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Sunday, October 31, 2010
MesotheliomaDo you know what is it?
Well Malignant mesothelioma is a rare type of
cancer that occurs in the thin layer of cells lining
the body's internal organs, known as the
mesothelium. There are any three recognized types of
mesothelioma.
1. Pleural mesothelioma : is the
most common form of the disease, accounting
for roughly 70% of cases, and occurs in the lining
of the lung known as the pleura.
2. Peritoneal
mesothelioma :occurs in the lining of the
abdominal cavity, known as the peritoneum
3.
pericardial mesothelioma: originates in the
pericardium, which lines the of heart.
Who is at risk for this mesothelioma?
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 person.
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 they should receive a
free mesothelioma information packet, detailing
treatment options, emerging therapies.
Mesothelioma Treatment
Once an individual has been diagnosed with
mesothelioma, the next step is to discuss
mesothelioma treatment options with his/her
physician. Recent scientific research has produced
significant breakthroughs with regard to
treatment protocols for mesothelioma patients
and more options are now available for
managing the disease and supporting improved
quality of life.
Newly diagnosed patients always
have many questions about the treatment
options that would be most effective for them,
including those about new treatment for people chemotherapy drugs.
In addition to these newer
drugs that are being used to treat asbestos
cancer, mesothelioma patients also have a
number of "conventional" treatment options to
consider, including chemotherapy, radiation
therapy and surgery.
Clinical trials and experimental treatments are still
other options that some mesothelioma patients
may be eligible to participate in. mesothelioma cancer
treatment section that includes important
information for patients and families. As well as a
comprehensive list of questions that you may
wish to discuss with your personal physician
when preparing a treatment plan.
dont forget for check back
often for the most recent advances in
mesothelioma treatments.
 | Mesothelioma |  |
What is Mesothelioma (Asbestos Cancer)?
It is a form of cancer in which malignant (cancerous) cells are found in the mesothelium which is a protective sac that covers most of the body's internal organs. Generally, most individuals who develop this cancer have worked on jobs or lived in apartments or buildings where asbestos particles were inhaled.
Asbestos cancer is when the mesothelium lining becomes abnormal and grows uncontrollably causing pain. This can be benign or malignant. The malignant form of the cancer will damage the tissue of the organ it resides on and possibly invade other organs. Most cases of mesothelioma are either pleural or peritoneal. the Most cases of begin in the pleura or peritoneum.
Mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart. The mesothelial tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women.
Mesothelioma (Asbestos Cancer) Symptoms
Symptoms may not show up in the body until between 20 - 50 years after exposure, which is why so many new cases of this form of cancer are being diagnosed in recent years. All though the dangers of asbestos cancer were realized many decades ago and precautions have been taken to reduce the risk of the disease, it can take very little exposure to cause the cancer.
As with many forms of cancer, the asbestos cancer tumor can spread in the body rapidly, often infecting the opposite pleura and continuing on to other internal organs. The symptoms of Asbestos cancer are listed below.
Pleural Mesothelioma:
* Shortness of breath
* Chest pain in the chest (caused by fluid accumulation in the pleura)
Peritoneal Mesothelioma
* Weight loss
* Abdominal pain
* Abdominal swelling (caused by fluid build-up in the abdomen)
* Bowel obstruction
* Blood clotting abnormalities
* Anemia
* Fever
If the asbestos cancer has spread beyond the mesothelium to other parts of the body, additional symptoms may include:
* Pain
* Trouble swallowing
* Swelling of the neck or face areas
If you are experiencing these or similar medical problem, please consult your doctor.
As with many forms of cancer, the asbestos cancer tumor can spread in the body rapidly, often infecting the opposite pleura and continuing on to other internal organs. The symptoms of Asbestos cancer are listed below.
Pleural Mesothelioma:
* Shortness of breath
* Chest pain in the chest (caused by fluid accumulation in the pleura)
Peritoneal Mesothelioma
* Weight loss
* Abdominal pain
* Abdominal swelling (caused by fluid build-up in the abdomen)
* Bowel obstruction
* Blood clotting abnormalities
* Anemia
* Fever
If the asbestos cancer has spread beyond the mesothelium to other parts of the body, additional symptoms may include:
* Pain
* Trouble swallowing
* Swelling of the neck or face areas
If you are experiencing these or similar medical problem, please consult your doctor.
Friday, October 29, 2010
Conventional Therapies
Conventional mesothelioma therapies include surgery, radiation and chemotherapy. You should keep in mind that if you choose one course of action for mesothelioma treatment, you may preclude other courses. All of your options should be considered as soon as possible.
