Primarily, mesothelioma occurs in three areas, based on which mesothelioma is categorized into:
o Pleural mesothelioma (mesothelioma of the pleura, the outer lining protecting the chest cavity as well as the lungs)
o Pericardial mesothelioma (mesothelioma of the pericardium, the sac enclosing the heart)
o Peritoneal mesothelioma (mesothelioma of the peritoneum, the lining protecting the abdominal cavity)
Based on the types of cells seen in a mesothelioma patient, mesothelioma can again be categorized into 3 types:
o Epithelioid mesothelioma (approximately 50 to 70 percent of all mesothelial cells)
o Sarcomatoid mesothelioma (least common mesothelioma cell type, approximately 10 to 15 percent)
o Biphasic mesothelioma. (approximately 20 to 40 percent of all mesothelial cells)
Symptoms of
The symptoms of mesothelioma depend on the kind of mesothelioma a patient may have. If a patient is suffering from malignant pleural mesothelioma, he would generally feel a pain in the chest region, accompanied by shallow breathing. These symptoms occur owing to the deposition of fluid in the pleura.
Peritoneal mesothelioma symptoms differ from those of pleural mesothelioma. In the case of localized peritoneal mesothelioma, the symptoms include:
o Fever
o Difficulties in bowel movements
o Anemia
o Abnormalities observed during blood clots
In the case of advanced peritoneal mesothelioma, the symptoms would further include pain, a swelling of the face or the neck, and difficulties in ingestion.
symptoms usually map to those of other, lesser serious ailments. Therefore it is prudent to consult a specialist to ensure what the symptoms indicate.
Diagnosis
diagnosis is not an easy task, as the symptoms map to other lesser ailments, as mentioned above. The first step to diagnosing mesothelioma is a review of the patient's medical history. It is important to know if the patient has had any illnesses whose symptoms mesothelioma too displays. At this time, it is also important to know if the patient has had prior exposure to asbestos. If the patient hasn't had any illnesses displaying the symptoms related to mesothelioma, and has had exposure to asbestos, then there can be suspicion of mesothelioma.
It is important to do a detailed physical examination of the patient, including x-rays, CT scans, and MRIs. The focus would usually be on the abdominal and chest regions. If there is anything suspicious at the end of these examinations, it is advisable to do a biopsy.
A biopsy is usually done by a specialist, either an oncologist or a surgeon. Biopsy involves taking a tissue sample from the patient and subjecting it to specific tests to determine the presence or absence of mesothelioma. Biopsy in the case of mesothelioma can be:
o Thoracoscopy (done by taking tissue samples from inside the chest region, using a thoracoscope)
o Peritoneoscopy (done by taking tissue samples from the abdominal region, using a peritoneoscope)
Once the diagnosis is made, it is vital to learn the stage at which mesothelioma has been detected. Depending on whether the cancer is still at the original site or whether it has spread to other parts of the body, the mesothelioma can be called:
o Localized (still at the original site)
o Advanced (spread to other parts of the body)
Treatment
treatments vary depending on the type of mesothelioma, as also the stage at which it has been detected. The three most commonly used treatment forms against mesothelioma are:
o Surgery - Surgically removing the cancerous body part. For example, malignant pleural mesothelioma treatment could involve removal of the affected lung by performing a pneumonectomy.
o Radiation therapy - Exposing the affected part to high-energy rays to kill the malignant cells
o Chemotherapy - Using chemicals/drugs to destroy the malignant cells, either by injecting them into the patient, or intravenously, or by direct placement in the chest or abdomen (intracavitary chemotherapy).
Besides these three options, research is underway to find newer and more effective treatment options. Clinical trials have played a major role in developing newer treatment options.
Prognosis
In the case of mesothelioma, prognosis is not as accurate as it is with other lesser serious ailments. This is because prognosis usually depends on the phase at which an illness is detected. is usually detected quite late in a patient, so it becomes difficult to state the cure percentage or lifespan of a patient after treatment. Whatever statistics are available are not as reliable as one would like them to be. While it has not been easy to determine which of the two - pleural or peritoneal - mesothelioma is harder to stage, experts are generally in agreement that a prognosis is quite difficult for both.
However, latest studies and research have shown that mesothelioma patients might not be as bad off as was initially believed. This data is tabulated below.
Stage of Detection Chances of Survival (No. of Years) Percentage of Patients
Mid to advanced stages 3 years 10%
5 years 5%
Early stages 2 years 50%
5 years 20%
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