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Mesothelioma: Causes, Symptoms, Treatment, and Prevention

by Lukman Paramadina (2020-07-13)


Mesothelioma: Causes, Symptoms, Treatment, and Prevention
Mesothelioma is a cancer that develops in the mesothelium, a layer of tissue that covers most of the organs in the body, such as the abdominal and thoracic cavities. But every 1 in 4 people with this disease starts in the chest cavity. Mesothelioma is an aggressive and deadly cancer. Treatment for this disease is available, but most cures for sufferers cannot be done.

Type of Mesothelioma

Most sufferers die from respiratory failure or pneumonia. Some other sufferers get small bowel obstruction when the tumor develops through the diaphragm, the muscle that separates the chest and the abdominal cavity. Few people die of heart complications when tumors attack the pericardium (the thin sacs that surround the heart) and the heart itself.

This disease consists of several types based on which part of mesothelium is affected, the following types and their explanations:
1. Pleural Mesothelioma (Lungs)

The first type is most often formed in the tissue surrounding the lungs (pleura). This is the most common form of aggressive disease. About 80 to 90% of all cases diagnosed are pleural.
2. Peritoneal Mesothelioma (Abdomen)

Is the second most common type of cancer that attacks the lining of the abdominal cavity (peritoneum). About 15% to 20% of all cases diagnosed with this type of mesothelioma.
3. Pericardial Mesothelioma (Heart)

Tumors form in the lining of the heart (pericardium). This cancer is very rare, which is about 1% of the total number of cancer cases.
4. Testicular Mesothelioma (Testicles)

This cancer develops in the testicular layer (tunica vaginalis) and is also classified as very rare, which is less than 1% of all cases. Medical literature also only explains about 100 cases.

Causes of Mesothelioma

Mesothelioma is a type of deadly cancer caused by breathing in asbestos fibers (asbestos). When asbestos fibers are small in the lining of the lungs, it can cause changes in cells that develop into cancer. Exposure to asbestos fibers in the workplace or household is at a higher risk of developing mesothelioma. Schools, construction sites and many other locations are also at risk.

Asbestos fiber can be found in household items, such as talcum powder, clay pots and paint. It is important to know all asbestos products and understand when you might be at high risk of exposure.

Asbestos fiber is the only cause of this cancer, at least about 90% of mesothelioma cases. However, researchers have discovered various other risk factors that can increase the risk of mesothelioma cancer, one of which is a history of smoking. Knowing better about the causes of this disease can help you prevent disease, increase awareness and and care.
How Does Asbestos Fiber Cause Cancer?

Asbestos fibers can be inhaled and eventually stick to the lining of the lungs, stomach or heart. This condition causes dangerous inflammation that forms tumors. Mesothelioma can develop into several types according to its location.

Asbestos causes DNA damage both directly and indirectly. Directly, asbestos interferes with the process of mitosis in cell division, which causes cell damage and mutation. While indirectly, asbestos causes mesothelial cells to release mutagenic reactive oxygen and nitrogen, which also causes mutations.
Cancer Risk Factors

In addition to exposure to asbestos fiber, there are various factors that can increase your risk of getting mesothelioma cancer, including:
1. Age

Mesothelioma is a cancer that only occurs in older people. About 91% of sufferers are 55 years old or older. However, it is important to note when symptoms appear. Although only in the elderly, younger adults are also at risk.
2. Gender

Mesothelioma is more risky in men than women. One potential cause is that work related to asbestos is dominated by men. The more men who work in mines and refineries, the more men experience symptoms of this disease.
3. Specific Diseases

Poor health increases the risk of various types of diseases, including this cancer. Weakened immune system makes it harder for the body to fight foreign substances. Patients with mesothelioma due to poor health can also complicate treatment choices and the body's ability to respond to treatment.
4. Genetic

BAP1 is a gene that fights tumors, and if the mutated gene will be more at risk for the tumor to develop. People who have a family with a genetic mutation in the BAP1 gene may be more susceptible to mesothelioma.
5. Smoking

Although there is no evidence that smoking is related to mesothelioma. However, not a few studies have shown that smokers are 50 to 90% more likely to experience lung cancer associated with asbestos. In fact, smokers who are exposed to asbestos are twice as likely to develop mesothelioma cancer.

