Mesothelioma- Causes, Prognosis, Diagnosis, Treatment and Life Expectancy
Mesothelioma is a cancer caused by asbestos exposure. The malignant tumors form in the lining of the lungs, abdomen or heart. Symptoms can include shortness of breath and chest pain.
Mesothelioma- Causes, Prognosis, Diagnosis, Treatment and Life Expectancy
The life expectancy for most mesothelioma patients is approximately 12 months after diagnosis.
What is Mesothelioma?
Mesothelioma is characterized by malignant tumors that develop in the mesothelium, a layer of protective tissue that covers several organs.
The four types of mesothelioma are identified by the location where tumors develop: Pleural mesothelioma (lungs), peritoneal mesothelioma (abdomen), pericardial mesothelioma (heart) and mesothelioma of the tunica vaginalis (testes).
Mesothelioma is a rare and aggressive cancer. Treatments are available to extend life expectancy and improve quality of life, but there is no cure.
Key Facts About Mesothelioma
- Approximately 3,000 mesothelioma cases are diagnosed yearly.
- Mesothelioma has a long latency period, taking 20-50 years to develop into cancer.
- Pleural mesothelioma accounts for 75% of all mesothelioma cases.
- The average age of diagnosis is 65 or older.
- People working directly with the asbestos mineral or with products containing asbestos are most at risk.
- Symptoms of malignant mesothelioma are treatable, but the cancer is incurable.
Mesothelioma Symptoms
Symptoms of mesothelioma appear when tumors spread, grow and press against the chest wall and the abdominal cavity. Early diagnosis can help patients’ chances of benefitting from more treatment options. Because symptoms are like those of other conditions, an initial misdiagnosis is common. It’s important to be aware of your history of asbestos exposure and discuss it with your doctor as soon as possible.
Common Mesothelioma Symptoms
- Dry cough
- Shortness of breath
- Respiratory complications
- Chest or abdominal pain
- Fever or night sweats
- Pleural effusion (fluid around the lungs)
- Fatigue
- Weakness in the muscles
Mesothelioma Causes
The primary cause of mesothelioma is asbestos exposure. This exposure can happen from repeated use of asbestos-contaminated consumer products such as talc. Asbestos in the workplace, homes, schools, military structures and naval ships also leads to dangerous exposure. Mesothelioma cancer develops decades after asbestos exposure occurs because it takes time for asbestos fibers to cause the damage that leads to cancer.
How Mesothelioma Develops
- A person inhales or swallows microscopic airborne asbestos fibers.
- The asbestos fibers become lodged in the lining of the lungs, abdomen or heart.
- Embedded fibers damage mesothelial cells and cause inflammation.
- Over time, tumors form on the damaged mesothelium, leading to mesothelioma.
People Most at Risk of Developing Mesothelioma
People most at risk of developing mesothelioma cancer handled asbestos for a prolonged period of time or were exposed to large amounts of occupational asbestos. Secondhand exposure is also common, especially among the spouses and children of people who worked with asbestos. Veterans were also exposed while serving in the U.S. armed forces.
- Veterans
- Firefighters
- Auto mechanics
- Chimney sweeps
- Miners
- Construction workers
- HVAC technicians
- Textile mill workers
- Electricians
- Family members
Types of Mesothelioma
The four types of mesothelioma are defined by where tumors develop in the body. The most common types are pleural and peritoneal mesothelioma. Pericardial and testicular mesothelioma account for less than 2% of cases combined.
Tumors form in the mesothelium, which is the thin protective lining that covers the lungs, abdomen, heart and testes. The mesothelium goes by different names depending on the parts of the body it covers. The pleura surrounds the lungs and chest wall, the peritoneum covers the abdominal cavity and organs, the pericardium covers the heart, and the tunica vaginalis lines the testes.
Prognosis, symptoms and treatment options vary by mesothelioma type.
Pleural Mesothelioma
Pleural mesothelioma accounts for 75% of cases. It forms on the soft tissue covering the lungs. Multimodal therapy combining two or more therapies remains the best treatment approach.
Peritoneal Mesothelioma
Peritoneal mesothelioma accounts for less than 20% of cases. It develops on the lining surrounding the abdomen. This type responds best to a combination of surgery and heated chemotherapy.
