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Pleural Mesothelioma

Pleural mesothelioma is one of the common types of cancer. Mesothelioma is observed more frequently than childhood leukemias or melanomas. The primary cause of pleural mesothelioma is the inhalation of asbestos fibers into the body. Industries such as shipbuilding, insulation, brakes, and construction have a higher risk of exposure to asbestos, making them susceptible to pleural mesothelioma. However, asbestos can also be found in nature which can lead to pleural mesothelioma in people living in these areas. The Department of Thoracic Surgery of Uniqacare provided information about pleural mesothelioma.

What is pleural mesothelioma?


The chest cavity contains lung tissue. The lung is covered by a very thin membrane similar to an onion skin, which also extends to the inner side of the ribs. The cancer that develops in this membrane is called pleural mesothelioma.


What are the symptoms of pleural mesothelioma?


Pleural mesothelioma (Mesothelioma) typically manifests with the development of fluid around the lungs, which is commonly known as pleural effusion. The presence of pleural mesothelioma (Mesothelioma) on a specific side can cause a dull ache on that side. Coughing is a rarer symptom in pleural mesothelioma cases. Patients may experience shortness of breath due to the accumulation of fluid in the lungs. A sensation of chest discomfort can also be a sign of pleural mesothelioma. Early-stage symptoms of pleural mesothelioma are uncommon. Pleural mesothelioma differs from lung cancer in several ways, including its symptoms. When pleural mesothelioma presents with fluid accumulation, it's usually in the second stage.


The symptoms of pleural mesothelioma (Mesothelioma) include:

  • Pleural effusion (fluid accumulation around the lungs)

  • Shortness of breath

  • Pain

  • Unexplained weight loss

  • Occasionally, cough similar to lung cancer


What are the causes of pleural mesothelioma?


"What causes pleural mesothelioma (Mesothelioma)?" and "What are the causes of pleural mesothelioma (Mesothelioma)?" are among the topics that patients are curious about.


Among the causes of pleural mesothelioma (Mesothelioma), asbestos is the most significant factor. Although very rarely, developments related to viruses can also contribute to the development of pleural mesothelioma (Mesothelioma). Despite asbestos exposure being the most important factor, pleural mesothelioma (Mesothelioma) is not an uncommon disease. Industries such as shipbuilding, insulation, construction, hardware stores, brake manufacturing, and tank manufacturing, as well as individuals who have worked in these sectors, lived near these workplaces, or worked in the construction industry, have a higher risk of asbestos exposure, hence a higher likelihood of developing pleural mesothelioma.

For pleural mesothelioma to manifest, there is typically a latency period of about 10 years after asbestos exposure. Individuals who were exposed to asbestos in their early adulthood may develop pleural mesothelioma many years later.


Asbestos exposure is not limited to industrial sectors. Natural inhalation of asbestos fibers can lead to the development of pleural mesothelioma.


Living with someone who has been exposed to asbestos can also cause pleural mesothelioma. Individuals exposed to asbestos can carry its fibers on their skin or clothing into their homes. This type of exposure can increase the risk of pleural mesothelioma. People who work extensively with asbestos in their workplaces can reduce the risk of bringing asbestos fibers home by showering and changing clothes before leaving work.


Direct contact with asbestos on the skin does not cause pleural mesothelioma. In order for asbestos to contribute to the development of pleural mesothelioma, it needs to be inhaled through the respiratory system.


How is pleural mesothelioma diagnosed?

If a person shows symptoms of pleural mesothelioma and has been in contact with asbestos for a prolonged period, a Computerized Tomography (CT) scan is initially conducted for imaging. To further confirm the diagnosis of pleural mesothelioma, a biopsy is taken from the patient using a method called Thoracoscopy, and the sample is sent to the laboratory.


What are the treatment methods of pleural mesothelioma?


Effective planning is crucial in the treatment of pleural mesothelioma. Expertise, careful monitoring, and a multidisciplinary approach are essential in treating pleural mesothelioma. While surgical methods are prominent in treating pleural mesothelioma, approaches like chemotherapy, radiation therapy, and immunotherapy are also employed.


