What is mesothelioma? 

Mesothelioma is a cancer that affects the mesothelial cells that line most internal organs. There are two main types of Mesothelioma. pleura and peritoneum. 

In rare cases, mesothelioma can develop in the pericardium, the inner lining of the heart. This is called pericardial mesothelioma. In more rare cases, mesothelioma may develop in the testicular membranes (testicular mesothelioma). 

It is estimated that in 2023 more than 900 people will be diagnosed with mesothelioma. The average age at diagnosis is 76 years. 

pleural mesothelioma 

This is a type of cancer that starts in the membrane that lines the lungs. Although it starts in the chest and affects the lining of the lungs, it is not lung cancer and is treated differently than lung cancer. Pleural Mesothelioma is the most common type of mesothelioma, accounting for approximately 90% of all mesotheliomas. 

peritoneal mesothelioma 

The other major type is peritoneal mesothelioma, which accounts for about 10% of cases. It occurs in the mucous membrane of the abdomen. 

Signs and symptoms of pleural mesothelioma 

The main symptoms of pleural mesothelioma are: 

shortness of breath 

chest pain 

shoulder and upper arm pain 

sensitive skin 

loss of appetite and/or weight loss 

energy loss 

A persistent cough or a change in your usual cough 

Excessive sweating, especially at night. 

The early signs of pleural mesothelioma are similar to those of other diseases. However, if you think you have been exposed to asbestos, contact your doctor. Signs and symptoms of peritoneal mesothelioma 

The main symptoms of peritoneal mesothelioma are: 

swelling or pain in the stomach 

decreased appetite 

nausea and/or vomiting 

fever or night sweats 

Intestinal or urinary problems. 

Less commonly, mesothelioma begins in the membranes around the heart or reproductive organs. A growth forms, gradually grows and spreads to the surrounding area. In rare cases, mesothelioma may occur in more than one location. 

NCauses of mesothelioma 

The only known risk factor for mesothelioma is exposure to asbestos. It can take many years (20 to 60 years) for mesothelioma to develop after asbestos exposure. 

People who may have been exposed to asbestos at work include construction workers, plumbers, electricians, welders, asbestos miners, automotive workers, and textile workers. 

In some cases, mesothelioma may be related to previous radiation therapy to the breast. 

Diagnosis of mesothelioma 

Tests to diagnose mesothelioma include: 

Blood test 

Blood tests can be used to check your general health and the function of your blood cells, liver, and kidneys. 

x-ray 

X-rays can detect abnormalities in the lungs, thickening of the pleura, and fluid in the space between the lungs and the chest wall. X-rays can also help detect fluid in the abdomen. 

CT scan 

A CT scan (computed tomography) generates her three-dimensional images of multiple organs at once and can even scan the lymph nodes in the breast. CT scans can also be used to determine if mesothelioma has spread to other areas. 

biopsy 

A biopsy involves removing a sample of pleural or abdominal tissue for examination under a microscope. This is the main step in diagnosing pleural mesothelioma and can be performed in two ways. One is through VATS (video-assisted thoracoscopic surgery), which is a type of keyhole surgery. Alternatively, it is done by CT-guided core biopsy, which is performed using a needle guided by a CT scan under local anesthesia. Drainage of fluid from the pleura 

This may be done to relieve symptoms of shortness of breath caused by leakage of pleura into the chest cavity (called a pleural effusion) and in some cases to diagnose pleural mesothelioma. People with peritoneal mesothelioma may have fluid buildup in their abdomen (called ascites), which causes swelling and pain. 

Under the guidance of a doctor using ultrasound, fluid is drained into the pleural effusion or abdomen through a needle inserted into the chest wall. A sample of the fluid is then sent to a pathologist for testing. 

Diagnosis can be difficult because mesothelioma cells can resemble other types of cancer cells. Combining body fluid sample results with X-ray and CT scan information can provide an acceptable level of diagnostic certainty. 

If mesothelioma is diagnosed, further tests, such as a CT scan, are usually done to find out if the disease has spread to other parts of the body. FDG positron emission tomography (FDG-PET); mediastinoscopy (used to examine and remove lymph nodes in the center of the chest). or endobronchial ultrasound (EBUS). 

After being diagnosed with mesothelioma 

After finding out you have mesothelioma, you may feel shocked, upset, scared, and confused. These are normal reactions. It may be helpful to talk to your doctor, family, or friends about Treatment options. Get as much information as you think you need. It's up to you how involved you want to be in decisions about your treatment. 

mesothelioma treatment 

There is currently no cure for mesothelioma, but aggressive treatment is recommended for some people. This may include chemotherapy, radiation therapy, surgery, or a combination of these treatments. For some people, it may help control the disease for longer. The two types of mesothelioma are treated with different treatments. 

chemical treatment 

Chemotherapy drugs aim to destroy cancer cells while minimizing damage to healthy cells. The chemotherapy drugs most commonly used to treat pleural mesothelioma include pemetrexed and cisplatin or carboplatin. Chemotherapy for pleural mesothelioma aims to prolong life, shrink the cancer, and improve quality of life.

