Contemporary Management of Malignant Pleural Mesothelioma
Mesothelioma Treatment Options
Pleural Mesothelioma is a cancer that affects the pleura, the outer lining of the lung. The pleura has two layers; the inner (visceral) layer, next to the lung, and the outer (parietal) layer which lines the chest wall. These two layers of the pleura are in contact and slide over each other when we breathe.
Australia has one of the highest rates of mesothelioma in the world. This is due to Australia’s history of high rates of usage and mining of asbestos (a naturally-occurring mineral silicate utilised in commercial building and manufacturing).
Mesothelioma is a cancer typically related to exposure to asbestos that affects the mesothelium, a thin tissue membrane that covers internal organs of the body including the thoracic cavity (pleura), the heart sac (pericardium) and the abdominal cavity (peritoneum). The mesothelium supports and protects the body’s organs and cavities while also providing a source of lubrication that helps the organs move and function.
While mesothelioma is difficult to diagnose, research shows that more than 90% of reported mesothelioma cases occur in the pleura (the lining of the lungs), and is called Pleural Mesothelioma, which is caused primarily by the inhalation of asbestos fibres into the lungs.
Symptoms of mesothelioma usually occur between 20 to 50 years after exposure – although exposure to asbestos does not necessarily result in the disease. Some people who have been exposed to asbestos will develop pleural plaques, a benign condition that does not seem to be related to mesothelioma.
Pleural Mesothelioma
Pleural Mesothelioma is formed when small asbestos fibres remain in the lung. While the human body is usually able to remove foreign particles the asbestos fibres are very small and embed themselves into the mesothelium (lining of the lung). As the body’s immune system tries to rid the body of the asbestos fibres it causes permanent scarring and hardening of the surrounding tissue. As the disease progresses the lining of the lungs, in the affected area(s), thickens.
Symptoms of Pleural Mesothelioma
The symptoms of Pleural Mesothelioma are quite vague. The most common symptoms are breathlessness, chest pain, fatigue and weight loss. In most cases the first sign of something being wrong is when breathlessness or pain in the chest occurs as a result of an effusion. This is when fluid accumulates in the space (pleural cavity) between the two layers of the pleural lining.
Symptoms of Mesothelioma include:
* Breathlessness
* Dry cough
* Pain in the chest or ribs area
* Fatigue
* Unexplained weight loss
* Night sweats or fever
These symptoms may be caused by this condition or may be due to other, less serious conditions. It is important to see a doctor about any symptoms you may have. Only a doctor can make a diagnosis. If you have come into contact with Asbestos or products containing Asbestos and experience any of these symptoms, you are encouraged to talk to your doctor.
Diagnosis of Pleural Mesothelioma
Pleural Mesothelioma is not an easy disease to diagnose. Often a number of investigations and hospital visits are required and even then it is not always possible to be certain that mesothelioma is present.
The diagnosis may be suspected based on chest X-ray and CT scan findings, and must be confirmed by a pathological examination from a biopsy. This is where tissue or fluid is removed from the affected area, placed under the microscope, and a pathologist makes a diagnosis when mesothelioma cells are found.
The steps involved in diagnosis may include:
* Providing a full and accurate medical history
* Providing an occupational history (including possible asbestos exposure)
* A fully physical examination