of the lungs and the heart.
  • The type of mesothelioma cells and their appearance under a microscope.
  • The number of white blood cells and the amount of hemoglobin in the blood.
  • If the patient is male or female.
  • If the cancer was recently diagnosed or recurred (returned).

Stages of Malignant Mesothelioma

IMPORTANT POINTS

  • After diagnosing malignant mesothelioma, tests are performed to determine if cancer cells have spread to other parts of the body.
  • The cancer spreads in the body in three ways.
  • The cancer may spread from where it started to other parts of the body.
  • The following stages are used for malignant mesothelioma of the lung:
    • Stage I
    • Stage II
    • Stage III
    • Stage IV

Malignant Mesothelioma Staging Processes

The process used to determine if the cancer has spread outside the pleura or the peritoneum is called staging. The information obtained from the staging process determines the stage of the disease. It is important to know if the cancer has spread to plan treatment.

The following tests and procedures may be used during the staging process:

  • Computed tomography (CT): A procedure for which a series of detailed images of the chest and abdomen are taken from different angles. The images are created with a machine connected to a computer ray X. it injected one dye into a vein or swallowed so that the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized axial tomography or CT scan.
  • Positron emission tomography (PET): A procedure to find cells of tumors malignant in the body. A small amount of radioactive glucose (sugar)is injected into a vein. The PET scan rotates around the body and creates an image of places in the body that use glucose. Malignant tumor cells look brighter in the image because they are more active and absorb more glucose than normal cells.
  • Magnetic resonance imaging (MRI): a procedure for which a magnet, radio waves and a computer are used to create a series of detailed images of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (MRI).
  • Endoscopic ultrasound (EE): A procedure for which an endoscope is inserted into the body. An endoscope is a thin, tube-shaped instrument with a light and a lens to observe. A probe placed at the end of the endoscope is used to bounce high-energy (ultrasonic) sound waves into tissues or internal organs and create echoes. The echoes form an image of body tissues called an echogram. This procedure is also called endoecography. EE also serves to guide fine-needle aspiration (AAF) biopsy in the lung, lymph nodes or other areas.
  • Laparoscopy: A surgical procedure to observe the organs inside the abdomen and determine if there are signs of disease. Small incisions (cuts) are made in the wall of the abdomen and a laparoscope (a thin tube with a light)is inserted into one of the incisions. It is possible to introduce other instruments in the same incision or in other incisions to perform procedures such as the removal of organs or the removal of tissue samples to observe them under a microscope and check for signs of disease.
  • Lymph node biopsy: A total or partial removal of a lymph node. A pathologist looks at the lymph node tissue under a microscope to detect cancer cells.
  • Mediastinoscopy: A surgical procedure to see if there are abnormal areas in the organs, tissues and lymph nodes that are between the lungs. An incision (cut) is made in the upper part of the sternum and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin tube-shaped instrument, with a light and a lens to observe. Sometimes it has a tool to remove samples of tissue or lymph nodes, which are observed under a microscope to check for signs of cancer.

How Cancer Spreads

Cancer spreads in the body in three ways. Cancer can spread through tissue, lymphatic system and blood:

    • Tissue: Cancer spreads from where it starts and spreads to nearby areas.
    • Lymphatic system: Cancer spreads from where it began and enters the lymphatic system. The cancer travels through the lymphatic vessels to other parts of the body.
    • Blood: Cancer spreads from where it began and enters the blood. The cancer travels through the blood vessels to other parts of the body.

Stages of Malignant Mesothelioma

The following stages are used for malignant mesothelioma of the lung:

Stage I

The stage I is divided into stages IA and IB:

  • In stage IA, cancer is found in the inner lining of the chest wall on one side of the chest. On the same side of the chest, cancer may also be found in one or more of the following sites:
    • The thin layer of tissue that lines the lung.
    • The thin layer of tissue that lines the organs between the lungs.
    • The thin layer of tissue that lines the upper part of the diaphragm.
  • In stage IB, the cancer is found in the inner lining of the chest wall and in each of the thin layers of tissue that line the lung, the organs that are between the lungs, and the upper part of the diaphragm on one side of the chest. On the same side of the chest, the cancer has also spread to one or more of the following sites:
    • Diaphragm.
    • Lung tissue.
    • The tissue between the ribs and the inner lining of the chest wall.
    • The fat between the lungs.
    • The soft tissues of the chest wall.
    • The bag that surrounds the heart.

Stage II

In stage II, the cancer is found in the inner lining of the chest wall on one side of the chest. On the same side of the chest, cancer may also be found in one or more of the following sites:

  • The thin layer of tissue that lines the lung.
  • The thin layer of tissue that lines the organs between the lungs.
  • The thin layer of tissue that lines the upper part of the diaphragm.
  • The cancer has spread to the lymph nodes along the center of the chest on the same side as the tumour.

