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Pleural Mesothelioma Cancer of the Lung Lining
˙ūP l e u r a l M e s o t h e l i o m a C a n c e r o f t h e L u n g L i n i n g
W h a t i s P l e u r a l M e s o t h e l i o m a ?
P l e u r a l M e s o t h e l i o m a o r m a l i g n a n t p l e u r a l m e s o t h e l i o m a i s c a n c e r i n t h e l a y e r o f t h e l u n g s t h a t c a n s p r e a d t o t h e l u n g s . T h e s p r e a d o f t h e t u m o r o v e r t h e p l e u r a r e s u l t s i n p l e u r a l t h i c k e n i n g . T h i s h i n d e r s t h e r e f l e x i v i t y o f t h e p l e u r a a n d e n c a s e s t h e l u n g s i n a n i n c r e a s i n g r e s t r i c t i v e b e l t . W i t h t h e l u n g s t h u s r e s t r i c t e d , t h e y g e t c o n s t r i c t e d i n n o t i m e a n d a p e r s o n i s a l w a y s o u t o f b r e a t h .
P l e u r a l m e s o t h e l i o m a c a n b e :
- D i f f u s e a n d m a l i g n a n t ( c a r c i n o g e n i c )
- L o c a l i z e d a n d b e n i g n ( n o n - c a n c e r o u s )
B e n i g n p l e u r a l m e s o t h e l i o m a c a n b e r e m o v e d s u r g i c a l l y , b u t t h e m a l i g n a n t t u m o r s a r e t h e r e a l t e r r o r h e a d s .
M o s t c o m m o n a m o n g o t h e r m e s o t h e l i o m a c a s e s , P l e u r a l M e s o t h e l i o m a i s c a u s e d d u e t o e x p o s u r e t o b l u e a s b e s t o s f o r a l o n g e r p e r i o d o f t i m e , s a y 2 0 y e a r s , i n w h i c h t i m e t h e d i s e a s e i n c u b a t e s o n l y t o s h o w i t s f e a r f u l c o u n t e n a n c e v i a c e r t a i n s y m p t o m s .
T h e s y m p t o m s o f P l e u r a l M e s o t h e l i o m a
T h e s y m p t o m s o f P l e u r a l M e s o t h e l i o m a i n c l u d e d i f f i c u l t y i n b r e a t h i n g , d i f f i c u l t y i n s l e e p i n g , p a i n i n t h e c h e s t a n d a b d o m i n a l r e g i o n s , b l o o d v o m i t s , w e a k n e s s , w e i g h t l o s s , l o s s o f a p p e t i t e , l o w e r b a c k p a i n s , p e r s i s t e n t c o u g h i n g , h o a r s e n e s s o f v o i c e , s e n s o r y l o s s a n d d i f f i c u l t y i n s w a l l o w i n g .
D i a g n o s i s o f P l e u r a l M e s o t h e l i o m a
T h e f i r s t s t e p i s t o g o t h r o u g h a c h e s t X - r a y o r a C T s c a n ( c o m p u t e d c h e s t t o m o g r a p h ) , w h i c h w i l l r e v e a l a p l e u r a l t h i c k e n i n g a n d a n e f f u s i o n . T h i s i s f o l l o w e d b y a b r o n c h o s c o p y . H o w e v e r , i t s h o u l d a l w a y s b e l e f t t o a m e d i c a l p r a c t i t i o n e r f o r a b e t t e r u n d e r s t a n d i n g o f t h e r e s p e c t i v e c a s e s . A n o t h e r m e t h o d i s a b i o p s y , w h i c h c a n b e a n e e d l e b i o p s y , a n o p e n b i o p s y , o r a t h o r a c o s c o p y , w h e r e a m i n i c a m e r a i s i n s e r t e d i n s i d e t h e b o d y a n d w i t h t h a t a t i s s u e s a m p l e i s a t t a i n e d f o r f u r t h e r d i a g n o s i s .
T r e a t m e n t o f P l e u r a l M e s o t h e l i o m a
T r e a t m e n t i s d i r e c t l y p r o p o r t i o n a l t o t h e t i m e o f t h e r e v e l a t i o n o f t h e d i s e a s e , i . e . , a t a n e a r l y s t a g e t h e t u m o r c a n b e r e m o v e d t h r o u g h s u r g e r y .
A p i o n e e r i n g m e s o t h e l i o m a t r e a t m e n t o p t i o n i s i m m u n o t h e r a p y , e . g . , i n t r a p l e u r a l i n o c u l a t i o n o f B a c i l l u s C a l m e t t e - G u e r i n ( B C G ) i s a u s e f u l m e s o t h e l i o m a t r e a t m e n t i n w h i c h a n e f f o r t i s m a d e t o i n t e n s i f y t h e i m m u n e r e s p o n s e .
R a d i a t i o n t r e a t m e n t a n d c h e m o t h e r a p y i s p r o b a b l y t h e n t h e a n s w e r t o t h e m a l i g n a n t p l e u r a l m e s o t h e l i o m a , b u t t h i s c a n a i d t h e p a i n m a n a g e m e n t o n l y ; t h e r e ' s n o e s c a p i n g d e a t h w i t h P l e u r a l M e s o t h e l i o m a .
S i d e e f f e c t s o f T r e a t m e n t
T h e s i d e e f f e c t s a n d p e n a l t y o f m e s o t h e l i o m a l u n g c a n c e r t r e a t m e n t a r e m o r e t h a n i t s t r e a t m e n t , w h i c h i s d a m a g e d h e a l t h y t i s s u e s , a s t a t e o f a b s o l u t e f a t i g u e n e s s ; e x c e s s i v e r a d i a t i o n c a u s e s t h e s k i n t o b e c o m e r e d , d r y a n d i t c h y .
O t h e r s i d e e f f e c t s o f r a d i o t h e r a p y a r e n a u s e a a n d v o m i t i n g , d i a r r h e a , u r i n a r y d i s c o m f o r t a n d a s u d d e n r e d u c t i o n i n t h e n u m b e r o f w h i t e b l o o d c o r p u s c l e s .
T h e a v e r a g e l i f e s p a n o f a p e r s o n w i t h P l e u r a l M e s o t h e l i o m a i s u p t o 6 m o n t h s t o a y e a r a n d t h e m a x i m u m c a n r e a c h u p t o 5 y e a r s - t h e m a g n e s i u m - s i l i c a t e m i n e r a l f i b e r s t a k e i t s t o l l t h a t ' s m o r e t h a n p a i n f u l .
O t h e r f a c t o r s t h a t m a y a c c e l e r a t e t h e p o s s i b i l i t y o f p l e u r a l m e s o t h e l i o m a a r e c h r o n i c l u n g i n f e c t i o n s , t u b e r c u l o u s p l e u r i t i s , r a d i a t i o n ( T h o r o t r a s t ) , e x p o s u r e t o t h e s i m i a n v i r u s 4 0 ( S V 4 0 ) o r m i n e r a l f i b e r s ( Z e o l i t e ) a n d t o b a c c o s m o k i n g t o a c e r t a i n e x t e n t .
P l e u r a l M e s o t h e l i o m a d o e s n o t g i v e a p e r s o n t h e a v e n u e f o r f a i r p l a y . T h o u g h t h e e x i s t e n c e d e p e n d s m u c h o n t h e v a r i o u s s t a g e s o f t h e d i s e a s e , i t i s a n u l t i m a t e k i l l i n g m e n a c e t h a t s u c k s o u t t h e l i f e o f t h e c o m m o n m a n .
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