Diagnostic Procedures

Diagnostic surgery is a necessary step in confirming and staging mesothelioma.

Thoracoscopy enables a physician to examine the pleural space and [...]]]> There are three main modes of treating mesothelioma, these are; Chemotherapy, Surgery and Radiotherapy. Surgical procedures used in treatment of the disease are of three types;-Diagnostic Procedures, Palliative Procedures, Potentially Curative Procedures

Diagnostic Procedures

Diagnostic surgery is a necessary step in confirming and staging mesothelioma.

Thoracoscopy enables a physician to examine the pleural space and to take multiple tissue biopsies under direct vision. In up to 98% of cases, a definitive diagnosis can be obtained. Often, chemical pleurodesis aimed at reducing the accumulation of fluid in the intrapleural space, can be accomplished during the same procedure. It is also possible to gauge the extent of the tumor, and to see the possibility of removing the tumor surgically. While less invasive than an open biopsy, it can only be performed on patients where tumor has not completely blocked the pleural space.

VATS, or video-assisted thoracic surgery is an alternative to thoracoscopy, although because of its more invasive nature, it could lead to seeding of the tumor {dislodgement of fragments of the tumor by contact}. By using small incisions on the skin, the surgeon can view the pleural space with the assistance of a camera, and obtain sufficient tissue samples for analysis by a pathologist. Extent of the tumor (i.e., pleural involvement, chest wall invasion) may also determined, and recommendation as to the type of debulking {shrinking} procedure necessary can be made at this time.

Mediastinoscopy is sometimes used as an aid in staging extent of disease when enlarged nodes are seen using imaging techniques.

Laproscopy is used in mesothelioma patients in cases where imaging techniques suggest possible invasion of the tumor through the diaphragm. This information can be important in evaluating a patient for potential pleurectomy{complete removal of pleura on one side} or extrapleural pneumonectomy{complete removal of one lung}.

Palliative Procedures
Palliative surgical procedures are those which treat the symptoms of mesothelioma, without aggressively treating the disease itself.

Chest Tube Drainage and Pleurodesis is considered the most common of palliative treatments. Fluid build-up, or pleural effusion, is most often the first symptom which will prompt mesothelioma patients to seek medical attention. Once this effusion has occurred, it is many times persistent, returning rapidly after initial thoracentesis (draining of the fluid). In order to eliminate this problem, the pleural space must be closed. This is accomplished by use of a talc slurry or other sclerosing agent which produces an adhesion that causes the layers of the pleura to stick together thus closing the pleura space.

Thoracoscopy and Pleurodesis is done in conjunction with VATS using a powdered form of talc versus talc slurry. Both this and chest tube drainage and pleurodesis will be only effective if there is no tumor encasing the lung which restricts its expansion.

Pleurectomy, used as a palliative procedure, may be performed where more extensive surgery is not an option. In these cases, it is understood that all visible or gross tumor will not be removed. It is considered the most effective means of controlling pleural effusion in cases where the lung’s expansion is restricted by disease.

Potentially Curative Procedures
These procedures are performed with “curative intent”. Their goal is removal of all gross disease, with the knowledge that microscopic disease will most likely remain. Adjuvant therapy (another form of treatment in addition to the primary therapy) in form of chemotherapy and or radiotherapy is given to eliminate any residual disease.

For Pleural Mesothelioma:
-Pleurectomy/Decortication is usually performed on patients with early stage disease (Stage I and selected Stage II), and attempts to remove all gross tumor. If it is found that all tumor can not be removed without removing the lung, this may be done at the same time and is called pneumonectomy.

-Extrapleural Pneumonectomy is considerably more radical than other surgical approaches, and should be carried out by surgeons with great expertise in evaluating patients and performing the procedure itself.

For Peritoneal Mesothelioma:
• Cytoreductive Surgery is aimed at removing all or nearly the entire gross or visible tumor in the peritoneal cavity. In order to treat any remaining cancer cells, Intra-Peritoneal Hyperthermic (heated) Chemotherapy (IPHC) is then delivered to the abdominal cavity. The type of chemotherapy drug used may vary according to the physician’s preference.

Surgery is usually combined with other types of treatments to achieve maximal result during treatment.
Patients should also educate themselves about mesothelioma and treatment options and reach out to available resources to make coping with a mesothelioma diagnosis easier.