In the past, surgical procedures for pleural mesothelioma involved the complete removal of both the lung and the lung lining. However, recent studies have shown that removing only the lung lining is sufficient. Subsequently, chemotherapy and, if necessary, radiation therapy are administered. The sequence of treatment can vary for some patients. In recent years, immunotherapy, which focuses on the immune system, has been effectively utilized in treatment.


FREQUENTLY ASKED QUESTIONS ABOUT PLEURAL MESOTHELIOMA

What are the types of pleural mesothelioma?


Pleural mesothelioma generally has 3 types:

  • Epithelioid

  • Sarcomatoid

  • Biphasic (Mixed type)

Unlike lung cancer, pleural mesothelioma does not have small cell or large cell types.


What is the difference between pleural mesothelioma and lung cancer?


The difference between pleural mesothelioma and lung cancer is not only where they originate. The cells of pleural mesothelioma are different from those of lung cancer. During the development of the human body, stem cells that form internal organs are distinct. Stem cells forming the pleura and nerve tissues differ from each other.


While lung tissue doesn't have pain receptors, the pleura contains pain receptors.

Another distinction between pleural mesothelioma and lung cancer is their pattern of growth. Due to the entire pleura covering the chest cavity, pleural mesothelioma does not develop in a single point like lung cancer. It affects the entire chest cavity, covering a wide area.


What are the stages of pleural mesothelioma?


The stages of pleural mesothelioma are not as sensitive in indicating a patient's chances of recovery compared to lung cancer. They can differ from the classical cancer staging. Particularly, stages other than stages 1 and 4 can show variations in terms of survival.


In general, pleural mesothelioma has 4 stages:

  • Stage 1: Tumor is confined to the pleura with minimal thickening.

  • Stage 2: Tumor has spread to the chest wall, heart, and esophagus lining.

  • Stage 3: Tumor has extended beyond the diaphragm and into the abdominal lining, with possible lymph node involvement.

  • Stage 4: Tumor has metastasized to other organs.


What is the life expectancy of pleural mesothelioma?


The life expectancy of pleural mesothelioma patients can vary based on the stage of the disease, the treatment received, and the patient's response to treatment. The life expectancy of pleural mesothelioma can differ from patient to patient.


For a patient with pleural mesothelioma:

  • Without treatment: 8 months

  • With chemotherapy: 12-18 months

  • With multimodal treatment (including surgery): Average of 24 months


However, results can differ for each patient, especially with the use of immunotherapy in recent years, which has shown significant improvements in life expectancy for pleural mesothelioma.

The presented life expectancies can vary based on the patient's response to treatment.


What treatment options are available for pleural mesothelioma?


There are numerous treatment options for pleural mesothelioma. Due to the higher risk of recurrence, staging treatment options is important. Instead of using all treatment options simultaneously, a step-by-step approach according to the progression of the disease can yield better results.


Can targeted drugs be used in the treatment of pleural mesothelioma?


Immunotherapy, which has been increasingly used in recent years, has shown positive results in the treatment of pleural mesothelioma. Immunotherapy, particularly, has a greater effect on sarcomatoid and biphasic types of pleural mesothelioma.


Is there a herbal treatment for pleural mesothelioma?


The question of whether herbal therapy is beneficial for pleural mesothelioma is frequently raised by patients. According to scientific studies, there is no natural or herbal treatment for pleural mesothelioma. The most important preventive measure is avoiding asbestos exposure. Additionally, consuming products grown in asbestos-contaminated soil does not pose a risk


How should nutrition be for pleural mesothelioma?


In pleural mesothelioma, as with all cancers, it's important to have a diet low in carbohydrates and high in protein.


Does pleural mesothelioma metastasize?


In pleural mesothelioma, especially the sarcomatoid type can metastasize. The sarcomatoid type can often metastasize to bone, liver, brain, heart, and abdominal lining. The epithelioid type usually grows and recurs in the same area it originated from. It can also metastasize to the abdomen or opposite lung. Common areas of metastasis for pleural mesothelioma include the abdominal and heart linings.

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