Malignant Mesothelioma - Types, Causes, Stages and Treatment Options

Malignant mesothelioma is an uncommon form of cancerous tumors originating in the body tissue known as the mesothelium. The mesothelium is a specialized layer of cells that line and protect many internal organs such as the chest and abdominal cavities.

Types of Malignant Mesothelioma

The first type of malignant mesothelioma is called Pleural Mesothelioma or mesothelioma of the pleura. It is the most common type of mesothelioma making up approximately 75% of all mesothelioma cases. The pleura is a thin serous membrane found between the lungs and the chest cavity that provides a lubricated surface preventing the lungs from chafing against the chest walls. It also serves as a protective layer.

The second most common type of mesothelioma is Peritoneal Mesothelioma, also known as mesothelioma of the peritoneum. The peritoneum is a thin serous membrane that encloses the organs of the abdomen. Peritoneal Mesothelioma is a rare form of malignant mesothelioma cancer. This disease accounts for approximately 10% to 20% of all mesothelioma cases. It tends to be a more invasive form of cancer; patients diagnosed with this disease have a shorter life expectancy than if they had attracted Pleural Mesothelioma.

The third and least common type of mesothelioma is pericardial mesothelioma also known as mesothelioma of the pericardium. It accounts for less than 10% of all mesothelioma cases. The pericardium (heart sac) is the serous membrane that surrounds and protects the heart.

There are about 2,200 new cases of malignant mesothelioma of the visceral pleura each year. Mesothelioma is difficult to diagnose and is rarely curable. The most common symptoms are dyspnea and chest wall pain.

Causes



Asbestos is the predominant cause of malignant mesothelioma of the visceral pleura. The period between the time of exposure to asbestos and the onset of symptoms is about 20 to 50 years. Because of this late onset, it occurs most commonly in the later years of life. It also occurs more often in men than in women.

Diagnosis

Doctors usually make an incision through the chest wall and insert an instrument called a thoracoscope between two ribs to view the area. Doctors will then do a biopsy to select a tissue sample that can be analyzed under a microscope.

Stages of Mesothelioma

Stage I: The cancer is found in the lining of the chest cavity near the lung and heart or in the diaphragm or the lung.

Stage II: The cancer has spread beyond the lining of the chest to lymph nodes in the chest.

Stage III: Cancer has spread into the chest wall, center of the chest, heart, through the diaphragm, or abdominal lining, and in some cases into nearby lymph nodes.

Stage IV: Cancer has spread to distant organs or tissues.

Treatment



Radiation and radiotherapy are used in situations where the cancer is localized at the point of origin.

Chemotherapy is used in more advanced stages of malignant mesotheliomas.

Cytoreductive surgery plus hyperthermic (heated) chemotherapy improves the survival and quality of life for patients with peritoneal metastases (tumors involving the lining of the abdomen).

Surgery is the option used for Stage I malignant mesothelioma. For stages II to IV, treatment by surgery is still evolving.

Dave Casey is a medical writer for Mesothelioma-Adviser.com, a guide for mesothelioma lung cancer victims. Visit the site for informative articles on the causes of mesothelioma, mesothelioma stages and treatment options.

Copyright 2007 Mesothelioma-Adviser.com

Mesothelioma Cancer Stages Explained

Mesothelioma cancer is a type of cancer that attacks the lungs and chest cavity. Also known as asbestos lung cancer, it forms deadly tumors where mesothelial cancer cells form a protective lining over the lungs, heart, and abdominal organs. It is a type of lung cancer that takes many years to develop and produce symptoms. Roughly 3,000 cases per year (mostly men over the age of 40) are reported. It is estimated that number will grow to about 300,000 cases before 2030.

Types of Mesothelioma Asbestos Cancer

Epithelial mesothelioma is a rare and fatal form of cancer affecting the membrane lining of the chest cavity, heart, lungs, and abdominal cavity. There are three forms of epithelial mesothelioma: the most common is Pleural Mesothelioma, the second most common, Peritoneal Mesothelioma (accounting for only a quarter of the cases), and the rarest form, pericardial mesothelioma.

