Pleural mesothelioma, the most common type of asbestos-related cancer, develops on the lining of the lungs. Cancer symptoms usually appear in the late stages of the disease. In fact, pleural mesothelioma is a rare form of malignant cancer caused by asbestos. The first signs of pleural mesothelioma are typically chest pain and shortness of breath. You may also have no symptoms at all during the early stages of pleural mesothelioma progression.
The average life expectancy of a patient with pleural mesothelioma is less than 18 months, but some patients can live for much longer. Combining several treatments, such as chemotherapy, surgery, and radiation therapy, can help people with pleural mesothelioma live longer lives. Mesothelioma typically develops twenty to fifty years after the first asbestos exposure. This lag time, known as the latency period, explains why the disease primarily affects the elderly.
Who is at risk of developing pleural mesothelioma?
Almost 80% of men over the age of 75 who are diagnosed with pleural mesothelioma are men. Historically, asbestos exposure was most common in industrial jobs where men made up the majority of the workforce.
Shortness of breath, pleura or chest pain, persistent raspy or dry cough, difficulty swallowing, and coughing up blood are all symptoms of pleural mesothelioma. Shortness of breath affects one in every four patients with pleural mesothelioma, and more than half report pleural pain.
Symptoms of Pleural Mesothelioma
Pleural mesothelioma, like other mesothelioma cancers, can cause excess fluid to accumulate between the two layers of the pleura, a condition known as pleural effusion. This condition is found in nearly 90% of pleural mesothelioma patients. Though a small amount of fluid is required, too much fluid will make breathing difficult. The extra fluid may put extra pressure on the lungs, causing chest pain that worsens when you cough or take deep breaths. There are some additional symptoms associated with pleural mesothelioma.
Lumps under the skin on the chest Coughing up blood (hemoptysis) Unexplained weight loss Shortness of breath (dyspnea) Pain in the lower back or rib area Fatigue Persistent dry or raspy cough Difficulty swallowing (dysphagia) Night sweats or fever Painful breathing
Lung pleural is made up of two layers. The outer layer, known as the parietal pleural membrane, lines the entire interior of the chest cavity. Our lungs are protected by the inner layer, also known as the visceral membrane. A pleural mass can form on any of these layers and quickly spread to the other. As the tumors spread or metastasize on the pleural surface, they will form a sheath mass around the lung.
Pleural Mesothelioma Diagnosis
Pleural mesothelioma is notoriously difficult to diagnose. Because many respiratory diseases mimic the symptoms of pleural mesothelioma, doctors are likely to misdiagnose it as pneumonia or flu without further testing.
The diagnostic process begins when a doctor, most often a primary care physician, assesses the initial symptoms. Cheat pain and breathing difficulties warrant a chest X-ray, which is typically the first examination to detect tumors or fluid.
Imaging Diagnostics
Following a review of occupational and medical history, as well as a physical examination, patients are frequently required to undergo imaging tests used to diagnose pleural mesothelioma, such as CT scans, Chest Xrays, and PET scans. In some cases, X-rays can reveal pleural effusions and pleural tumors. CT scans, particularly more advanced CT scan images, can frequently reveal evidence of asbestos exposure. PET scans can detect signs of cancerous spread to the lymph nodes.
Doctors appear to be having difficulty distinguishing between certain cases of pleural mesothelioma and cancer-related cancer. While doctors may suspect mesothelioma based on the patient's symptoms, history of asbestos exposure, and abnormal imaging scan results, these specific signs are insufficient to confirm the diagnosis of pleural mesothelioma.
With the introduction of the PET scan in the early 1960s, doctors were able to distinguish between cancerous and noncancerous growths on the pleura. While imaging is useful in staging malignant pleural mesothelioma and guiding treatment, it cannot be used to diagnose the cancer itself.
How Is Pleural Mesothelioma Diagnosed?
There are several different staging approaches for malignant pleural mesothelioma. They all define four stages of progressive development. The first two stages require tumors to be localized. The tumors that spread are classified in the final two stages. The International Mesothelioma Interest Group (IMIG) developed the most widely used staging system for pleural mesothelioma. It applies to the tumor-node-metastasis (TNM) approach used to stage some other cancers.
The Brigham and Women's staging approach, as well as the Butchart staging approach, are two other staging approaches that are used less frequently. The Brigham and Women's staging approach was developed by pleural mesohtleima specialist Dr. David Sugarbaker. The other, Butchart, was created in 1976 by Eric Butchart and is the first staging system.
Pleural Mesothelioma Treatment Options
Traditionally, pleural mesothelioma has been treated with traditional cancer treatments such as radiation therapy, surgery, and chemotherapy. Most treatment plans combine these three, which is known as multimodal therapy. These treatments can be palliative or cytoreductive, depending on how far the cancer has spread.
Pleural Mesothelioma Prognosis
Doctors will analyze the disease's expected course and outcome, known as the prognosis, throughout the diagnosis process. Doctors face difficulties in providing an accurate prognosis because the disease is complex and each patient responds differently to treatment. The stage of the disease at diagnosis is the most important factor in pleural mesothelioma prognosis. Patients with the most common cell subtype, known as epithelial, may live up to 200 days longer than those with the least common subtype.