Mesothelioma

Mesothelioma is a rare type of Cancer that develops in the mesothelial cells found in one's body. These cells form membranous linings that surround and protect the body's organs, and line body cavities such as the chest and abdomen. Approximately two-to-three thousand cases of mesothelioma are diagnosed each year in the United States, comprising around three percent of all cancer diagnoses. All forms of mesothelioma, except for benign mesothelioma, are invariably fatal. Mesothelioma is a very aggressive form of cancer that is difficult to diagnose and highly resistant to treatment, and full recovery is extremely rare.

Causes Of Mesothelioma
Symptoms Of Mesothelioma
Diagnosis Of mesothelioma

CT Scan
Imaging Scans

Types Of Mesothelioma

Pleural Mesothelioma
Peritoneal Mesothelioma
Pericardial Mesothelioma
Testicular Mesothelioma
Benign Mesothelioma
Malignant Mesothelioma

Staging Of Mesothelioma
Treatment Of Mesothelioma
Preventions Of Mesothelioma

Treatment

Treatment Of Mesothelioma

There are several types of treatment available for patients with mesothelioma, some recommended more frequently than others. The most commonly-used treatments are surgery, chemotherapy, and radiation therapy. In addition, some experimental treatments are becoming more widely used, or are showing some encouraging results in clinical trials. These treatments include photodynamic therapy, gene therapy, and immunotherapy.
Most of these treatments are not used in isolation. In many cases, treatment may consist of a combination of therapies. For example, surgery to remove as much of the cancer as possible may be followed by radiotherapy or chemotherapy to remove residual cancer cells. This is one of the most common treatment options for mesothelioma among those who are candidates for surgery.

Surgery

Surgical treatments for mesothelioma are of three main types - diagnostic surgery, curative surgery, and palliative surgery. Some types of surgery fall into more than one category. For example, thoracentesis may be used as a diagnostic procedure, and as a palliative treatment to provide symptomatic relief.
Only curative surgery can potentially remove all cancer from a patient with mesothelioma. However, for curative surgery to be effective, it is particularly important that mesothelioma be diagnosed as early as possible. Unfortunately, mesothelioma is usually not diagnosed until it reaches Stage III or IV and surgery is not an option.

Chemotherapy

Most forms of chemotherapy involve the intravenous administration of drugs such as Alimta and Cisplatin. Chemotherapeutic drugs are targeted to kill cells that are rapidly dividing by interfering with processes that occur during cell division. However, while cancer cells themselves divide rapidly, so do some types of healthy cells, causing some of the unpleasant side effects that are often associated with this form of treatment. Though chemo drugs of old seemed to do little to fight mesothelioma, newer chemotherapy drugs are showing much promise.
A relatively new form of chemotherapy called heated chemotherapy is an option for patients with peritoneal mesothelioma. This treatment is carried out following surgery, and involves the perfusion of heated chemotherapeutic drugs into the peritoneum.
Radiation
Radiation therapy, or "ionizing radiation", is used to kill cancer cells and to limit the spread of cancer. For patients with mesothelioma, radiation therapy is most often used in conjunction with surgery. However, in some cases radiation may be used as a stand-alone treatment to relieve pain and other symptoms associated with mesothelioma. In either case, however, it is rare for radiation therapy to provide more than short-term symptomatic relief.
Mesothelioma patients may receive one of two types of radiation therapy, depending on whether or not they are suitable candidates for either procedure. External beam radiation therapy is the traditional type of radiation therapy, where tumors are bombarded with beams of radiation to kill cancer cells. Brachytherapy is a newer type of radiation treatment. It involves tiny radioactive rods which are implanted within a tumor to provide a strong, concentrated dose of radiation to tumors while doing very little damage to surrounding healthy tissue.

Photodynamic Therapy

Photodynamic therapy is a highly specialized and specific form of treatment that is most often used to treat skin cancers, and some types of lung cancer, including pleural mesothelioma. However, this treatment is usually unsuitable for patients with metastasized cancer; it is most effective in patients who have localized disease.
This type of therapy involves the use of light energy to kill cancer cells. In a photodynamic therapy treatment, the patient is given an intravenous solution of a drug that makes cancer cells highly sensitive to a particular kind of light. One to three days after this treatment, the patient is exposed to the light, and cancer cells that have absorbed the drug are killed.

Gene Therapy

Gene therapy involves using genetic material to specifically target cancer cells and make them more vulnerable to chemotherapy treatment. The main type of gene therapy being developed for use in mesothelioma patients is called "suicide gene therapy", because it forces cancer cells to produce substances that kill them.
When undergoing this type of gene therapy, the patient is treated with a non-infectious virus that has been altered with genetic material that makes them produce a particular protein. Following this procedure, the patient is then treated with a chemotherapeutic drug that is specially formulated so that it is toxic only to cancer cells. This type of therapy has produced some promising results for mesothelioma patients, but it is still only available through clinical trials.
Immunotherapy is a type of treatment in which the patient's own immune system is 'tricked' into killing cancer cells. A healthy, normally-functioning immune system does not kill cancer cells, because even though these are diseased cells, the immune system is unable to recognize them as being harmful.
There are two main types of immunotherapy - active, and passive. In active immunotherapy, mesothelioma cancer cells are removed from a patient and then treated in a laboratory to turn them into a vaccine. Following this laboratory treatment, the patient is injected with the vaccine and if the treatment is successful, the patient's immune system recognizes the vaccine as a harmful substance, thus recognizing the cancer as being harmful as well.
Passive immunotherapy is somewhat different in that it does not attempt to activate the patient's immune system. Instead, it uses substances such as cytokines - molecules that direct and regulate the immune system - and other agents to help boost the patient's immune response to their cancer.

Causes Of Mesothelioma

Causes of Mesothelioma

Mesothelioma is a highly aggressive cancer that is difficult both to diagnose and to treat. Between two and three thousand cases of malignant mesothelioma are diagnosed each year in America, and the incidence of mesothelioma cancers is projected to increase during the next decade.

Causes

An overwhelming body of scientific and medical evidence points to the fact that malignant mesothelioma is caused by asbestos exposure. Currently, there is no other known cause for the disease.
Asbestos is a naturally-occurring fibrous substance that was very widely used in the construction and shipbuilding industries during the first three-quarters of the twentieth century. Asbestos was touted for its durability, fire resistance, and excellent insulating properties, and was used in several thousand different manufactured products, including construction materials, household appliances, and brake linings.

How does Asbestos cause Mesothelioma

Internal organs and body cavities are covered by a thin tissue membrane called mesothelium. This lining covers the lungs (where it is called the pleura), the heart (where it is known as the pericardium), and body cavities such as the abdominal cavity (where it is called the peritoneum). The mesothelium provides both support and protection for organs and body cavities, as well as providing a source of lubrication that helps support organ function and health.
Mesothelioma develops in the linings of organs and body cavities, typically in the pleura, pericardium, or peritoneum. In very rare cases, mesothelioma may develop in the lining of the testicles, known as the tunica vaginalis.
The exact method by which asbestos causes mesothelioma is still being researched, but medical professionals offer four different theories:

• Asbestos causes irritation and inflammation of mesothelial cells, eventually leading to irreversible scarring, cellular damage, and eventually cancer.
• Asbestos fibers enter cells and disrupt the function of cellular structures that are essential for normal cell division, causing cellular changes that lead to cancer.
• Asbestos causes the production of oxygen 'free radicals'. These molecules damage cellular DNA, and cause cells to mutate and become cancerous.
• The presence of asbestos causes cells to produce oncoproteins. These molecules cause mesothelial cells to ignore normal cellular division restraints, leading to cancer.
  