Pleural mesothelioma, the most common type of this disease involves the pleura, a thin membrane located between the lungs and the chest cavity. The pleura provide a lubricated surface so that the lungs do not rub and chafe against the chest walls. There are two types of pleural mesothelioma the first being 'diffuse and malignant'. This type is cancerous and is generally fatal within a year of diagnosis. The second type is 'localized and benign' and is generally non-life threatening. It can usually be removed through surgery.

Lung Lining cancer is not to be confused with lung cancer. In lung lining cancer, the effected area of the body is called the mesothelium, a thin membrane that covers many of the internal organs of the body. The mesothelium of the lungs is called the pleura. Lung Lining cancer is also sometimes called mesothelioma after the area in which it occurs.

This thin membrane is comprised of two layers - one that surrounds the organ and another that forms an exterior sac around the first layer. Between the layers of the mesothelium is a fluid that allows vital organs to glide easily against objects that come in contact with them.

Localized pleural mesothelioma is not always caused by asbestos exposure. However, if it has spread to other parts of the body, for instance the lymph nodes, lungs, chest wall, or abdominal organs, then it is considered malignant and is more often than not the result of asbestos exposure.

Peritoneal mesothelioma appears as a tumor in the peritoneum membrane of the abdomen. This type of mesothelioma is very rare, comprising less than a fourth of all known cases of the disease. There are no effective treatments for this condition, and most patients live less than a year after diagnosis.

Mesentery cancer is likened to peritoneal cancer (mesothelioma). This cancer primarily affects the sections of the peritoneum that attach different organs to the wall of the abdominal cavity, (i.e. mesogastrium for the stomach, mesojejunum for the jejunum). Mesentery cancer includes all abdominal peritoneal extensions. Tumors rarely originate in the actual mesentery, though it is a frequent route for the spread of mesothelioma through the abdominal cavity.

Pericardial mesothelioma is the rarest form of mesothelioma, affecting the membrane around the heart (called the pericardium or pericardial sac). In this disease, solid masses and effusion (fluid) develop around the pericardium. Not all effusions are strictly related to mesothelioma.

The Causes

Mesothelioma cancer is caused by exposure to asbestos fibers or dust. Workers in the asbestos industry are prime targets for attracting this deadly disease. Asbestos fibers enter the body, either by breathing in the tiny asbestos fibers or by swallowing them. The fibers cause healthy cells to mutate into cancer. Since the body is unable to dispel these fibers, the lungs become inflamed (asbestosis). This condition worsens and eventually becomes malignant. Asbestos exposure is thought to be responsible for roughly 75% of all cases of lung lining cancer.

Symptoms

Mesothelioma is a very difficult cancer to detect in early stages. The early symptoms tend to be generic and even nonexistent in some cases, and it can take as much as 15 to 50 years after exposure to develop. The first symptom is often constant chest pain, followed by coughing, lung damage, and shortness of breath. Patients who have peritoneal mesothelioma (a less common form of mesothelioma) generally experience abdominal pain, loss of appetite, nausea, and abdominal swelling, often in addition to the symptoms of pleural mesothelioma. They may also develop bowel obstruction or further breathing obstruction.

Stages and Diagnosis of Mesothelioma

There are three staging systems used to determine treatment for mesothelioma: Butchart System, TNM System, and the Brigham System

Butchart Staging System

The Butchart System is the oldest system and the most common. This system concentrates upon determining the extent of primary tumor mass and divides mesothelioma into four stages.

Stage I of the Butchart System consists of the presence of mesothelioma in the lining of the right or left lung and may also involve the diaphragm on the same side. Stage II includes the progression of mesothelioma into the chest wall, esophagus, or lung lining on bother sides. There may also be lymph nodes in the chest. The onset of Stage III begins when the mesothelioma surpasses the diaphragm into the lining of the abdominal cavity or peritoneum. In this stage the cancer may also affect the lymph nodes extending beyond those in the chest. Doctors identify Stage IV, the final stage, when evidence of the spread of cancer to other organs (metastasis) is confirmed.

