An Overview of Pleural Mesothelioma

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Pleural mesothelioma is a rare type of cancer that causes the abnormal and malignant cell growth of the pleural layer of the lungs. Pleural mesothelioma is typically caused by exposure to asbestos, which may have caused individuals to swallow or inhale asbestos fibers. This type of cancer affects the respiratory system, initially, though this condition may spread to other areas of the body.

Approximately 2,000 to 3,000 new cases of pleural mesothelioma develop each year. Similar to many other types of cancer, treatment methods for pleural mesothelioma can include surgical removal, radiation therapy, or chemotherapy. A doctor will determine the extent and severity of the damage and assess which treatment method is the most suitable for each case.

Symptoms

Research states that symptoms of pleural mesothelioma include lower back pain, persistent cough, hoarse and raspy voice, shortness of breath, difficulty swallowing, lethargy, fever, fluid buildup in and around the lungs, a dull aching pain near the rib cage, swelling of the face and arms, and unexplained weight loss.

These symptoms often appear much later in the course of the condition and individuals who are in the early stages of pleural mesothelioma may experience little to no symptoms.

Causes

Pleural mesothelioma is most commonly caused by inhaling or swallowing fibers of asbestos. In order to develop symptoms or a diagnosis of pleural mesothelioma, individuals usually must be frequently exposed to high levels of asbestos over a long period of time. 

A growing number of individuals are developing this type of cancer as a result of exposure to large amounts of asbestos between 1940 and 1980. While asbestos is a naturally occurring mineral, appropriate measures have been taken for the removal or safe use of asbestos in commercial settings where people are likely to be exposed.

Occupations such as shipbuilding, pipefitting, construction, and auto repair place individuals at the greatest risk for high levels of asbestos exposure. Individuals who live with someone who is frequently exposed to high levels of asbestos are also at risk for developing pleural mesothelioma, due to the transfer of fibers on clothing, shoes, or their body.

Asbestos is still present in many common objects, but most individuals will be exposed to this substance so minimally that it does not cause any harm. While there is no complete ban on using asbestos in the United States, there have been restrictions that limit how much asbestos is used in certain industries and commercial products.

Individuals may also develop pleural mesothelioma after exposure to high levels of radiation or contracting infections due to certain viruses.

Researchers believe that the needle-like asbestos fibers can burrow into tissue and cause chronic irritation to body cells and systems, which leads to the development of mesothelioma over time.

Diagnosis

Pleural mesothelioma can be diagnosed through a physical exam and review of medical history, during which a doctor will check for abdominal lumps and ask an individual about their past jobs and lifestyle habits.

Additionally, diagnostic tests such as computed tomography (CT) scans and positron emission tomography (PET) scans of the chest can reveal abnormal growths or the spreading of already existing cancer cells. A biopsy may also be completed to test chest or abdominal cells for cancer. Bronchoscopies are another procedure that are commonly used to gain a clearer picture of a person’s internal lung structures. A bronchoscopy may also assist a doctor in receiving tissue samples.

Laboratory tests cannot be used in isolation to diagnose pleural mesothelioma, but a complete blood count (CBC) can provide information about a person’s immune system and ability to fight the development of this condition.

Treatment

Pleural mesothelioma can be treated through a variety of surgical methods, including removal of some cancerous tissue, removal of the lung’s entire covering (called the pleura), or removal of one entire lung along with the pleura and the lining around the heart.

Another treatment method involves the use of drugs to cause pleural scarring and stop fluid buildup in the lungs. This method is called pleurodesis.

Other individuals with pleural mesothelioma may opt for radiation therapy, which involves the use of radiation waves to kill cancer cells. This method is typically used following one of the surgical methods, as surgery cannot effectively remove all of the cancerous tissue.

Chemotherapy is another treatment option that involves the use of injected or oral drugs to stop cancer cell growth. Immunotherapy medications may be used to trigger the body’s immune response to fight cancer internally. Targeted drug therapy is another way to utilize medications to stop cancer multiplication at the cellular level by inhibiting the division of those cells.

Your doctor will provide information as to what treatment method is best for your situation. This will be dependent on the current stage of pleural mesothelioma. This is determined using the acronym TNM. The T stage describes how large the main tumor is and the extent that it has spread. The N stage describes if the cancer has migrated to neighboring lymph nodes, which are small organs part of the immune system. The last stage is the M stage that describes whether the cancer has spread to larger organs and structures of the body. 

Prognosis

Doctors often use repeat tests to determine the effectiveness of treatment methods that were used. This will allow doctors to determine the next course of action to address the effects of pleural mesothelioma.

The prognosis of pleural mesothelioma is highly dependent on whether or not the cancer has spread to other parts of the body and how severe the existing cancer is.

A Word From Verywell

To best manage living with pleural mesothelioma, it is important to regularly see your doctor and specialists as needed. This will ensure that your condition is closely being monitored and that you are able to receive any additional treatments as your condition warrants. 

Use social support such as family and friends to maintain a positive mindset about your condition. You should consult your doctor as you feel you need more assistance for your condition, or if you feel you are no longer able to care for yourself. Rehabilitative therapies may be the best option for you to regain your strength and assist in the management of your condition.

Stress management tools may also assist in maintaining a positive outlook on your condition. Alternative methods such as deep breathing, meditation, yoga, and muscle relaxation can assist in calming your mind to cope with your condition

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Article Sources

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  1. American Cancer Society. Signs and symptoms of mesothelioma. Published November 16, 2018.

  2. Bibby AC, Tsim S, Kanellakis N, Ball H, et al. Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment. Eur Respir Rev, 25(142), 472-486. doi:10.1183/16000617.0063-2016

  3. National Cancer Institute. Malignant mesothelioma. Published February 2019.

  4. American Lung Association. Mesothelioma symptoms, causes, and risks. Published April 4, 2018.

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