Mesothelioma is an aggressive and rare cancer that accounts for approximately 3,000 cases per year in the United States. This guide will provide an in-depth overview of mesothelioma’s various types and cell variations, including symptoms, diagnosis, staging, treatment, prognosis, and survival statistics.
What is Mesothelioma?
Mesothelioma is a cancer that impacts the innermost lining of various body cavities or internal organs. The most common site it affects is the chest wall or the lungs. The only known cause of mesothelioma is asbestos exposure. Asbestos fibers become lodged in the mesothelial lining and cause genetic mutations over time that can lead to cancerous cell growth.
The symptoms of mesothelioma can take many years to develop after initial asbestos exposure and often include shortness of breath, chest pain, and fatigue or weight loss.
Mesothelioma has been notoriously difficult to treat over the years, with the typical prognosis being very poor. However, research continues to provide hope through emerging treatment options and a deeper understanding of the disease’s pathology. If you want to learn more about mesothelioma, you can visit sites such as Mesothelioma Hope that provide detailed and accurate information on this rare cancer.
Types of Mesothelioma Cancer
Pleural Mesothelioma
This is the most common form of this cancer, impacting the pleura, which is the mesothelial lining around the lungs. It accounts for about 80-90% of all mesothelioma diagnoses. Common symptoms of pleural mesothelioma include:
- Shortness of breath and difficulty breathing
- Persistent cough
- Chest pain and tightness
- Unexplained weight loss
- Swelling and lumps around the chest or abdomen
- Hoarseness
- Difficulty swallowing
Symptoms are often dismissed as being caused by less serious conditions. But any respiratory symptoms combined with a history of asbestos exposure should be evaluated for mesothelioma.
Diagnosis and Staging
Diagnosing pleural mesothelioma begins with imaging tests like CT scans, PET scans, MRIs, and chest X-rays. These help identify abnormalities in the pleura that may indicate cancer. But the only way to conclusively diagnose mesothelioma is through a biopsy. This involves taking a small tissue sample and examining the cells under a microscope.
Staging of pleural mesothelioma describes how far the cancer has progressed. Earlier stages that are confined to the pleura have better outlooks. Higher stages in which it has spread to lymph nodes and other organs are harder to treat.
Treatment
Treatment for pleural mesothelioma usually involves a multimodal approach using a combination of surgery, chemotherapy, and radiation. Early detection and effective treatments can prolong life expectancy.
Peritoneal Mesothelioma
This type affects the peritoneum, which is the lining around the abdominal cavity. It is a less common form of cancer, making up about 10-15% of all mesothelioma cases. Common symptoms of peritoneal mesothelioma include:
- Swelling and fluid buildup in the abdomen
- Abdominal pain and cramping
- Bowel obstruction
- Nausea and vomiting
- Weight loss
- Fever
- Anaemia
These symptoms often don’t appear until the cancer is in its later stages. Anyone with persistent abdominal issues and an asbestos exposure history should see their doctor.
Diagnosis and Staging
Diagnostic testing includes CT scans, MRIs, and PET scans of the abdomen. These help identify abnormalities in the peritoneum lining that may indicate cancer. As with pleural mesothelioma, a biopsy is required to confirm peritoneal mesothelioma under a microscope.
Once diagnosed, the cancer is staged from 1 to 4 based on size and spread. Earlier stage 1-2 cancers limited to the peritoneum have a better prognosis. Late stages 3-4 with metastasis have worse outlooks.
Treatment
Multimodal therapy, including surgery, chemo, and radiotherapy, is typically recommended for peritoneal mesothelioma.
Pericardial Mesothelioma
Pericardial mesothelioma, impacting the membrane around the heart, is extremely rare. It accounts for 1% of all mesothelioma cases. Possible manifestations include:
- Breathing difficulties
- Persistent cough
- Chest pain
- Palpitations
- Fever and night sweats
- Fatigue
- The buildup of fluid around the heart (pericardial effusion)
Symptoms may be vague and mistaken for heart disease or other conditions unless asbestos exposure is known.
Diagnosis and Staging
A definitive diagnosis is made by examining cells from pericardial fluid or tissue samples. Pericardial mesothelioma staging goes from 1 to 4 based on the extent of localized spread.
Treatment
Due to the rarity of this cancer, there are no standard treatment protocols. Multimodal therapy involving surgery, radiation, and chemotherapy may be used to attempt to extend life expectancy. Overall survival rates are poor, with most pericardial mesothelioma patients living 6-12 months after diagnosis.
Testicular Mesothelioma
This extremely rare type affects the tunica vaginalis, the innermost lining of the testis. It also accounts for 1% of all mesothelioma cases. Symptoms include:
- Swelling or lump in one testicle
- Pain or discomfort in the testicle or scrotum
- The feeling of heaviness in the scrotum
- Abdominal pain
- Low back pain
- Hydrocele (fluid buildup around the testes)
Diagnosis and staging
- Physical exam to check for lumps, swelling, and fluid buildup
- Ultrasound of the scrotum
- Blood tests for tumor markers
- Surgical biopsy to examine cells under a microscope
Staging is done based on how far the cancer has spread to nearby tissue. Often diagnosed at stage I or II since a lump is noticed early.
Treatment
The most common treatment is surgical removal of the affected testis, followed by chemotherapy or radiotherapy. Testicular mesothelioma has a better prognosis than other types. Early diagnosis and aggressive treatment are key.
The cell types of mesothelioma
The cell type provides information about how the cancer will likely grow and spread. All four types of cancer present with any of these types of cells. The three main cell variations of mesothelioma include:
Epithelioid mesothelioma
- Epithelioid is the most common cell type, making up about 50-70% of mesothelioma cases
- The cells resemble healthy mesothelial cells in their shape – similar to squashed spheres
- Grow relatively slowly compared to other cell types
- Epithelioid mesothelioma cells respond best to treatment, conferring a better prognosis
- Median survival is up to 23 months with treatment
Sarcomatoid mesothelioma
- Sarcomatoid cells account for about 10% of mesothelioma cases
- The cells appear spindle-shaped under a microscope
- This cell variety is the least responsive to treatment
- Sarcomatoid mesothelioma has the worst prognosis, with a median survival time of up to 11 months
Biphasic mesothelioma
- Biphasic cell mesothelioma has both epithelioid and sarcomatoid features
- It comprises about 20-35% of mesothelioma cases
- These cancers tend to progress faster than epithelioid but have better outcomes than sarcomatoid
- Median survival is up to 14 months
Conclusion
While mesothelioma has a poor prognosis, research is advancing, and patients should not lose hope. Catching it early and leveraging all available treatments provides the greatest chance for positive outcomes.
