Mesothelioma - Symptoms, causes and treats

Mesothelioma is a cancer that attacks the mesothelium, the tissue that lines various organs of the body. There are four types of mesothelioma cancer, namely:
  1. Pleural mesothelioma (pleural mesothelioma), which is a cancer that attacks the lining of the mesothelium (pleura). This type is the most common type.
  2. Mesothelioma peritoneum (peritoneal mesothelioma), namely mesothelioma of the lining of the abdominal cavity (peritoneum).
  3. Mesothelioma pericardium (pericardial mesothelioma), which is mesothelioma which attacks the protective layer of the heart organ.
  4. Testicular mesothelioma, which is a mesothelioma that attacks the protective layer of the testicles or testicles.

There is a benign tumor in the chest called the solitary fibrous tumor which is sometimes called benign mesothelioma. This condition is not included in mesothelioma which will be discussed.

Causes of Mesothelioma

The cause of mesothelioma is not certain. However, mesothelioma is always associated with asbestos exposure or asbestos. Asbestos is a mineral that is widely used as a building construction material, such as roofs, because of its heat resistance and fire resistance. The use of asbestos has been officially banned since 1999.

When asbestos is destroyed, either during the process of mining or renovating a building, asbestos will produce fiber or fine dust. Asbestos fine fiber is very easy to breathe, then enters and settles in body organs, especially the lungs. Swallowed asbestos fibers can also move through the lymphatic system, settle, and infect cells in the lining of the abdominal cavity (peritoneum).

Asbestos exposure can also affect the function of the reproductive organs and the heart. However, the spread process is not yet known because it is very rare.

In general, there are several factors that increase the risk of mesothelioma, namely:
  • Work environments that are vulnerable to asbestos exposure, such as mineral mines, construction sites, the automotive industry, power plants, the textile industry and steel mills.
  • Residing in old buildings or environments where the land contains asbestos.
  • Have family members who work in environments that are vulnerable to asbestos exposure. Asbestos can be attached to the skin and clothing, so that asbestos can be carried into other homes or environments.
  • Having a history of mesothelioma or genetic disorders that increase the risk of cancer.

Apart from asbestos, there are several other factors that can increase the risk of mesothelioma, although it is rare. These include exposure to erionite minerals, radiation exposure to thorium dioxide chemicals used in X-ray photo examinations until the 1950s, and infection with simian viruses (SV40).

Symptoms of Mesothelioma

Symptoms of mesothelioma develop gradually and usually take 20-30 years until symptoms appear. Patients may not feel any symptoms when mesothelioma is at an early stage. But over time, cancer cells will develop and suppress nerves or other organs, causing symptoms.

Symptoms of mesothelioma differ depending on the location of the presence of cancer cells. In pulmonary mesothelioma, symptoms that may appear are as follows:
  • Fever is accompanied by sweat, especially at night.
  • Excessive fatigue.
  • Cough accompanied by unbearable pain.
  • Shortness of breath due to accumulation of fluid in the lungs, precisely in the pleural cavity, which is a room between the two layers of pleura that lines the lungs.
  • Weight loss without obvious reasons.
  • Chest pain.
  • Swelling and changes in shape at the fingertips (clubbing).
  • Lumps appear on the tissue beneath the surface of the skin in the chest area.

Meanwhile, peritoneal mesothelioma has the following symptoms:

  • Loss of appetite.
  • The weight dropped dramatically.
  • Diarrhea.
  • Constipation.
  • Pain in the abdomen.
  • Swelling in the abdominal area.
  • A lump in the abdomen appears.
  • Disorders of bowel movements and urination.

Mesothelioma pericardium and testis are types of mesothelioma that are very rare. Mesothelioma pericardium usually causes symptoms such as chest pain and respiratory disorders, while testicular mesothelioma is characterized by swelling or the appearance of lumps in the testicular area.

Symptoms of mesothelioma are not specific and can be caused by other conditions. Therefore, immediately see a doctor if you feel the symptoms above, especially if you have a history of exposure to asbestos.

Mesothelioma diagnosis

The doctor will suspect a patient has mesothelioma, if there are symptoms, which are strengthened by a physical examination. But to make sure, an imaging test is needed. Among others are:

  • X-rays, to detect abnormalities, such as thickening in the lung layer, fluid in the pleural cavity, or changes in lung shape.
  • CT scan, to examine the chest and abdomen, and detect signs of cancer, determine the location of the cancer, and check whether the cancer has spread to other organs.
  • PET (Positron Emission Tomography). Examination by using compounds containing radioactive atoms that are injected into the body to get a detailed picture of the tissue suspected of having cancer cells.
  • MRI, to get a more detailed picture of the tissue to determine the location of the tumor.

In addition, the doctor can also suggest a follow-up examination in the form of:

  • Examination of fluid samples. If the patient experiences fluid buildup in the body related to mesothelioma, the doctor will take a liquid sample using a needle inserted through the skin into the area where the liquid is located. Furthermore, the fluid will be analyzed in the laboratory to detect the presence of cancer cells. There are several types of fluid and tissue sample tests, namely:
  • Thoracentesis, taking fluid samples in the area of ​​the pleural cavity.
  • Paracentesis, taking fluid in the abdominal cavity.
  • Pericardiocentesis, taking fluid in the layer (membrane) around the heart.
  • Biopsy, which is the procedure for removing tissue samples from certain body parts to be analyzed in the laboratory. There are several types of biopsy examinations, namely:
  • Needle biopsy. This type of biopsy uses a long needle inserted through the skin into the chest or abdominal cavity to take tissue samples.
  • Thoracoscopy, laparoscopy, and mediastinoscopy. This type of biopsy uses an elastic hose with a camera and a special surgical device that is inserted through one or more small incisions to take tissue samples. The type of procedure for removing samples generally depends on the area of ​​the body undergoing the examination, namely:
  • Thoracoscopy, to examine the space between the lung and the chest wall.
  • Laparoscopy, to examine the inside of the abdominal organs.
  • Mediastinoscopy, to examine the area around the heart.
  • Biopsy through surgery. For some conditions, the doctor will perform an invasive procedure to take larger tissue samples to determine the diagnosis. Sometimes, the doctor will also do the procedure to remove the entire tumor if possible. There are two types of biopsy procedures through surgery, namely:
  • Thoracotomy, which is a type of biopsy performed through open surgery on the chest.
  • Laparotomy, which is a type of biopsy performed through open surgery in the abdomen.
  • Bronchoscopic biopsy. Procedure for removing tissue samples using a long, thin elastic tube inserted through the throat to examine the respiratory tract.

