• 16Jul

    What is Mesothelioma?

    The tumour of pleura or the lining of lungs is called mesothelioma. This tumour may be cancerous or non-cancerous. Exposure to asbestos is the commonest cause of this condition. Among patients with malignant or cancerous pleural mesothelioma, 77% have previously been exposed to asbestos. This is a chronic condition that occurs due to years of exposure to asbestos. Very fine fibres of asbestos that are suspended in the air are inhaled accidentally, usually due to occupational exposure. These fibres settle in the lungs and cause low grade or chronic inflammation. This may result in genetic mutations in the cells of lungs or pleura and development of cancer. Mesothelioma usually starts at the lower part of the chest and then involves the diaphragm and encases the lungs. Once this develops, it spreads rapidly to other organs like esophagus, ribs and chest wall. 


    Asbestos and mesothelioma

    The crocidolite and amosite asbestos, is the carcinogen primarily implicated in the genesis of malignant pleural mesothelioma. This occupational disease is seen in people working in asbestos mills, shipping yards and mines. The industries like ship building, ceramics, asbestos cement manufacture, asbestos brake lining manufacture, railroad repair and insulation have a high incidence of asbestos related diseases including mesothelioma.

    Clinical features

    This cancer is more commonly seen in men than women with a ratio of 3:1. The peak incidence occurs during 5th to 7th decade of life. Difficulty in breathing and chest pain are the common symptoms seen in majority of people suffering from pleural mesothelioma. The other features include chest discomfort, fever with sweating, easy fatigability and loss of weight. Many of these patients develop collection of fluid in the chest called pleural effusion. This fluid compresses the lungs and adds to discomfort and breathing difficulty though a few may remain asymptomatic.

    What is Mesothelioma?

    Mesothelioma is asbestos related disease.

    Mesothelioma diagnosis

    Pleural effusion is detected on taking chest radiographs. This may also demonstrate nodular thickening of the pleura, involvement of the diaphragm and a reduction in size of the affected part of chest. More than 90% of patients with pleural mesothelioma present with pleural effusion that decreases after it is aspirated or drained.

    The diagnosis is confirmed by thoracoscopic biopsy. In this procedure, a telescope is passed into the chest and a small tissue from pleura is removed. This shows evidence of mesothelioma on microscopic examination. The cancer cells of mesothelioma are also seen in the pleural effusion fluid that is aspirated with a syringe, called thoracentesis and is examined microscopically. Diagnosis is difficult because results from fluid analysis of the tumor’s effusion are not usually diagnostic whereas thoracoscopic biopsy is positive in 98% of cases.

    A computed tomography (CT) or MRI scan of the chest or a positron emission tomography (PET) scan can also be used in the diagnosis of mesothelioma.

    Management of mesothelioma

     A multimodality method is used for management of these patients as there is better response with such multipronged approach. The options include surgical resection, radiotherapy and chemotherapy. Some of the drugs used in chemotherapy include Cisplatin, gemcitabine and pemetrexed. Death in these cases is usually due to chest infection or respiratory failure.

    Prognosis

    Once this cancer develops, the chances of survival are very bleak. A person may live for another 6 to 8 months without treatment. With the treatment, life may extend by one to one and a half years. Even after surgery, the tumour may recur in more than 50% of people.

    This cancer is difficult to diagnose, therefore a high index of suspicion is essential especially in people working in the high risk industries. A regular health check-up is essential to help in the early diagnosis and treatment. Prevention is always better and care should be taken as per the industry guidelines against inhalation of asbestos in the prone environment.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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