Find More Mesothelioma Patient Articles

Pleural mesothelioma develops when the cancer affects the pleura {the membranous lining of the lungs}.This form of [...]]]> Pleural mesothelioma is the commonest type of mesothelioma. Mesothelioma is a rare form of cancer that attacks the mesothelial cells in the mesothelium, the tissue that forms the membranous lining of the body’s major internal organs and cavities.

Pleural mesothelioma develops when the cancer affects the pleura {the membranous lining of the lungs}.This form of cancer is commonest in the UK, followed by South Africa, then Australia, then USA, then Eastern Europe.

The pleura has two layers which gives support and protection to the lungs and chest cavity:

-The outer layer, or parietal layer, lines the entire chest cavity and the diaphragm.

-The inner layer or the visceral layer which applies directly over the lungs.

Pleural mesothelioma can start from any of these two layers then spread to the other layer. Exposure to asbestos has been strongly linked to the development of this type of cancer. The toxic fibers get trapped in the spaces between the mesothelial cells of the pleura.

Symptoms

The asbestos fibers trapped in the body cause cancerous cells to multiply and divide haphazardly without control. These results in the thickening of the pleural membrane and mesothelial cells, leading to fluid build up in the pleura {pleural effusion}. This accumulated fluid will gradually start pressing on the lungs and the respiratory system leading abnormal and difficult breathing.

These developments eventually form the basis of most of the symptoms of pleural mesothelioma. These symptoms include:

A} Persistent dry or raspy cough

B} Haemoptysis, the coughing up of blood in the sputum

C} Difficulty in swallowing {dysphagia}

D} Difficulty in breathing, labored breathing known as dyspnoea

E} Pleurisy, pain in the chest during breathing

F} Development of lumps under the skin of the chest wall

G} Night sweats or fever

H} Unexplained weight loss

I} Fatigue

Diagnosis

Just like in other forms of mesothelioma, the symptoms of pleural mesothelioma show up many years after the initial exposure to asbestos and these symptoms are not specific to pleural mesothelioma, they also occur in some other less serious lung diseases like pneumonia and influenza.

All these factors make the diagnosis of pleura mesothelioma very difficult.

Once there is a strong clinical suspicion of pleural mesothelioma, diagnosis is then confirmed by imaging tests such as x-rays, CT scan, to confirm the location of the cancer. The patient is also subjected to fluid and tissue analysis known as biopsy to confirm the type of cancer involved.

Treatment

Newly developed drugs and detection techniques have improved the outlook for patients with pleural mesothelioma.

In general there are three main modes of treatment: a} Surgery b} Chemotherapy c} Radiotherapy. Most patients receive a combination of two or more of the different modes of treatment.

The earlier the cancer is detected, the better the prognosis and the wider the range of treatment options. When the tumor is detected early, curative surgery is done to remove the cancer, this is followed by chemotherapy or and radiotherapy to kill off any remnant cancerous cells. Curative surgeries is only carried out in patients that have good general state of health and whose cancers have not spread beyond localized sections of the lungs.

The level of progression of the tumor is classified in terms of the stage of the cancer. The stages range from stage 1 to stage 4 depending on the level of spread of the tumor.

Stage 1 and Stage 2 pleural mesothelioma have better prognosis and better treatment options.

The latter stages of the cancer, namely stage 3 and stage 4 are mostly limited to palliative modes of treatment to improve the quality of life and not their prognosis. These palliative treatments include the draining of excessive fluids in the pleural spaces and surgical removal of tumors to relieve pressure on the lungs.

According to current studies, approximately 10% of all pleural mesothelioma patients will survive for three to five years after diagnosis and 5% will survive for 5 years and above.

Pleural mesothelioma develops when the cancer affects the pleura {the membranous lining of the lungs}.This form of [...]]]> Pleural mesothelioma is the commonest type of mesothelioma. Mesothelioma is a rare form of cancer that attacks the mesothelial cells in the mesothelium, the tissue that forms the membranous lining of the body’s major internal organs and cavities.

Pleural mesothelioma develops when the cancer affects the pleura {the membranous lining of the lungs}.This form of cancer is commonest in the UK, followed by South Africa, then Australia, then USA, then Eastern Europe.

The pleura has two layers which gives support and protection to the lungs and chest cavity:

-The outer layer, or parietal layer, lines the entire chest cavity and the diaphragm.

-The inner layer or the visceral layer which applies directly over the lungs.

Pleural mesothelioma can start from any of these two layers then spread to the other layer. Exposure to asbestos has been strongly linked to the development of this type of cancer. The toxic fibers get trapped in the spaces between the mesothelial cells of the pleura.

