Mesothelioma: Causes, symptoms, diagnosis and treatment

Alex Huynh February 6, 2022 9 0

Mesothelioma is a rare cancer that occurs in the tissue surrounding the internal organs (mesothelioma). The extent of damage and the ability to spread the disease progresses very quickly, so if the patient is not detected and treated in time, the risk of death is very high.

Mesothelioma is divided into several different types depending on which part of the mesothelioma is affected: Mesothelioma surrounding the lung (or pleural carcinoma) is the most common, but it is also possible. There were cases of mesothelioma in the pericardium, abdomen, and peritesticular region.

Mesothelioma is a potentially fatal disease, so timely detection and selection of treatment options will have a chance to cure or reduce the risk of death. However, mesothelioma is similar to other forms of cancer, most of the symptoms in the early stages do not appear prominent or cause confusion with other disease symptoms, leading to the patient’s condition that cancer is detected. when the disease has progressed seriously.

Cancer in general originates from a change that occurs in a cell’s DNA sequence (also known as a gene mutation). Mutant cells appear and continuously multiply uncontrollably, then accumulate to form a tumor. Cancer cells do not stop but continue to spread to surrounding tissues and organ systems to replace healthy cells with cancerous cells. Only by promptly treating cancer cells before they spread to the whole body can the patient’s life be saved.

In most cases of cancer patients, no specific cause is known, because the impact on the formation of malignancies can be traced back to many factors that persist over a period of time. certain. Influencing factors can come from genetic factors, chronic medical problems or external factors from the environment such as toxic chemicals or gases, environmental pollution, etc.

The case of pleural mesothelioma (the most common type) is considered by medical professionals to be caused by influencing factors such as:

Exposure to asbestos dust: Asbestos dust is known to be a naturally occurring mineral commonly used as an insulator that can withstand fire and heat. This type of substance is easily found in factories, construction sites, shipyards or motorcycle brakes,… Asbestos will enter the air in the form of fiber micromolecules that can easily enter the body. humans to influence the formation of cancer.

People who do not directly work in areas containing Asbestos, but have contact with people infected with Asbestos can still be at risk of cancer, especially mesothelioma.
Heredity: If you have a parent or sibling with a history of mesothelioma, you may also be at risk.
Pathological factors: Patients with a history of cancer, especially breast cancer and receiving radiation therapy, have a higher risk of developing mesothelioma.

Mesothelioma is a cancer that is difficult to detect at an early stage because symptoms do not appear much or appear only transiently or do not have any recognizable signs. Only when the tumor grows larger and shows signs of invasion of surrounding tissues, does the patient begin to feel abnormal changes in the body.

In the case of mesothelioma in the pleura, symptoms will often appear such as:

Cough: Initially, the cough does not appear much, so the patient does not pay attention until the disease is more advanced, then the cough will last for many days without getting better. Patients with mesothelioma may present with a dry cough or a cough with sputum (in some cases with blood) depending on the area of the damaged organ and the extent of the damage.

cough that persists for several days without improvement

Shortness of breath : Symptoms of shortness of breath appear because cancer cells cause the pleura to harden, the functioning of the thorax is affected, leading to difficulty breathing. Shortness of breath is often accompanied by symptoms of chest pain, the more you try to take a deep breath, the more painful it will be.
Chest pain : Chest pain often occurs when the patient tries to breathe, in addition, the upper back may also be painful due to the influence of unstable breathing.
The larger mesothelial tumor will put pressure on the nerves, the surrounding venous network or the spinal cord, … the patient has symptoms of swelling in the neck and face.

Mesothelioma appearing in the abdomen (rarely) will have symptoms such as: Abdominal pain, abdominal swelling, unexplained weight loss, …

Complications of mesothelioma: When pleural mesothelioma has shown signs of spreading to all organs in the chest, the disease symptoms will appear more and more severe. The pain does not only appear in the chest and back but can spread to the head or whole body when the nerve groups are compressed excessively. Respiratory or digestive activities are greatly affected, the risk of pleural effusion is high, the tumor grows too large, it will cause severe lung compression, leading to difficulty breathing or stopping breathing and possibly death if not. handled in a timely manner…

Stage I: The tumor has just formed and is located in only part of the chest linings, with no signs of invasion to any surrounding tissues. Patients often have no symptoms or only a few transient signs that are not clear.

Stage II: The mesothelioma has grown larger, has spread beyond the chest lining and reaches one lobe of the lung or the diaphragm. No lymph node or cancer metastasis.