The element that ties each theory together states that asbestos causes cellular damage that causes cells to lose control over their own cycles of normal division and begin dividing uncontrollably. Healthy cells follow cycles of cell division that ensure tissues and organs do not grow beyond normal size - in cancer cells, these restraints are lost.
In cases of mesothelioma, the result is that membranes in the affected location begin to thicken, and fluid builds up in the spaces between membrane layers. As cancer cells continue to divide and pile on top of one another, tumors begin to form. The end result of uncontrolled division of cancer cells is that the function of the body's organs and systems are impaired, due to factors such as internal pressure caused by the growth of tumors, and the reduction of availability of essential nutrients for organs.

Other Causes of Mesothelioma

The answer to this question is a simple "no". Doctors and research scientists have not been able to determine any other causes of mesothelioma other than asbestos exposure. They do know, however, that smoking can aggravate a less serious asbestos-related disease, such as asbestosis, and prompt the formation of tumors and the onset of mesothelioma. Those who have been exposed to asbestos on a regular basis are advised not to smoke.

Symptoms Of Mesothelioma

Symptoms

Mesothelioma has earned a reputation as a cancer that is very difficult to treat effectively, This reputation is partly due to the fact that in its early stages, mesothelioma symptoms are quite non-specific, making early diagnosis quite difficult. In addition, the disease usually lays dormant for up to five decades and symptoms don't appear until the cancer has reached its late stages.

Non-Specific Symptoms of Mesothelioma

The first symptoms of mesothelioma are often similar to symptoms of other diseases that are much less serious. For example, early symptoms of pleural mesothelioma (which develops in the pleural lining of the lungs) often resemble symptoms of influenza or pneumonia. Similarly, symptoms of pericardial mesothelioma (which develops in the pericardial lining of the heart) are similar to symptoms of other cardiac conditions.
If you have a history of asbestos exposure and experience any of the following symptoms, it is best to seek immediate medical advice. Also, in the interest of early detection, those who were exposed but have not yet exhibited symptoms should undergo regular chest x-rays or pulmonary function tests to monitor any adverse affects of asbestos inhalation.

Symptoms Of Pleural Mesothelioma

Pleural mesothelioma is the most common form of the cancer. Approximately two-thirds of mesothelioma cases originate in the pleural lining of the lungs.
Known symptoms of pleural mesothelioma include:

• Persistent dry or raspy cough (typically non-productive, meaning there is little or no phlegm)
• Coughing up blood
• Difficulty in swallowing
• Night sweats or fever
• Unexplained weight loss of 10% or more
• Fatigue
• Persistent pain in the chest or rib area, or painful breathing
• Shortness of breath that occurs even when at rest
• The appearance of lumps under the skin on the chest
  

Symptoms of pleural mesothelioma occur as a result of thickening of the pleural membrane and the build-up of fluid between membrane layers. Tissue thickening and fluid build-up put pressure on the lungs, leading to reduced respiratory function.

Symptoms Of Peritoneal Mesothelioma

Approximately 25% to 30% of mesothelioma originates in the lining of the abdominal cavity, known as the peritoneum. Peritoneal mesothelioma symptoms are caused by thickening of the peritoneal membrane and the resulting build-up of fluid between membrane layers. These changes in membrane composition but pressure on the abdominal region and organs, leading to the following types of symptoms:

• Night sweats or fever
• Unexplained weight loss
• Swelling or pain in the abdomen
• Anemia
• Fatigue
• Diarrhea or constipation (in general, any change in bowel habits or regularity)
• Nausea or vomiting
• The appearance of lumps under the skin on the abdomen
  

Symptoms Of Pericardial Mesothelioma

Less than 5% of mesothelioma cases originate in the membranous lining of the heart, known as the pericardium. As the pericardium layers thicken due to growth of cancer cells, fluid builds up between membrane layers, leading to impaired cardiac function and causing the following types of symptoms:

• Heart palpitations or irregular heartbeat
• Chest pain
• Difficulty breathing, even when resting
• Fever or night sweats
  

Peritoneal mesothelioma is so rare that the recognized body of symptoms is not as well-developed as with more common types of mesothelioma. It is a particularly difficult type of mesothelioma to diagnose, and because of this, patients who are diagnosed with pericardial mesothelioma tend to have a poor prognosis.

Symptoms Of Testicular Mesothelioma

Testicular mesothelioma is an extremely rare form of this type of cancer. Less than one hundred cases of testicular mesothelioma have been recorded in the last sixty years. With so few cases recorded, very little is known about the symptoms of the disease. However, if diagnosed early, it is also relatively simple to treat in many cases. The only known symptom of testicular mesothelioma is the appearance of testicular lumps. These may or may not be painful.
It's important to note that testicular mesothelioma may arrive spontaneously in the testicle or may be a secondary tumor. In the latter case, the primary cancer is typically peritoneal.

Diagnosis Of mesothelioma

CT Scans

During the mesothelioma diagnostic process, the person under diagnosis will have to undergo a variety of different medical imaging procedures. One of those is often a CT scan, which provides some highly detailed information about the type of disease that is involved and how far it has advanced.
Along with the results of other tests such as PET scan, MRI scan, and x-ray, the results of your CT scan are used by doctors to diagnose and stage your cancer. This information is used to determine the best and most appropriate course of treatment, and to give you a prognosis, which is a general idea of how doctors expect the disease to progress. CT scans and other tests may also be carried out after you're diagnosed. In these cases the tests are used to determine how effective your current treatment is.

The CT Scan Procedure

A CT scan is almost like an x-ray, in that a series of several separate x-ray pictures are taken when you are undergoing the procedure. However, the major difference is that a CT scan takes a large number of pictures, rather than just one or two. Using a CT scan to take many different images allows technicians and doctors to build up a three dimensional image of the inside of the body.
If you undergo a CT scan you may be given an intravenous injection of dye that helps produce more a detailed picture by increasing the contrast of the images that are taken. The injection might be slightly uncomfortable, but unless you have an unexpected allergic reaction to the dye that is used, there is no danger. Usually if you have an allergy you'll already be aware of it, and can inform your doctor. The technician will then use a different type of dye when preparing you for the test.
The CT scan itself is usually over quite quickly, in ten minutes or less. The technology used for these diagnostic tests is highly sophisticated and allows a complete scan to be taken in just a few minutes.
In some cases you may receive a CT scan at the same time as another procedure called a PET scan. Carrying out both tests at the same time allows specialists to get additional information about the location of mesothelioma and whether it has spread to other locations.

Getting Test Results

In most cases, test results for your CT scan will be available within a few days. The scan images are interpreted by a doctor who is specialized in reading the detailed images produced by CT equipment. After the results have been read, your doctor will receive a summary of the findings, and you can talk to your doctor to find out about the results and what they mean.