Alternative Treatments
Many of those being treated for serious illness find comfort in different alternative therapies such as massage and acupuncture. These untraditional methods of disease management can complement conventional therapies and allow the patient to be more at peace and comfortable during this difficult time. Meditation and Yoga are common methods used by many to reach a state of relaxation, and release endorphins, our body's natural pain relievers.
Experimental Therapies
Several forms of mesothelioma treatment such as the drug Alimta®, gene therapy, immunotherapy, photodynamic therapy and multimodality therapy are still in their experimental stages. We invite you to read the following articles on experimental therapies for malignant mesothelioma.
Treatment by Stage
This section lists typical treatment strategies based on the stage (using the Butchart staging system) of a pleural mesothelioma.
Cancer centres
Top Cancer Centers for mesothelioma treatment have been listed alphabetically by state for your convenience. Listings include contact information and Web site links where available.
Clinical Trials
Information about current studies of promising new or experimental mesothelioma treatments.
Once you have been diagnosed with mesothelioma, your doctor will want to learn the extent of the disease and whether the cancer has spread to various parts of the body or to the lymph notes. Finding out this information is called staging. Knowing the phase or stage of mesothelioma will help your doctor plan treatment. For example, mesothelioma patients in early stages of the disease may be eligible for surgery. 
Once the mesothelioma is more advanced, pain reduction or palliative treatment may be the best course of actionGenerally, mesothelioma is considered localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.There is no standard staging system for peritoneal mesothelioma. There are two staging systems for pleural mesothelioma—the TNM system, which is concerned with tumor size, lymph node analysis, and how far the tumor has spread (metastasis), and the older Butchart system, based on the extent of the primary tumor. Most cancer centers are using the TNM system in preference to the Butchart system of staging.
Once the mesothelioma is more advanced, pain reduction or palliative treatment may be the best course of actionGenerally, mesothelioma is considered localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.There is no standard staging system for peritoneal mesothelioma. There are two staging systems for pleural mesothelioma—the TNM system, which is concerned with tumor size, lymph node analysis, and how far the tumor has spread (metastasis), and the older Butchart system, based on the extent of the primary tumor. Most cancer centers are using the TNM system in preference to the Butchart system of staging.
Some elements common to most staging systems are:
- Location of the primary tumor.
- Size and number of the tumors.
- Lymph node involvement.
- Cell type and tumor grade
- metastasis.
Many cancer registries, such as the National Cancer Institute's Surveillance, Epidemiology, and End Results Program (SEER) use summary staging, a system used for all types of cancer. Summary staging groups cancer into five main categories:
- In situ - cancer that is present only in the layer of cells in which it began.
- Localized - cancer that is limited to the organ in which it began with no evidence of spread.
- Regional - cancer that has spread from the primary site to nearby lymph nodes or organs.
- Distant - cancer that has spread from the primary site to distant lymph nodes or organs.
- Unknown - cases where not enough information exists to indicate stage.
Several types of testing may be used to help doctors determine stage, and to formulate a treatment plan.
- Physical examinations. The doctor examines the body by looking, feeling and listening to anything out of the ordinary.
- Imaging techniques. Procedures such as x-rays, CT scans, MRIs and PET scans may show the location, size of the tumor and whether the cancer has spread.
- Laboratory tests. Studies of blood, urine, fluid and tissue can provide information about the cancer. Tumor markers, sometime elevated when cancer is present, may provide information.
- Pathology reports. Results of the examination of tissue samples can include information about the size of the tumor(s), extension into adjacent structures, type of cells and grade of the tumor. Results of the examination of cells in fluid, such as that from a mesothelioma-related pleural effusion, may also provide information.
- Surgical reports. Observations about the size and appearance of the tumor(s), lymph nodes and nearby organs.
Staging information should be provided to the patient by his doctor so that potential treatment plans can be discussed. Stage of the mesothelioma, as well as consideration of other factors such as age, health status and the patient's wishes may dictate different treatment options.
The oldest staging system and the one most often used is the Butchart System which is based mainly on the extent of primary tumor mass and divides mesotheliomas into four stages. The more recent TNM system considers variables of tumor in mass and spread, lymph node involvement, and metastasis. The Brigham System is the latest system and stages mesothelioma according to resectability (the ability to surgically remove) and lymph node involvement.
