What is Mesothelioma

Mesothelioma is a cancer that attacks the mesothelium, which is a thin layer of tissue that envelopes most of the internal organs. Some organs have mesothelium, including the lungs (pleura), abdomen (abdomen), heart (pericardial), and testicles (tunica vaginalis). This cancer is classified as aggressive and many sufferers are not successfully treated.



Mesothelioma most commonly attacks the mesothelium of the lungs (called pleural mesothelioma) and the chest wall. Another type of mesothelioma less commonly encountered is peritoneal mesothelioma, which attacks the mesothelium of the abdominal cavity. Mesothelioma is different from benign mesothelioma in the chest which is also called solitary fibrous tumor.

Causes of Mesothelioma

Cancer diseases that attack organs start from a cell mutation that causes its growth to become uncontrolled until then doubled. Experts still can not confirm the cause of these cell mutations. However, the interaction between lifestyle, derivative and environmental conditions is alleged to be a factor that triggers cancer.
Although the exact cause of mesothelioma is unknown, the major risk factor of mesothelioma is asbestos. This disease is rarely encountered before the commercial use of asbestos begins. Asbestos is a mineral used as a material for making brakes, floors, roofs, and insulation.

Asbestos dust is inhaled or swallowed will accumulate in the lungs and abdomen for a long time, usually about 20-50 years, before it eventually develops into mesothelioma. Mesothelioma is also more commonly diagnosed in men than in women, and in people over the age of 65 years.

Some other factors that can trigger this disease, namely:

  • An environment where the soil contains asbestos.
  • Living in an area or living with someone who has work related to exposure to Asbestos can stick also in skin and clothing so as to bring asbestos into the home or other environment.
  • Ever exposed to asbestos or have family members suffering from mesothelioma.



Symptoms of Mesothelioma

Symptoms of mesothelioma may vary based on where the cancer cells are located. Pericardial mesothelioma may cause chest pain and difficulty breathing, while mesothelioma tunica vaginalis will show symptoms of swelling of the testicles.
Pleural mesothelioma has the following symptoms:

Cough accompanied by unbearable pain.


  • Shortness of breath due to the buildup of fluid in the chest.
  • An unhealthy lump on the tissue behind the breast skin.
  • Weight loss for no apparent reason.
  • Often overwhelmed by excessive fatigue.
  • Fever accompanied by sweat especially at night.
  • Swollen fingertips.
  • Chest pain that feels under the ribs.
Peritoneal mesothelioma has the following symptoms:
  • Pain in the abdominal area.
  • There is a lump on the abdominal tissue.
  • Swelling in the abdominal area.
  • Weight loss without cause.
  • Diarrhea or constipation.

Given the symptoms of mesothelioma are not specific and can be associated with other conditions, then you should see a doctor immediately feel the symptoms above, especially if there is a history of exposure to asbestos.

Diagnosis of Mesothelioma

The examination will begin with anamnesa about the symptoms suffered, personal and family medical history. Anamnesa is a conversation performed by the doctor to the patient directly as a way to get data about the condition and medical problems that are being experienced by the patient. In addition to anamnesa, the doctor will perform a physical examination to check for lumps or other abnormal signs.

Furthermore, the doctor may instruct the investigation to be performed as part of the effort to diagnose the disease. Common checks are performed to diagnose mesothelioma, among other X-rays to check if there are chest disorders and CT scan to check the chest and abdominal area.

Biopsies or other tests may also be performed to determine which illness causes the symptoms to appear. A biopsy is a laboratory examination of a small amount of tissue that can be taken from different parts of the body, depending on the location of the illness. The tissue is then examined in the laboratory to determine what cell types cause abnormalities, as well as to know the type of cancer they have. As for some types of biopsy that may be recommended for the diagnosis of mesothelioma, namely:

  • Biopsy uses a small fine needle to pull tissue or fluid from the chest or abdomen.
  • Laparoscopy - Biopsy by making small wedges in the abdominal area to take tissue. This procedure is aided by very small operation and camera devices.
  • Laparotomy - Biopsy by dissecting open the abdomen to take tissue to be examined for the presence of disease or other abnormalities.
  • Torakoskopi or VATS (video-assisted thoracoscopic surgery) - Biopsy by making a small wedge between the ribs to insert a camera and a small operation device into the chest cavity and take a small sample of the tissue to be examined.
  • Torakotomy - Biopsy by dissecting an area between the ribs to examine the area, whether there are signs of illness and taking tissue samples if necessary.
Once the diagnosis is obtained, the doctor will conduct further tests on the patient's body, such as MRI imaging tests and PET mapping, to determine the stage of the disease and treatment steps that can be taken. There are four stages (stage) in pleural mesothelioma, while the spreading stage in mesothelioma of the more rare species is still not known with certainty. Four stages of pleural mesothelioma consist of:
  • Stage I - The condition of cancer is still local, which is only in one area on one chest layer.
  • Stage II - The cancer has spread beyond the chest to the area of ​​the lung or diaphragm.
  • Stage III - Cancer has spread to other areas of the chest or has attacked the nearest lymph nodes. Some of the locations of the lymph nodes in humans are in the neck, underarms, and around the groin,
  • Stage IV - Advanced stage cancer that has spread throughout the chest or other body areas, such as the brain and liver.