OR

The cancer is found in the inner lining of the chest wall and in each of the thin layers of tissue that line the lung, the organs that are between the lungs, and the upper part of the diaphragm on one side of the chest. On the same side of the chest, the cancer has also spread to one of the following sites or both:

  • Diaphragm.
  • Lung tissue.
  • The cancer has spread to the lymph nodes along the center of the chest on the same side as the tumor.

Stage III

The stage III is divided into IIIA and IIIB.

  • In stage IIIA, cancer is found in the inner lining of the chest wall and in each of the thin layers of tissue that line the lung, the organs that are between the lungs, and the upper part of the diaphragm on one side of the chest. On the same side of the chest, the cancer has also spread to one or more of the following sites:
    • The tissue between the ribs and the inner lining of the chest wall.
    • The fat between the lungs.
    • The soft tissues of the chest wall.
    • The bag that surrounds the heart.

    The cancer has spread to the lymph nodes along the center of the chest on the same side as the tumour.

  • In stage IIIB, the cancer is in the inner lining of the chest wall and may also be found in the thin layers of tissue that line the lung, the organs that are between the lungs, or the upper part of the diaphragm. one side of the chest On the same side of the chest, it is possible that the cancer has also spread to one or more of the following sites:
    • Diaphragm.
    • Lung tissue.
    • The tissue between the ribs and the inner lining of the chest wall.
    • The fat between the lungs.
    • The soft tissues of the chest wall.
    • The bag that surrounds the heart.

The cancer has spread to lymph nodes that are above the clavicle on either side of the chest, or the cancer has spread to the lymph nodes along the center of the chest on the side opposite to the tumour.

OR

The cancer is found in the inner lining of the chest wall and in each of the thin layers of tissue that line the lung, the organs that are between the lungs, and the upper part of the diaphragm on one side of the chest. The cancer has also spread to one or more of the following sites:

  • The chest wall and sometimes the ribs.
  • Through the diaphragm to the peritoneum.
  • The tissue that lines the chest on the side of the body opposite the tumor.
  • The organs that are between the lungs (esophagus, trachea, thymus, blood vessels ).
  • The backbone.
  • Through the bag that surrounds the heart to the heart muscle.
  • It is possible that the cancer has spread to the lymph nodes.

Stage IV

In stage IV, the cancer has spread to the tissue that lines the lung or lung on the opposite side, the peritoneum, bones, liver, lymph nodes outside the chest or to other parts of the body.

Recurrent Malignant Mesothelioma

The malignant mesothelioma relapsing is cancer that relapsed (returned) after treatment. Cancer returns to the chest, abdomen or other parts of the body.

General Aspects of Treatment Options

Important Points

  • There are different types of treatment for patients with malignant mesothelioma.
  • Four types of standard treatment are used:
    • Surgery
    • Radiotherapy
    • Chemotherapy
    • Targeted therapy
  • New types of treatment are being tested in clinical trials.
    • Biological therapy
  • Sometimes, treatment of malignant mesothelioma causes side effects.
  • Patients may consider participating in a clinical trial.
  • Patients may enter clinical trials before, during or after starting their cancer treatment.
  • Sometimes follow-up tests are needed.

 Malignant Mesothelioma Treatment Types

There are different types of treatment available for patients with malignant mesothelioma. Some treatments are standard (treatment that is currently used) and others are being tested in clinical trials. A clinical treatment trial is a research study to improve existing treatments or obtain information about new treatments for cancer patients. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may consider participating in a clinical trial. In some clinical trials, only patients who have not yet received treatment are accepted.

Four types of standard treatment are used:

Surgery

The following surgical procedures are used for malignant thoracic mesothelioma:

  • Wide local excision: Surgery to remove the cancer and some of the healthy tissue that surrounds it.
  • Pleurectomy and decortication: Surgery to remove part of the tissue that lines the lungs, the lining of the chest and the part of the outer surface of the lungs.
  • Extrapleural pneumonectomy: Surgery to remove an entire lung and part of the lining of the chest, the diaphragm, and the lining of the bag that surrounds the heart.
  • Pleurodesis: A surgical procedure for which chemicals or medications are used to form a scar in the space between the layers of the pleura. First, the liquid is removed from the space with a catheter or chest tube and then the chemical or medication is placed in that space. Healing interrupts the accumulation of fluid in the pleural cavity.

After the doctor removes all visible cancer at the time of surgery, some patients may receive chemotherapy or radiotherapy to destroy any cell cancer remaining. The treatment given after surgery to decrease the risk of cancer coming back is called adjuvant therapy.

Radiotherapy

Radiation therapy is a cancer treatment for which high-energy x-rays or other types of radiation are used to destroy cancer cells or prevent them from growing. There are two types of radiotherapy.

  • External radiotherapy: type of radiotherapy for which a machine that sends radiation to cancer from outside the body is used.
  • Internal radiotherapy: type of radiotherapy for which a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly in or near the cancer is used.

