Diagnosis of Mesothelioma

Diagnosis of Mesothelioma

Only a physician can properly diagnose mesothelioma. A review of the patient's medical history, including any past exposure to asbestos, should be conducted for any patient displaying dyspnea, chest pain, fluid build-up, or pain and/or swelling in the abdomen. This review is followed up with a complete physical examination, which should involve the use of imaging techniques. X rays, computed tomography (CT) scans, and magnetic resonance (MRI) scans of the chest and/or abdomen, as well as lung function, can provide the doctor with critical diagnostic information. Although positron emission tomography scans are expensive and not covered under most insurance, this diagnostic tool has proven very useful in determining tumor sites and staging of the disease.

If indicated, the doctor may wish to internally examine the patient's chest and/or abdominal cavity. These diagnostic procedures, known as thoracoscopy (chest) and peritoneoscopy (abdomen), are usually conducted in a hospital setting. Both procedures involve a fiber-optic imaging tool being inserted into the patient through an incision. These endoscopic tools will provide the doctor with a closer look at the body cavity, and any abnormal tissue or fluid build-up found therein. Excess fluid can be suctioned out through a needle or tube, in a process known as thoracentesis (for the chest) or paracentesis (for the abdomen). Additionally, the doctor may perform a biopsy of any abnormal tissue they discover during this time. Pathological examination of abnormal tissue, as well as fluid, remains the only effective method of confirming the diagnosis of mesothelioma. Biopsy will also assist the doctor in properly staging the disease's progression.

Once a confirmation of malignant mesothelioma has been established, the doctor will conduct further tests to determine the extent to which the primary disease has spread. This diagnostic process is known as "staging." Malignant pleural mesothelioma of can be broken into four stages:

• Localized Malignant Mesothelioma (Stage 1)—Cancer is present in the right or left pleura. May involve the lung, the pericardium, or diaphragm on that side.
• Advanced Malignant Mesothelioma (Stage 2)—Cancer has spread beyond the right or left pleura to lymph nodes on that side. May involve the lung, the pericardium, or diaphragm on that side.
• Advanced Malignant Mesothelioma (Stage 3)—Cancer has spread into the chest wall, diaphragm, ribs, heart, esophagus, or through the abdominal lining. Nearby lymph nodes may or may not be involved.
• Advanced Malignant Mesothelioma (Stage 4)—Cancer shows evidence of metastasis or spread through the bloodstream to distant organs and/or tissues.

Recurrent malignant mesothelioma may also occur, where the cancer returns in its original location or elsewhere in the body even after treatment.

Causes & signs Of Mesothelioma

Causes & signs Mesothelioma

About 80% of all mesothelioma patients have a history of asbestos exposure. The huge majority of these patients were employed in an industry that involved the use of asbestos in some fashion. In addition to occupational exposure, household exposure of relatives members is not unusual. An exposed individual can carryover the asbestos particles on their clothing, skin, & in their hair when they return home, leading to paraoccupational exposure. Even brief exposure to asbestos, as small as to months, may finish up in long-term consequences. Although the dangers of asbestos have been known for plenty of years, the long latency period of mesothelioma (30 to 40 years) means that majority of patients were already exposed as far back as the 1950s. It is estimated that up to eight million Americans have already been exposed. Several industries, in particular, show a higher incidence of asbestos exposure:

Ø  Insulators (Asbestos workers)

Ø  Boilermakers

Ø  Ship-fitters

Ø  Steel workers

Ø  Maintenance workers

Ø  Plumbers

Ø  Brake mechanics

Mesothelioma is very aggressive one time it truly takes hold. However, its preliminary signs are usually non-specific in nature and/or mimic other conditions, such as persistent pneumonia or gastronomical disorders. Some patients will exhibit no signs at all. As such, proper evaluation & diagnosis are often delayed & must be confirmed by a doctor.

Patients suffering from pleural mesothelioma most often exhibit signs of dyspnea, pleural effusions, and/or chest pain. The large majority of pleural effusion signs will exhibit in the right lung (60% of the time). Patients may also exhibit persistent cough, weight loss, weakness, fever, & difficulty swallowing.

Patients suffering from peritoneal mesothelioma most often exhibit signs of pain and/or swelling in the abdomen from liquid retention or tumor growth. Weight loss, nausea, bowel obstruction, anemia, fever, & swelling in the legs and/or feet are also known symptoms.

Definition And Descryptions of Mesothelioma

 Definition

Mesothelioma is an unusual disease that causes malignant cancer cells to form within the lining of the chest, abdomen, or around the heart. Its primary cause is believed to be exposure to asbestos.

Description

Malignant mesothelioma is also known as asbestos cancer or simply "meso." Mesothelioma causes cancerous cells to develop in the body's mesothelium, where they can spread to and damage vital organs and tissue. These malignant cells can also metastasize to other regions of the body. Mesothelioma is very difficult to diagnose and responds poorly to most treatment modalities, accounting for a poor prognosis.

The disease derives its name from the mesothelium, a sac-like membrane that protects most of the body's internal organs. It is divided into two distinct protective layers of cells: the visceral (the layer directly surrounding the organ) and the parietal (a sac around the body cavity). By releasing a lubricating fluid, the mesothelium allows the organs to move more freely within the body cavity; for example, the contraction and expansion of the lungs. The mesothelium is also referred to according to where it is located in the body: pleura (chest), peritoneum (abdomen), and pericardium (heart).

Over two-thirds of all mesothelioma cases begin in the pleura region. Pleural mesothelioma spreads through the chest cavity, occasionally developing in the lungs as well. The disease most commonly causes pleural effusion, an excess build-up of fluid inside the chest cavity. This excess fluid increases pressure on the lungs and restricts breathing. In addition, malignant cells can cause the pleural lining to thicken and restrict the breathing space even further.

Peritoneal mesothelioma is the second most common form of the disease, accounting for less than 30% of all cases. Malignant cells form in the peritoneum, affecting the abdomen, bowel, liver, and spleen. Similar to pleural mesothelioma, the disease also causes a build up of excess fluid in the abdominal cavity. Normal bodily functions, such as digestion, can be hindered by the obstruction of organ movement.

Very rare forms of mesothelioma occur in the pericardium, as well as the mesothelium of the male and female reproductive organs. Cystic mesothelioma of the peritoneum, another rare form of the disease, occurs predominantly in women and is more benign in nature.

Malignant mesothelioma takes the form of one of three cell-types: epithelioid (50% to 70% of cases), sarcomatous (7% to 20% of cases), and biphasic/mixed (20% to 35% of cases). Of these cell-types, epithelioid mesothelioma carries the most favorable prognosis, followed by biphasic, and finally sarcomatous (very aggressive).

Mesothelioma remains relatively uncommon in the United States, with approximately 2,500 new cases reported annually. The incidence rates are much higher in Western Europe (over 5,000 cases reported annually). These numbers are expended to climb dramatically over the next 20 years. Older males (median age 60 at diagnosis) are three to five times more likely to develop mesothelioma than women. This is most like do to male predominance in those professions with an increased risk of asbestos exposure