Peritoneal Mesothelioma and Benign Mesothelioma
Nov 11, 2006
Peritoneal mesothelioma:Peritoneal mesothelioma involves the abdominal cavity, infiltrating the liver, spleen or the bowel. As with pleural mesothelioma pain is the most common presenting complaint. In addition, due to fluid accumulation in the abdominal cavity (ascites), the abdomen appears enlarged. The patients experience nausea, vomiting, swelling of their feet, fever and difficulty in moving their bowels.
The prognosis is poorer than for pleural mesothelioma with a median survival time of about 10 months from the onset of symptoms.
Benign Mesothelioma:
A rare form of mesothelioma is the cycstic mesothelioma of the peritoneum. Its prognosis is benign. Its occurrence has been described primarily in young women. However the diagnosis presents difficulties, requiring extensive electron miscroscopy and immunohistochemical studies.
Rare Sites:
Mesothelioma of the pericardium, is a very seldom seen cardiac cancer. The mass is usually detected at a late stage by echocardiography, the prognosis is very poor , with or without therapy. Mesothelioma of the ovaries and the scrotum have also been reported in the literature. The management differs based on the stage of the disease, the prognosis is also very poor. The etiology of the few cases of mesothelioma described in children remains unclear and is not believed to be asbestos-related, the therapy and prognosis differ on an individual basis.
The prognosis is poorer than for pleural mesothelioma with a median survival time of about 10 months from the onset of symptoms.
Benign Mesothelioma:
A rare form of mesothelioma is the cycstic mesothelioma of the peritoneum. Its prognosis is benign. Its occurrence has been described primarily in young women. However the diagnosis presents difficulties, requiring extensive electron miscroscopy and immunohistochemical studies.
Rare Sites:
Mesothelioma of the pericardium, is a very seldom seen cardiac cancer. The mass is usually detected at a late stage by echocardiography, the prognosis is very poor , with or without therapy. Mesothelioma of the ovaries and the scrotum have also been reported in the literature. The management differs based on the stage of the disease, the prognosis is also very poor. The etiology of the few cases of mesothelioma described in children remains unclear and is not believed to be asbestos-related, the therapy and prognosis differ on an individual basis.
Pleural Mesothelioma
Pleural mesothelioma spreads within the chest cavity, sometimes involving the lung. Metastases can occur in any organ, including the brain, and are much more common than previously thought.
The onset of mesothelioma is usually very slow, the most common presenting symptom is persistent pain localized in the chest. Sometimes the pain is accompanied by severe difficulty breathing, due to an accumulation of fluid in the pleural space known as pleural effusion. Cough, weight loss and fever are not uncommon. The most valuable single test to show the extent of the disease is a computed chest tomograph (CT-scan).
There are currently no serum markers available for the diagnosis of mesothelioma. The detection of elevated serum levels of hyaluronic acid may be useful in differentiating mesotheliomas from other tumors, or to follow the effect of treatment.
The median survival is about 17 months from the beginning of symptoms. The 3-year survival is 10% the 5-year survival is approximately 5% ( if 100 patients are diagnosed with mesothelioma at a specific point in time, that means that 10 patients will still be alive at the end of 3 years and 5 patients will only be alive at the end of 5 years).
The onset of mesothelioma is usually very slow, the most common presenting symptom is persistent pain localized in the chest. Sometimes the pain is accompanied by severe difficulty breathing, due to an accumulation of fluid in the pleural space known as pleural effusion. Cough, weight loss and fever are not uncommon. The most valuable single test to show the extent of the disease is a computed chest tomograph (CT-scan).
There are currently no serum markers available for the diagnosis of mesothelioma. The detection of elevated serum levels of hyaluronic acid may be useful in differentiating mesotheliomas from other tumors, or to follow the effect of treatment.
The median survival is about 17 months from the beginning of symptoms. The 3-year survival is 10% the 5-year survival is approximately 5% ( if 100 patients are diagnosed with mesothelioma at a specific point in time, that means that 10 patients will still be alive at the end of 3 years and 5 patients will only be alive at the end of 5 years).
Survival Rate
Nov 10, 2006
Mesothelioma is fairly rare. There are an estimated 2,000 to 3,000 new cases per year of mesothelioma in the United States, The average age at diagnosis is 50 to 70 years old. The disease affects men 3 to 5 times more often than women. Mesothelioma is less common in African Americans than in white Americans.Mesothelioma is a serious disease. By the time the symptoms appear and cancer is diagnosed, the disease is often advanced. The average survival time is about one year. However, if the cancer is found early and treated aggressively, almost half of the patients whose cancer is found early reach the two-year mark, and about 20% survive five years.