TNM System



Stage I of the TNM System involves the lining of the right or left lung, pericardium, or diaphragm on the same side. At this stage, lymph nodes are not involved. Stage II begins when mesothelioma spreads from the lining of the lung on one side to a lymph node on the same side. At this stage, the cancer may also spread to the lung, pericardium, or diaphragm on the same side. Stage III begins when mesothelioma is present in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side as the primary tumor. In the final stage, Stage IV, the mesothelioma has travelled into the lymph nodes in the chest on the side opposite the primary tumor, into the lung opposite the primary tumor, or directly into the organs in the abdominal cavity or neck. Metastasis is the final result in this stage.

Brigham System

The Brigham System determines the resectability (the ability to surgically remove) the mesothelioma mass. In Stage I the tumor is resectable, while lymph nodes remain unaffected. In Stage II the tumor remains respectable but the mesothelioma affects the lymph nodes. In Stage III the tumor becomes unresectable. It has penetrated through the diaphragm, or peritoneum. Stage III can occur with or without lymph involvement and extends into the chest wall and heart. Stage IV occurs when doctors discover metastatic disease involving distant organs.

After doctors identify the stage of a patient's malignant mesothelioma, the patient and doctor consider the various treatment options available. Mesothelioma treatment programs are contingent upon many factors, including the stage of the cancer, the location of the cancer, the spread of mesothelioma cancer, the characteristics of the cancer cells under a microscope and the patient's age and concerns.

Dave Casey is a freelance writer for Mesothelioma-Adviser.com, a comprehensive informational site on mesothelioma cancer. He hopes to expose the continued cover-up of the asbestos industry responsible for the causes of mesothelioma.

Copyright 2007 Mesothelioma-Adviser.com

Various Stages of Mesothelioma

Mesothelioma is a terrible disease that has a huge latency period. To explain in more detail, latency period refers to the time duration between the exposure to the causative agent and the onset of the disease. The causative agent in the case of this disease is asbestos. The manifestation of indications of this disease is much after exposure to asbestos. Sometimes, this may be even after 20-50 years.

Another notorious characteristic of this disease is that it has symptoms that are very similar to other benign diseases. Many times pleural mesothelioma (lung cancer) is confused with pneumonia and this leads to dire consequences. What happens is that the patient is in the last stages before they even realize they have such a killer disease. Therefore, little can be done to help them the last stages of cancer.

Certain treatments have been devised for mesothelioma. However, these only help to mitigate the painful symptoms. Normally, the spread of the disease cannot be checked. There is no known cure for this disease. The choice of treatment for a mesothelioma patient is based on the stage of mesothelioma that he or she is in.

Stages of Mesothelioma

Butman System

The Butman system is used to define the Mesothelioma staging system. The entire basis of this system is the extent to which the tumor has spread. The various levels of mesothelioma based on this system are as follows:

Stage I: At this stage, the presence of mesothelioma is in the right side or the left side of the pleura (lungs). It may also be in the pericardium or diaphragm. Diaphragm is the muscle that separates the chest and the abdomen. In this stage, mesothelioma is only on one side (left or right) of the pleura.

Stage II: In this degree of mesothelioma, the disease spreads to the other side of pleura or to the esophagus or heart or chest wall or even the lymph nodes.

Stage III: In this phase, the disease is in a serious assaulting phase. It spreads from the diaphragm into the peritoneum. Peritoneum refers to the abdominal cavity lining. While in the previous stage, the lymph modes of the chest may be involved. This stage may involve the lymph nodes beyond the chest too.

Stage IV: This is the final terrible stage of mesothelioma wherein the disease spreads to the other organs through the bloodstream.

TNM staging System

The American Joint Committee on Cancer (AJCC) has developed another new staging system. This TNM staging system is very similar to that used for other types of cancers. In this system T stands for tumor

N stands for the assault on lymph nodes and M stands for metasis.

The staging system is based on the following: § the size of the tumor and the extent to which it has spread to nearby organs § the extent of spread to lymph nodes § the extent of spread to distant organs.

The various degrees of mesothelioma as per the TNM staging system are as follows:

Stage I: The mesothelioma may be in the right or the left pleura. It may also have assaulted the pericardium or the diaphragm on the same side. However, it would not have spread to the lymph nodes.

Stage II: The disease may have spread to the lungs, diaphragm, lymph nodes or pericardium on the same side.

