cancer (malignant) cells are found in the sac lining the chest (the
pleura) or abdomen (the peritoneum). Most people with malignant
mesothelioma have worked on jobs where they breathed asbestos.
A doctor should be seen if a person has shortness of breath, pain in
the chest, or pain or swelling in the abdomen. If there are symptoms,
the doctor may order an x-ray of the chest or abdomen.
The doctor may look inside the chest cavity with a special instrument
called a thoracoscope. A cut will be made through the chest wall and
the thoracoscope will be put into the chest between two ribs. This
test, called thoracoscopy, is usually done in the hospital. Before the
test, the patient will be given a local anesthetic (a drug that causes
a loss of feeling for a short period of time). Some pressure may be
felt, but usually there is no pain.
The doctor may also look inside the abdomen (peritoneoscopy) with a
special tool called a peritoneoscope. The peritoneoscope is put into
an opening made in the abdomen. This test is also usually done in the
hospital. Before the test is done, a local anesthetic will be given.
If tissue that is not normal is found, the doctor will need to cut out
a small piece and have it looked at under a microscope to see if there
are any cancer cells. This is called a biopsy. Biopsies are usually
done during the thoracoscopy or peritoneoscopy.
The chance of recovery (prognosis) depends on the size of the cancer,
where the cancer is, how far the cancer has spread, how the cancer
cells look under the microscope, how the cancer responds to treatment,
and the patient's age.
Malignant Mesothelioma Treatment
There are treatments for all patients with malignant mesothelioma.
Three kinds of treatment are used:
Surgery (taking out the cancer)
Radiation Therapy (using high-dose x-rays or other high-energy rays to
kill cancer cells)
Chemotherapy (using drugs to fight the cancer)
Surgery is a common treatment of malignant mesothelioma. The doctor
may remove part of the lining of the chest or abdomen and some of the
tissue around it. Depending on how far the cancer has spread, a lung
also may be removed in an operation called a pneumonectomy. Sometimes
part of the diaphragm, the muscle below the lungs that helps with
breathing, is also removed.
Radiation therapy uses high-energy x-rays to kill cancer cells and
shrink tumors. Radiation may come from a machine outside the body
(external radiation therapy) or from putting materials that produce
radiation (radioisotopes) through thin plastic tubes in the area where
the cancer cells are found (internal radiation therapy).
If fluid has collected in the chest or abdomen, the doctor may drain
the fluid out of the body by putting a needle into the chest or
abdomen and using gentle suction to remove the fluid. If fluid is
removed from the chest, this is called thoracentesis. If fluid is
removed from the abdomen, this is called paracentesis. The doctor may
also put drugs through a tube into the chest to prevent more fluid
from accumulating.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be
taken by pill, or it may be put into the body by a needle in the vein
or muscle. Chemotherapy is called a systemic treatment because the
drug enters the bloodstream, travels through the body, and can kill
cancer cells throughout the body. In mesothelioma, chemotherapy may be
put directly into the chest (intrapleural chemotherapy).
Intraoperative photodynamic therapy is a new type of treatment that
uses special drugs and light to kill cancer cells during surgery. A
drug that makes cancer cells more sensitive to light is injected into
a vein several days before surgery. During surgery to remove as much
of the cancer as possible, a special light is used to shine on the
pleura. This treatment is being studied for early stages of
mesothelioma in the chest.
Recurrent Malignant Mesothelioma
Treatment depends on many factors, including where the cancer came
back and what treatment the patient received before. Mesothelioma
Clinical trials are testing new treatments.
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