Diagnosis Of mesothelioma

Imaging Scans and Diagnosing Mesothelioma

Mesothelioma is a form of cancer that affects, for the most part, those with long term exposure to asbestos fibers. Up until recently, this kind of cancer could be very hard to diagnose because the symptoms displayed in the patient are similar to a number of other illnesses and conditions. Now there are better, faster and more accurate methods that are excellent at assisting doctors with diagnosing mesothelioma and finding the tumors that are associated with it.
There are several symptoms that are displayed when an individual has developed this cancer of the mesothelium. In a lot of cases, these symptoms show up in other ailments and can make diagnosing mesothelioma very difficult. When the cancer has affected the chest area, the patient may experience chest pain, shortness of breath, fatigue, wheezing or cough and they may begin to cough up blood. If the cancer has affected the abdomen, an individual may have abdominal pain and swelling and their bowels may not function correctly. Extreme weight loss may occur as well. In severe cases, blood clots may appear throughout the body. The eyes and skin may also become yellowed, indicating jaundice. In some extreme situations, a few of the organs in the body may begin to bleed.

Diagnosis Using Imaging Scans

Because the symptoms match those of many other diseases in the body, mesothelioma can be very hard to find. The tumors that are produced may show up in any part of the mesothelium and can even be found between organs. A doctor is going to begin any patient examination with a thorough review of the patient's medical history and the typical preliminary exams an individual receives when visiting the doctor. As the diagnosis process progresses, there may be several tools used simultaneously to get the most accurate results. Along with blood tests and other tests for the body, a medical professional may use one or more of several scans of the body to see of they can detect any abnormalities.

X-Ray

The first and most basic imaging scan is an x-ray. This scan is limited, but may be able to detect certain areas that show damage or abnormalities in the body. One of the biggest drawbacks in the x-ray is it can only produce a flat two-dimensional image. When an x-ray is taken, electromagnetic radiation is sent through the body with a photographic film on the other side. The way the waves, or rays, behave changes as they pass through the body and different kinds of tissue, thus, they show up on the picture differently.

CAT Scan

Computed tomography scans, referred to as either CT or CAT scan, still utilizes x-rays to capture images from inside the body. The x-ray machine and the film travel around the body on one axis and take a large number of pictures. The pictures can then be collated and combined to give doctors an excellent idea of what different tissues are to be found in the area(s) of concern. The data can even be manipulated to show different slices of the tissue and can be rendered into three-dimensional representations. An incredibly valuable tool to the medical industry, a CAT scan is still only able to present its data in various shades of light and dark.

MRI Scans

Magnetic resonance imaging scans use electromagnetic radiation to develop images of the body. Hydrogen atoms in the body respond to the magnetic signals by putting out a very weak radiowave, which the computer can analyze. With a few exceptions MRI scans are not harmful to the human body, while excessive exposure to x-rays can be. These scans do everything that a CAT scan does and more. The biggest bonus to MRI scans is the ability of the computer to differentiate between tissues in the body and assign them various colors. This lets doctors get a very clear picture of the interior of the body and find tumors much earlier than the other two kinds of scans. The earlier mesothelioma is discovered and operated on, the better odds a patient has for survival.

PET Scans

One of the best and most widely used scans for detecting and diagnosing mesothelioma and other kinds of cancer is the positron emission tomography, or PET, scan. These scans use tracers and cameras to develop a detailed image of the body and even detect changes in biological processes, allowing doctors to find even the smallest tumor. PET scans involve an injection of a radioactive tracer isotope, combined with some kind of glucose, into the blood stream of the patient. After a short waiting period, the scanners are able to detect gamma radiation produced by the tissues in the body interacting with the tracer isotopes. The scans can produce very accurate representations of the body and can even display to doctors what is happening chemically in the tissue.
The most powerful scanning tchnique combines at least two of the above. Many different scanning machines are coming to medical facilities with PET scanners and CAT scanners in the same casing, and some are combined with MRI. The advantage to this is that biochemical processes, which show up in a PET scan, can be compared to what the anatomy that shows in the CAT scan. Both scans can happen almost simultaneously, so the body does not have to be moved during the scan. This ensures that the images are accurate and align with each other.

Diagnosis Of mesothelioma

Diagnosis

Mesothelioma is a serious cancer that advances quickly and aggressively. Historically, diagnosis of this disease does not happen until it reaches the later stages. This occurs because mesothelioma has a very long latency period. In a typical case, at least two to three decades elapse between asbestos exposure and the onset of the first symptoms of mesothelioma. In some cases, fifty or more years may pass before symptoms appear.
The second reason that mesothelioma is so difficult to diagnose is that the early symptoms and warning signs of the disease are highly non-specific and very often resemble the symptoms of other conditions that are much less serious. For example, the early symptoms of pleural mesothelioma may be mistaken for influenza or pneumonia and further testing may be required to recognize that it is indeed something more serious.

Initial Stages of Diagnosis

Studies show that mesothelioma patients are typically diagnosed within three to six months of their first visit to a doctor with complaints about breathing problems and chest pain.
The first step involved in diagnosis is providing a full and accurate medical history to your doctor, including details about current and past health concerns, and the types of symptoms you are currently experiencing. A mention of any exposure to asbestos is essential. Without revealing this fact, your doctor may not consider asbestos-related diseases in his/her diagnosis.
Next, patients will undergo a physical examination, where a doctor will examine causes for any types of symptoms you may be displaying. Most likely, his next step will be to recommend further testing.

Diagnostic Tests

If your doctor suspects an asbestos-related disease, the next step in diagnosis will be tests to confirm the presence of mesothelioma, determine the location, size and type of cancer involved, and to determine whether the cancer has spread to other parts of the body. This will often involve imaging tests such as:

• Chest X-ray: This is the most commonly used imaging test for the diagnosis of mesothelioma " almost all diagnoses will involve an x-ray but a more sophisticated test may follow.
• CT Scan: An x-ray-like procedure in which several x-ray pictures are taken and combined via computer to produce a detailed image of body tissues. If you undergo a CT scan, you may be given an intravenous injection of dye that helps produce more detailed images.
• PET Scan: Glucose solution is administered via intravenous injection, and a scanner is used to spot deposits of cancer cells. Malignant cells take up and use sugars more quickly than normal cells, so they can be easily distinguished using this procedure.
• MRI Scan: A combination of radio waves and a strong magnetic field is used to create detailed three-dimensional images that can be carefully examined by a radiologist.
  

Fluid and Tissue Tests

These tests, also known as biopsy tests, involve collecting small samples of fluid or tissue and checking them for the presence of cancer cells. Such tests include:

• Fine Needle Aspiration: Mesothelioma cancers cause fluid to build up in affected locations, such as in the pleural membranes of the lungs. During a fine needle aspiration, your doctor will remove a fluid sample using a very long, thin and hollow needle.
• Thoracoscopy: Thoracoscopy is used in cases where pleural or pericardial mesothelioma is suspected. During this procedure a very small incision is made in the chest wall, through which a sample of tissue is removed.
• Bronchoscopy and Laparoscopy: These procedures are similar to the thoracoscopy, but are performed on different parts of the body. The bronchoscopy is used to view the trachea and airway, whiles the laparoscopy is used to remove samples of peritoneal tissue.
• Mediastinoscopy: This procedure is used to view lymph nodes in the chest and neck, to determine if cancer has spread from its point of origin

Types Of Mesothelioma

Benign Mesothelioma

In most cases, asbestos diseases like mesothelioma do not surface for anywhere between 20 and 50 years after exposure. However, a rare disease known as benign or non-malignant mesothelioma can occur much sooner. Not a form of cancer, benign mesothelioma can be addressed easily and immediately once detected. It also sometimes acts as a sort of "wake-up call", prompting the patient's doctor to search for other asbestos-related diseases or signaling the need for consistent monitoring in case of future concerns.
In contrast to malignant mesothelioma, which has an extremely high mortality rate, effective treatment and full recovery is possible for most people who are diagnosed with benign mesothelioma.