Pericardial mesothelioma develops in the pericardium, a membrane made up of mesothelial cells that surrounds the heart and provides protection and support to this organ. The membrane is composed of two different layers: an outer layer called the parietal layer (called the heart sac or theca cordis), and an inner layer known as the visceral layer (called the epicardium). The parietal layer is part of a larger membrane that lines the entire chest cavity, while the visceral layer is the pericardial membrane that lines the heart. The pericardium is wrapped around the heart and the origin points of all the body’s major veins and arteries. The pericardium keeps the heart in place, stops it from expanding when it is under pressure, and provides lubrication for the heart’s beating motion. There are two layers to the pericardium, the visceral layer and the parietal layer. The visceral layer is inside, next to the heart, while the parietal layer is outside. Between the two layers is a fluid layer, called pericardial fluid. The parietal layer is tougher and stronger than the visceral layer; the two layers and the liquid insulating layer provide protection for the heart from damage to the chest.
Relatively little is known about pericardial mesothelioma because it is a fairly rare form of the disease; nearly all mesothelioma sufferers have pleural or peritoneal mesothelioma.
It is established that asbestos exposure is the primary cause for pericardial mesothelioma, however; what is not known is exactly how the asbestos reaches the heart. One possibility is that the smallest asbestos fibers might enter the bloodstream from the lungs, and be thus carried into the heart cavity.
Prognosis for those with pericardial mesothelioma is grim and palliative treatment is usually the only option for people diagnosed with pericardial mesothelioma. This type of treatment is performed to improve a patient's quality of life, and reduce the severity of symptoms caused by the build-up of fluid in the pericardium. Fine needle aspiration may be carried out to remove excess fluid as well. In some cases, radiation therapy may be an option. Unfortunately, the proximity of the heart and lungs make this a risky prospect.
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.
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
* When Mesothelioma spreads to distant organs, it may cause:
* Bone pain
* Neurologic changes (such as weakness or numbness of a limb, dizziness)
* Jaundice (yellow coloring of the skin and eyes)
* Masses near the surface of the body, due to cancer spreading to the skin or to lymph nodes (collection of immune system cells) in the neck or above the collarbone.
A. Pleural Mesothelioma Symptoms
Some of the symptoms of pleural mesothelioma (mesothelioma cancer of the lung lining) include:
pain in the lower back or the side of the chest
shortness of breath
a persistent cough
difficulty swallowing food
fever and sweating
fatigue
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.
B. Peritoneal Mesothelioma Symptoms
Symptoms of peritoneal mesothelioma (abdominal mesothelioma - mesothelioma of the lining of the stomach) include:
stomach pain
nausea and vomiting
weight loss.
Like pleural mesothelioma, these symptoms are also common to many minor ailments and, therefore, may not cause a doctor to suspect mesothelioma.
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.
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.
Mesothelioma can be a very difficult disease to diagnose. Many of the symptoms present as being similar to viral or bacterial diseases like pneumonia or bronchitis, and the diagnosis is further complicated by the fact that many mesothelioma patients also develop these lung conditions as a result of their illness and its weakening of their immune system. It is critically important that physicians understand whether a patient has had a significant asbestos exposure history; without that knowledge, a clinician is likely to assume that mesothelioma symptoms are caused by a much more common condition. The diagnostic process usually begins with a complete physical examination, lung function tests, and an X-ray of the chest or abdomen. CT scans and MRIs are also often done at this stage so that the physician can get an idea of the condition of the lungs or abdomen and detect effusions (pools of liquid within the pleural sac or the abdominal cavity) which are often present in the case of mesothelioma.
The diagnosis of mesothelioma will entail scans and biopsies arranged by your doctor. A CT or MRI scan is often used to detect the possible presence of the disease, and if there is a positive indication of the presence of mesothelioma, the scans are followed up by a biopsy. Doctors often run an examination on the fluid surrounding the lungs, but all too often this is inadequate to make a firm diagnosis. In these circumstances the doctor may perform a small operation in order to remove a tissue sample and run a biopsy on that. This is known as open pleural biopsy. If you are suspected of suffering from peritoneal mesothelioma the biopsy will be performed on tissue taken from the abdominal area, known as a peritoneal biopsy.
Examination of the tissues removed by a pathologist is usually sufficient to permit the diagnosis of malignant mesothelioma, and to distinguish mesothelioma from other similar conditions such as adenocarcinoma. Patients typically do not seek medical care for mesothelioma until the symptoms have been ongoing for four to six months; this lateness of diagnosis is one of the reasons that mesothelioma has such a high mortality rate.
ou have worked with or had contact with asbestos at any time in your life, it is important that you let your doctor know. The difficulty in diagnosing mesothelioma means that you doctor may put your symptoms down to any number of diseases before testing for mesothelioma. However, if you have already made it known that you have worked with asbestos, it will give the doctor a head start in making a diagnosis. This means that test can be carried out far earlier and the necessary treatment can be prescribed.
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