Stage III: In this phase, the mesothelioma may have spread into the muscles of the chest wall, ribs, esophagus, heart and other organs on the same side. It may also have spread further into the lymph nodes on the same side.

Stage IV: In this stage, mesothelioma affects the lymph modes in the chest on the same side or may start spreading to the lungs or pleura on the other side. Also, if mesothelioma is found in the distant organs or if it spreads to organs other than the abdomen and chest, (through the blood stream), it is the fourth stage.

Though the TNM system is more clear and comprehensive, still the Butchart system is popularly used to describe the stages of mesothelioma. Whatever the staging system used, it is important to understand that mesothelioma stage depiction is important for deciding the type of treatment to be used on a patient.

How are the stages of mesothelioma determined?

CAT scans, MRI testing and other tests like x-rays help to determine the stage of mesothelioma in the patient. After this, the doctor informs the patient and his or her family about the level and type of treatment that is required. Mesothelioma has no known cure. So, the doctor can only offer to reduce the symptoms, to mitigate the pain and provide psychological support.

What are the treatments offered to mesothelioma patients?

Chemotherapy, radiation and surgery are the options available for treating a mesothelioma patient. Apart from these traditional treatments, various new ones keep coming up every once in a while. However many are under study and need testing. To avail of them, a patient can undergo a medical trial. In this way, he will benefit the medical research in mesothelioma as well as avail of the new medicine or method of treatment. The health of the patient and the age of the patient will also be considered when deciding the level and type of treatment offered for a patient. While undergoing treatment for mesothelioma cancer, the patient needs not only physical strength but also emotional strength. The patient should be strong at heart to face whatever happens next.

Archana Sarat is a freelance writer who has undertaken indepth research about mesothelioma. http://mesothelioma-guidance.blogspot.com To know more about the disease, go to http://www.rarehope.com

What Are The Four Stages of Mesothelioma Cancer?

One rare form of cancer is called Mesothelioma, a malignant tumor in the mesothelial tissues of the lungs and the abdomen, arising from the inhalation of asbestos. Its rarity is one of the reasons why a lot of people are not aware of this kind of fatal disease. In fact, many people die of Mesothelioma undiagnosed. Although there is now a growing awareness of the hazards of asbestos to health, still many have not heard of Mesothelioma and thus, have not understood its nature, cause, signs and treatment. Even some physicians find it hard to detect Mesothelioma because its symptoms are akin to other diseases like lung cancer and pneumonia. Furthermore, it takes decades for a patient who was exposed to asbestos to develop Mesothelioma -- fifty years, at most.

Being unaware of Mesothelioma poses higher risks since it deters diagnosis and treatment. A person undergoing treatment must know the different stages of the cancer or the extent of the disease. Chances of recovering from Mesothelioma and the kind of treatment depend on the stage of the illness. There are basically two staging systems used for Pleural Mesothelioma (lungs): TNM system and Brighan system. These staging systems are also used in other kinds of cancers; however, the first is commonly used. There is no established method in determining the stage of the Peritoneal Mesothelioma cancer (abdominal) so the TNM system is used.

There are three variables in the TNM system: tumor, lymph nodes and metastasis. In the earliest stage of Mesothelioma, stage I, the malignant Mesothelioma cells start to grow and multiply only one layer of the pleura. The pleura is the membrane that encloses the lungs and lines the wall of the chest cavity. However, there are some instances wherein the pericardium (membrane that covers the heart) and diaphragm cover are already affected. In this case, the cancer patient is still in stage I Mesothelioma.

In the second stage, the two layers of the pleura are already affected by Mesothelioma. Take note, however, that in this stage, only one side of the body is affected. Normally, the pleura produces only small amount of lubricating fluid that allows easy expanding and contracting of the lungs. The excess fluid is absorbed by the blood and the lymph vessels so there's a balance between the amount of fluid produced and removed. During the second stage Mesothelioma, fluid starts to build up between the membrane of the lungs and the membrane of the chest wall, resulting to pleural effusion. The increase in the volume of fluid produced causes shortness of breath and chest pain. Other Mesothelioma cancer patients experience dry and persistent cough. Diagnosis of the pleural effusion is achieved through a chest x-ray.