Pericardial Mesothelioma
Pericardial mesothelioma accounts for 1% of cases. It forms on the soft tissue around the heart. A multimodal approach of surgery and chemotherapy offers the best chance of survival.
Testicular Mesothelioma
Testicular mesothelioma accounts for less than 1% of cases. It develops on the tunica vaginalis, which is the lining of the testes. This type responds best to surgery followed by chemotherapy.
Diagnosing Mesothelioma
Several procedures may be used in the diagnostic process, but a biopsy is the key mesothelioma test to confirm a diagnosis. An early mesothelioma diagnosis in the cancer’s first stages may increase a patient’s eligibility for all treatment options.
Common Mesothelioma Testing Procedures
Imaging Scans
Most people initially undergo a basic chest X-ray to check for any abnormalities. If an abnormal growth or fluid around the lung is detected, doctors will recommend a more detailed imaging scan such as a PET scan, CT scan or MRI.
Biopsies
If cancer is suspected, doctors will recommend taking a sample of tissue, which is also known as a biopsy. Doctors use this tissue sample to definitively confirm the presence of malignant mesothelioma cells.
Blood Tests
Blood tests may be used but do not confirm the presence of mesothelioma. Researchers are evaluating if blood tests can aid in the early diagnosis of at-risk former asbestos workers.
Staging
An important part of the diagnostic process is determining the cancer’s stage of growth. Doctors use imaging scans and biopsies to assess the growth and spread of mesothelioma tumors. The TNM staging system is the most commonly used system for staging malignant mesothelioma.
Stages of Mesothelioma
Staging tracks malignant mesothelioma tumor growth and helps doctors make a treatment plan and predict patient prognosis. The stages of mesothelioma range from 1 to 4 and are based on tumor size and location.
Early-stage mesothelioma is more confined to one site, while late-stage mesothelioma shows tumors spreading beyond the chest or abdominal cavity. Staging is an important part of determining treatment.
· Stage 1
The cancer is localized. Surgery is most effective at this stage. Survival rate is higher. A patient’s median life expectancy at stage 1 is 22.2 months.
· Stage 2
Tumors have spread from the original location into adjacent structures. Surgery is still an option. Median life expectancy at stage 2 is 20 months.
· Stage 3
Cancer has spread into regional lymph nodes. Surgery is an option in select cases. The patient’s median life expectancy at stage 3 is 17.9 months.
· Stage 4
Tumors have spread into distant organs. Chemotherapy and immunotherapy ease symptoms. Median life expectancy at stage 4 is 14.9 months.
Mesothelioma Life Expectancy and Prognosis
When doctors discuss a mesothelioma cancer patient’s prognosis, they are determining the overall outlook for that specific individual. Typically, when patients inquire about their mesothelioma prognosis, what they’re interested in is information about life expectancy.
While there is no cure, the outlook for each patient varies depending on factors such as the patient’s age, overall health, how early a diagnosis is made and if their prognosis can be improved with treatment and the adoption of a healthy lifestyle.
Mesothelioma Treatment Options
Mesothelioma cancer is treated with conventional therapies such as surgery, chemotherapy and radiation, according to the latest study in the American Society of Clinical Oncology. Emerging cancer treatments, including immunotherapy, are also available for some patients. Though not every patient is eligible for each type of mesothelioma cancer treatment, most patients can benefit from palliative care to help manage symptoms.
· Surgery
These procedures are used for diagnosing disease, removing tumors and easing pain. Extrapleural pneumonectomy or pleurectomy and decortication surgeries offer the greatest chance of survival for patients with strong health and limited cancer spread.
· Chemotherapy
More than 70% of patients undergo chemotherapy. The therapy’s strong drugs shrink tumors and kill cancer cells but also come with treatment side effects.
· Radiation Therapy
Radiation therapy can be administered at any cancer stage. Doctors use it to reduce pain and slow tumor growth. It is often combined with surgery and chemotherapy.
· Immunotherapy
Immunotherapy drugs control cancer growth and help some mesothelioma patients live longer. Doctors use immunotherapy at any stage, and success rates vary for each patient.
· Tumor Treating Fields (TTFields)
This FDA-approved cancer therapy treats pleural mesothelioma. TTFields works in combination with chemotherapy to limit cancer growth and improve survival.
· Clinical Trials
Researchers and doctors offer these experimental therapies to eligible patients across the nation. Mesothelioma clinical trials can lead to new or improved treatments.
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