Mesothelioma Stadium

Based on the level of spread, mesothelioma is divided into four stages. The division of this stage allows the doctor to identify the development of cancer cells in the body and determine the treatment steps to be taken. The four stages of mesothelioma, namely:

  • Stage 1: Tumors are still local, ie only in one area of ​​the body and mesothelioma cells have not spread to other tissues or organs. Surgery is performed to remove the tumor. The life expectancy of patients diagnosed with stage 1 mesothelioma is 21 months or more.
  • Stage 2: Larger tumor size and mesothelioma cells begin to spread to nearby areas. Surgery to remove the tumor can still be done, even though the results are not very effective. Life expectancy for patients with stage 2 mesothelioma is 19 months or less.
  • Stage 3: Mesothelioma cells have spread to surrounding organs. Surgery is no longer effective because some cancer cells have spread to other areas. The life expectancy of stage 3 mesothelioma patients is around 16 months.
  • Stage 4: Mesothelioma cells have spread to various areas throughout the body through the bloodstream. Treatment that is still in the research stage will be offered to patients to extend the patient's life chances. The life expectancy of patients with end-stage mesothelioma is very low, which is around 12 months.


Mesothelioma treatment

Mesothelioma is one type of cancer that is rare and has not been cured until now. Treatment is done to control or reduce the symptoms experienced and extend the patient's life chances. Treatment steps are generally determined based on several factors, namely:

  • Age and overall health condition of the patient.
  • Type and location of mesothelioma.
  • Stadium or spread of cancer cells in the body.
  • Size of mesothelioma

Based on the considerations above, there are several treatment steps that might be recommended by doctors, namely:

  • Chemotherapy, therapeutic treatment with anticancer drugs to destroy or inhibit the growth of cancer cells that cannot be removed through surgery. Chemotherapy can be done before or after surgery to shrink the tumor, facilitate the process of removing the tumor, and reduce the risk of cancer reappearing.
  • Radiation therapy (radiotherapy), therapeutic treatment with X-rays and proton rays that are focused on certain areas of the body. Radiotherapy is usually done after the patient has undergone an operating procedure, to remove the remaining cancer cells. This treatment therapy is also done to reduce the symptoms of advanced cancer when surgery is not possible.
  • Operation. Surgery is done when mesothelioma is still in its early stages. There are several choices of actions that the doctor may take during surgery. Among others are:
  • Removal of cancer cells as much as possible from the patient's body. This action can support the treatment of patients with radiotherapy to reduce pain and inhibit cancer growth.
  • Suction of fluid due to fluid buildup in the chest area which can interfere with breathing. This is done by inserting a catheter tube into the chest to suck up the liquid. Doctors can also inject drugs to glue the pleural cavity so that the fluid cannot accumulate again. This action is known as pleurodesis
  • Removal of tissue around the abdominal cavity, ribs, or lung affected by cancer cells.
  • Removal of affected lung organs and surrounding tissues. This procedure is usually followed by radiotherapy.
  • Multimodality therapy. This therapy is a combination of three or more treatment steps, such as surgery, postoperative chemotherapy and radiation therapy to increase the success rate of treatment.
  • Research phase. The doctor will inform the patient about the treatment method that is still in the research stage. However, the possibility of a patient to recover is not yet known with certainty, so it needs to be carefully considered. On the other hand, this method of treatment can increase the chance of doctors to learn more about the treatment of mesothelioma. There are several methods of treatment that are still in the research phase that can be carried out by patients, namely:
  • Biological therapy - using the patient's immune system to fight cancer, also called immunotherapy.
  • Gene therapy - changes the gene contained in cancer cells to stop this disease.
  • Target therapy - use drugs to attack abnormalities that occur in cancer cells.
  • Supporting treatment. This treatment can help sufferers in controlling the signs and symptoms of mesothelioma, such as:
  • Breathing exercises, to control breathing when the patient experiences symptoms of difficulty breathing.
  • Body relaxation exercises, to reduce breathing muscle tension, so that patients can breathe more easily.

Prevention of Mesothelioma

The main preventive action of mesothelioma is to avoid contact with everything that contains asbestos. If you work in a high-risk environment exposed to asbestos, then follow the safety regulations set by the company. Among others are:

  • Use personal protective equipment while in a work area that is vulnerable to exposure to asbestos.
  • Dispose of the remaining asbestos material in a safe place and not endanger the environment.
  • Do not bring home the clothes and shoes used during work

In addition, there are several things that can be done to reduce the risk of mesothelioma, namely:

  • Perform routine health checks to detect symptoms or signs of asbestos-related diseases.
  • Quit smoking. Cigarettes do not directly cause mesothelioma, but cigarettes are a trigger factor and can increase the risk of various types of cancer, including mesothelioma.
  • Learn and follow instructions on handling safe asbestos in the surrounding environment. Do not move material that contains asbestos carelessly.