Mesothelioma:
Mesothelioma means cancer of the mesothelium (-oma is a medical term for tumor or cancer). The mesothelium is the sac that lines and protects vital organs such as the heart, the lungs, and the abdominal cavity (stomach). This disease causes the cells of the lining to become abnormal and malignant. About two thirds of all mesothelioma cases develop in the pleural mesothelium or lung lining. The remaining cases, about one third, develop in the abdomen. Rarely, mesothelioma occurs in other mesothelial tissue, such as around the heart or in the reproductive organs.
Without treatment, most patients will die from mesothelioma within 4 to 12 months from the time of diagnosis. Patients generally die as a result of respiratory failure or pneumonia. Small bowel obstruction, resulting from direct extension of tumor through the diaphragm, develops in about one-third of patients. About 10% die of cardiac complications when the tumor invades the pericardium and heart. Three subtypes of mesothelioma have been identified according to microscopic appearance; these are epithelial, sarcomatoid, and mixed types. A number of studies have demonstrated that the epithelial variant is associated with the best prognosis. Other favorable prognostic variables include younger age, good performance status, early stage disease, and lack of chest pain at diagnosis.
The increased incidence of mesothelioma has been closely linked to the rise of the asbestos industry and the use of asbestos in fireproofing and insulation. Between 50% and 80% of patients diagnosed with MPM are aware of exposure to asbestos at some point in their lives. Men are typically affected more, due to the common presence of asbestos in industrial settings. The increasing incidence suggests either that the benefits of legislation to reduce asbestos exposure in the workplace have not yet taken effect, or that asbestos exposure during the 1960's was more widespread than previously believed. In addition, some researchers have implicated exposure to the SV-40 virus, which is known to have contaminated some polio vaccines, as potentially related to this malignancy, but this has not been proven.
The absence of asbestos exposure in a significant percentage of mesothelioma patients is used by some experts to argue for a genetic predisposition. The fact that only about 5% of South African asbestos mine workers developed mesothelioma suggests that other environmental or genetic factors are involved. Another associated risk factor is radiation. Radiation-induced malignant mesothelioma appears to have the same prognosis as asbestos-related mesothelioma.
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Malignant Pleural Mesothelioma
Pleural Mesothelioma Symptoms
Malignant Mesothelioma
Benign Mesothelioma
Peritoneal Mesothelioma
Pericardial Mesothelioma
Malignant Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. It is the most common type of mesothelioma and traditional treatments include surgery, chemotherapy and combined approaches utilizing multiple types of therapy (multimodality). Malignant pleural mesothelioma (MPM) affects over 3,000 people a year in the US, and considering the 30- to 40-year latency period between exposure and expression of the disease, there will be an estimated 300,000 cases before the year 2030. Epidemiological studies predict that approximately 250,000 Europeans will develop mesothelioma in the next few decades.
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In the early stages of the disease, symptoms are subtle. In the asymptomatic patient, a small buildup of fluid between the lining of the lung and the chest cavity, called a pleural effusion, may be present. Cough and shortness of breath are the most frequent early complaints. Fatigue, weakness and weight loss typically occur later. Pain is also common later in the disease as the tumor invades the chest wall and/or mediastinum (the area in the chest behind the breast bone and in between the two lungs where the heart, major blood vessels, lymph glands, and nerve tissue exist). This type of the disease starts in the chest cavity and can then spread to other parts of the body. Pleural mesothelioma sufferers may also begin to display severe breathing difficulty, weight loss and fever as well as trouble swallowing and even swelling of the face and neck. Some patients may also develop a rasping voice and start coughing up blood. However, there are patients that may not have any significant symptoms at all.
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Tumors of the mesothelium can be benign (noncancerous) or malignant (cancerous). A malignant tumor of the mesothelium is called a malignant mesothelioma. Because most mesothelial tumors are cancerous, malignant mesothelioma is often simply called mesothelioma
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A type of tumor that used to be called benign fibrous mesothelioma can form in the pleura surrounding the lungs. The tumor actually starts from tissue under the mesothelium, called the submesothelium. The new name of this tumor is solitary fibrous tumor of the pleura. This disease is usually not cancerous, but cancerous forms can occur. These tumors do not invade adjacent tissues, and the lack of invasion into adjacent tissues is the key microscopic feature that distinguishes these tumors from those labeled malignant. These
tumors are not associated with asbestos exposure and are found with equal frequency in men and women. A similar disease starting in the peritoneum is called solitary fibrous tumor of peritoneum. Complete surgical resection is the treatment of choice.
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Malignant peritoneal mesothelioma is a cancer of the cells lining the abdominal cavity. Peritoneal mesothelioma represents about one fifth to one third of all forms of mesothelioma and is a rapidly fatal malignancy with a median survival of less than 1 year. A small percentage of patients have a history of asbestos exposure, sometimes called chrysotile peritoneal mesothelioma, but a search for other cancer-causing agents continues. Traditional treatments include surgery, chemotherapy and combined approaches utilizing multiple types of therapy (multimodality).
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Pericardial mesothelioma is the rarest form of mesothelioma, accounting for less than 1% of all cases. It is a cancer of the cells that line the heart called the pericardium.
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