Pleural mesothelioma

Pleural mesothelioma

Pleural mesothelioma is a cancer that develops in the pleura, the protective membrane of the lungs and the chest cavity. It is caused by exposure to asbestos and is the most common type of mesothelioma. Symptoms of pleural mesothelioma may include dry cough, shortness of breath, and chest pain.

What is pleural mesothelioma?

Pleural mesothelioma is a rare malignant cancer. Nearly 75% of diagnosed mesothelioma cases are formed in the pleura, making it the most common of the four types.

The cause of pleural mesothelioma is exposure to asbestos fibers, which are inhaled into the lungs. Mesothelioma usually takes 20 to 50 years to develop after the first exposure to asbestos. Because of this latency period, the disease usually affects people over 75 years of age.

The average life expectancy of mesothelioma of the pleura is often less than 18 months, but it depends on many factors.

Although mesothelioma can not be cured, some patients live much longer with the treatments. The combination of several treatments, such as surgery, chemotherapy and radiotherapy, has helped some people to live for years. Clinical trials provide access to new treatments such as immunotherapy.

Facts about pleural mesothelioma

• Most common type of mesothelioma

• forms on soft tissues covering the lungs

• Symptoms: shortness of breath, chest pain, dry cough and tiredness

• Diagnostic tools: imaging scanners and tissue biopsies

• Treatments: chemotherapy, surgery, radiotherapy, immunotherapy and experimental therapies

• Life expectancy: about 40% live at least one year

What are the causes of pleural mesothelioma?

Asbestos causes pleural mesothelioma. After inhaling the needle-shaped fibers of the mineral, they tend to lodge in the lungs and gradually migrate into the mucosa of the pleura.

Over a long period, these fibers cause irritation, chronic inflammation and genetic changes that make the cells cancerous.

These cancer cells grow rapidly and uncontrollably, threatening the surrounding organs.

Two layers make up the mucosa of the pleura. The outer layer covers the entire inside of the thoracic cavity (inside the ribs) and the inner layer covers the lungs.

A malignant tumor can develop on one or the other layer and spread quickly to the other layer. As tumors develop on the surface of the pleura, they develop to form a mass around the affected lung. They also cause pleural fluid accumulation in the chest cavity.

The combination of the tumor mass on the lung and pleural fluid collection prevents the expansion of the lungs, resulting in breathing difficulties.

Symptoms of pleural mesothelioma

For many people, the symptoms of mesothelioma are not noticeable until the cancer is advanced.

• Shortness of breath

• chest pain or painful breathing

• persistent dry or rough cough

• Coughing blood

• difficulty swallowing

• Pain in the lower back or ribs

• Unexplained weight loss and fatigue

• Swelling of the face or arms

• Night sweats or fever

• bumps under the skin on the chest

Patients rarely mention weight loss and fatigue during their first visit to the doctor. These symptoms may appear if the cancer is advanced. Some patients develop swelling of the face or arms, back pain or nerve pain.

Options for treatment of pleural mesothelioma

The standard treatment options for pleural mesothelioma may include surgery, radiation and chemotherapy.

Chemotherapy is the most common type of pleural treatment. A combination of treatments may be used, called multimodal therapy, if a patient is diagnosed early. These treatments can improve symptoms, such as chest pain and breathing difficulties, and improve survival.

Patients can access these treatments in the country's main cancer centers specializing in the treatment of pleural mesothelioma.

Surgery

Pleural mesothelioma patients diagnosed at an early stage benefit the most from the surgery. The goal of the surgery is to remove cancer and prevent it from happening again as long as possible.

The two most common surgeries for pleural mesothelioma are extrapleural pneumonectomy and pleurectomy and decortication. A mesothelioma specialist can determine if you are eligible for surgery and advise you on the most appropriate procedure for your diagnosis.

Extrapleural pneumonectomy

A more aggressive the surgical option, extra-pleural pneumonectomy removes the pleura, all the cancerous lung, the diaphragm and the cardiac sac (pericardium).

Pleurectomy and decortication

A pleurectomy and a decortication, or radical pleurectomy, consists in removing the tumors and the affected pleura (lining of the lung).

Chemotherapy

The most common pleural mesothelioma treatment is chemotherapy. He uses one or more drugs, usually a combination of cisplatin or carboplatin and pemetrexed (Alimta), to kill cancer cells or prevent them from reproducing. Recent advances have improved patients' response to chemotherapy, but overall success rates remain low.

Radiotherapy

Targeted radiation can destroy cancer cells and reduce the size of the tumor. Radiation therapy can not cure mesothelioma of the pleura, but it is an effective way to manage chest pain. Radiation can also help prevent the recurrence of cancer after surgery.

External radiotherapy is the most common form of radiotherapy for pleural mesothelioma. The sessions are quick, painless and take only a few minutes.

Emerging treatments

New treatments include immunotherapy, gene therapy and photodynamic therapy to treat pleural mesothelioma. These treatments are designed to fight cancer more effectively, while reducing side effects for the patient.

You may be able to receive an experimental treatment as part of a clinical trial on mesothelioma. Some patients may be eligible for immunotherapy drugs and other emerging treatments in compassionate use programs.

Complementary and alternative medicine

Some patients may benefit from the combination of complementary therapies, such as medical marijuana, dietary supplements, or acupuncture, with conventional cancer therapy to alleviate the symptoms and side effects of treatment.

To avoid harmful drug interactions, always consult your medical team before starting any other drug or treatment.