Malignant Versus Benign Mesothelioma

Tumors form when previously healthy cells begin rapid division. This rapid pace of cellular growth leads to the formation of tumors because cells mass on top of one another, forming a solid lump of cells. Tumor cells are not all the same, however - they may be either benign or malignant. (Note that benign tumors are not called cancer. The word cancer refers only to malignant tumors.)
There are two important differences between malignant and benign tumor cells. First, malignant tumors can invade nearby tissues and cause damage to healthy tissues and organs. Second, malignant tumor cells can 'relocate' to other parts of the body by traveling through the blood or lymphatic system. When this occurs, these cells can begin forming new tumors in new locations.
The key difference, therefore, is that benign tumors do not invade nearby tissues, and do not spread to other parts of the body. For this reason, rare benign mesothelioma is much less serious than malignant mesothelioma though it can certainly be life-threatening if not addressed.
While benign mesothelioma tumors will not invade or spread within the body, they can grow to large sizes, and larger tumors can have a negative impact on the tissues and organs around them. When these particular tumors grow large enough, they may cause fluid to build up in mesothelial membranes, and very large tumors can cause serious side effects such as coma and seizures.
Symptoms of benign mesothelioma are quite similar to those of malignant mesothelioma. Most people with benign mesothelioma of the pleura (lung membranes) experience shortness of breath, chest pain, and a chronic, dry cough. People with malignant mesothelioma also experience these symptoms, but additionally may experience fever, night sweats, weight loss, and other symptoms.
Diagnosis of benign mesothelioma is also similar to diagnosis of malignant mesothelioma. Patients will provide a complete medical history and undergo a physical examination. If a problem is suspected, the doctor will recommend one or more imaging tests or biopsy procedures.
Imaging tests include chest X-rays, CT scans, and MRI scans. Each of these allows your doctor to determine where tumors are located. A chest X-ray is usually the first test ordered by the physician, followed by CT and/or MRI scans, which are used to obtain a more detailed picture of the exact location of tumors inside the body.
Other diagnostic tests involve taking samples of tumor tissue or the fluid in or surrounding the tumor. A tissue biopsy, for example, involves removing a sample of tumor cells from the affected area, whereas a fluid biopsy (also called needle aspiration) involves the insertion of a long needle into the tumor to remove fluid.

Treatment

In most cases of benign mesothelioma, the only treatment that is needed is a surgical procedure to remove the tumor. In contrast to malignant mesothelioma, there is no need for follow-up treatment such as chemotherapy, for example, because in these cases the tumor is not cancerous and has not spread.
Because approximately 75% of individuals with benign mesothelioma develop tumors in the lung, most commonly, a surgical procedure called a thoracotomy is performed. However, the exact nature of the procedure depends on the size and location of the tumor. Thoracotomy may involve removal of one segment of the lung, a lobe, or even the entire lung (note that removal of the entire lung is very rare in cases of benign mesothelioma).
Although benign mesothelioma itself is a relatively harmless disease, complications may develop following surgery. The most common side effect of surgery is pleural effusion, a fluid build-up in the pleural spaces, which puts pressure on the lungs and heart. Patients are usually fitted with a chest drain for the first few days after surgery to remove excess fluid and prevent effusion.
Following surgical treatment, most people experience complete recovery. Studies show that 90% of those who develop a benign mesothelioma tumor will never experience a repeat occurrence of tumor development following successful surgery.

Types Of Mesothelioma

Testicular Mesothelioma

Malignant mesothelioma is a rare form of cancer that is diagnosed in just two to three thousand Americans each year. Testicular mesothelioma, in particular, is the rarest form of the disease - to date, less than one hundred cases of this type have been reported.
Testicular mesothelioma develops in the tunica vaginalis. This is a membranous lining that surrounds the testicle, providing protection and support for the organ. This membrane is composed of mesothelial cells, which are present in most of the body's membranous linings. The tunica vaginalis is made up of two layers, known as the parietal (outer) and visceral (inner) layers.

How does Asbestos cause Testicular Mesothelioma

Because testicular mesothelioma is extremely rare, very little is known about how it develops. Most researchers theorize that there are two possible points of origin for testicular mesothelioma. In some cases, patients with testicular mesothelioma have primary tumors in the peritoneal membrane, and develop secondary tumors in one or both testicles. In other cases, patients have developed primary tumors in the testicle.
In cases where testicular cancer develops as a secondary tumor, most believe the peritoneal mesothelioma metastasizes and spreads to other areas of the body. However, there is no current theory to explain why exposure to asbestos might cause a primary tumor to develop in the testicles.
Once cells have become cancerous, they are no longer able to regulate their own cycles of growth and division. A primary tumor that develops in the testicle is formed from cancerous cells that divide without restraint, causing thickening of the tunica vaginalis, and eventually forming tumors.

Symptoms and Diagnosis

Due to the rarity of testicular mesothelioma, there is no recognized set of symptoms for this form of cancer. In the majority of the few reported cases of the disease, noticeable symptoms have been confined to the appearance of testicular lumps.
Testicular mesothelioma is not usually diagnosed until these lumps appear. In some cases, testicular mesothelioma has been detected when a patient undergoes surgery for another reason (such as hernia repair). In these cases, a sample of tissue may be removed, or biopsied, for diagnostic purposes, or the entire tumor may be removed, if it is possible to do so.

Treatment

Treatment for testicular mesothelioma typically involves removal of a portion of one testicle, or even an entire testicle if necessary, depending on the extent of the cancer. Treatment may be followed up by chemotherapy or radiation therapy to kill any remaining cancer cells.
However, because testicular mesothelioma is often a secondary tumor, and the primary tumor is located within the peritoneum, treatment may not be as simple as removing testicular tumors. In these cases, the primary tumors must be treated, too.
It should be noted that both peritoneal and testicular mesothelioma are classified as being clinically aggressive types of cancer. This means they can spread rapidly and invasively. In addition, testicular mesothelioma tends to recur within a few years, even in cases where tumors are surgically removed. All of these factors make prognosis for those with testicular mesothelioma quite grim.

Types Of Mesothelioma

Pericardial Mesothelioma

Pericardial mesothelioma develops in the pericardium, a membrane made up of mesothelial cells which 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, and an inner layer known as the visceral layer. 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.