Stage III : Mesothelioma may have invaded some structures in the chest cavity, there is damage to the lymph node groups, the lesion begins to increase sharply, causing a lot of discomfort to the patient. However, there were no signs of distant cancer metastasis.

Stage IV: Most of the organs and tissues in the chest are damaged. The groups of lymph nodes near or far are at risk of being invaded by cancer cells and metastasized to other organ systems in the body.

Besides pleural mesothelioma, there are other types of mesothelioma located in the abdomen or around the heart, but these cases are much rarer.

Most patients are indicated for surgical treatment in stages I-III, but in cases where patients have progressed to the end stage, the ability to treat is extremely difficult, even there is no chance of survival. after 6-9 months. Therefore, early detection and appropriate treatment options can reduce the risk of death and prolong survival for patients.

To diagnose pleural mesothelioma, the doctor will examine the patient’s clinical symptoms first, if there are signs of suspicion, then perform specific diagnostic tests. In addition, doctors also learn more about cancer risk factors such as underlying medical conditions, heredity in the family, and cancer agents to which the patient has been exposed.

Diagnosis through pictures:

Chest X-ray: Check the thickness and calcifications appearing at the lung margins, determine whether there is fluid accumulation in the chest, the extent of tumor invasion to nearby structures.
Computed tomography (CT scan): A CT scan will show the exact shape, size, and location of the tumor. At the same time check the extent of damage to nearby organs.
Positron tomography (PET scan): Using a radioactive sugar substance put into the blood, then using radiolocalization technology to show the tumor and the cancer’s invasion more clearly ( Cancer cells absorb more sugar than usual.)
Magnetic Resonance Imaging (MRI): Using magnetic waves to reproduce clearer images, examine tumors and invasive cancer cells more clearly.

Histological examination and body fluids:

Cytological examination: Mesothelioma causes severe irritation of the chest wall leading to pleural effusion. Doctors will do a pleural puncture to check for cancer cells in the pleural fluid.
Needle biopsy: In case there are large tissue groups close to the chest wall, a needle biopsy can be performed through CT scan images. Look for cancer cells in the tissue sample being biopsied.
Surgical biopsy: In some cases where more tissue samples are required to diagnose cancer, a biopsy must be performed under thoracoscopy. The results of the surgical biopsy sample will give the most accurate diagnosis.

Treatment of mesothelioma requires doctors to determine the location of the tumor, the stage of disease progression and the patient’s actual health status, then select the most appropriate treatment regimen. In order to choose the most appropriate treatment for the patient, doctors need to discuss more specifically with the patient (or loved one) about the treatment methods, possible side effects after treatment and success rate after treatment.

Treatment of mesothelioma through surgery

In case the mesothelioma is newly formed and has not shown any signs of spreading, surgery can completely remove the cancer cells. In case the patient has progressed to the end stage, the ability to perform surgery has almost no cure for the disease, but can only reduce the severe symptoms for the patient, helping the patient feel more comfortable. .

Surgical options for mesothelioma are:

Management of pleural effusion: Perform pleural drainage and induce pleural adhesions with Betadine or talc powder to prevent the risk of recurrent pleural effusion.
Surgery to remove groups of damaged tissue around the lungs: This method is understood as pleural resection to minimize severe symptoms caused to the patient.
Lung removal surgery: In cases where the lung has been severely damaged and cannot be restored, the measure of complete removal of a lung will be indicated. Combined removal of tissue groups around the damaged lung.

Treatment of mesothelioma with chemotherapy and radiotherapy

Most cancer patients are advised to undergo surgery to treat will provide the best treatment results. However, there are many cases where the patient cannot perform surgery or cannot perform surgery because the tumor is too large. Chemotherapy and radiation therapy will be added to the treatment regimen to improve the likelihood of success.

Chemotherapy is a method of using chemicals directly into the patient’s body to kill cancer cells, stop the growth of the tumor and reduce the size of the tumor so that it can be carried out. surgery. In addition, chemotherapy can also be performed in parallel with radiation therapy to improve the effectiveness of treatment.
Radiation therapy is a method of using ultraviolet rays directly at cancer cells to eliminate them. Conventional radiation therapy will be indicated after surgery to remove residual cancer cells or treat early-stage recurrence of cancer.

Both chemotherapy and radiation therapy can cause many side effects during treatment, so not all patients want to perform these two cancer treatments.

Summary of common symptoms of patients with mesothelioma: