What is Mesothelioma ?

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What is Mesothelioma ?

What is Mesothelioma ?

Mesothelioma is a very rare cancerous tumor reaching the mesothelium cells. It is one of the recognized occupational diseases because it is caused in the vast majority of cases by exposure to asbestos. However, it can occur in people who have never been exposed to asbestos.

It ‘s hard to diagnose because the first symptoms do not appear in the early stages of the disease.

What is Mesothelioma?

Mesothelioma is a very rare form of cancer. It begins in the mesothelium, the latter being a membrane covering and protecting most of the internal organs of the body.

There are different forms of mesothelioma:

  1. Pleural Mesothelioma: This is the most common known form of mesothelioma, affecting the pleura, i.e., the lining of the lungs. It accounts for about 70-80% of all cases of mesothelioma.

  2. Peritoneal mesothelioma: affecting the peritoneum, the envelope of the abdominal cavity. It accounts for 25% of mesothelioma cases.

  3. Pericardial mesothelioma: touching the envelope of the heart, the pericardium.

Mesothelioma of the vaginal tunic developing in the testicle envelope. Mesothelioma affects men more often than women.
There are benign tumors of the mesothelium as well as fibrous tumors of the pleura, also mild but can develop symptoms resembling those of malignant mesothelioma. We can also talk about multi-cystic mesothelioma when several benign cysts affect the peritoneum. Finally, there are adenomatoid mesotheliomas: benign tumors growing in the mesothelium of the reproductive organs.

There are three cellular subtypes of mesothelioma:

Epithelioid (epithelial), which accounts for 50-60% of all mesotheliomas; Sarcomatoid (fibrous) which accounts for about 10% of mesotheliomas; Mixed (of biphasic type) which represents the rest of the mesotheliomas.

Causes and risk factors for mesothelioma

  • In the case of mesothelioma, causes and risk factors are closely entangled. Indeed, asbestos is recognized as the major cause of mesothelioma. And so, the occupational exposure to asbestos is a risk factor; Indeed, even minor exposures have been reported as triggers for mesothelioma.

  • Mesothelioma occurs 15 to 40 years after exposure to asbestos, which explains why its incidence increases from 50 years.

  • Moreover, in Europe, asbestos has been banned since 1997, the number of cases is expected to peak around 2020.

The other potential causes are:

  • Erionite (natural mineral substance);

  • Ionizing radiation (during radiotherapy );

  • The mutation of the BAP 1 gene.

Good to know: if smoking increases the risk of lung damage, it does not affect the risk of mesothelioma. On the other hand, it multiplies the risks in case of exposure to asbestos.

Mesothelioma: Diagnosis and symptoms

The signs of the disease are often spotted late because they are not very evocative.

For pleural mesothelioma, one can cite:

  • Chest pain;

  • Neuralgia in the arm;

  • Pain in the back or scapula;

  • A persistent cough;

  • The pleural effusion accompanied by shortness of breath is more evocative.

Symptoms for peritoneal mesothelioma:

  • Abdominal pain;

  • Abdominal swelling;

  • Nausea;

  • Vomiting;

  • Intestinal obstruction;

  • weightloss.

Unfortunately, these symptoms can come from other pathologies; the diagnosis is often delayed. In 95% of the cases, a pleural effusion occurs, prompting the consultation of a doctor.
During the diagnostic process, many examinations can be carried out, aiming at different conclusions:

Chest radiographs to confirm pleural effusion;

  • Computer-aided tomography (CT);

  • MRI, to assess the magnitude of a tumor;

  • Positron emission tomography (PET): the gold standard for determining the site of the mesothelioma and its stage;

  • Analysis of fluids;

  • Tissue analysis;

  • Ultrasound.

Determining the stage of mesothelioma is also important to evaluate the future effectiveness of the treatment. This stage is part of a classification: the international classification system TGM for diffuse malignant pleural mesothelioma. For the other mesotheliomas, the general TGM is used for cancer.

Good to know: it is difficult to tell the difference between a pleural mesothelioma and lung cancer.

Treatment of Mesothelioma

Each patient is a unique case, and as such, many treatments are possible, including by combining several techniques. The treatment of mesothelioma is very difficult.

The different options are:

  • Surgery ;

  • Chemotherapy;

  • Radiotherapy;

Integrating ongoing clinical trials for the development of new drugs.
There are two surgical approaches for pleural mesothelioma: pleurectomy / decortication and extrapleural pleuropneumonectomy. These are two highly specialized surgeries that are not possible in all hospitals.
The prognosis and survival associated with mesothelioma depend on many factors: medical history, age, type and stage of mesothelioma, treatment chosen and reaction to treatment. Nevertheless, mesothelioma has rather dark statistics regarding prognosis and survival.
Rare but virulent cancer, mesothelioma develops in the membranes surrounding the internal organs. It affects mostly the pleura (about 80% of cases) and is due in about 85% of cases to exposure to asbestos. Because of this, it is cancer whose professional link has been established. Of diagnosis and treatment complex, there remains cancer whose prognosis and survival at one year, at five years, are particularly dark.