Symptoms

The asbestos fibers trapped in the body cause cancerous cells to multiply and divide haphazardly without control. These results in the thickening of the pleural membrane and mesothelial cells, leading to fluid build up in the pleura {pleural effusion}. This accumulated fluid will gradually start pressing on the lungs and the respiratory system leading abnormal and difficult breathing.

These developments eventually form the basis of most of the symptoms of pleural mesothelioma. These symptoms include:

A} Persistent dry or raspy cough

B} Haemoptysis, the coughing up of blood in the sputum

C} Difficulty in swallowing {dysphagia}

D} Difficulty in breathing, laboured breathing known as dyspnoea

E} Pleurisy, pain in the chest during breathing

F} Development of lumps under the skin of the chest wall

G} Night sweats or fever

H} Unexplained weight loss

I} Fatigue

Diagnosis

Just like in other forms of mesothelioma, the symptoms of pleural mesothelioma show up many years after the initial exposure to asbestos and these symptoms are not specific to pleural mesothelioma, they also occur in some other less serious lung diseases like pneumonia and influenza.

All these factors make the diagnosis of pleura mesothelioma very difficult.

Once there is a strong clinical suspicion of pleural mesothelioma, diagnosis is then confirmed by imaging tests such as x-rays, CT scan, to confirm the location of the cancer. The patient is also subjected to fluid and tissue analysis known as biopsy to confirm the type of cancer involved.

Treatment

Newly developed drugs and detection techniques have improved the outlook for patients with pleural mesothelioma.

In general there are three main modes of treatment: a} Surgery b} Chemotherapy c} Radiotherapy. Most patients receive a combination of two or more of the different modes of treatment.

The earlier the cancer is detected, the better the prognosis and the wider the range of treatment options. When the tumor is detected early, curative surgery is done to remove the cancer, this is followed by chemotherapy or and radiotherapy to kill off any remnant cancerous cells. Curative surgeries is only carried out in patients that have good general state of health and whose cancers have not spread beyond localized sections of the lungs.

The level of progression of the tumor is classified in terms of the stage of the cancer. The stages range from stage 1 to stage 4 depending on the level of spread of the tumor.

Stage 1 and Stage 2 pleural mesothelioma have better prognosis and better treatment options.

The latter stages of the cancer, namely stage 3 and stage 4 are mostly limited to palliative modes of treatment to improve the quality of life and not their prognosis. These palliative treatments include the draining of excessive fluids in the pleural spaces and surgical removal of tumors to relieve pressure on the lungs.

According to current studies, approximately 10% of all pleural mesothelioma patients will survive for three to five years after diagnosis and 5% will survive for 5 years and above.

More Mesothelioma Patient Articles

The most serious of form of [...]]]> Mesothelioma, also known as asbestos cancer is caused by exposure to the toxic mineral called asbestos which is usually found in asbestos related worksites. This form of cancer is common amongst people working at worksites such as shipyards and can be traced to asbestos products present in these locations.

The most serious of form of all asbestos related cancers is malignant mesothelioma other asbestos related diseases include lung cancer and asbestosis. Malignant mesothelioma is a cancer that affects the lining of the lungs, abdominal cavity and the heart.

  Pleural mesothelioma is the commonest form of the cancer.  Exposure to asbestos is the main cause of mesothelioma, although other factors, such as smoking, could result in additional complications.  Although it is an uncommon form of cancer, the symptoms typically associated with this disease makes it difficult for many doctors to diagnose as most of the early symptoms of the disease are not specific to the disease, they also occur in some other lung and chest diseases. 

Most of the time by the time a definitive diagnosis is made, the disease will have advanced to a stage where treatment will be of limited help.

 Another important feature of the disease is that there is usually a long period of latency between the time someone is exposed to asbestos and the time the disease manifests in the form of malignant mesothelioma.

Pleural Mesothelioma

Malignant pleural mesothelioma most often originates within the chest cavity and can involve the lung.  This form of mesothelioma can metastasize to various organs in the body – even the brain – and tends to do so more often than not.

This form of mesothelioma is not easily detectable.  Often, in the early stages of mesothelioma, symptoms may be somewhat mild and non specific.  Patients sometimes report pain in one are of the chest that never goes away, fever and weight loss.  Other symptoms can be more severe and tend to include breathing problems due to the build up of fluid in the chest.

Survival rates for patients diagnosed with pleural mesothelioma tend to be very low.  Typically, patients do not live beyond 17 months from the onset of the symptoms. Only about 8% of those diagnosed with this disease will live 3 to 5 years from the initial onset of the symptoms.