How does Asbestos cause Pericardial Mesothelioma

It has long been known that pleural mesothelioma, which develops in the lining of the lungs, is caused by inhalation of asbestos fibers. However, the way in which asbestos causes the development of pericardial mesothelioma is not very well understood. Some experts believe that inhaled asbestos fibers travel via the bloodstream from the lungs to the heart, although there is no conclusive evidence to support this theory.
What is known is that asbestos fibers somehow become lodged in the pericardial membranes that surround the heart. When this occurs, the body is unable to eliminate the asbestos fibers, and they remain stuck in the membranes. Over a very long period of time - two decades or more - these asbestos fibers cause the cells of the pericardium to undergo chances that may cause them to become cancerous.
Once cells become malignant, or cancerous, they begin to divide continuously, without the restraint that regulates the growth cycles of normal healthy cells. As these malignant pericardial mesothelioma cells continue to grow, they cause thickening of the pericardial membranes, and eventually cause tumors to develop. These changes in the pericardial membrane lead to the build-up of fluid between the pericardial layers, and this, combined with the thickening of the layers, puts pressure on the heart.

Symptoms

Pericardial mesothelioma is a relatively rare form of this type of cancer. For this reason, it has so far been somewhat difficult for mesothelioma specialists to develop a set of recognizable symptoms that can be used to help diagnose the disease. An additional problem is that the symptoms of pericardial mesothelioma resemble symptoms of other heart conditions, and this makes the cancer relatively difficult to diagnose quickly. Diagnosing pericardial mesothelioma may require a variety of tests to confirm the presence of cancer.
Most symptoms of pericardial mesothelioma are caused by the build-up of fluid and the thickening of pericardial layers. The following symptoms may indicate pericardial mesothelioma.

• Heart palpitations or irregular heartbeat
• Chest pain
• Difficulty breathing, even when at rest
• Fever or night sweats
  

Diagnosis
A fast and accurate diagnosis of pericardial mesothelioma is difficult, due to the non-specificity of the symptoms of this type of cancer. To diagnose pericardial mesothelioma, a patient's symptoms, medical history, and current medical condition must all be assessed. The initial stages of diagnosis involve taking a medical history and undergoing a thorough physical examination.
Following these initial steps, a variety of imaging tests may be order to determine exactly where cancer is located. The final stage of diagnosis typically involves a biopsy to confirm the point of origin of the cancer and a diagnosis of mesothelioma. A biopsy involves the removal of tissue or fluid from the pericardium, followed by laboratory tests on the tissue and fluid to confirm the presence of mesothelioma.

Treatment

Most people diagnosed with this form of mesothelioma are not good candidates for surgery. However, there are rare cases where the cancer is diagnosed early, and surgery can be carried out to remove small, localized pericardial tumors. This type of surgery carries great risk, however, simply due to the proximity of the heart.
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 in order to improve a patient's quality of life, and reduce the severity of symptoms caused by build-up of fluid in the pericardium. Fine needle aspiration may be carried out to remove excess fluid. In some cases, radiation therapy may be an option. However, the proximity of the heart and lungs make this a risky prospect.

Types Of Mesothelioma

Peritoneal Mesothelioma

Malignant mesothelioma is a relatively rare type of cancer that only develops in people who have experienced long-term or repeated exposure to asbestos. In America, peritoneal mesothelioma cases account for approximately 25% of the two to three thousand reported cases of mesothelioma each year.
Peritoneal mesothelioma develops in the abdomen, in the mesothelial cells that form the peritoneum. The peritoneum is a membranous layer that is made up of two 'sub-layers' called the parietal and visceral layers. The parietal layer covers the abdominal cavity, while the visceral layer surrounds abdominal organs. Together, these two layers provide support and protection for abdominal organs and the abdominal cavity as a whole.

How does Asbestos cause Peritoneal Mesothelioma

There are two main theories regarding the method by which asbestos exposure leads to the development of peritoneal mesothelioma:

• Asbestos fibers are ingested, and these fibers work their way from digestive organs into the peritoneal membrane
• Asbestos fibers are inhaled, and travel to the peritoneal membrane via the lymphatic system
  

Regardless of how asbestos fibers actually enter the peritoneal layers, once they do enter the membrane, the body is unable to expel them. The fibers become trapped in the peritoneal membrane, and over a period of two or more decades, they cause certain changes in the mesothelial cells of the peritoneum.
The exact way in which asbestos fibers cause changes in these mesothelial cells is uncertain. One theory is that asbestos fibers cause long-term inflammation and irritation that eventually causes mesothelial cells to become cancerous. When cells become cancerous, they lose the ability to regulate their own division and growth. Cancerous mesothelial cells divide and grow without restraint, and this uncontrolled cell growth causes thickening of the peritoneum, and the build-up of fluid in the peritoneal layers. Over time, as cancerous cells continue to divide, tumors form.

Symptoms

Most peritoneal mesothelioma symptoms are caused by membrane thickening, fluid build-up, and eventual tumor development, all of which put pressure on internal organs.
Symptoms of peritoneal mesothelioma include:

• Abdominal pain or swelling
• Changes in bowel habits (such as diarrhea or constipation)
• Development of lumps under the skin on the abdomen
• Night sweats or fever
• Unexplained weight loss
• Nausea or vomiting
• Fatigue
• Anemia

Diagnosis

Diagnosis of peritoneal mesothelioma cannot be made on the basis of symptoms alone. The diagnostic process begins with a thorough medical history and physical examination, followed by sophisticated diagnostic testing, such as a CT scan, PET scan, or MRI. These tests can not only confirm a diagnosis of peritoneal mesothelioma, but also provide important information that will help determine the patient's best treatment options.
Following these imaging tests, a biopsy is usually performed to confirm that the cancer involved is indeed mesothelioma. A biopsy is a minor surgical procedure that involves the removal of fluid or tissue from the peritoneum. After the biopsy, the fluid and tissue is tested in a laboratory for the presence of mesothelioma cells.

Treatment

One of the biggest stumbling blocks in treating peritoneal mesothelioma effectively stems from the fact that the disease is very difficult to diagnose in its early stages, therefore providing few treatment options.
Some peritoneal mesothelioma patients can opt for intraperitoneal chemotherapy in which drugs are injected directly into the peritoneum, immediately following surgery. In some cases, patients may undergo radiation therapy first, to shrink tumors, before undergoing surgery.
Most patients, however, are not good candidates for surgery, either because their cancer has spread too extensively or because their general health is not good enough to cope with the stress of surgery. These patients are usually limited to palliative treatment options. Palliative treatments do not attempt to cure a patient - instead they are designed to relieve symptoms and improve the quality of life for peritoneal mesothelioma patients.

Pleural Mesothelioma

Pleural Mesothelioma

Malignant mesothelioma is a rare form of cancer that can develop in people who are repeatedly exposed to asbestos. Two to three thousand Americans are diagnosed with this type of cancer each year, and of those, around two thirds have the pleural form of mesothelioma.
Pleural mesothelioma develops in the lining of the lungs. This lining is called the pleura, or pleural membrane, and it is made up of mesothelial cells. This pleural membrane consists of two layers - the parietal layer, and the visceral layer. The parietal layer is an outer layer that lines the entire chest cavity and diaphragm, while the visceral layer is an inner layer that covers the lungs. Together, these two layers provide support and protection for the lungs and the chest cavity.

How does Asbestos cause Pleural Mesothelioma

The method by which asbestos causes pleural mesothelioma is much better understood than for other types of mesothelioma. In cases of pleural mesothelioma, asbestos exposure occurs via inhalation of asbestos fibers. Once these fibers have entered the lungs, they work their way to the pleural membrane, and the body is not able to expel them. Over a long period of time - typically two decades or more - asbestos fibers cause changes in these pleural cells, which may cause scarring of the lungs and, eventually, the formation of tumors.
When pleural cells become cancerous, they are no longer regulated by the mechanisms that control division of normal healthy cells. They begin to divide continuously, and this causes thickening of pleural membranes. As a result, lung capacity is reduced, and fluid begins to build up between pleural layers.

