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Vital organs of the human body, including the abdomen, heart and lungs, are affected by mesothelioma – a cancer that harms the thin membranes that protect these organs. Although there is unfortunately no cure for the disease completely, there are treatment options such as surgery, chemotherapy and radiation therapy.
When individuals inhale asbestos fibers, potential risks for the development of the type of cancer known as pleural mesothelioma can become a growing concern. When these fibers penetrate the protective lining of the lungs, also known as pleura, they can cause genetic mutations in the surrounding cells–in some cases, this could lead to pleural mesothelioma.
About 75 percent of all cases of mesothelioma diagnosed annually are pleural mesotheliomas. As it stands to be one of the most common types of mesothelioma, specialists have more opportunities to develop new treatments and/or new treatment strategies for the disease. New, promising treatments are being tested every day in the hope of helping patients–and one day discovering a cure. Additional treatment opportunities that could potentially increase a prognosis can also be discovered through clinical trials as well.
Why is your diagnosis significant?
Apart from telling patients what causes their symptoms, it is important to make a correct diagnosis when considering treatment options. Treatment options may be affected as cell type and stage vary in pleural mesothelioma.
What treatments are obtainable?
Typically, many patients with pleural mesothelioma are prescribed and recommended chemotherapy and/or radiation therapy in order to slow the spreading of aggressive mesothelioma cells. However, the best chances for an extended prognosis involve surgical options such as a pleurectomy.
What is the prognosis for this disease?
A patient’s overall health and stage at which they had been diagnosed at are important factors that a prognosis can be dependable on. Most patients live for just over a year after diagnosis, but due to new treatments, there are patients who have lived with the disease for years.
Treating Pleural Mesothelioma
The standard treatments options that are available to mesothelioma patients include surgery, chemotherapy, and radiation therapy. When a doctor combines two or more of these treatments, the multimodal therapy approach has been known to significantly improve a patient with mesothelioma life expectancy.
Extrapleural Pneumonectomy (EPP)
Patients with pleural mesothelioma have obtainability of extrapleural pneumonectomy, or EPP – one of the most effective surgeries available. It has been developed by Dr. David Sugarbaker, the world-renowned mesothelioma surgeon.
During the operation a surgeon removes:
It is believed that the EPP offers the best chance of removing mesothelioma from the body by many specialists. However, a doctor will only suggest an EPP if a patient is in good standing of health as this procedure is invasive and requires a strong recovery. Despite its risk, researchers have shown the efficiency of the EPP in several studies. In fact, one study reported that the median survival rate for EPP patients was 27 months – that is twice the average mesothelioma survival rate.
Pleurectomy with Decortication (P/D)
The lung-sparing, less invasive alternative to the EPP is known as a pleurectomy/decortication, or P/D. Dr. Robert Cameron, a mesothelioma specialist, developed the procedure in the belief that the EPP was unnecessarily radical.
The two surgical techniques of a P/D include:
Pleurectomy – the lung’s protective lining in which the tumor grows is removed by surgeons
Decortication – the visible tumors located around and on the diseased lung are removed by surgeons
Compared to the EPP, researchers have shown that P/D can give rates equal to and sometimes better for survival.
Pleurodesis is a palliative surgery that can be used by doctors to relieve pain and pressure caused by fluid in the chest. This buildup of fluid is known as a pleural effusion. Pleural effusions build up occurs between the internal and external pleural linings which inhibit the expansion of the lung and the chest.
To relieve pressure in both the chest and lungs, a pleurodesis is performed by inserting a hollow tube into the chest wall, which drains the excess fluid. This procedure makes it easier for patients to breathe and reduces overall chest pain.
Chemotherapy for Pleural Mesothelioma
A chemotherapy drug may be used in combination or by itself with other chemotherapy drugs as treatment for pleural mesothelioma. Alimta and Cisplatin are the first particularly successful combination of chemotherapy drugs for mesothelioma. The medicines together increased patients ‘ survival time by an average of three months.
Chemotherapy can also be combined with surgery. It has been shown that survival times can be increased when chemotherapy is prescribed before (neoadjuvant), during (intraoperative), or after (adjuvant) a procedure. A recent medical study indicated that compared to those who had only surgery survived for 22 months while patients who had undergone a combination of surgery and heated chemotherapy survived for 35 months.