Chemotherapy may be used alone or before or after surgery for peritoneal mesothelioma. Patients with peritoneal mesothelioma receive chemotherapy directly into the abdomen. 

Radiotherapy (radiotherapy) 

Radiotherapy, which uses X-rays to kill or damage cancer cells (also called radiotherapy), can be used in different ways at different stages of pleural mesothelioma. For example, they can reduce symptoms such as tumor-related pain, and when given after chemotherapy or surgery, they can kill remaining cancer cells. 

Radiation therapy is rarely used to treat peritoneal mesothelioma, but it may be used to relieve pain and kill cancer cells left after surgery or chemotherapy. surgery 

There are two main types of surgery that can be considered for active treatment of pleural mesothelioma. One is extrapleural pneumonectomy (EPP), which involves removing the tumor and part of the pleura, affected lung, diaphragm, and lining of the heart. or pleurectomy with pulmonary dissection (PD) to remove the pleura and as much disease as possible. 

Surgery for peritoneal mesothelioma may be possible if the cancer has not spread. In this surgery, called a peritoneum, the surgeon removes the part of the peritoneum where the mesothelioma has grown. 

Trimodal therapy 

Trimodal therapy uses a combination of chemotherapy, radiation therapy, and major surgery. Used to treat some people with mesothelioma. Treatment of symptoms 

When mesothelioma is diagnosed at an advanced stage, the main goal of treatment is to reduce symptoms and keep them under control for as long as possible. 

Treatment may include surgery to relieve shortness of breath caused by fluid buildup. In VATS (video-assisted thoracoscopic surgery), the chest wall and part of the lining of the lungs are removed. During this procedure, sterile talcum powder is injected into the chest cavity to cause inflammation and close it, preventing fluid from accumulating again. 

More extensive open surgery may be done to drain fluid that has built up in the lungs or to relieve chest pain. For people who are not candidates for VATS or open surgery, an indwelling pleural drain may be used that allows fluid to be drained once or twice a week, depending on how quickly the fluid reaccumulates. 

The treatment team will discuss appropriate treatment options with the patient to reduce other symptoms such as insomnia, pain, fatigue, loss of appetite, and weight loss. 

palliative care 

In some cases of mesothelioma, your medical team may discuss palliative care with you. Palliative care aims to improve quality of life by reducing cancer symptoms. 

Palliative treatment not only slows the spread of mesothelioma, but also reduces pain and helps manage other symptoms. Treatment may include radiation therapy, chemotherapy, or other medications. 

treatment team 

Depending on your treatment, your treatment team may include a variety of health care professionals, including: 

GP (General Practitioner) – Manages general health conditions and works with specialists to coordinate treatment. 

Radiologist – Interprets diagnostic scans (including CT, MRI, and PET scans). 

Pulmonologist - examines symptoms, participates in diagnosis, and determines initial treatment options. 

Interventional Radiologists – Use imaging techniques (CT, MRI, ultrasound) to guide needles and other instruments to drain fluid and remove tissue for diagnosis. Pathologist – examines cells and tissues under a microscope 

Thoracic surgeon (thoracic surgeon) – Diagnoses and performs surgery for cancer and other diseases of the lungs and chest. 

Medical oncologist – prescribes and adjusts the course of chemotherapy. 

Radiation Oncologist – Prescribes and coordinates radiation therapy treatments. 

Palliative care team – We help you control your symptoms and maintain your quality of life, and provide a variety of support services. 

Oncology Nurse – Assists with treatment and provides information and support throughout treatment. Other health professionals – social workers, pharmacists, counselors, etc. 

Mesothelioma screening 

There is currently no national screening program for mesothelioma in Australia. 

prevent mesothelioma 

Reducing your exposure to asbestos, both at work and at home, is the most likely way to reduce your risk of mesothelioma. Australia has a code of practice for the management and control of asbestos: www.safeworkaustralia.gov.au. 

Mesothelioma prognosis 

It is impossible for doctors to predict the exact course of the disease, as it depends on each individual's circumstances. However, your doctor can give you a prognosis and expected course of the disease based on the type of mesothelioma, test results, how fast the tumor is growing, your age, physical fitness, and medical history. 

In general, the earlier cancer is diagnosed, the better the outcome. However, because early symptoms often go unnoticed, mesothelioma is often diagnosed only at an advanced stage. Successful treatment of advanced cancer is more difficult, but it may be possible to control the disease for months or years and improve quality of life by reducing symptoms.