What is mesothelioma?
Mesothelioma is a type of cancer arising from the mesothelium. The mesothelium is the thin layer of tissues that covers the outer surface of many internal organs such as the heart, abdomen, lungs, testis, etc.
Epidemiology
It’s estimated that as many as 43,000 people worldwide die each year due to this disease in Australia, Japan, North America combinedly. The annual incidence of mesothelioma occurs in people is estimated to be 3300 cases per year. In 2000, it shows a peak in its occurrence but later it declined as there is a secondary control to exposure to asbestos (asbestos is one of the risk factors for mesothelioma). But in the UK there 2500 dies every year. In England, it’s the eighteenth most common cause of cancer deaths.
Risk factors for developing mesothelioma
There are many risk factor which contributes to developing mesothelioma in people is Industrial worker as well as automobile worker and construction worker who got exposed to asbestos who are at great risk of developing it. Asbestos is made up of fibers that are soft and flexible yet resistant to heat, fire, and several chemicals. When it is broken down such as removing insinuation or during the mining process dust is created and the fibers can be airborne.
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- Not only that people living close to them can also get affected as the dust of asbestos present in the cloth and hair can lead to secondary exposure.
- Zeolites are another type of chemical which are also responsible for this.
- Exposure to high-dose radiation can also be a risk factor to develop it.
- SV40 can increase the risk of this cancer.
- Some people are genetically exposed to this disease.
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Generally, it takes twenty to forty years to develop mesothelioma in person after initially getting exposed to asbestos.
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Asbestos dust present in the hair and cloth can become a potential source for the wife or children of the exposed person.
Signs and symptoms of mesothelioma
Shortness of breath and non-pleuritic chest pain is the most common presenting symptoms of malignant pleural mesothelioma. Fever, night sweats, weight loss, fatigue, chest discomfort, shoulder pain can also be present.
Symptoms of abdominal mesothelioma
Fever, weight loss, swelling, and pain in the abdomen, bowel obstruction, anemia. If it spreads in the other parts it may include swelling of the neck or face.
Stages of mesothelioma
There are four stages of this cancer.
- Stage one:Â means it has not spread and confined to the mesothelium.
- Stage two: means the tumor is spreading and becoming larger, possible lymph node involvement, surgical resection is possible.
- Stage three: means now it has invaded the chest wall or esophagus or the lymph node.Stage four means it has spread around the chest and other organs.
- Stage four: means it has spread to various organs. It may be present in the bloodstream, liver, and bones. surgery cannot be possible at this stage.
Diagnosis of mesothelioma
Chest x-ray and CT scan can be done but these are not confirmatory. Chest x-ray shows abnormal thickening or calcium deposits on the lung lining and fluid between the lung and chest wall. It shows pleural plaques. MRI is used to see the soft tissue especially to see the mesothelioma whether it involves the diaphragm or not.
The biopsy is more confirmatory. Types of biopsy depending on where the symptoms belong. The options are:
- Fine needle aspiration
- Thoracoscopy
- Laparoscopy
- Thoracotomy
- Laparotomy
Treatment
depends on the age, location of cancer, stage, and overall patient health. Stage one to three can be considered for surgical resection. For advanced cases, it is not possible. Surgery option includes wide local excision-by which remove cancer cells, pleurectomy removes part of covering of lungs, cytoreduction with hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma.
- Pleurodesis means using a chemical or drug to make the lung lining scar and it prevents fluid to build up; it improves symptoms to control.
- Radiation therapy also used to treat it by using high-energy X-rays. It can improve painful areas or tumor masses.
- Chemotherapy used to kill the growth of cancer cells.it involves using medication injected intravenously or taken orally.
Prognosis
It usually depends on the stage of cancer; the size of mesothelioma, whether it can be removed by surgery, the patient’s age, general health, amount of fluid in the chest wall, how far cancer has spread.
Fig: Pleural mesothelioma. Image credit: James Heilman, MD, License: https://creativecommons.org/licenses/by-sa/3.0/deed.en
Mesothelioma compensation
An employee exposed to asbestos and detected with mesothelioma should consult an attorney to claim compensation. It reduces the financial burden on him and his family. In the USA asbestos compensation options for workers with a history of occupational exposure include asbestos trust funds, mesothelioma lawsuits, and settlements.
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Potential workers’ compensation benefits include medical care, temporary or permanent disability payments, vocational rehabilitation: finding another type of job.
Mesothelioma vs asbestosis
Mesothelioma | asbestosis |
|---|---|
It is a cancer | It is not a cancer |
Life expectancy 12 to 21 months | Can be several decades |
Can develop in any part of human body having mesothelium | Only develops in the lungs after high asbestos exposure for a long time |
Pleural effusion can be seen in lung mesothelioma | Pleural effusion is usually absent in asbestosis |
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