Mesothelioma

When a patient learns of a mesothelioma diagnosis, confusion is often one of the first emotions experienced. What exactly is mesothelioma? Is it a disease? A virus? Mesothelioma is actually a rare type of cancer. When people refer to mesothelioma disease, they are actually referring to mesothelioma cancer. Mesothelioma develops in the mesothelium, the membrane that surrounds several body cavities. The mesothelium is comprised of mesothelial cells, which become abnormal and divide uncontrollably if mesothelioma is present.

Four different types of mesothelioma exist. Pleural mesothelioma is the most common form of the cancer and develops in the lining of the lungs, known as the pleura. Peritoneal mesothelioma affects the lining of the abdomen, known as the peritoneum. Pericardial mesothelioma is very rare, as approximately 200 cases have been reported internationally. Pericardial mesothelioma develops in the pericardium, the membrane that surrounds the heart and protects the organ. Testicular mesothelioma is the rarest form of mesothelioma and develops in the lining surrounding the testicles, known as the tunica vaginalis.

Approximately 2,000 to 3,000 people are diagnosed with mesothelioma annually in the United States. Many patients are not diagnosed with the cancer until it has reached later developmental stages since it may take 20 to 50 years for a patient to demonstrate symptoms of mesothelioma. The cancer is caused almost exclusively by asbestos exposure and it often takes decades for a patient to express mesothelioma symptoms from the time initial asbestos exposure occurred.

Mesothelioma Symptoms

Diagnosis can be difficult because symptoms often resemble more common illnesses and are non-specific. Patients are often unaware of the severity of their condition until they are diagnosed with mesothelioma. A patient with peritoneal mesothelioma may express symptoms such as a persistent dry or raspy cough, difficulty breathing and swallowing, night sweats and fever, among others. Pericardial mesothelioma patients may complain of swelling or pain in the abdomen, fatigue, nausea, night sweats or the appearance of lumps under the skin on the abdomen. A patient with pericardial mesothelioma may experience heart palpitations or irregular heartbeat, chest pain, difficult breathing, fever and fatigue. Testicular mesothelioma symptoms have been confined to the appearance of testicular lumps.

Mesothelioma Diagnosis

Once a patient demonstrates unusual symptoms and visits a doctor, a medical review and physical examination often follow. Typically, further testing will be needed and an x-ray will likely be requested to pinpoint the location of the cancer and determine whether or not it has spread to other areas of the body. Additional imaging tests such as a CT scan, PET scan or MRI are often recommended for a more detailed image of the cancer. A fluid and tissue test, known as a biopsy is then typically conducted to collect a sample of fluid or tissue to test for the presence of cancerous cells. A pathologist generally examines the sample to determine whether or not mesothelioma is present.

Mesothelioma Treatment

After diagnosis, patients and their loved ones are often anxious to do everything possible to fight mesothelioma. This may involve several different treatment options. The most common treatments mesothelioma patients utilize include surgery, chemotherapy and radiation. Though a cure for mesothelioma does not currently exist, many patients undergo several treatments for relief from symptoms to improve the quality of life. Patients may also experience relief through experimental options and treatments available through clinical trials and alternative therapies.

Mesothelioma patients are typically diagnosed within three to six months of their first visit to a doctor with complaints about breathing problems or chest and abdominal pain. The first step involved in a diagnosis of mesothelioma is providing a full and accurate medical history to your doctor, including details about current and past health concerns, as well as the types of symptoms you are currently experiencing.

It is important to mention any possible exposure to asbestos. Without revealing this fact, your doctor may not consider asbestos-related diseases in his or her examination. Next, patients will undergo a physical examination where a doctor will examine causes for any types of symptoms being displayed. In most cases, the doctor's next step will be to recommend further testing.

Mesothelioma Diagnostic Tests

If your doctor suspects an asbestos-related disease such as mesothelioma, the next step in the diagnostic process includes testing to confirm the presence of mesothelioma, determine the location, size and type of cancer involved, and determine whether the asbestos cancer has spread to other parts of the body. This will often involve imaging tests such as:

• Chest X-ray: This is the most commonly used imaging test for the diagnosis of mesothelioma. Almost all diagnoses will involve an X-ray, but a more sophisticated test may follow.
  
• CT Scan: This is an X-ray-like procedure in which several X-ray pictures are taken and combined with a computer to produce a detailed image of body tissues. If you undergo a CT scan, you may be given an intravenous injection of dye that helps produce more detailed images.
  
• PET Scan: A glucose solution is administered through intravenous injection and a scanner is used to spot deposits of cancer cells. Malignant cells take up and use sugars more quickly than normal cells, so they can be easily distinguished using this procedure.
  
• MRI Scan: A combination of radio waves and a strong magnetic field is used to create detailed three-dimensional images that can be carefully examined by a radiologist.

• Fine Needle Aspiration: Mesothelioma cancers cause fluid to build up in affected locations, such as in the pleural membrane. During a fine needle aspiration, a doctor will remove a fluid sample using a very long, thin and hollow needle.
  
• Thoracoscopy: Thoracoscopy is used in cases where pleural or pericardial mesothelioma is suspected. During this procedure, a very small incision is made in the chest wall and a sample of tissue is removed.
  
• Bronchoscopy and Laparoscopy: These procedures are similar to the thoracoscopy, but are performed on different parts of the body. The bronchoscopy is used to view the trachea and airway, while the laparoscopy is used to remove samples of peritoneal tissue.
  
• Mediastinoscopy: This procedure is used to view lymph nodes in the chest and neck, to determine if cancer has spread from its point of origin.