Radiation Therapy for Pleural Mesothelioma
To shrink pleural mesothelioma tumors, doctor utilize radiation therapy – which can be used as in combination with surgery and chemotherapy or as a palliative treatment.
A recent study has shown that the combination of radiation therapy with surgery and chemotherapy can have an effect on the average survival time of many pleural mesothelioma patients to 33 months – that is three times the life expectancy of many pleural mesothelioma patients.
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Symptoms of Pleural Mesothelioma
Pleural mesothelioma symptoms mainly affect the respiratory system, including the airway, breathing muscles, and lung. As a result of pleural effusion (excess fluids) within the lining of the lungs, the beginning signs a patient may experience is a persistent cough and/or shortness of breath.
Patients may also experience the following additional symptoms of pleural mesothelioma:
Diagnosing Pleural Mesothelioma
Due to its nonspecific symptoms – which is a symptom that is shared between other medical conditions – pleural mesothelioma can be difficult to diagnose. Similar symptoms include those of common respiratory conditions such as chronic obstructive pulmonary disease (COPD) or pneumonia.
It is also difficult for doctors to distinguish pleural mesothelioma from other cancers under a microscope. Therefore, doctors typically run tests to confirm the cell type, stage of cancer, and location of the mesothelioma.
It is important to note that a patient’s diagnosis can impact the type of treatment they may be able to receive. For instance, doctors are less likely to perform an operation on a patient that is entering and in later stages. Getting another specialist’s second opinion can however provide a different diagnosis and open up additional treatment options.
Diagnostic Imaging Tests
To locate abnormal-looking growths and/or masses, the chest area is examined with diagnostic imaging test such as CT or x-ray. Although these imaging scans require a patient to remain still for a long period of time they are painless and can show the stage and location of the tumor.
To begin a diagnosis, doctor’s commonly use the following imaging tests:
A biopsy request may be pursued depending on the results from the imaging test. A biopsy requires a small sample of fluid or tissue; it provides important information, such as the mesothelioma cell type, that doctors use to create a treatment plan that is most effective for a patient.
Stages of Pleural Mesothelioma
A doctor will also determine the stage of mesothelioma as part of the diagnostic process, which determines the origin in the lining of the lungs and describes how far it has spread from that point. This information is significant to doctors when determining potential treatment availabilities. Standard treatment options are more commonly available to patients with stage 1 or stage 2 compared to patients with the later 3 and 4 stages.
The following are the pleural mesothelioma stages:
Stage 1: The cancer remains localized to the point of origin
Stage 2: Although the cancer has not spread far, it has begun to spread towards parts of the diaphragm, the lung itself, and nearby lymph nodes.
Stage 3: The cancer has progressively spread throughout one side of the chest, within chest wall, esophagus, and additional lymph nodes.
Stage 4: The cancer has now spread into both sides of the chest and now affects the blood, bone cells, and other organs.
Improving a Prognosis
If pleural mesothelioma is diagnosed, you have a better prognosis than patients diagnosed with mesothelioma elsewhere.
When a patient is diagnosed with pleural mesothelioma, the prognosis is more favorable than those diagnosed with mesothelioma elsewhere. It is the most common form of the disease; more doctors have seen and treated it compared to other mesothelioma sites.
The following factors are dependable to the prognosis:
Although all of these factors are important, the cancer stage and cell type are the most influential role for a prognosis. For example, more treatment opportunities are available to a patient that has stage 1 or stage 2 pleural mesothelioma. Early-stage pleural mesothelioma has not experienced far spreading from the lung lining, making it is easier for doctors to remove surgically.
Similarly, if a pleural mesothelioma patient is diagnosed with epithelioid cell type they will most likely have a more favorable prognosis as these cells react more positively and do not spread as quickly as other cells.
Take Control of Your Prognosis
No matter your diagnosis— the cell type, location of the mesothelioma, or stage of cancer — an experienced doctor’s specialized treatment will help you improve your prognosis and quality of life.
A mesothelioma diagnosis can be devastating; however, it does not mean it is an immediate death sentence. A proactive approach combined with a variety of treatments may help people live longer. If you or a loved one has been diagnosed with pleural mesothelioma, make it a mission to find the treatment(s) that’s provide the best odds in life extension. This can be done by locating a qualified specialist and/or receiving a second opinion if needed.
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