Symptoms

Thickening of pleural membrane layers and the resulting build-up of fluid (called pleural effusion) begins to put pressure on the lungs and the respiratory system in general, preventing normal breathing. Symptoms of pleural mesothelioma are largely caused by these developments, and may include the following:

• Persistent dry or raspy cough
• Coughing up blood
• Difficulty in swallowing
• Shortness of breath that occurs even when at rest
• Persistent pain in the chest or rib area, or painful breathing
• Development of lumps under the skin on the chest
• Night sweats or fever
• Unexplained weight loss
• Fatigue
  

Diagnosis

As with other types of mesothelioma, pleural mesothelioma is difficult to diagnose. There are two reasons for this. First, the long latency period of the disease means that often, cancer develops long before the first symptoms are noted. Second, the symptoms of pleural mesothelioma are very non-specific. In the early stages, pleural mesothelioma symptoms are often mistaken for those of less threatening diseases such as influenza and pneumonia.
Diagnosis of pleural mesothelioma is made partly on the basis of symptoms, but because symptoms are non-specific, additional diagnostic tested are needed to confirm the presence of cancer. Following a medical history and physical examination, patients must typically undergo imaging tests to confirm the location of cancer, and fluid and tissue tests to confirm the type of cancer involved.

Treatment

All forms of mesothelioma are very aggressive and often resistant to treatment. In addition, early diagnosis is so rare that mesothelioma treatment is usually not able to provide a complete cure.
However, with the development of new drugs and early detection techniques, the outlook is improving for pleural mesothelioma patients in particular, because this is the most common form of mesothelioma and there is a much larger body of knowledge and research to draw upon in treating patients. According to some current studies, about 10% of all pleural mesothelioma patients will survive for three to five years following diagnosis, and about 5% will survive five years or more.
In general, pleural mesothelioma patients have three options: surgery, chemotherapy, and radiation therapy. Typically, patients will receive a combination of two or more of these types of treatment.
Early detection of pleural mesothelioma can improve a patient's prognosis considerably, and such patients have more extensive treatment options. If the disease is diagnosed early enough, surgery to remove localized tumors, followed by chemotherapy or radiation therapy to kill any remaining cancer cells, can be an effective treatment. Curative surgery candidates must be in a good general state of health, and their cancer must not have spread beyond localized sections of the lungs.
Pleural mesothelioma patients who are not diagnosed early enough for curative treatment have fewer treatment options, and these are mostly limited to palliative treatments. These types of treatments are designed to relive pain and discomfort to improve a patient's quality of life, rather than to improve their prognosis. Palliative treatments include removal of built-up fluid from the pleural spaces, and surgical removal of tumors, to relieve pressure on the lungs.

Types Of Mesothelioma

Types of Mesothelioma

Mesothelioma is caused by long-term, repeated exposure to asbestos fibers. The disease is generally found in four different forms - pleural, peritoneal, pericardial, and testicular. In each case, the cancer develops in mesothelial cells, which form the membranous linings that surround and protect organs. The different names for each type of mesothelioma refer to the point of origin of the cancer.
Mesothelial membranes are made up of two different layers, called the parietal and visceral layers. Parietal layers are outer layers, and these typically cover large areas such as the chest cavity (in the case of pleural and pericardial membranes) and the abdominal cavity (as in the case of peritoneal membranes). Visceral layers are those that cover organs such as the lungs and heart. Mesothelioma develops in these membranes when asbestos fibers become trapped in the spaces between mesothelial cells.
Mesothelioma is a particularly aggressive type of cancer, and is highly resistant to treatment, resulting in very high mortality rates and poor prognosis for people diagnosed with the disease. In general, pleural mesothelioma responds more positively to treatment, particularly if the disease is diagnosed early. However, all forms of mesothelioma are difficult to diagnose, and unfortunately, it is common for the disease to be diagnosed too late for treatment to be effective.

Pleural Mesothelioma

Pleural mesothelioma develops in the mesothelial lining of the lungs, which is known as the pleura. About 70% of all mesothelioma cases are pleural.
Symptoms of pleural mesothelioma include difficulty swallowing, a persistent dry cough, persistent chest pain, or pain when breathing, and difficulty breathing even when resting. These symptoms result from pressure on the lungs and respiratory system, caused by thickening of the pleural membrane, and fluid build-up between membrane layers. As the cancer advances, lumps may develop under the skin of the chest.
Diagnosis of pleural mesothelioma involves imaging tests such as chest X-rays, MRIs, and CT scans, and may also include biopsies that remove tissue and fluid to test for the presence of cancer cells. These tests also help determine the stage of the cancer and the options available for treatment. Generally, patients in Stage one and two mesothelioma are good candidates for surgery, whereas patients in stages three and four have more limited treatment options, and may only be able to receive palliative treatments.

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Peritoneal Mesothelioma

Peritoneal mesothelioma develops in the peritoneal lining of the abdominal cavity. This is a relatively rare form of mesothelioma; about 25% of all mesothelioma cases are peritoneal in nature.
Symptoms of peritoneal mesothelioma include pain or swelling of the abdomen, changes in bowel habits (such as constipation or diarrhea), unexplained weight loss, and nausea or vomiting. These symptoms are caused by thickening of peritoneal membranes and fluid build-up, which puts pressure on internal organs and prevents normal function of some organs. As the cancer advances, people with peritoneal mesothelioma may notice lumps developing under the skin of the abdomen.
Diagnosis of peritoneal mesothelioma involves imaging tests such as CT scans and MRIs, as well as biopsies of fluid and tissue to detect the presence of mesothelioma cells. There is currently no recognized staging process for peritoneal mesothelioma.
Peritoneal mesothelioma is problematic in terms of treatment, because the cancer can spread quickly throughout the peritoneum, and often metastasizes more quickly than other types of mesothelioma. In some cases surgery is possible, but this is typically a palliative treatment option.

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Pericardial Mesothelioma

Pericardial mesothelioma develops in the membrane that surrounds the heart, also known as the pericardium. This is a very rare form of mesothelioma, occurring in just 5% of cases. It's also very difficult to treat.
Symptoms of pericardial mesothelioma include irregular heartbeat or palpitations, chest pain, and difficulty breathing. These are caused by the pressure put on the heart by the build-up of fluid in the spaces between pericardial membrane layers.
It is very rare for pericardial mesothelioma to be diagnosed early enough for any form of treatment to be effective, and pericardial mesothelioma patients typically have an extremely poor prognosis. In very rare cases, the cancer may be diagnosed early enough for surgery to have a positive effect; however, the proximity of this cancer to the heart makes such surgery a high-risk treatment option.
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Testicular Mesothelioma

Testicular mesothelioma is the rarest of all mesothelioma cancers, with less than one hundred cases ever recorded. This type of mesothelioma develops in the lining that surrounds the testicles, known as the tunica vaginalis.
Due to the extreme rarity of testicular mesothelioma, very little has been noted about its symptoms and the treatment options available. Often, the disease is not diagnosed until patients notice the appearance of testicular lumps. In some cases, surgery for an unrelated condition such as a hernia leads to the detection of testicular mesothelioma.
If the primary tumor has developed in the testicles, treatment involves removal of part or all of the affected testicle, followed by chemotherapy or radiation therapy. However, often the testicular tumor is secondary, and the primary cancer is located in the peritoneum. In these cases, treatment follows established patterns for peritoneal mesothelioma in addition to removal of testicular tumors.
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Malignant Mesothelioma

