When you think of mesothelioma, you probably think of a disease of that affects the lungs. There are actually four kinds of mesothelioma: peritoneal, pericardial, testicular, and pleural. Peritoneal affects the lining around the organs in your abdomen; pericardial is a cancer of the lining around your heart; and testicular relates to the tissue lining the interior of the testes. All types of this rare cancer are caused by asbestos exposure. Pleural mesothelioma is the most common type; as many as three quarters of mesothelioma patients have pleural mesothelioma.
What is Pleural Mesothelioma?
Pleural mesothelioma is a cancer of the mesothelium that surrounds the lungs. The mesothelium is a thin membrane that surrounds the internal organs of your body. It is a sort of internal skin. The mesothelium secretes a fluid that allows your organs to move as you move, without friction.
This type of mesothelioma occurs when microscopic asbestos fibers become airborne, where they can be inhaled and lodge in your lungs. Your lungs have natural cleaning processes to expel foreign objects, but the sharp ends of asbestos fibers can become embedded and stay in your lung tissue.
Asbestos fibers can remain in the lungs for years, causing inflammation and irritation. Eventually, that irritation may develop into pleural mesothelioma. The time between asbestos exposure and a mesothelioma diagnosis can be 40 years or more.
Pleural Mesothelioma Symptoms
If you have been exposed to asbestos, you should be vigilant for the symptoms of pleural mesothelioma. Symptoms can include:
A cough or a wheeze in your chest that won’t go away
Trouble breathing
Coughing up blood
Chest pain
Persistent exhaustion
Excess fluid around the lungs
All these symptoms can be indicative of other diseases as well as pleural mesothelioma. Get checked by a doctor to rule out other lung ailments. Because the symptoms can be caused by many other more common diseases, your doctor might overlook the possibility of mesothelioma at first. Let your doctor know that you have been exposed to asbestos, so you can get as early a diagnosis as possible.
Diagnosing Pleural Mesothelioma
If your doctor suspects pleural mesothelioma, the first step could be non-invasive tests, such as an X-ray, MRI or CT scan. These tests can indicate the possibility of mesothelioma, but they can’t always provide a definitive diagnosis.
Before your doctor can determine whether you have mesothelioma, he or she will probably need to do a biopsy of the tissue in your tumor. Modern surgical techniques have made the biopsy a very simple operation. In most cases, a biopsy requires only a very small incision in the chest. The lab will examine the tissue removed to determine whether pleural mesothelioma cells are present.
Pleural Mesothelioma Treatments
Surgery is not always the best option for patients with pleural mesothelioma, though there have been some promising advances recently. An operation called extrapleural pneumonectomy or EPP, removes not only the tumor but also the lining around the lung, the lung itself, part of the diaphragm and the lining around the heart. Some believe that, if mesothelioma is caught very early and if the surgery is followed by chemotherapy and radiation, this treatment can hold hope for a cure for mesothelioma.
Another surgical option is pleurectomy and decortication. Pleurectomy removes the pleura, which is the lining around the lung. This helps prevent fluid buildup around the lungs, which is a common problem for patients with pleural mesothelioma. Decortication is surgery that removes the covering over an organ. Decortication for pleural mesothelioma involves removing individual tumors while leaving the lung intact. These surgical treatments performed together promise to leave patients with more lung power while removing as much cancerous tissue as possible. This treatment has great potential to extend life expectancy in patients whose health was relatively good before their diagnosis and who catch the disease in the early stages.
Another surgical option is pleurectomy and decortication. Pleurectomy removes the pleura, which is the lining around the lung. This helps prevent fluid buildup around the lungs, which is a common problem for patients with pleural mesothelioma. Decortication is surgery that removes the covering over an organ. Decortication for pleural mesothelioma involves removing individual tumors while leaving the lung intact. These surgical treatments performed together promise to leave patients with more lung power while removing as much cancerous tissue as possible. This treatment has great potential to extend life expectancy in patients whose health was relatively good before their diagnosis and who catch the disease in the early stages.
A more common treatment, which has been shown to extend the lives of patients with mesothelioma, is chemotherapy. Cisplatin was one of the first chemotherapy drugs shown to extend life expectancy in patients with pleural mesothelioma. Chemotherapy may involve a combination of drugs, to increase the effectiveness of the treatment. Some studies have found that pleural mesothelioma patients have fewer side effects from chemotherapy when given a regimen of vitamins during this therapy.
Radiation treatment can have negative side effects for pleural mesothelioma patients because of the location of their tumors, so it is rarely used by itself. After surgery, radiation may be used as a follow up treatment, often in combination with chemotherapy. Targeted radiation may also be used to keep the cancer from spreading during other treatment modalities.
Immunotherapy is a developing area of treatment for mesothelioma. As DNA typing technology has become affordable and available, doctors can decode the DNA of your pleural mesothelioma tumor to detect the exact cancer mechanism at work. This information may enable your doctor to prescribe an immunotherapy drug that outwits the tricks your cancer is using to fool your immune system. These drugs trigger the body’s own immune response, which is a powerful disease fighting force, to attack pleural mesothelioma. Immunotherapy may not be the right choice in every case, but it is a growing area of promise and hope for future pleural mesothelioma treatment.
Specialists in Pleural Mesothelioma
While you can get treatment for pleural mesothelioma throughout the United States, you may want to seek out a specialist. Even if there isn’t one near you, it may be worth the travel to undergo a course of treatment or simply consult with a physician whose practice is focused on helping patients with mesothelioma find the best outcomes.
An oncologist specializing in pleural mesothelioma will be informed about the very latest medical developments. This specialist can determine if a new advance or experimental treatment might show promise in treating your tumor. University California San Francisco and Stanford are two locations with centers that workto develop cutting edge treatments for pleural mesothelioma.
If you are a veteran and you were exposed to asbestos during your military service, you can get care for pleural mesothelioma at any VA facility. The VA centers in Boston and Los Angeles, in particular, employ mesothelioma specialists. If you aren’t able to travel to one of these centers, you and your doctor can consult over the telephone with a specialist.
Oncologists experienced in treating patients with pleural mesothelioma can be found at major centers throughout the United States. Ask your family doctor for a referral to the specialist nearest you.
The effort it takes to find the best care after you have been diagnosed with pleural mesothelioma can pay off in the most precious resource of all: more time to spend with the people you love.
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