Pleural Mesothelioma
Pleural mesothelioma is the most common of all types of mesothelioma. The manipulation of the soft tissues around the lungs known as a chest or pleural membrane. Mesothelioma cancer can develop in various parts of the body, but they come from the pleura in about 75 percent of all cases. Anyway cancers in the mesothelium, a membrane that the tissue of various organs and body cavities protects.
Pleural mesothelioma is usually caused by occupational exposure to asbestos fibers in the air. Because this exposure is often male-dominated industry, about 80 percent of all mesothelioma patients are men. When inhaled into the lungs, asbestos fibers acicular migrate to the pleural membrane, where the body does not easily get rid of them. The fibers irritate the pleura, which can lead to chronic inflammation and scarring. In rare cases cause pleural mesothelioma.
Over a longer period - usually three or more decades - asbestos causes genetic changes in pleural cells. When cells become cancerous, they begin to divide uncontrollably, form tumors that reduces lung capacity and generates the accumulation of excess fluid from the pleural layers.
The Anatomy and Function of the Pleura
The pleura has two layers of protection and support for the lungs and other vital structures in the breast care. It also produces a lubricating fluid to the cavity between the two layers by expansion and contraction of the lungs and breathing. The outer layer, parietal pleura, lines the chest cavity. The inner layer or layer that is visceral lungs.It's not uncommon for mesothelioma affects both layers of the pleura. Pleural mesothelioma usually develops in one layer of the pleura and rapidly invades surrounding communities, such as the diaphragm, chest wall and lungs. If the cancer to the lymph nodes, can metastasize or spread to distant sites in the body.
Pleural Mesothelioma Symptoms
When asbestos fibers may be normal cells become malignant pleural pleural membrane shape and gradually thickens. The thickening can pleural effusion, excessive accumulation of fluid in the space between the layers of the pleura. This fluid on the lungs, causing chest pain, and the absence of normal breathing. These complications are largely responsible for the symptoms of pleural mesothelioma include:
- Persistent dry cough or rough
- Coughing up blood (hemoptysis)
- Shortness of breath (dyspnea)
- Pain in the lower back or chest
- painful breathing
- The development of lumps in the breast skin
- Difficulty swallowing (dysphagia)
- Night sweats or fever
- unexplained weight loss
- fatigue
Even if someone at a later stage of weight loss and fatigue experienced pleural less than 30 percent of patients with these symptoms for diagnosis or in the early stages of the disease. During an initial consultation with their doctors, more than 60 percent of patients, chest pain and shortness of breath due to pleural effusion spiritual experience.
Pleural Mesothelioma Diagnosis
In other forms of the disease, pleural mesothelioma can be difficult to diagnose, even for experts. Symptoms usually occur long after the initial exposure to asbestos. And since many respiratory diseases cause similar symptoms, pleural mesothelioma is often confused with less deadly diseases such as influenza and pneumonia. Moreover, it is difficult for the physician to distinguish between pleural mesothelioma and adenocarcinoma, a common form of lung cancer.Diagnostic Imaging
A diagnosis of mesothelioma may be achieved in part based on symptoms, but other diagnostic tests is often necessary to confirm the presence of cancer. For the best treatment options and patient's perspective, early diagnosis is crucial. After a review of medical and occupational history and physical examination, patients typically undergo imaging studies to identify potential tumors. Conventional radiographs may reveal pleural effusion and pleural-based mass in some cases, but CT images are often more advanced or asbestos.With the introduction of PET in the early 1960s, doctors could better distinguish benign (non-cancerous) or malignant pleural tumors. In addition, PET can detect lymph node cancer spread scanners often miss an advantage that is particularly useful for organizing mesothelioma. A combination of two promising technique, called PET-CT, born 2000. Some experts claim that PET-CT can accurately patient's response to chemotherapy as PET and CT scans administered alone to predict, but further research should be conducted to confirm with certainty.
Cytology and biopsy
But sometimes, the results are unclear or pleural completely absent. In these cases, doctors perform biopsies for pleural tissue samples to obtain. Stains dye was added to the samples to help doctors to visualize cell structures. A popular method of fine needle aspiration biopsy, but the researchers found that thoracoscopy is much more likely to yield positive results. Thoracoscopic biopsy produced a diagnosis in 98 percent of patients with mesothelioma. The current gold standard for the diagnosis of pleural mesothelioma tissue samples must be examined under an electron colorful. If a series of tests or biopsies can confirm the presence of mesothelioma, the doctor develop a treatment plan based on the results.