Malignant Mesothelioma

Malignant mesothelioma is a cancer that affects the thin tissue layer that covers your internal organs, called the mesothelium. Physicians divide malignant mesothelioma into types dependent on the area of the mesothelium affected.
The most common form of malignant mesothelioma is pleural mesothelioma, cancer of the pleura, the lining of the lungs. Peritoneal mesothelioma, the second most common form, is a cancer of the lining of the abdomen, and accounts for between 10 and 20 percent of malignant mesothelioma diagnoses. In much rarer cases, malignant mesothelioma can occur in the pericardium, the lining of the heart, or the tunica vaginalis, the lining around the testicles.
Malignant mesothelioma is caused by exposure to asbestos. This form of cancer develops when asbestos fibers are inhaled and lodge in the pleura, peritoneum, or pericardium, causing scarring and inflammation, and - eventually - tumors.
Not everyone who is exposed to asbestos will develop malignant mesothelioma. Some individuals may have no reaction to the toxic mineral at all while others may develop less severe asbestos-related diseases such as asbestosis or pleural plaques.

Types of Malignant Mesothelioma

Histologically, malignant mesothelioma is divided into three types: epithelioid, sarcomatoid, and biphasic. These classifications pertain to the shape and structure of the cancer cells. All are treated similarly though some are handled more aggressively than others as they offer a shorter lifespan. Each case is considered individually

Epithelioid Malignant Mesothelioma

In terms of cellular histology, there are three different types of mesothelioma cells: epithelioid, sarcomatoid, and biphasic. Epithelioid mesothelioma is the most common of the three types of malignant mesothelioma, occurring in between 50% and 70% of cases.
Epithelioid mesothelioma cells are given this name because, when viewed under a microscope, they have the appearance of epithelial cells. These are cells which line structures and cavities located throughout the body. Mesothelial cells are themselves a type of epithelial cell, and it is these cells that become cancerous when malignant mesothelioma develops within the pleura, peritoneum, or pericardium. Epithelioid mesothelioma cells tend to have a well-defined, uniform shape when viewed under a microscope.
An important point to note is that malignant epithelioid mesothelioma cells very closely resemble cells of another type of cancer known as adenocarcinoma, which can develop in the lungs or in other vital organs. This type of cancer also originates in epithelial tissue. When adenocarcinoma develops in the lungs, it can often spread to the mesothelial lining of the lungs (the pleural membrane).
For these reasons, those diagnosed with adenocarcinoma who have been exposed to asbestos in the past should seek a second opinion so as to insure accurate diagnosis.

Prognosis and Treatment

Generally, each of the three types of mesothelioma - epithelioid, sarcomatoid, and biphasic - are treated in much the same way as treatment is based on the location and stage of the cancer, rather than the type of cells involved.
However, there are distinct differences in the way each type of cancer responds to treatment. In general, patients with malignant epithelioid mesothelioma have a better prognosis than patients with either sarcomatoid or biphasic mesothelioma so treatment may not be as aggressive at the onset.

Mesothelioma - Malignant - Sarcomatoid

Cancer specialists use a variety of different methods to categorize malignant mesothelioma. The most well-known of these to non-medical people is that the cancer is categorized according to its point of origin in the body. For example, pleural mesothelioma develops in the lining of the lungs, pericardial mesothelium in the lining of the heart, and peritoneal mesothelioma in the lining of the abdominal cavity.
Malignant mesothelioma and other types of cancer are also categorized according to have far advanced each case of cancer is, in terms of factors such as the size of tumors, and whether cancer has spread to lymph nodes or other locations. To read more about how cancers are categorized in this way, please see "Mesothelioma - Staging Systems - Overview."
In addition, malignant mesothelioma and other cancers are categorized according to the size, shape and general appearance of cells when viewed under a microscope, and the types of proteins that can be detected on the surface of the cells. This type of categorization is called histology, or histopathology.
Each of these systems of categorization provides mesothelioma specialists with important information that they use to determine the exact type of cancer cells they are dealing with in a given case. This information is then used to determine how best to treat each patient on an individual basis.

Biopsy and Histopathology

Patients who undergo medical evaluation to determine if they have malignant mesothelioma will undergo a variety of medical tests that determine the location and nature of the cancer. One of these is a biopsy of cells that are suspected to be cancer cells. During a biopsy, samples of suspected cancer cells are removed from several different locations in the tumor site. These cell samples are then evaluated in a laboratory to determine whether the cells are malignant, and what type of cells they are. For more information about biopsy procedures a mesothelioma patient might undergo, please see "Mesothelioma - Surgery - Biopsy."
In the laboratory, cells that are suspected to be cancerous are tested in two ways. First, they are viewed under a microscope to determine their general appearance. Second, they are tested for the presence of oncoproteins and other molecules that are produced by specific types of cancer cells.
When viewed under a microscope, mesothelioma cells, and other types of cancer cells, can be distinguished from normal healthy cells because of their shape and other differences in appearance. Further tests are needed to determine the exact nature of the cells, however. These tests evaluate the types of proteins that are present on the surface of the cells. When mesothelial cells become malignant and turn into mesothelioma cells, they begin producing different types of proteins, and some of these are present on the surface of the cells. Examining the types of proteins present allows a histologist to determine if the cells are malignant mesothelioma, another type of cancer, or healthy cells.

Malignant Sarcomatoid Mesothelioma

Malignant sarcomatoid mesothelioma is the least common of the three cellular mesothelioma types. This form of mesothelioma accounts for between 10% and 15% of cases. When viewed under a microscope, malignant sarcomatoid mesothelioma cells appear as elongated spindle-shaped cells that are irregularly shaped and often overlap one another.
It's important to know that malignant sarcomatoid mesothelioma is sometimes difficult to diagnose on the basis of histological methods. For example, cells of another type of cancer called pulmonary sarcomatoid carcinoma are very similar in appearance and other characteristics to malignant sarcomatoid mesothelioma.
For this reason, if you are diagnosed with cancer and you know that you have been exposed to asbestos at some time in the past, obtaining a second diagnostic opinion may be important. Different types of cancer vary widely in terms of prognosis and treatment options, and if you are misdiagnosed, you may not receive the most appropriate treatment for your cancer.

Prognosis and Treatment

Each of the three types of mesothelioma - sarcomatoid, epithelioid, and biphasic - are generally treated in the same way. Treatment is not based on the specific type of cells involved, but instead on the location of tumors and the stage of the cancer. Please see "Mesothelioma Treatment" for further information about treatment options for this type of cancer.
Even so, each type of cancer responds to treatment very differently. In general, patients with malignant sarcomatoid mesothelioma have a poorer prognosis than patients with epithelioid mesothelioma, because sarcomatoid cancers are more aggressive and more resistant to treatment. However, the general prognosis for all types of mesothelioma is usually poor, and the difference in prognosis between sarcomatoid, epithelioid, and biphasic cancers may amount to as little as only a few months.

