Mesothelioma Exposed!

Mesothelioma is an uncommon tumour arising from mesothelial lining of serous cavities, most often in the pleural (covering of lungs) cavity, and rarely in peritoneal (coverings of abdomen) cavity and pericardial (covering of the heart) sac. They are of two types --- benign (solitary) and malignant (diffuse). The biological behavior of the mesothelioma’s can be usually predicted by their gross appearance; thoses forming solitary, discrete masses are generally benign, whereas those, which grow diffusely, are usually malignant.

BENIGN (SOLITARY) MESOTHELIOMA

Benign or solitary mesothelioma is also called pleural fibroma. Asbestos exposure plays no role on the etiology of benign mesothelioma. Grossly it consists of of a solitary, circumscribed, small, firm mass, generally less than 3cm in diameter. Cut surface shows whorls of dense fibrous tissue. Microscopically, the tumour is predominantly composed of whorls of collagen fibres and reticulin with interspersed fibroblasts. Rarely, mesothelial-lined clefts are seen in the tumour. Benign mesothelioma causes no symptoms and is detected as an incidental radiologic finding. Sometimes the tumour is associated with systemic syndrome of osteoarthropathy or hypoglycemia. Removal of the tumour is generally curative.

MALIGNANT (DIFFUSE) MESOTHELIOMA

Malignant or diffuse mesothelioma is rare. It is a highly malignant tumour associated with high mortality. The tumour is significant in view of its recognized association with occupational exposure to asbestos for a number of years, usually 20-40 years. About 90% of malignant mesothelioma’s are asbestos –related. Mechanism of carcinogenecity by asbestos is not quite clear but it appears that prolonged exposure of amphibole type of asbestos is capable of inducing oncogenic mutation in the mesothelium. However prolonged exposure is considered more significant rather than heavy exposure as documented by its occurrence in the family of asbestos workers. Although combination of cigarette smoking and asbestos exposure greatly increases risk to develop bronchgenic carcinoma, there is no such extra increased risk of developing mesothelioma in asbestos workers who smoke. Recently, SV40 (simian vacuolating virus) has also been implicated in the etiology of mesothelioma.

Peritoneal Mesothelioma Treatment

Peritoneal mesothelioma treatment depends upon a number of factors, such as the size and stage of cancer cells, the patient’s general condition and health, past medical history of the patient and the patient’s age. Peritoneal mesothelioma is the cancer of the membrane in the abdomen. As with all cancer diseases, premature detection and treatment provides the best possible result.

Peritoneal mesothelioma treatments are classified into localized treatments and systemic treatments. Systemic treatments are whole body treatments like chemotherapy. Localized treatments include surgery and radiotherapy.

Surgical treatment is often not practical in the case of peritoneal mesothelioma. If the growth of cancer cell is found very early, it may be possible to remove tumor by operation. The peritoneal mesothelioma surgery is known as a peritonectomy. The surgery involves cutting out the peritoneum, the lining of the abdomen where the mesothelioma has started growing. Sometimes it is needed to remove a lung or part of the diaphragm, for the surgery to succeed in removing the afflicted cell.

Radiation therapy or radiotherapy uses high energy rays (like x-rays) to kill cancer cells in the affected area. There are several ways to administer radiotherapy and each one breaks down the cancer cells so that they may be eliminated from the body. The general method includes a machine kept outside the body, which produces radiation. Another method is by placing a radiation-emitting device directly to the affected cell by way of plastic tubes. In addition to controlling radiation, doctors use these tubes to inject the required drugs.

Chemotherapy for peritoneal mesothelioma controls symptoms and tries to slow the cancer down. This therapy is used to kill mesothelioma cells by injecting anti-cancer drugs that are usually injected into a vein. Medicines can be administered in tablet form. Depending on the type of medicine used, the treatment can be applied weekly or every two to three weeks.

Peritoneal mesothelioma does not always respond to traditional mesothelioma treatment ways. Physicians and researchers are constantly working to improve upon the existing peritoneal mesothelioma treatment.