The relationship between smoking, lung disease and various forms of cancer (especially lung cancer) is undeniable. Smoking can cause conditions in the lungs that make asbestos fibers more easily stick and cause inflammation and ultimately cause cancer. These conditions include:

    Weakening of lung tissue: Asbestos fibers can more easily get stuck in the lining of the lungs.
    Decreased overall health: Smoking can cause a number of other medical problems and can significantly reduce mesothelioma treatment options and patient life expectancy.
    Increased mucus production: Irritations in the airways cause them to produce more mucus. This obstructs the airway and affects the lung's ability to cleanse itself.
    
Symptoms of Mesothelioma

Symptoms tend to develop gradually over time, and symptoms appear after not appearing after exposure to asbestos for decades. Symptoms of mesothelioma in general include:

    Chest pain
    Difficulty breathing (dyspnea)
    Cough
    difficulty swallowing (dysphagia)
    Stomach ache and swelling
    Anemia
    Fatigue
    Fever and night sweats
    Fluid buildup (pleural effusion or peritoneal effusion)
    Hoarseness
    Low oxygen level (hypoxemia)
    Muscle weakness
    Respiratory complications
    Weight loss without cause

When to see a doctor?

If you feel the signs and symptoms above are worrying. The signs and symptoms of this disease are not specific because they are rare and are more likely to be related to other health conditions.

If signs and symptoms persist that appear unusual or interfere with health, consult your doctor to find out the cause. Also, tell your doctor if you are exposed to asbestos fibers.
Complications

Pleural mesothelioma that spreads in the chest will put pressure on the structure in the area. This condition can cause complications, such as:

    Difficulty breathing
    Chest pain
    Trouble swallowing
    Pain due to pressure on the nerves and spinal cord
    Accumulation of fluid in the chest (pleural effusion), which can compress the lungs and have difficulty breathing

Diagnosis

When the body shows symptoms of mesothelioma, the doctor will do a physical examination, look at the medical history and begin to rule out more common diseases and conditions. The doctor will then carry out a series of tests and the following procedure to find out the cause of the symptoms.
1. Biopsy

This procedure involves taking a small amount of tissue for examination in a laboratory. This test is the only way to determine whether you have mesothelioma cancer. Depending on the area of the body affected, the doctor will choose the right biopsy procedure.
2. Scanning

Tests that help identify tumors, tumor location and cancer metastases (spread of cancer) during the diagnostic process. The most common scans used to diagnose mesothelioma, include:

    X-ray

X-rays can make 2D images of bones and soft tissue to identify abnormalities and help overcome other conditions. Chest X-rays or abdominal X-rays are the most commonly performed, and can find common mesothelioma such as pleural effusion or abdominal ascites (fluid buildup around the lungs or stomach).

    CT scan

Computed tomography (CT) scans make 3D visuals of your body, distinguishing abnormalities in normal organs and tissues. This test is used as an important tool for the diagnosis of all types of mesothelioma and to be followed up after treatment.

    MRI scan

Magnetic resonance imaging (MRI) makes detailed 3D images of bone and soft tissue, normal tissue images and makes mesothelioma cancer images clear. MRI imaging serves to detect cancer attacks to the surrounding tissue, as part of the stage and pre-surgical examination.

    PET scanning

Positron emission tomography (PET) is a test to produce images of mesothelioma cancer by using nuclear imaging technology to identify high metabolic activity of cancer cells and distinguish between normal and cancerous tissue. This scan helps show metastasis to nearby lymph nodes or other areas of the body.

    Ultrasound

Ultrasonography (USG) is a test that provides a direct view of the body, shows organs, vessels and tissues, and helps identify tumors after symptoms appear. In mesothelioma, this type of scan is used to identify pleural effusion bags or ascites that may need to be drained.
Cancer Stage

Cancer stage refers to the process of categorizing malignant mesothelioma according to the level of disease in the body. Stages of cancer by stage include:

    Stage I: Mesothelioma cancer cells are in the mesothelial layer. Usually surgery is an option.
    Stage II: Cancer cells enter the lymph nodes. Surgery also remains an option.
    Stage III: Cancer cells spread to nearby organs and distant lymph nodes. Surgery may be an option. Chemotherapy is also more common at this stage.
    Stage IV: Cancer cells have metastasized throughout or outside the chest or stomach cavity. Surgery is no longer an option. but chemotherapy can increase life expectancy and ease symptoms.
    