Mesothelioma Treatment

There are several steps of mesothelioma treatment that may be recommended by a doctor. The selected treatment plan will depend on the condition of the disease, the stage of the cancer, and the general health of the patient. However, considering mesothelioma is a cancer that can not be cured and generally new can be detected at an advanced stage, then the treatment step is more aimed at reducing the symptoms felt by the patient.

While there are several treatment options for pleural and abdominal mesothelioma, another case with pericardial and tunica vaginalis mesothelioma has not been treated because it is considered more rare. However, the cancer that is still at an early stage can be removed through surgery or the patient can still through other treatments to reduce the symptoms.

Here are some common mesothelioma treatment steps:

Chemotherapy


Chemotherapy is a drug used to shrink or inhibit cancer growth. This drug can spread to all parts of the body and can be used before surgery or after surgery. In the case of peritoneal mesothelioma, the drug can be heated and given directly into the abdominal cavity in order not to injure healthy tissue in other body parts. This allows the doses of chemotherapy drugs to be given in high doses.

Chemotherapy given before undergoing surgical procedures can facilitate surgery because cancer cells have been minimized before they are removed. Chemotherapy given after surgery will reduce the risk of cancer reappearing.

Radiotherapy


Radiotherapy may be performed after surgical procedures to eradicate leftover cancer cells or reduce symptoms of advanced cancer when surgery is not possible. In its application, this therapy uses high-energy jets, such as X-rays and proton light, which are focused on specific body areas.

Surgery


Surgery is done to remove the cancer that is generally still in the early stages of disease progression, although in some cases still can not successfully remove cancer cells completely. Surgery can also be done to reduce the symptoms of advanced cancer that has spread to other body parts in order to reduce symptoms suffered. Here are some commonly performed surgery options and their use for mesothelioma sufferers.

  • Operating procedure to remove as much as possible cancer cells that can be removed from the patient's body. This procedure allows doctors to continue treatment with radiotherapy to reduce pain and prevent excessive fluid accumulation due to mesothelioma.
  • Operating procedures to reduce fluid buildup in the chest area that may interfere with breathing. The surgery is done by inserting a catheter tube into the chest to suck fluid. Doctors can also inject drugs to prevent recurrence of fluid buildup, also known as pleurodesis procedures.
  • Surgical removal of tissue around the abdominal cavity, ribs, or lungs that have been exposed to cancer cells to help reduce the symptoms and signs of mesothelioma.
  • Surgical removal of affected lung portions following adjacent tissues to relieve symptoms in pleural mesothelioma patients. This procedure is usually followed by high-dose radiotherapy.
  • Multimodality therapy
  • This therapy is a combination of three or more treatment steps, such as surgery, postoperative chemotherapy (adjuvant chemotherapy), and radiation therapy to enlarge the success rate of treatment.

Alternative medicine


Alternative treatment has not been clinically proven to treat mesothelioma, but some of these treatments have shown good development in mesothelioma patients. Here are related healing techniques.

  • Respiratory exercises to control breathing when the patient begins to feel breathless.
  • Relaxation exercises of the body, especially the respiratory muscles, can also make it easier for people to breathe lightly.
  • Sitting close to the fan facing the face can reduce the sensation of difficulty breathing felt by the sufferer.

Acupuncture.

Discuss alternative treatment steps that you choose with your doctor before you start using it.
Complementary or other supplementary treatment may be recommended by a physician to reduce mesothelioma symptoms. Additional treatments, such as oxygen or certain medications, may help the patient breathe more comfortably considering mesothelioma can cause pressure in the chest that may interfere with breathing.

Clinical trials


Some clinical trials are generally available and informed to cancer survivors, but the possibility of cure remains uncertain so it is important to consider carefully. Talk to your doctor about existing clinical trials and if appropriate for the condition of the patient. On the other hand, following a clinical trial will increase the chance for doctors to find treatment against mesothelioma.

Here are some of the clinical trials that are being studied for mesothelioma conditions:

  • Biological therapy - using the patient's immune system to fight cancer, also called immunotherapy.
  • Gene therapy - alters the genes present in cancer cells to stop the disease.
  • Therapy uses drugs to attack abnormalities / abnormalities that occur in cancer cells.

Complications of Mesothelioma

Here are the complications of pleural mesothelioma that have spread to the chest and caused structural stress on the infected area.

  1. Pain in the chest area.
  2. Pain caused by pressure on the nerves and spinal cord.
  3. Hard to breathe.
  4. Hard to swallow
  5. The accumulation of fluid in the chest that suppresses the lungs and complicate the process of breathing

Mesothelioma Prevention

The main precaution of mesothelioma is by reducing contact with everything related to asbestos, a major cause of the development of mesothelioma. People who work or are often exposed to asbestos are high-risk groups, such as miners, factory workers, manufacturers / makers of insulation devices, construction workers, and mechanics.

If you are part of any of the above risk groups then you are required to comply with the safety rules set by the company. Sometimes it is better to leave asbestos in place than to attempt to remove it without the help of experts, although both of these are at risk of health hazards. Find out, learn, and follow instructions on safe asbestos handling in your neighborhood.

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