The 5-year survival rate refers to the percent of patients who live at least 5 years after their cancer is diagnosed. Many of these patients live much longer than 5 years after diagnosis, and 5-year rates are used to produce a standard way of discussing prognosis. Five-year relative survival rates exclude from the calculations patients dying of other diseases, and are considered to be a more accurate way to describe the prognosis for patients with a particular type and stage of cancer. Of course, 5-year survival rates are based on patients diagnosed and initially treated more than 5 years ago. Improvements in treatment often result in a more favorable outlook for recently diagnosed patients.
The 5-year survival rate refers to the percent of patients who live at least 5 years after their cancer is diagnosed. Many of these patients live much longer than 5 years after diagnosis, and 5-year rates are used to produce a standard way of discussing prognosis. Five-year relative survival rates exclude from the calculations patients dying of other diseases, and are considered to be a more accurate way to describe the prognosis for patients with a particular type and stage of cancer. Of course, 5-year survival rates are based on patients diagnosed and initially treated more than 5 years ago. Improvements in treatment often result in a more favorable outlook for recently diagnosed patients.
Distinction between mesothelioma and other cancers
It is often hard to diagnose mesothelioma by looking at the cells from the fluid around the lungs, abdomen or heart. It is even hard to diagnose mesothelioma with tissue from biopsies. Under the microscope, mesothelioma can look like several other types of cancer. For example, pleural mesothelioma may resemble some types of lung cancer and peritoneal mesothelioma may resemble some cancers of the ovaries. For this reason, special laboratory tests are often done to help distinguish mesothelioma from some other cancers. These tests often use special techniques to recognize certain markers (types of chemicals) known to be contained in mesotheliomas. Different markers are present in cancer of the lung or ovary. The electron microscope can sometimes be helpful in diagnosing mesothelioma. This microscope can magnify samples more than 100 times greater than the light microscope which is generally used in cancer diagnosis. This stronger microscope makes it possible to see small parts of the cancer cells that distinguish mesothelioma from other types of cancer.The diagnosis of mesothelioma presents problems primarily initially in the distinction between mesothelioma and other forms of cancer such as adenocarcinoma or benign, noncancerous pleural inflammation. The best diagnostic tools at the moment remain the open pleural biopsy performed during thoracoscopy. This procedure also allows for direct visualization of the inside of the chest, and information of involvment of other organs and extension of disease. Other procedures with lower yields are CT guided pleural biopsy, or blind pleural biopsy. In addition to the gross appearance of the tumor, pathologists often rely on a panel of histochemical and immunohistochemical stains to diagnose or exclude meosothelioma. Currently markers linked to prognosis of mesothelioma are under study, but have not been validated for the general use.
Pleural effusion
Nov 9, 2006
In patients with a pleural effusion, a sample of this fluid can be removed by inserting a needle into the chest cavity. A similar technique can be used to obtain abdominal fluid and pericardial fluid. The fluid is then tested to show its chemical make up and viewed under a microscope to determine whether cancer cells are present.A tissue sample of a pleural or pericardial tumor can be obtained using a relatively new technique called thoracoscopy. A thoracoscope (telescope-like instrument connected to a video camera) is inserted through a small incision into the chest. The doctor can see the tumor through the thoracoscope, and can use special forceps to take a tissue biopsy. Similarly, laparoscopy can be used to see and obtain a biopsy of a peritoneal tumor. In this procedure, a flexible tube attached to a video camera is inserted into the abdominal cavity through small incisions on the front of the abdomen. Fluid can also be collected during thoracoscopy or laparoscopy.
For patients who might have pleural mesothelioma, the doctor may also do a bronchoscopy. In this procedure a flexible lighted tube is inserted through the mouth, down the trachea, and into the bronchi to see if there are other masses in the airway.
The patient may also have a mediastinoscopy. A lighted tube is inserted under the sternum (chest bone) at the level of the neck and moved down into the chest. Mediastinoscopy allows the surgeon to view the lymph nodes in this area and remove samples to check for cancer. Lymph nodes are bean-sized collections of immune system cells that help the body fight infections and cancers. Cancers arising in the lung often spread to lymph nodes, but mesotheliomas rarely do this. Tests of lymph nodes can give the doctor information on whether a cancer is still localized or if it has started to spread, and can help distinguish lung cancer from mesothelioma.
For patients who might have pleural mesothelioma, the doctor may also do a bronchoscopy. In this procedure a flexible lighted tube is inserted through the mouth, down the trachea, and into the bronchi to see if there are other masses in the airway.
