Malignant Mesothelioma: Diagnosis and Treatment

Malignant Mesothelioma is a disease in which malignant cells are found in the pleura or the peritoneum. Most people who are diagnosed with Malignant Mesothelioma have worked or lived in places where they have either inhaled or swallowed asbestos. The time from exposure to diagnosis is often a long period of time.1 There have also been reported cases of individuals acquiring this disease as a result of living with a person who has been directly exposed or those who have been exposed to a certain virus.

Signs that typically lead an individual to seek medical care are:

• Trouble breathing
• Pain under the rib cage
• Pain or swelling in the abdomen
• Lumps in the abdomen
• Weight loss for no known reason

Diagnostics that are typically ordered in order to confirm a diagnosis of Mesothelioma include:

• Physical exam and history
• Chest x-ray
• Complete blood count (red blood cells, white blood cells and platelets)
• Sedimentation rate
• Biopsy (there are several types of biopsy that can be performed and they include; fine-needle aspiration, thorascopy, peritonescopy, laparotomy, thoracotomy)
• Bronchoscopy
• Microscopic exam of cells(Cyctologic exam)2

Once a diagnosis of Malignant Mesothelioma is made treatment and prognosis depends on the size of the tumor, the stage of the cancer, the amount of fluid in the chest or abdomen, and whether the tumor can be removed completely by surgery. Other factors that are included when determining prognosis is the patient’s age, their overall health status, and whether it is the initial diagnosis or if this is a recurrent diagnosis.3 Staging is how physicians determine how far the cancer has spread. This is done with the following diagnostics x-rays, MRI and CT scans.4

The International Mesothelioma Interest Group developed a specific staging system for Mesothelioma that has been adopted by the American Joint Committee on Cancer. The system is based off of the letters of T (which stands for Tumor), N (spread to the lymph nodes) and M (for metastasis). The initials TNM are then combined with Roman numerals from I to IV.4

Typically treatment for Mesothelioma includes surgery, radiation and chemotherapy. Surgery can be done for the purpose of curing the disease or to relieve the pain and discomfort often associated with the disease process (palliative therapy). Often palliative therapy is done to help relieve pain in those patients where the entire tumor can not be removed, the tumor has spread beyond the Mesothelioma or when the patient is too fragile to tolerate more invasive surgery. Curative surgery is performed when the patient is in overall good health and it is believed that there is a high likelihood of removing the whole tumor.5

Radiation therapy is used to treat Mesothelioma by using high energy x-rays to destroy cancer cells. External beams of x-ray are delivered from outside the body in a manner where they are focused on a specific area. Radiation therapy is often the treatment of choice for those patients who are thought otherwise unable to undergo surgical intervention. As with surgical intervention, radiation therapy can either be performed with the goal to cure or to relieve the pain and discomfort associated with the disease.6

Chemotherapy is the use of drugs for treating cancer. It is a systemic therapy where the drug can either be ingested or injected directly into the bloodstream, and then circulates throughout the body to seek and destroy the cancer cells. Sometimes with Mesothelioma, chemotherapy is entered in the abdomen or into the abdominal cavity. One of the most effective drugs used to treat Mesothelioma is Adriamycin. The downside associated with chemotherapeutic agents to treat Mesothelioma is that is can also kill health or otherwise normal cells in the body.6

The prognosis of Mesothelioma is poor in general. Most individuals who have a lot of the symptoms live as little as six months. For those who have little or none of the symptoms, they will live at least one year and have a forty percent chance of living two years.

Please contact our office regarding how we best can help you in a case that may involve this disease.

References:
1 National Cancer Institute. General Information About Malignant Mesothelioma http://www.cancer.gov/cancertopics/pdq/treatment/
malignantmesothelioma Retrieved March 2007. pg. 2

2 National Cancer Institute. General Information About Malignant Mesothelioma http://www.cancer.gov/cancertopics/pdq/treatment/
malignantmesothelioma Retrieved March 2007. pg. 4

3 National Cancer Institute. General Information About Malignant Mesothelioma http://www.cancer.gov/cancertopics/pdq/treatment/
malignantmesothelioma Retrieved March 2007. pg. 5

4 American Cancer Society. How is Malignant Mesothelioma Staged? http://www.cancer.org
Retrieved March 2007. pg. 1

5 Mesothelioma.com. Mesothelioma Treatment: Conventional Therapies http://www.mesothelioma.com/conventional therapies.htm
Retrieved March 2007. pg. 1

6 Mesothelioma.com. Mesothelioma Treatment: Conventional Therapies http://www.mesothelioma.com/conventional therapies.htm
Retrieved March 2007. pg. 2

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