Pleural Mesothelioma

Defined as an asbestos-related cancer of the mesothelium in the lungs. It accounts for 3 out of 4 (75%) mesothelioma diagnoses because most asbestos fibers are inhaled, which lodges it into the lining of the lungs.  Pleural mesothelioma begin in cells that line the sacs of the chest (pleura).  Once the cancer invades this outer lining of the internal chest wall and lungs, it becomes known as pleural mesothelioma.

Pleural mesothelioma is often difficult to detect and currently a CT scan of the chest is the best way for assessing how far the disease has progressed. Many cancers are diagnosed by serum markers, however, mesothelioma cannot be diagnosed this way as currently no serum markers exist.

Pleural Mesothelioma Symptoms

Mesothelioma in general is difficult to diagnose because there are no real symptoms in the early stages. Furthermore, once symptoms do start to develop, they are often mistaken for common illnesses.  Early symptoms include coughing, muscle weakness, night sweats, fever, and fatigue. Unfortunately, early symptoms go undiagnosed or misdiagnosed until further warning signs become apparent from more serious symptoms. It is important to see your doctor if you have or develop any of these symptoms listed above, especially if you have also been exposed to asbestos in the past.

Symptoms of pleural mesothelioma

  • Shortness of breath
  • Fatigue
  • Chest pain
  • Unexplained weight loss
  • Persistent cough
  • Sweating
  • Hoarse voice
  • Difficulty swallowing
  • Changes in shape of fingers/nails

Advanced Stages Of Mesothelioma Symptoms

  • Nerve problems
  • Bone pain
  • Horner’s syndrome
  • Hypoglycemia
  • Nerve problems in the arm
Mesothelioma symptoms often don’t emerge until about 20 to 50 years after initial exposure, and the symptoms do not appear until the disease has progressed into advanced stages. Pleural mesothelioma is the only type of this cancer that is classified into stages.

The 4 Stages Of Pleural Mesothelioma

Pleural Mesothelioma Stages

The staging for pleural mesothelioma is different from peritoneal (abdominal) mesothelioma. Doctors use four stages to describe how mesothelioma grows. Patients in stage 1 or 2 have the most treatment options. Patients with stage 3 or 4 can use palliative treatments to improve their quality of life.

Stage 1 Pleural Mesothelioma

The least serious stage is stage l.  No lymph node involvement, and the patient usually qualifies for extrapleural pneumonectomy.  This surgery attempts to remove the tumor and as much of its growth as possible. Highest rate of survival.

Stage 2 Pleural Mesothelioma

In stage ll, the tumor has become larger and it has invaded the diaphragm or the lung. Lymph nodes may now be involved. Doctors may mistake the signs of this stage of mesothelioma for other illnesses, such as the flu.  Patients at this stage have likely lost weight but still feel bloated. Surgical resection may still be possible

Stage 3 Pleural Mesothelioma

In Stage lll, the mesothelioma has now invaded an area of the chest wall or other region such as the esophagus, chest wall or the lymph nodes. At this time surgery is usually ruled out as a beneficial treatment.  Patient usually will be suffering from sever chest pains along with discomfort throughout the body.

Stage 4 Pleural Mesothelioma

Stage lV mesothelioma has now invaded multiple areas of the body including the diaphragm, pericardium, lymph nodes and other organs. The cancer may also be present in the bloodstream, liver, or bones as well. Surgical option is no longer feasible. Chemotherapy & radiation treatments are now used to extend the life of the patient and provide symptom relief.

Mesothelioma Stages Video

Mesothelioma Stages are a 4-tier classification of the location, extent and severity of the cancer. Doctors use four primary stages to determine the seriousness of a diagnosis of mesothelioma. There four stages are, Stage l, ll, lll, or lV. A lower number means you have more treatment options and a better chance for long-term survival.

Pleural mesothelioma, pericardial, peritoneal and testicular mesotheliomas do not share a universal staging system. These diagnoses are rare and there are not enough cases to accurately describe them using stages.

Patients diagnosed with peritoneal or pericardial mesothelioma are usually categorized as having localized or advanced mesothelioma. A doctor with experience treating mesothelioma can determine how far the cancer has spread and what treatment options will work best.

Learn More About The 4 Stages Of Mesothelioma.

Traditional Pleural Mesothelioma Treatment Options

Surgery Options For Pleural Mesothelioma

Surgery to remove the mesothelial lining of the lung and chest cavity.

A procedure that uses drugs or chemicals in order to make a scar between the layers of the pleura. Fluid is drained from the space first with a chest tube, then the chemical is put into that space. The subsequent scarring will stop the buildup of fluid inside the pleural cavity.

Surgery to remove all or part of a lung.

Surgery that removes a whole lung and some of the lining of the diaphragm, chest and the sac that is around the heart.

Also known as pleuroscopy, this is a procedure where a thoracoscope is introduced through a tiny incision in the chest. Through other small incision, an endoscope is inserted to obtain internal images and videos. When surgeons perform thoracoscopy to aid another surgery, it is termed as video-assisted thoracoscopic surgery or VATS.

This is an extensive surgical procedure that exposes the patients’ lungs, heart, diaphragm, and trachea to the doctor. It is a 4 to 10-inch long incision made on any side of the chest. It helps the doctor to perform wedge resection, lobectomy, pneumonectomy, segmentectomy, extrapleural pneumonectomy and pleurectomy/decortication like major surgical treatments to manage the lung cancer.

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Resources:

  1. D. G. West and W. S. Walker. Staging malignant pleural mesothelioma: additional investigation may not improve accuracy
  2. European Journal of Cardiothoracic. Surgery., May 1, 2011; 39(5): 800 – 800.
  3. De Perrot M, Uy K, Anraku M, Tsao MS, Darling G, Waddell TK, Pierre AF, Bezjak A, Keshavjee S, Johnston MR. Impact of lymph node metastases on outcome after extrapleural pneumonectomy for malignant pleural meso-thelioma. J Thorac Cardiovasc Surg 2007;133(1):111—6.
  4. Ismail-Khan, Roohi. Robinson, Lary D. Malignant Pleural Mesothelioma: A Comprehensive Overview. Cancer Control: Journal of the Moffit Cancer Center. 2006; 13(4):255-263.
  5. O’Bryne, K and Rusch V. (2006). Malignant Pleural Mesothelioma New York.
  6. Mesothelioma Symptoms. Mayo Clinic. Retrieved From: http://www.mayoclinic.com/health/mesothelioma/DS00779/DSECTION=symptoms.
  7. Diagnosing and Treating Mesothelioma. American Lung Association. Retrieved From: http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/mesothelioma/diagnosing-treating-mesothelioma.html.

Last Modified: Dec 31, 2016 @ 2:19 am

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