The patient may also have a mediastinoscopy. A lighted tube is inserted under the sternum (chest bone) at the level of the neck and moved down into the chest. Mediastinoscopy allows the surgeon to view the lymph nodes in this area and remove samples to check for cancer. Lymph nodes are bean-sized collections of immune system cells that help the body fight infections and cancers. Cancers arising in the lung often spread to lymph nodes, but mesotheliomas rarely do this. Tests of lymph nodes can give the doctor information on whether a cancer is still localized or if it has started to spread, and can help distinguish lung cancer from mesothelioma.
Imaging tests
A chest x-ray may show irregular thickening of the pleura, pleural calcifications (mineral deposits), lowering of the lung fissures (spaces between the lobes of the lungs), and fluid in the pleural space. These findings suggest asbestos exposure leading to the development of a mesothelioma.
Imaging studies such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans will help determine the location, size, and extent of the cancer. The CT scan uses a rotating x-ray beam to create a series of pictures of the body from many angles. A computer combines these pictures to produce detailed cross-sectional images of a selected part of the body. To highlight details on the CT scan, you may be asked for permission to have a harmless dye injected into a vein. MRI uses magnetic fields instead of x-rays to create images of selected areas of the body. As with the CT scan, a computer generates a detailed cross-sectional image.
A chest x-ray may show irregular thickening of the pleura, pleural calcifications (mineral deposits), lowering of the lung fissures (spaces between the lobes of the lungs), and fluid in the pleural space. These findings suggest asbestos exposure leading to the development of a mesothelioma.
Imaging studies such as x-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans will help determine the location, size, and extent of the cancer. The CT scan uses a rotating x-ray beam to create a series of pictures of the body from many angles. A computer combines these pictures to produce detailed cross-sectional images of a selected part of the body. To highlight details on the CT scan, you may be asked for permission to have a harmless dye injected into a vein. MRI uses magnetic fields instead of x-rays to create images of selected areas of the body. As with the CT scan, a computer generates a detailed cross-sectional image.
A complete medical history (interview) is taken to check for risk factors and symptoms. This will include questions to determine if you have been exposed to asbestos.A physical exam will provide information about signs of mesothelioma and other health problems. Patients with pleural mesotheliomas (mesotheliomas of the chest) often have pleural effusion (fluid in their chest cavity) caused by the cancer. Ascites (fluid in the abdominal cavity) in cases of peritoneal mesothelioma, and pericardial effusion (fluid in the pericardium) in cases of pericardial mesothelioma can also be detected during a physical exam.
Diagnosis of mesothelioma
How is mesothelioma diagnosed?
If there is a reason to suspect you may have a mesothelioma, the doctor will use one or more methods to find out if the disease is really present.
Medical history and physical examination
A complete medical history (interview) is taken to check for risk factors and symptoms. This will include questions to determine if you have been exposed to asbestos.
A physical exam will provide information about signs of mesothelioma and other health problems. Patients with pleural mesotheliomas (mesotheliomas of the chest) often have pleural effusion (fluid in their chest cavity) caused by the cancer. Ascites (fluid in the abdominal cavity) in cases of peritoneal mesothelioma, and pericardial effusion (fluid in the pericardium) in cases of pericardial mesothelioma can also be detected during a physical exam.
If there is a reason to suspect you may have a mesothelioma, the doctor will use one or more methods to find out if the disease is really present.
Medical history and physical examination
A complete medical history (interview) is taken to check for risk factors and symptoms. This will include questions to determine if you have been exposed to asbestos.
A physical exam will provide information about signs of mesothelioma and other health problems. Patients with pleural mesotheliomas (mesotheliomas of the chest) often have pleural effusion (fluid in their chest cavity) caused by the cancer. Ascites (fluid in the abdominal cavity) in cases of peritoneal mesothelioma, and pericardial effusion (fluid in the pericardium) in cases of pericardial mesothelioma can also be detected during a physical exam.
Risk factors of mesothelioma
Nov 8, 2006
A risk factor is anything that increases a person's chance of getting a disease such as cancer. Different cancers have different risk factors. For example, unprotected exposure to strong sunlight is a risk factor for skin cancer and smoking is a risk factor for lung cancer as well as other types of cancer. Scientists have found several risk factors that make a person more likely to develop mesothelioma.
Asbestos:
The main risk factor for developing mesothelioma is exposure to asbestos. Asbestos refers to a family of magnesium-silicate mineral fibers. In the past, asbestos was used widely for insulation because it does not conduct heat well and it is resistant to melting or burning. As the link between asbestos and mesothelioma has become well known, the use of this material has decreased. However, up to 8 million Americans may already have been exposed to asbestos.