Natural Treatment of Mesothelioma

There is no alternative treatment that has been proven to help treat mesothelioma cancer. But complementary and alternative medicine can help control the signs and symptoms. So, consult with your doctor to determine the right treatment.

Mesothelioma is a disease that causes pressure in the chest, which makes you feel as if you are always out of breath. Your doctor may recommend using additional oxygen or taking medicine to make you more comfortable. Combining the treatments that doctors recommend with complementary and alternative medicine might help you feel better.

Alternative treatments that can help deal with shortness of breath include:

    Acupuncture This therapy uses thin needles that are inserted at precise points into the skin.
    Physiotherapy. A physical therapist can teach you breathing techniques to use when feeling short of breath. Using this technique can help you feel more in control of breathing.
    Relaxation exercise. Tension and relaxation of different muscles slowly can help feel more comfortable and breathe easier. Your doctor may refer you to a therapist who can teach relaxation exercises so you can practice it yourself.

    Also read: 11 Ways to Maintain Lung Health (Healthy to Old)

Medical treatment

Although there is no cure for mesothelioma to date, active treatment is recommended for some sufferers. Treatment includes chemotherapy, radiotherapy, surgery, or a combination of the three.
1. Chemotherapy

Chemotherapy drugs aim to destroy cancer cells. The most common chemotherapy drugs used to treat pleural mesothelioma include pemetrexed with cisplatin or carboplatin.

Chemotherapy aims to prolong life and reduce the size of cancer and improve quality of life. Chemotherapy is sometimes used for peritoneal mesothelioma either before or after surgery. Chemotherapy is given directly to the stomach for patients with peritoneal cancer.
2. Radiotherapy

This treatment uses x-rays to kill or damage cancer cells, which can be used at several stages of pleural mesothelioma and in different ways. For example, relieve symptoms such as pain caused by a tumor, and given after chemotherapy or surgery, to help kill the remaining cancer cells.

Radiotherapy is rarely used to treat peritoneal mesothelioma, but it can be used to relieve pain or kill cancer cells left after surgery or chemotherapy.
3. Operation

There are two main types of surgery that are actively considered to treat pleural mesothelioma, namely extrapleural pneumonectomy (PPE), which removes the tumor and pleura, the affected lung, the diaphragm and part of the heart lining, or pleurectomy with lung decortication, which cleans the pleura and as much disease as possible.

Surgery for peritoneal mesothelioma may be possible if the cancer has not spread. The surgeon will remove the part of the peritoneum where the mesothelioma grows. This operation is called peritonectomy.

In certain situations, other treatments may be used to treat mesothelioma, including:
4. Trimodality Therapy

This therapy uses a combination of chemotherapy, radiotherapy and major surgery, which is used to treat some patients with mesothelioma.
5. Immunotherapy

This treatment, which uses the immune system to fight cancer, might be an option if other treatments don't work.

The immune system that fights disease may not attack cancer because cancer cells produce proteins that make the immune system cells weaken. Immunotherapy works to prevent the disorder.
6. Target Therapy

Targeted therapy uses drugs to attack cancer cells. These drugs are not commonly used to treat mesothelioma, but your doctor may suggest targeted therapy based on the results of a tumor DNA test.
Prevention

An important step for prevention is to reduce exposure to asbestos which can reduce the risk of mesothelioma. Steps you can take to avoid exposure to asbestos fiber include:
1. Find out if you work with asbestos

Most people with mesothelioma are exposed to asbestos fibers in the workplace. Workers who may be exposed to asbestos fibers from:

    Asbestos Miners
    Electrical technician
    Plumber
    Insulator (material or method for limiting heat or electricity transfer)
    Shipyard worker
    Demolition workers
    Renovate the house
    Mechanical brake

2. Follow the Work Safety Regulations

Follow all safety precautions at work, such as using protective equipment, or may have to take a shower and change clothes before lunch break or go home. Consult with your doctor about other precautions you can take to protect yourself from asbestos exposure.
3. Securing asbestos around the house

Older houses and buildings may contain asbestos. In most cases, removing asbestos is more dangerous than leaving it intact. Breaking down asbestos can also cause fibers to fly through the air, so they can be inhaled.

Look for items that contain asbestos fiber in your home. If found, do not throw it away yourself, ask for help from experts.

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