Pericardial Mesothelioma

Pericardial mesothelioma is the least common form of mesothelioma.  Pericardial mesothelioma involves the heart. This type of mesothelioma is rare.  It invades the sac that surrounds the heart, otherwise known as the pericardium.  The heart is not able to supply oxygen to the body cells efficiently as the cancer progresses.  This causes further decline in health at a rapid rate. Symptoms commonly associated with this type of mesothelioma can mimic those of a heart attack which include pain in the chest, shortness of breath, and nausea.

Peritoneal Mesothelioma

Peritoneal mesothelioma originates in the abdomen and will often spread to other organs in area including the bowel, spleen and liver.  The most common complaint patients give their doctor is severe abdominal pain.  They may also experience a discomfort level with fluid build up in the abdomen as well.  Other symptoms include nausea and vomiting, fever, swollen feet and difficult bowel movements.

The survival rate is even lower for those diagnosed with peritoneal mesothelioma.  Patients with this type of mesothelioma typically survive only ten months from the onset of the symptoms noted above.

Related Mesothelioma Patient Articles

People who participate in these trials are most often than not patients who have invasive and [...]]]> Clinical trials are generally bio-medic research studies in humans that strictly follow a pre-defined protocol. It is a process that all potential treatment alternatives and medicines go through before they are considered safe or effective for the general population.

People who participate in these trials are most often than not patients who have invasive and treatment-resistant diseases. Most of these patients see it as their last hope for a cure.

There are three stages.

Phase I
is for determining the correct dosage and safety of a particular drug. This phase is not to test the efficacy of the drug, but more the safety. This phase is normally tested in a small group of people; usually 20-80 persons for the first time.

Phase II
is for determining if the new drug actually works against a particular health problem. This stage further evaluates the optimum dosage and confirms the results of Phase I trials. Phase II gives tests to a larger group of people; around 100-300 persons.

Phase III
is the final phase of a clinical trial before the new drug is approved for treating a disease. In this stage, the new drug is compared against the current standard treatment for a particular illness. Different doses and drug combinations are also tested in this stage. Up to 3,000 people are participative in the last phase.
A fourth stage is used nowadays for post-marketing studies. This phase determines if a drug or treatment is safe over time, and is done only after all three previous phases were approved by the FDA.

Doctors conduct clinical trials before any new treatment is recommended to patients. Since mesothelioma is one of the most devastating diseases, participation in such trials has become an important option for many malignant mesothelioma patients.

There are clinical trial reports on mesothelioma and all were aimed to raise hope for patients suffering from this disease.

Phase III Vorinostat (SAHA) trial is conducted for progressive malignant pleural mesothelioma patients. In this trial, doctors use Vorinostat, a chemotherapy drug, to kill cancerous cells, stop their division, and block enzymes that cells need in order to grow and multiply.
Phase II Pemetrexed Disodium with Gemcitabine or Carboplatin advanced malignant mesothelioma patients is a study conducted to examine the effects of chemotherapy drugs such as Gemcitabine, Pemetrexed Disodium, and Carboplatin on advanced and recurrent malignant mesothelioma.
Phase II AZD2171 is a study for patients with unresectable malignant mesothelioma. Here, doctors investigate the use of chemotherapy drugs to inhibit enzymes which slow the growth and block blood flow into the tumor. This study aims to help victims suffering from sarcotamous, advanced, epithelial, and recurrent malignant mesothelioma.

The individuals who participate in extensive clinical trials are brave individuals who wish to take a more active role in helping mesothelioma patients. These individuals greatly contribute to a more thorough understanding of this disease and help further medical science’s options in treating mesothelioma.

Product DescriptionPacked with practical advice on disease education, lifestyle management and emotional support from children, parents and the medical experts at Children’s Hospital Boston, the Family Health Education Series is designed to empower families with a child facing ulcerative colitis. Based on real-life experiences, it is the [...]]]>

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Packed with practical advice on disease education, lifestyle management and emotional support from children, parents and the medical experts at Children’s Hospital Boston, the Family Health Education Series is designed to empower families with a child facing ulcerative colitis. Based on real-life experiences, it is the first step in helping children with ulcerative colitis live life to the fullest.

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Product DescriptionPacked with practical advice on disease education, lifestyle management and emotional support from children, parents and the medical experts at Children’s Hospital Boston, this DVD, “Growing up with Crohn’s Disease: What Every Family Should Know” is [...]]]>

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