What is Mesothelioma?

Mesothelioma is a rather rare but very aggressive cancer, primarily attacking the mesothelium, a thin layer of tissue covering most of the internal organs. This disease most often results from contact with hazardous materials, most especially asbestos. Though malignant pleural mesothelioma, affecting the lungs, is the most common type, this cancerous disease may strike different parts of the body, including the abdomen, heart, and testicles.

Understanding Mesothelioma

What Is Mesothelioma?

Mesothelioma refers to a type of cancer wherein tumors grow in the mesothelium. The mesothelium protects most internal organs in the form of a thin membrane lining. These include:

• Pleura: Lining within the chest cavity, enveloping the lungs.
• Peritoneum: This surrounds abdominal and pelvic organs.
• Pericardium: This is a membrane that encases the heart.
• Tunica Vaginalis: This is the membranous covering of the testicles.

When using the word mesothelioma, most are usually talking about pleural mesothelioma, which is malignant and caused by asbestos.

Types of Mesothelioma

Mesothelioma is divided into several types, depending on the different areas of the body that the disease will attack. These include the following:

• Pleural Mesothelioma: This affects the lining of the lung.
• Peritoneal Mesothelioma: This affects the lining of the abdomen.
• Pericardial Mesothelioma: This affects the lining that covers the heart.
• Testicular Mesothelioma: This affects the lining surrounding the testicles.

There is also a division between benign, which is non-cancerous, and malignant, which is cancerous. Malignant mesothelioma is more common and dangerous because it is highly invasive.

Cell Types of Mesothelioma

Mesothelioma tumors are also divided into cell type-based categories in determining the tumor:

• Epithelioid Cells: This is considered the most favorable type of mesothelioma. Epithelioid cells are the most common type occurring in the body, and they usually respond best to treatment.
• Sarcomatoid Cells: Sarcomatoid mesothelioma is rarer but significantly more aggressive due to the shape of the cells, which make them much more likely to metastasize, or spread.
• Biphasic Cells: These tumors contain both epithelioid and sarcomatoid cells, leading to mixed outcomes depending on the ratio of the cell types.

Risk Factors for Mesothelioma

Who Is at Risk?

Mesothelioma is closely associated with asbestos exposure. This does not primarily affect people nowadays but rather those working in specific industries many decades ago. Asbestos was a common ingredient in construction, shipbuilding, and even manufacturing processes due to the material's resilience against heat and strength. Although laws related to asbestos use have become much tighter, many individuals who were exposed during these earlier decades are only recently beginning to show symptoms of such diseases.

The demographic most affected with mesothelioma includes men from 50 to 70 years due to occupational exposures. Industry-specific exposures include the following:

• Construction and demolition: Asbestos was part of insulation or building materials.
• Shipbuilding: Asbestos was used extensively in ship construction or maintenance.
• Mining and milling: Natural asbestos in mining activities
• Automotive mechanics: Brake linings and other vehicle parts contain asbestos.

There are rare cases of children receiving radiation therapy and those exposed to other minerals like silica, which increase the risk for mesothelioma. Children who have had previous cancers and any associated radiation treatments are at increased risks for developing the illness, although asbestos is not always associated with pediatric cases.

 Symptoms and Causes

Symptoms of Mesothelioma

Mesothelioma symptoms may vary according to tumor location and type. Some common symptoms include:

• Fever
• Night sweats
• Fatigue or malaise
• Weakness
• Unexplained weight loss
• Pleural Mesothelioma Symptoms:
• Dyspnea that is progressive in nature.
•  Persistent chest pain.
•  Dysphagia or difficulty swallowing.
•  Chest lumps.
•  Pleural effusion or fluid accumulation around the lungs.
• Abdominal Pain and swelling
• Anemia
• Ascites or accumulation of fluid in the stomach.
• Nausea, vomiting, diarrhea
• Intestinal obstruction
• Pericardial Mesothelioma
• Chest pain and discomfort.
• Abnormal heart rhythms.
• Low blood pressure.
• Difficulty breathing.
• Testicular Mesothelioma
• Hydrocele of the scrotum.
• Formation of a testicle lump.
• Inguinal hernia.

Causes of Mesothelioma

In adults, the cause of mesothelioma is normally due to exposure to asbestos fibers. These microscopic fibers can be taken into the body through inhalation or ingestion and thereby result in inflammation and scarring of the mesothelial tissue. This may lead, over time, to mutations of the cells and tumor formulation. In many instances, the latency period can be a very long period, such as 20 to 40 years, and early detection is quite difficult.

Diagnosis and Testing

How Is Mesothelioma Diagnosed?

The key to dealing with mesothelioma lies in early diagnosis, which significantly contributes to better treatment outcomes. A case history and physical examination are the general starting points in diagnoses. Based on that, several diagnostic tests may be recommended by healthcare providers, including:

Blood Tests: Blood biomarkers linked with mesothelioma can be checked.

Imaging Tests: Chest X-rays, CT scans, PET scans, and MRIs may be done to see abnormalities in the areas concerned.

Biopsies: A biopsy is the surest way through which mesothelioma is diagnosed. During this procedure, tissue samples are studied under a microscope to check for malignant cells.

Mesothelioma Treatment Options

Treatment of Benign Mesothelioma

For benign mesotheliomas, surgery may be the front-line treatment. It is usually performed with the intention of completely removing the tumor to reduce the possibility of its recurrence. In some patients, doctors might recommend a course of chemotherapy as a precautionary measure.

Treatment of Malignant Mesothelioma

The treatment for malignant mesothelioma depends on the tumor stage and location. These may include the following treatments below:

• Surgery: This removes the tumor. However, only about 33% of patients with pleural mesothelioma are candidates for surgery.
• Chemotherapy: Shrinks the tumor or kills remaining cancer cells after surgery.
• Radiation Therapy: This is considered most often in combination with chemotherapy to control the growth of tumors.
• Targeted Therapies: These are experimental treatments that, like biologic agents and antiangiogenic therapies, act by not allowing the cancer to develop a blood supply, thus starving the tumor.

Managing Complications

Treatments for mesothelioma can be effective; however they also carry risks. Common complications include:

• Infection.
• Organ failure.
• Surgical complications, including respiratory problems.
• Prevention

The best way to prevent mesothelioma is by avoiding asbestos and other dangerous minerals. People using them should wear protectors and take safety measures.

Outlook and Prognosis

The prognosis of malignant mesothelioma is usually poor; most patients survive only 12 months following diagnosis. Early detection and treatment may extend survival. Supportive care and clinical trials may provide other options to alleviate symptoms and enhance the quality of life.

Living with Mesothelioma

Living with mesothelioma involves frequent follow-up and side effect management arising from treatments. This process is greatly enhanced by support by healthcare providers, family, and peer groups that greatly improve quality of life.