The way in which radiotherapy is administered depends on the type and stage of the cancer being treated. External radiation therapy is used to treat malignant mesothelioma and is sometimes also used as palliative therapy to relieve symptoms and improve quality of life.

Chemotherapy

Chemotherapy is a cancer treatment in which medications are used to stop the formation of cancer cells, either by destruction or by preventing their multiplication. When chemotherapy is taken by mouth or injected into a vein or muscle, medications enter the bloodstream and can reach cancer cells throughout the body ( systemic chemotherapy ). When chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the thorax or peritoneum, medications primarily affect cancer cells in those areas ( regional chemotherapy). The combination chemotherapy is the use of more than one anticancer drug.

The intraperitoneal chemotherapy hyperthermic is used to treat mesothelioma that has spread to the peritoneum (lining of the abdomen, and covers most of the organs in the abdomen). After the surgeon removes, all visible cancer, a solution containing cancer drugs that is heated and pumped in and out of the abdomen is used to remove the remaining cancer cells. When cancer drugs get hot, more cancer cells are destroyed.

The way chemotherapy is administered depends on the type and stage of the cancer being treated.

Targeted therapy

The targeted therapy is a type of treatment for which drugs or other substances to attack specific cancer cells are used. Typically, targeted therapies produce less damage to normal cells than chemotherapy or radiation therapy.

The therapy of monoclonal antibodies is a cancer treatment for the used antibodies produced in the laboratory from a single cell type of the immune system. These antibodies identify substances in cancer cells or normal substances that help cancer cells multiply. Antibodies adhere to these substances and destroy cancer cells, block their multiplication or prevent them from spreading. Monoclonal antibodies are administered by infusion. They are used alone or to carry medications, toxins or radioactive material directly to cancer cells.

The Bevacizumab is a monoclonal antibody used to treat mesothelioma advanced. It binds to a protein called vascular endothelial growth factor (VEGF). It is possible that this antibody prevents the growth of the new blood vessels that tumors need to grow. Other monoclonal antibodies are also studied to treat malignant mesothelioma.

The kinase inhibitors are a type of targeted therapy being studied for the treatment of malignant mesothelioma. Kinase inhibitors are targeted therapy medications that disrupt the signals that cause tumours to grow.

Malignant Mesothelioma Treatment (In Stages)

Stage I malignant mesothelioma

If stage I malignant mesothelioma is in a part of the chest lining, treatment includes the following procedure:

  • Surgery to remove the part of the lining of the chest that has cancer and the surrounding tissue.

If stage I malignant mesothelioma is found in more than one place in the chest, treatment includes one of the following procedures:

  • Extrapleural pneumonectomy.
  • Pleurectomy and decortication, with or without radiotherapy as palliative therapy to relieve symptoms and improve quality of life.
  • Radiation therapy, as palliative therapy, to relieve symptoms and improve the quality of life.
  • Participation in a clinical trial of anticancer drugs placed in the chest after surgery to remove the tumor.
  • Participation in a clinical trial of combinations of surgery, radiotherapy, and chemotherapy.
  • Participation in a clinical trial of a new treatment.

If stage I malignant mesothelioma is in the lining of the peritoneum, treatment includes the following procedure:

  • Surgery to remove the part of the lining of the peritoneum that has cancer and the surrounding tissue.

Stage II, stage III or stage IV malignant mesothelioma

If the malignant mesothelioma in stage II, stage III or stage IV is in the chest, treatment includes one of the following:

  • Combined chemotherapy and targeted therapy with bevacizumab.
  • Chemotherapy placed directly in the chest cavity to reduce the size of tumours and prevent fluid accumulation.
  • Surgery to drain the fluid that accumulates in the chest to relieve discomfort and improve the quality of life. Sometimes pleurodesis is performed to prevent more fluid from accumulating in the chest.
  • Pleurectomy and decortication, as palliative therapy, to relieve symptoms and improve quality of life.
  • Radiation therapy, as palliative therapy, to relieve pain.
  • Participation in a clinical trial of combinations of surgery, radiotherapy, and chemotherapy.

If stage II, stage III or stage IV malignant mesothelioma is in the peritoneum, treatment includes one of the following procedures:

  • Surgery to remove the tumor followed by hyperthermic intraperitoneal chemotherapy.
  • Chemotherapy placed directly in the peritoneum to reduce the size of the tumor and prevent the accumulation of fluid.

Recurrent Malignant Mesothelioma

Treatment of recurrent malignant mesothelioma includes one of the following procedures:

  • Surgery to remove part of the chest wall.
  • Chemotherapy, if not given as initial treatment.
  • Participation in a clinical trial of biological therapy.
  • Participation in a clinical trial of targeted therapy.
  • Participation in a clinical trial of chemotherapy.
  • Participation in a clinical trial of surgery.
0 Shares

Leave a Comment