Stage III Mesothelioma means that the malignant cells have already spread to the chest wall, esophagus and the lymph nodes on one part of the chest. The patient may suffer severe pain near the parts affected. When not treated immediately or when the Mesothelioma patient doesn't respond well to medication, the cancer may advance to the fourth stage. The fourth stage Mesothelioma is formidable since at this stage the Mesothelioma cells have penetrated into the bloodstream and other organs in the body like the liver, the bones and the brain. The lymph nodes on the other side of the chest may also be affected by Mesothelioma in stage IV.

Brighan staging system, on the other hand, determines whether the Mesothelioma can be surgically removed or not and whether the lymph nodes are affected or not. In stage I Mesothelioma, the lymph nodes are not yet affected and the patient can still recover through surgery. In stage II, surgery can still be executed but some lymph nodes have already been infiltrated by the cancer cells. In stage III, the heart and chest wall are already affected; thus, surgery is no longer advisable. The lymph nodes in this stage, however, may or may not be affected. In the final stage, stage IV Mesothelioma, cancer cells have already gone to the bloodstream and other parts of the body like the heart, brain, bone and liver. In most cases, a patient who has reached stage IV Mesothelioma only has four to twenty-four months to live.

David Arnold Livingston is a believer in gaining knowledge around Health issues and recommends, as a resource: [http://www.newmesothelioma.com/Mesothelioma]

Types and Stages of Pleural Mesothelioma

Pleural mesothelioma is a cancerous tumor involving the mesothelial cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. It can also involve the heart and abdomen. Pleural mesothelioma is caused by exposure to asbestos fibers, including chrysotile, amosite, or crocidolite that occurred twenty or more years before the disease becomes evident. These fibers are ingested into to the body through breathing or swallowing. Pleural mesothelioma is the most common type of mesothelioma, accounting for about 75% of all cases.

Types of Plural Mesothelioma

"Localized and benign" mesothelioma is non-life threatening and can be removed by surgery.

"Diffuse and malignant" mesothelioma is a cancer that generally results in death within one year of diagnosis.

Symptoms of Pleural Mesothelioma

Chest wall pain, pleural effusion, or fluid surrounding the lung, shortness of breath, weight loss, fatigue or anemia, wheezing, hoarseness, or cough and blood in the sputum (fluid) coughed up. Patients may develop several tumor masses. Patients may experience pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.

Stages of Pleural Mesothelioma

There are four stages of this disease. Localized pleural mesothelioma cancer ranging from - Stage I; the cancer remains on the membrane surface where it originated to Stage IV; advanced. In this final stage, the cancer has (metastasized) spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

Screening and Diagnosis

Doctors first review the patient's medical history including any exposure to asbestos. The doctor may perform a complete physical examination. Doctors are then likely to order x-rays of the chest or abdomen and lung function tests. These tests include various imaging tests such as CT (or CAT) scan or an MRI.

A biopsy is needed to confirm a diagnosis of mesothelioma cancer. Doctors perform a thoracoscopy on patients showing symptoms of Pleural Mesothelioma. This procedure involves making a small cut through the chest wall then inserting a thin, lighted tube called a thoracoscope into the chest between two ribs. Doctors suction out any access fluid in the lungs through a procedure called thoracentesis. They can then obtain tissue samples for analysis. Other types of tube insertions include bronchoscopy or a mediastinoscopy

Treatment Options

Here are some of the most widely used treatments at this time.

Surgical removal of the entire lung and a part of the chest lining, the diaphragm and part of the sac surrounding the heart.

Radiotherapy is applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall. Though not particularly successful, radiation is preformed to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel.

Chemotherapy is used to stop the cancer cells from growing and dividing.

It is important to note that there are no successful treatments for pleural mesothelioma to date. Patients usually have a median survival time of 6 - 12 months after presentation of the symptoms.

Dave Casey is a medical writer for Mesothelioma-Adviser.com, a guide for mesothelioma cancer victims. Visit the site for mesothelioma cancer help, articles on asbestosis symptoms and legal advice.

Copyright 2007 Mesothelioma-Adviser.com