Treatment Pleural Mesothelioma
Historical mesothelioma doctors treated with conventional cancer treatments such as surgery, chemotherapy and radiotherapy. Depending on the distance between mesothelioma patient is, these therapies have both a curative or palliative. Even patients with pleural mesothelioma is rarely diagnosed early enough to benefit from curative surgery, there are many palliative treatments that can relieve painful symptoms, improve quality of life and significantly prolong survival. The researchers also evaluates several alternative treatments such as immunotherapy and gene therapy, which once developed a day be standard mesothelioma treatment.Surgery for pleural mesothelioma
Surgery continues to serve as a primary treatment for patients with pleural mesothelioma. A common method is pleurectomy / scaling (P / D) which is the surgical removal of the tumor of the pleura and influenced. A more aggressive surgical options, extrapleural pneumonectomy (EPP) is designed to safely remove an entire lung, the diaphragm and the pericardium, a protective membrane lining the heart. Only a fraction of patients have pulmonary function well enough to qualify for the EPP, and a large, multi-function analysis concluded that P / D gives better results with less risk EPP.Chemotherapy for Pleural Mesothelioma
One of the most common treatments for mesothelioma palliative chemotherapy, which uses one or more drugs to kill cancer cells and shrink tumors. Although recent advances have improved the patients' response to chemotherapy, were successful in general low. About 15 to 20 percent of mesothelioma patients experience a significant reduction in tumor size after chemotherapy.Showed mesothelioma clinical trials combining several chemotherapy in a single treatment potential. A multicenter phase 3 studies, for example, found that the combination of pemetrexed and cisplatin survival prolonged Median overall patients 2.8 months compared to patients treated with cisplatin alone. 41 percent of patients treated with pemetrexed / cisplatin regimen experienced tumor shrinkage of at least 50 percent. Even a combination of chemotherapy pleural mesothelioma treatments have not yet been discovered, it is an important goal for scientists is currently involved in several clinical trials.
Radiation therapy for pleural mesothelioma
Pleural are often resistant to radiation. In this treatment destroys the doctor who administers radiation cancer target cells and reduce tumor size. Although this is a poor curative options, radiotherapy can be very effective for the treatment of symptoms such as chest pain. One of radiotherapy techniques, the most successful is called intensity modulated radiation therapy. Usually given to patients with low-dose intervals after radical surgery PPE avoid this technique a recurrence of cancer in many cases. Although effective for preventing cancer recurrence in the areas where the radiation is administered, spread to distant locations is still a challenge.Multimodal therapies for pleural mesothelioma
Although there is no generally accepted treatment for pleural mesothelioma, most experts agree that survival can be improved significantly when multiple treatments are combined. This is known as multimodal therapy, and scientists are constantly experimenting with surgery, chemotherapy and radiation therapy to discover the most effective combination and timing of these treatments. In an example of a multimodal treatment of pleural mesothelioma, doctors surgery first extrapleural pneumonectomy. Radiation therapy is administered, and to reduce the risk of local recurrence of cancer and eliminate proliferation is prevented by chemotherapy.The prognosis for mesothelioma
When the process of diagnosis, doctors analyze clinical data on their patients mesothelioma predict the progress and outcome of the disease. This prediction is known as the patient's prognosis.Previous studies show that the median survival of between four to 18 months, but many factors can significantly affect the prognosis of patients with pleural mesothelioma. The main factors stage of the disease and the general health of the patient. Staging is a system doctors use to describe how mesothelioma has advanced, so early diagnosis gives a better prognosis. And healthy patients who can still perform normal daily tasks tend to better treatment requirements.
Other important prognostic factors include age, gender and smoking habits. Survival is generally better in women, nonsmokers and patients younger than 55 years. Cancer histology, or cellular structure of the tumor can also greatly affect the prognosis. Represents 50 to 70 percent of all cases a subtype called epithelial mesothelioma offers the most optimistic forecast. The epithelial mesothelioma patients respond better to treatment, and other subtypes as sarcomatous and mixed mesothelioma is associated with poorer survival.
Provide patients with an accurate prognosis mesothelioma can be a difficult task for physicians. Not only is the pleural a rare disease, but it is also common for patients diagnosed at an early stage. Since the majority of patients are not eligible for the operation and an operation is necessary for proper staging has survival data for stage I and II has been limited.
Overall about 40 percent of patients with pleural mesothelioma survive one year after diagnosis. About 20 percent survive for two years or more, and 10 percent will be alive five years later. However, it is important to understand that these statistics are based on large sample of patients. Each case is unique, the survival statistics are used as general guidelines.
Patients can work with specialists in the country for the best mesothelioma improve prognosis and discuss treatment to prolong life. Mesothelioma survivor turns into a dynamic treatment plan that combines traditional and alternative medicine to stimulate the forecast.