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Saturday, August 13, 2011

Mesothelioma



Definition:
  It is very rare form of malignant tumour that develops from the lining of the internal organs known as mesothelium.



Prognosis of mesothelioma is extremely poor.

Causes:
 It is mainly caused by exposure to the Asbestos
Most of mesothelioma patients have worked in asbestos exposed jobs. Frequent exposed to asbestos or inhalation of asbestos particles are very high risk to develop malignant mesothelioma.
Most of cases sign and symptoms doesn't appear until many year even more than decades after the asbestos exposed.
If early mesothelioma detected and managed well have good prognosis.


Types of mesothelioma:

A, Based on the location of Mesothelioma Cancer:

1, Pleural mesothelioma ( Most common site, aprox. 70%)

  •      Malignant mesothelioma arises from outer lining of the lungs and internal lining of the chest wall.


2, Peritoneal mesothelioma:

  •     Malignant mesothelioma arises from internal lining of the abdominal cavity.


3, Pericardial mesothelioma

  •     Malignant mesothelioma arises from pericardial lining of the pericardial sac.


4, Testicular mesothelioma

  •    Malignant mesothelioma arises from tunica vaginalis of the testes.


B, Based on the Cell type:

  1. Epitheloid mesothelioma ( Most common cell type, approx. 60%, better prognosis)
  2. Fibrous or Sarcomatoid
  3. Mixed or Biphasic (Both epitheloid and fibrous type)
  4. Desmoplastic ( Very rare )


Diagnosis:
  • Diagnosis of mesothelioma cancer is very difficult because the symptoms are similar to other medical conditions. It requres qualified mesothelioma doctor. Mesothelioma Doctor start to take all investigation like past medical history, past occupational history like asbestos exposure jobs.
  • Chest X- ray: May shows pleural thickening
  • Lung function tests should be performed.
  • CT scan or MRI should be performed
  • Thoracentesis or Chest thoracotomy should be done if there is accumulation of fluid in pleural cavity.
  • If ascites: Ascitic tap or paracentesis should be performed.
  • If Pericardial: pericardiocentesis should be performed.
  • Fluid Cytopathology must be done, even with cytopathology it is very difficult to diagnose mesothelioma
  • Biopsy of the affected site must be done to confirm diagnosis of mesothelioma
Treatment:
Prognosis of mesothelioma Cancer is extremely poor.
Qualified Mesothelioma Doctor can only treat mesothelioma patients.
Recently there is some improvements of treatments by newer chemotherapy or multimodality treatments.
Mesothelima at earlier stage has a better prognosis than late stage.
    The mainstay of treatment of mesothelioma is
    • Surgery: Pneumonectomy, pleurectomy, Decoritcation
    • Radiation
    • Chemotherapy: Only treatment has proven to improve survival.
    • Immunotherapy
       -Mesothelioma treatment is very expensive that's why it require insurance like health insurance, medical insurance and life insurance for treatment expense.
       -If patients had previous jobs which was exposed to asbestos or asbestos related products then it is very easy to lawsuit through  mesothelioma lawyers  to related company for compensation.

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