Malignant Biphasic Mesothelioma

In histological terms, there are three different types of mesothelioma: sarcomatoid, epithelioid, and biphasic. Malignant biphasic mesothelioma - or "mixed" mesothelioma - accounts for between 20% and 40% of all mesothelioma cases, making it the second most common type of mesothelioma.
Biphasic mesothelioma tumors are made up of a combination of both epithelioid and sarcomatoid cells. These are typically arranged in groups within a tumor, rather than appearing as an even mixture of cells. For this reason, during diagnosis, several different samples are taken from different locations within a tumor using a biopsy, to ensure that a correct diagnosis can be made, as this cancer does not have a unique cellular structure.

Prognosis and Treatment

Treatment for mesothelioma is not based on the type of cells involved, but instead on the location of tumors and the stage of the cancer. While cell type does not determine treatment options, each type of cancer responds to treatment in different ways.
In general, patients with biphasic mesothelioma have a poorer prognosis than patients with epithelioid or sarcomatoid mesothelioma, because biphasic tumors tend to be more treatment-resistant. Because of this, biphasic malignant mesothelioma is often treated more aggressively in hopes of extending the life of the patient.

Staging Of Mesothelioma

Staging Systems

For many decades, doctors have been addressing the seriousness of particular cancers in terms of stages. Over the years, various staging systems have been developed to assist doctors in determining a diagnosis and the best form of treatment for the patient in question.
There are three popular staging systems used to examine the extent of mesothelioma. Each of the three different staging systems measure various factors of malignant mesothelioma including the extent of tumor or primary mass, the metastasis (spreading), and the involvement of the lymph nodes.

Butchart System

The Butchart System is the oldest staging system for malignant mesothelioma and is the one that is most commonly used by doctors and specialists to diagnose and treat malignant mesothelioma. The Butchart System is based on the tumor size (mass) and divides malignant mesothelioma into four stages:

• Stage 1 - Malignant mesothelioma has affected the right or left side of the chest cavity (pleura) and may be seen in the diaphragm.
• Stage 2 - Malignant mesothelioma has been found in the pleura on both sides of the body and may have also moved into the heart, stomach, or esophagus on both sides. Lymph nodes may be affected.
• Stage 3 - Malignant mesothelioma has reached the abdominal cavity (peritoneum). Lymph nodes past the chest may be affected.
• Stage 4 - Malignant mesothelioma has reached other organs and has entered the blood stream.

TNM System

The TNM System is a more modern staging system for malignant mesothelioma. The TNM System is based on the extent of the tumor, metastasis, and lymph node involvement. Again, the TNM System divides malignant mesothelioma into four stages:

• Stage 1 - Malignant mesothelioma is present in the left or right chest cavity (pleura) and may have metastasized to the lung, the sac around the heart (pericardium) or the diaphragm on the same side. Lymph nodes at Stage 1 are not involved.
• Stage 2 - Malignant mesothelioma has reached from one side of the chest cavity to a lymph node near the lung area on the same side as the cancer. The cancer has metastasized to the diaphragm, pericardium (sac around the heart) or the lung on the same side as the original cancer.
• Stage 3 - Malignant mesothelioma has penetrated the chest lining, heart, esophagus, muscle, ribs and vital organs within the chest cavity on the same side as the cancer. Lymph nodes may or may not be involved during this stage.
• Stage 4 - Malignant mesothelioma has metastasized to the pleural area and the lymph nodes on the opposite side of where the cancerous tumor is located. It may also have reached the chest cavities or lungs on both sides, or may have spread to the abdomen.
  

Brigham System

The Brigham System is the most modern of the three malignant mesothelioma staging systems. The Brigham System looks at different variables such as the involvement of the lymph nodes and the surgical ability to remove a malignant mesothelioma tumor (respectability). For this reason, it is often not used to stage mesothelioma as the cancer is rarely operable. The Brigham System divides malignant mesothelioma into four stages:

• Stage 1 - Malignant mesothelioma tumor is still resectable (able to be removed surgically) and the lymph nodes are not affected.
• Stage 2 - Malignant mesothelioma tumor is still resectable (able to be removed surgically) but the lymph nodes are now affected.
• Stage 3 - Malignant mesothelioma tumor is not resectable (able to be removed surgically) and the malignant mesothelioma has penetrated the heart, chest wall, abdominal cavity or diaphragm. Lymph nodes may or may not be affected.
• Stage 4 - Malignant mesothelioma tumor is not resectable (able to be removed surgically) and has completely metastasized (spread throughout the body).
  

Process of Staging Malignant Mesothelioma


When mesothelioma is diagnosed by a physician or specialist, they must determine the extent of the cancer and how far it has spread (metastasized). Most often, they will use imaging procedures to see inside the chest or abdomen to help determine the staging of the malignant mesothelioma. The imaging options your physician may use include:
Chest x-ray
CT scan of the chest and/or abdomen
MRI (Magnetic Resonance Imaging) scan of the chest and/or abdomen
PET (Positron Emission Tomography) scan of the chest and/or abdomen
Once the doctor is able to determine the stage of the mesothelioma, he/she will be able to formulate a plan for treatment and provide a prognosis.

Preventions Of Mesothelioma

Mesothelioma Prevention

Mesothelioma is one of the deadliest forms of cancer, particularly because it is difficult to diagnose early in its development. Therefore, prevention of the disease is of the utmost importance.
Quite simply, there is only one way in which you can develop mesothelioma. This deadly cancer occurs only with exposure to asbestos. Asbestos is a natural substance, still mined in a handful of locations throughout the world, once used in hundreds of products, including insulation, building materials, and even clothing, largely due to its strength, durability, flexibility, and heat resistance. However, this substance is very fibrous and when fibers are released, small pieces of asbestos become trapped in the lungs, causing scarring and, in some cases, cancer.

Preventions at Home

The first step towards preventing mesothelioma is, of course, avoiding exposure to this toxic mineral. Asbestos is no longer used in the vast majority of products, due to national laws regulating this product. However, mesothelioma was used in almost every industry for many decades. Some of the older products in your house may contain asbestos, including:

• Joint compound
• Roofing tar
• Brake pads
• Fireproofing
• Pipes
• Insulation
• Countertops
• Floor tiles
• Textured wall and ceiling coatings

If these items are intact, they present no health hazards. However, if they are damaged or "friable", they should be removed from your house immediately. However, the removal should be done by a licensed abatement company and can be completed after air quality tests that confirm the presence of asbestos fibers.

Preventions On Job

Workers in particular industries may still be at risk for exposure to asbestos. If you are in the construction industry, for example, you may encounter old buildings that contain asbestos. It is necessary to take great care in protecting yourself if the presence of asbestos is suspected, which includes wearing proper gear so as to avoid inhalation.

Monitoring Your Health

If you've already been exposed to asbestos, regularly monitoring your health is essential in order to catch the early warning signs on the disease. Remember, your options for treatment are greater the earlier the disease is diagnosed. It is important to have regular chest x-rays and pulmonary function tests, even if you are experiencing no symptoms of the disease.
In addition, if you've been exposed to toxic asbestos in the past, you may be able to reduce your chances of developing mesothelioma by not smoking. Studies show that smoking greatly increases the risk of developing mesothelioma and, of course, anyone who does develop the disease should stop smoking immediately.