Mesothelioma

Mesothelioma is cancer of the mesothelium, a membrane that lines the inside of the body's cavities, such as the abdomen or chest. Three out of every four cases of mesothelioma disease begin in the chest cavity.

Causes of Mesothelioma #

Zeolites #

These minerals are chemically related to asbestos. One of these related minerals, erionite, is common in the soil in some areas of Turkey, according to the American Cancer Society. Exposure to erionite is believed to be responsible for high rates of mesothelioma rates in those areas.

Radiation #

The American Cancer Society notes that there have been a few published reports of mesotheliomas that developed following exposure to high doses of radiation to the chest or abdomen or after injections of thorium dioxide (Thorotrast), a material used by doctors in some chest X-rays until the 1950s.

SV40 virus #

Some studies in laboratory animals have raised the possibility that infection with the simian virus 40 (SV40) might increase the risk of developing mesothelioma, according to the American Cancer Society.

Genetics #

Some experts believe certain people may be genetically predisposed to mesothelioma. Rates of the disease vary among populations.

Symptoms of Mesothelioma #

• Weight loss

• Swelling and pain in the abdomen

• Blood clotting abnormalities

• Bowel obstruction

• Anemia

• Fever

Diagnosis of Mesothelioma #

Blood tests #

Blood levels of three substances fibulin-3, osteopontin, and soluble mesothelin-related peptides (SMRPs) are often higher in people with mesothelioma. Although these blood tests cannot confirm a diagnosis of mesothelioma more study is needed before they can be of reliable use in a clinical setting high levels of these substances make the disease more likely.

Fluid and tissue sample tests #

If you have a buildup of fluid in the body that may be related to mesothelioma, your doctor can remove a sample of the fluid by putting a needle through the skin into the area of fluid buildup. The fluid can then be examined under a microscope for cancer cells. If cancer cells are found, further tests can tell if the cancer is mesothelioma.

Needle biopsy #

This involves inserting a long, hollow needle through the skin to remove a tiny piece of a tumor. Your doctor may use imaging tests to guide the needle into the tumor. In some cases, the sample may be too small to make a diagnosis and a more invasive procedure is needed.

Thoracoscopy, laparoscopy, and mediastinoscopy #

In these procedures, the doctor inserts a thin, lighted scope through a small cut in the skin to see potential areas of mesothelioma. Small tools, put in through other cuts, can be used to remove pieces of tissue to examine under a microscope.

Surgical biopsy #

In some cases, more invasive procedures may be needed to get a large enough tissue sample to make a diagnosis. In that case, a surgeon may perform a thoracotomy (opening the chest cavity) or laparotomy (opening the abdominal cavity) to remove a larger sample of tumor or the whole tumor.

Chest X-ray #

An X-ray of the chest may show abnormal thickening of or calcium deposits on the lung lining, fluid in the space between the lungs and chest wall, or changes in the lungs, which could suggest mesothelioma.

Computed tomography (CT) #

The CT scan is a procedure that uses multiple X-rays and a computer to create detailed images of the inside of the body. CT scans are often used to look for signs of cancer, help find where the cancer is, and to check if the cancer has spread.

Positron emission tomography (PET) #

This test involves giving a shot of a compound containing a radioactive atom and then taking pictures of the body. Cancer cells absorb large amounts of the radioactive compound and show up brighter than normal tissue on the images. Doctors then focus further tests on these areas of potential cancer.

Magnetic resonance imaging (MRI) #

MRI scans use radio waves and strong magnets to make detailed images of the body. Because they provide detailed images of soft tissues, they may help your doctor find where the tumor is. For mesotheliomas that involve the diaphragm (a dome-shaped muscle under the lungs), MRI scans may be particularly useful.

Treatment of Mesothelioma #

Surgery #

The main surgeries used in mesothelioma treatment are:

• Wide local excision, which removes the cancer along with some of the healthy surrounding tissue

• Pleurectomy and decortication, in which the surgeon removes part of the covering of the lungs, chest lining, and outside surface of the lungs

• Extrapleural pneumonectomy, which involves removing one whole lung and part of the lining of the chest, the diaphragm, and the lining of the sac around the heart

• Pleurodesis, which involves using a chemical or drug to make the lung lining scar and stick to the lung.

• The scarring stops the buildup of fluid.

• This is used for symptom control and isn’t meant to be a cure.

Radiation therapy #

• This type of cancer treatment uses high-energy X-rays and other types of radiation to kill mesothelioma cells or keep them from growing.

• Radiation may be given externally or internally.

• External radiation therapy uses a machine outside the body to send radiation toward the cancer.

• Internal radiation uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into the area near the mesothelioma.

Chemotherapy #

• This uses drugs to stop the growth of cancerous mesothelioma cells, either by killing the cells or by stopping them from dividing.

• Chemotherapy can be given by mouth, injected into a vein or muscle to enter the bloodstream and reach mesothelioma cells throughout the body, or it can be placed directly into the affected area of the body to mainly affect mesothelioma cells in that area.

• Sometimes, doctors use more than one chemotherapy drug. This is called combination chemotherapy.

Immunotherapy #

• This uses certain drugs to help your immune system fight cancer.

• The combination of nivolumab (Opdivo) and ipilimumab (Yervoy) is approved by the FDA for unresectable mesothelioma.

• That’s mesothelioma that has spread over a large portion of the body and can’t be treated with surgery.

Tumor-treating fields (TTF) #

This type of treatment uses chemotherapy and electric fields with specific frequencies to slow the division of cancer cells.