Pleural Mesothelioma
Pleural mesothelioma is the most commonly diagnosed form of the rare asbestos cancer. Affecting more than 75% of all malignant mesothelioma sufferers, pleural mesothelioma is often confused with asbestos lung cancer because of its close proximity to the lungs. In actuality, the disease is a mesothelioma of the pleura, the thin serous membrane that lines and protects the lung cavity. Early stage pleural mesothelioma can also be confused with asbestosis, a non-malignant asbestos disease.
There are three types of malignant mesothelioma, the other two of which are peritoneal mesothelioma (mesothelioma of the peritoneum) and pericardial mesothelioma (mesothelioma of the pericardium). The development of all three types of mesothelioma has been linked exclusively with asbestos exposure that more often than not occurred 30- to 40-years prior in an occupational setting.
Symptoms of Pleural Mesothelioma
There are a number of symptoms of pleural mesothelioma that can help alert a sufferer to the problem while also serving as a diagnostic aid. The most common presenting symptom of pleural mesothelioma is chronic chest pain that is associated with a buildup of fluid within the pleural space (space between the parietal and visceral pleura); this is called pleural effusion. Palliative treatments such as thoracentesis or pleurodesis can provide relief from pleural effusion by draining the pleural space and/or closing it to prevent future occurrences.
Additional symptoms of pleural mesothelioma can include:
- Shortness of breath (dyspnea)
- Chronic coughing
- Weight loss
- Anorexia
- General fatigue
- Difficulty sleeping
- Hoarseness
People displaying one or more of the aforementioned pleural mesothelioma symptoms for an elongated period of time are urged to consult with a doctor immediately.
Diagnosis of Pleural Mesothelioma
The earlier a case of pleural mesothelioma can be diagnosed, the more options doctor and patient will have when it comes to selecting a treatment. Early diagnosis of pleural mesothelioma has proven to be extremely difficult because of the asbestos disease's latent nature; it can take anywhere from 30- to 40-years for a pleural mesothelioma sufferer to become symptomatic after exposure to asbestos, during which time the disease has slowly developed to an unmanageable stage.
Although diagnostic imaging tests (x-ray, MRI, CT scan, etc.) are used to generate an initial diagnosis of pleural mesothelioma, a definitive diagnosis cannot be made without the aid of a diagnostic surgical procedure called a biopsy. During a biopsy, a surgeon removes a small section of suspect tissue to be evaluated by a histopathologist. Histopathologists are experts in the study of diseased tissue and as such, can type the disease, stage it and recommend a course of treatment.
Additionally, histopathologists can class a case of pleural mesothelioma cancer based on one of three histological categories: epithelioid mesothelioma, sarcomatoid mesothelioma or biphasic mesothelioma.
Treatment of Pleural Mesothelioma
Although there are a number of modalities available for the treatment of pleural mesothelioma, none have proven capable of eradicating the aggressive asbestos cancer. As such, mesothelioma researchers are routinely working to develop new modalities through which to combat the common mesothelioma cancer.
Alimta is a newly developed chemotherapy drug that, when used in combination with platinum-based cisplatin (a traditional chemotherapy agent), is the only FDA approved drug for the treatment of malignant pleural mesothelioma.
Trimodality therapy that incorporates a highly invasive surgical procedure called an extrapleural pneumonectomy is the most proactive approach through which to combat pleural mesothelioma. The treatment involves the use of chemotherapy, radiation therapy and surgery in an attempt to slow tumor metastasis prior to removal. The surgery itself involves the removal of the pleura, the diaphragm, the closest affected lung and, on occasion, the pericardium. Although the procedure can take as long as eight months to recover from, it has proven capable of yielding survival rates of as long as five years (more than 3 years longer than the average pleural mesothelioma survival time).