According to the United States Environmental Protection Agency, as many as 733,000 schools and public buildings in the country today contain asbestos insulation. As many as 10% to 15% of schools in the United States may contain asbestos insulation. People who may be at risk for occupational asbestos exposure include some miners, factory workers, insulation manufacturers, railroad workers, ship builders, gas mask manufacturers, and construction workers, particularly those involved with installing insulation. Several studies have shown that family members of people exposed to asbestos at work have an increased risk of developing mesothelioma, because asbestos fibers are carried home on the clothes of the workers.
Asbestos:
The main risk factor for developing mesothelioma is exposure to asbestos. Asbestos refers to a family of magnesium-silicate mineral fibers. In the past, asbestos was used widely for insulation because it does not conduct heat well and it is resistant to melting or burning. As the link between asbestos and mesothelioma has become well known, the use of this material has decreased. However, up to 8 million Americans may already have been exposed to asbestos.
According to the United States Environmental Protection Agency, as many as 733,000 schools and public buildings in the country today contain asbestos insulation. As many as 10% to 15% of schools in the United States may contain asbestos insulation. People who may be at risk for occupational asbestos exposure include some miners, factory workers, insulation manufacturers, railroad workers, ship builders, gas mask manufacturers, and construction workers, particularly those involved with installing insulation. Several studies have shown that family members of people exposed to asbestos at work have an increased risk of developing mesothelioma, because asbestos fibers are carried home on the clothes of the workers.
Symptoms of mesothelioma.
What are the signs and symptoms of mesothelioma?
Early symptoms of mesotheliomas are not specific to the disease. People often ignore them or mistake them for common, minor ailments. Most people with mesothelioma have symptoms for only 2 to 3 months before they are diagnosed. About one-fourth have symptoms for at least six months prior to their diagnosis.
Over half of patients with pleural mesothelioma have pain in the lower back or at the side of the chest. Many report shortness of breath. A smaller percentage have trouble swallowing, cough, fever, sweating, fatigue, and weight loss. Other symptoms include hoarseness, coughing up blood, swelling of the face and arms, muscle weakness, and sensory loss.
Symptoms of peritoneal mesothelioma include abdominal (belly) pain, weight loss, nausea, and vomiting. There may also be a hernia, fluid in the abdominal cavity or a mass in the abdomen
Early symptoms of mesotheliomas are not specific to the disease. People often ignore them or mistake them for common, minor ailments. Most people with mesothelioma have symptoms for only 2 to 3 months before they are diagnosed. About one-fourth have symptoms for at least six months prior to their diagnosis.
Over half of patients with pleural mesothelioma have pain in the lower back or at the side of the chest. Many report shortness of breath. A smaller percentage have trouble swallowing, cough, fever, sweating, fatigue, and weight loss. Other symptoms include hoarseness, coughing up blood, swelling of the face and arms, muscle weakness, and sensory loss.
Symptoms of peritoneal mesothelioma include abdominal (belly) pain, weight loss, nausea, and vomiting. There may also be a hernia, fluid in the abdominal cavity or a mass in the abdomen
What is Mesthelioma?
What causes mesothelioma?
Asbestos exposure is the main cause of mesothelioma. After these fibers are breathed in, they travel to the ends of small air passages and reach the pleura where they cause physical damage to mesothelial cells that may result in cancer. In addition, they also cause injury to lung cells that can result in lung cancer and/or asbestosis (replacement of lung tissue by scar tissue). If swallowed, these fibers can reach the abdominal cavity where they have a role in causing peritoneal mesothelioma.
Exposure to asbestos, though mostly occupational, can also be environmental, or familial by household contamination, through the work clothes of an asbestos worker for instance.
Beginning 15 years after the onset of exposure, about 6% of asbestos workers die of mesothelioma. In one study of asbestos insulation workers, the death rate from mesothelioma was 344 times higher than in the general population.
Asbestos exposure is the main cause of mesothelioma. After these fibers are breathed in, they travel to the ends of small air passages and reach the pleura where they cause physical damage to mesothelial cells that may result in cancer. In addition, they also cause injury to lung cells that can result in lung cancer and/or asbestosis (replacement of lung tissue by scar tissue). If swallowed, these fibers can reach the abdominal cavity where they have a role in causing peritoneal mesothelioma.
Exposure to asbestos, though mostly occupational, can also be environmental, or familial by household contamination, through the work clothes of an asbestos worker for instance.
Beginning 15 years after the onset of exposure, about 6% of asbestos workers die of mesothelioma. In one study of asbestos insulation workers, the death rate from mesothelioma was 344 times higher than in the general population.