Diagnose pleural mesothelioma

The process of diagnosing pleural mesothelioma begins when a doctor evaluates the initial symptoms. Chest pain and breathing difficulties warrant a chest x-ray revealing fluid build-up or tumors around the lungs. The patient should be referred to a specialist for further testing.

Specialists should use advanced imaging analyzes and tissue biopsies to confirm the diagnosis of pleural mesothelioma. In addition to identifying cancer, determining the cancer stage and cell type is critical to creating an effective treatment plan.

A number of conditions may indicate a history of asbestos exposure and potential diagnosis of mesothelioma, including pleural plaques, pleural effusions, and pleural thickening.

Pleural plates

Small areas of thickening on the pleura are the most common sign of previous exposure to asbestos. Pleural plaques are not cancerous and do not usually cause symptoms, but they may indicate a high risk of cancer.

Pleural effusion

The irritation caused by asbestos fibers can cause a build-up of fluid between the two layers of the pleura. This condition, called pleural effusion, is present in many cases of pleural mesothelioma. A little liquid between the layers of the pleura is healthy. Excessive pressure on the lungs causes chest pain that worsens when you cough or take a deep breath.

Pleural thickening

When large areas of the pleura stiffen because of scarring, it can become difficult and painful to breathe. Pleural thickening around both lungs is often a sign of significant exposure to asbestos. Repeated episodes of pleural effusion can cause thickening of the pleura as scar tissue accumulates.

Stages of pleural mesothelioma

The determination of pleural mesothelioma is the way in which doctors determine the progression of cancer in a patient's body. The stage influences the treatment options that can be used.

The international interest group on mesothelioma has created the most widely used staging system for pleural mesothelioma.

Stages 1 and 2, considered as early stages, indicate localized tumors. Stages 3 and 4, which designate later stages, classify expanding tumors.

Mesothelioma Life Expectancy by Stage for Patients Eligible for Surgery

Stage	Time	Progression
Stage 1	22.2 months	Tumors remain localized in and around the tissue lining of one lung
Stage 2	20.0 months	Cancer cells are entering nearby lymph nodes
Stage 3	17.9 months	Cancer has spread to nearby tissues and distant lymph nodes
Stage 4	14.9 months	Cancer has spread to distant organs
Stage 4	14.9 months	Cancer has spread to distant organs

Prognosis For Pleural Mesothelioma

The average prognosis of pleural mesothelioma, or the course and expected outcome of the disease, is poor for most patients as it progresses rapidly and is resistant to many existing treatments.

It is difficult to accurately predict the prognosis of an individual because this disease is complex. Each person responds differently to the treatment.

Survival Rate Of Pleural Mesothelioma by Year

Year (s) After Diagnosis	Surfvival Rate
1 Year	73%
3 Years	23%
5 Years	12%
10 Years	4.7%

Factors that affect your prognosis

·         Stage: The most important factor in the prognosis of mesothelioma is the stage of the disease at the time of diagnosis. Early-stage cancer offers a better chance of long-term survival than advanced cancer.

·         Cell Type: The type of mesothelioma tumor cell also greatly influences the prognosis.

·         Age: Younger patients tend to live longer.

·         Gender: Women tend to live longer with the disease than men.

·         Pleural fluid: Higher amounts of pleural fluid in the chest are associated with a poorer prognosis.

·         Patient activity level: The most active patients have a better prognosis.

·         Recurrence of cancer: A recurrence of mesothelioma is associated with a darker prognosis.

Improve your prognosis

By taking proactive measures, it is possible to live longer and better with malignant pleural mesothelioma. Some patients even get a remission after treatment and live for years without cancer symptoms.

The inspiring stories of mesothelioma survivors reveal many different ways of meeting the cancer challenge. However, many survivors make the same basic choices to promote their well-being.

How can one live longer with pleural mesothelioma?

·         Try to find treatment from an experienced mesothelioma specialist

·         Improve your lifestyle to improve your overall health

·         Access the latest therapies with a clinical trial

·         Use palliative and complementary medications to improve your quality of life

A hope to cure mesothelioma

There is no definitive cure for pleural mesothelioma. However, a combination of surgery, chemotherapy and radiotherapy has allowed patients to improve their prognosis. Even patients who are not eligible for surgery survived years after their diagnosis through experimental clinical trials and emerging therapies such as immunotherapy.

Researchers around the world have dedicated their careers to finding more effective treatments to heal pleural mesothelioma and to diagnose cancer early.

·         Emily Ward was diagnosed in 2012 after working for 43 years as a registered nurse. She used her medical history to find the best mesothelioma specialists available to treat her cancer, including the late Dr. David Sugarbaker. After a pleurectomy and decortication, three cycles of chemotherapy and now monthly treatments at Keytruda, Ward enjoys a good quality of life by doing many of the things she did before her diagnosis.

·         Tim Crisler has passed the 17-year mark as a survivor of pleural mesothelioma in 2019. He attributes his long-term survival to extrapleural pneumonectomy surgery, which removes the lungs. He still suffers from residual pain, but he is able to travel the country with his beloved Harley Davidson since his diagnosis in 2002. "I have absolutely no problem with mesothelioma cancer today," he said. he declares. "It has not touched me for a long time."

·         Sallie Morton survived pleural mesothelioma for four years by discontinuing conventional therapy. She was not eligible for surgery when she was diagnosed in 2013 at the age of 87 and she refused chemotherapy after seeing too many friends cope with the serious side effects of the drugs. She did it in her own way, creating surprising doubts and organizing events and parties to the end. "It's one of the largest," she often describes herself.