Diseases

Pleural Mesothelioma – Causes, Symptoms & Treatment

Pleuramesotheliom

Pleural mesothelioma is a rare malignant tumor of the pleura. In most cases, the cause can be assumed to be long-term contact with asbestos dust. The disease cannot be cured and can only be treated palliatively.

What is pleural mesothelioma?

Pleural mesothelioma is a malignant tumor of the pleura, i.e. the pleura . It is a cancer with a very poor prognosis. The tumor is often recognized late because the preceding processes develop very slowly. After diagnosis, however, the median lifespan is only 18 months.

Of course there are also extreme deviations in individual cases. However, a cure is usually not possible because the diagnosis is usually only made when almost the entire pleura is affected. After exposure to asbestos, a pleural mesothelioma can develop after about 20 to 50 years. This cancer used to be very rare.

However, its frequency is increasing and, according to estimates by scientists, will peak in the 1930s. Only then will the after-effects of decades of exposure to asbestos dust have an impact. The main people affected are those who work with asbestos. The pleura is the outer skin of the lungs, covers them completely and at the same time lines the chest cavity.

It consists of a layer of squamous epithelium , which is separated from a layer of connective tissue by the pleural space. Both layers can be affected by the tumor. Tumors of the squamous epithelium are referred to as epithelioid mesothelioma and tumors of the connective tissue layer are referred to as sarcomadoid mesothelioma.

The mixed type of both mesothelioma is called biphasic mesothelioma . Epithelioid mesothelioma is the most common. The rarest is sarcomadoid mesothelioma.

causes

The main cause of a pleural mesothelioma is the long-term occupational exposure of the affected persons to asbestos dust. Today’s occupational safety measures largely prevent the inhalation of asbestos or other mineral fiber dust. In the past, however, the dangers of these substances were not known.

Asbestos or other mineral fibers consist of long-chain silicate fibers. When these fibers are inhaled, they lodge in the lungs and pleura without being able to be broken down. In an attempt to get rid of the fibers, the immune system creates inflammatory reactions in the affected areas , which are always associated with tissue death.

Since the asbestos fibers do not dissolve, the inflammation becomes chronic. However, the dead tissue cells of the pleura or lungs must be constantly replaced. After a long period of time, the permanent new formation of tissue can also produce degenerate cells that have lost their control over cell division. Cancer develops.

Symptoms, Ailments & Signs

In fully developed pleural mesothelioma, the entire pleura is affected by cancer. The process of cancer formation and growth usually takes a long time. It starts with the first exposure to asbestos fibers with chronic inflammatory reactions. In the beginning, however, there are no symptoms.

In the run-up to the development of the tumour, tissue changes can occur as part of what is known as asbestosis or pneumoconiosis , which can lead to respiratory problems. A pleural mesothelioma can also develop without prior exposure to asbestosis .

The first symptoms often only appear at a very late stage, when almost the entire pleura is affected. Typical symptoms are shortness of breath , chronic urge to cough , severe weight loss , exhaustion and severe pain in the chest area . So-called pleural effusions often occur .

These are caused by fluid formation as part of inflammatory processes in the pleura. The breathing difficulties and pain are caused on the one hand by this accumulation of fluid and on the other hand by the hardening of the pleura as a result of cancer growth. The lungs can no longer expand properly.

Metastases form relatively late. The disease always leads to death if left untreated. Even with therapy, it is usually not curable. But the survival time can be slightly increased.

Diagnosis & disease progression

Pleural mesothelioma is usually diagnosed at an advanced stage. Imaging procedures such as CT , MRT or X-ray examinations are carried out. A bronchoscopy with sample collection is performed for the differential diagnostic differentiation from bronchial carcinoma .

In some cases, a pleural puncture can detect tumor cells, although a lack of detection does not rule out a pleural mesothelioma. The most reliable way to confirm the diagnosis is with a thoracoscopy.

complications

Unfortunately, a pleural mesothelioma can no longer be treated or completely cured. Because of the tumor, the life expectancy of those affected is drastically reduced. However, the further course of the disease depends very much on the severity and the exact position of this tumor, so that a general prediction is not possible. Patients with this disease primarily suffer from severe breathing difficulties.

This leads to gasping and an insufficient supply of oxygen to the body. Permanent fatigue and exhaustion can also occur as a result of pleural mesothelioma and significantly reduce the quality of life of those affected. In most cases, those affected also experience chest pain and severe weight loss. Metastases can also develop and continue to lead to cancer in other regions of the body.

Pleural mesothelioma usually leads to premature death of the affected person. Pleural mesothelioma can no longer be treated. Various therapies can alleviate the symptoms and extend the life expectancy of the patient. However, these are always palliative measures. Special complications usually do not arise.

When should you go to the doctor?

With a pleural mesothelioma, a visit to a doctor is necessary in any case. This disease does not heal itself and in most cases the symptoms worsen if no treatment is initiated. The earlier the treatment begins, the higher the probability of a positive course of the disease. The doctor should be consulted if the pleural mesothelioma causes problems in the lungs.

Those affected suffer from a strong cough and generally from respiratory problems. There is also fatigue and a severe loss of weight that occurs for no particular reason. If the pleural mesothelioma is still not treated, metastases will form and the patient will die. Life expectancy is significantly reduced and limited by this disease.

Furthermore, pain in the chest area can indicate pleural mesothelioma and should be examined by a doctor if it does not go away on its own and occurs over a longer period of time. Pleural mesothelioma can usually be diagnosed by an internist . However, further treatment requires surgical intervention and is therefore carried out in a hospital.

Treatment & Therapy

Similar to other malignant tumors, the three treatment methods of surgery, radiation and chemotherapy are also combined with a pleural mesothelioma. There is no general recommendation for the implementation of the therapy. Treatment depends on physical fitness and disease stage.

In the case of a unilateral pleural mesothelioma, the removal of one half of the lung including the pleura can contribute to prolonging life. The surgical method is then combined with chemotherapy and radiation. In chemotherapy, the cytostatic permetrexed is administered together with a platinum-containing preparation.

It has also been shown that the addition of the anti-vascular monoclonal antibody bevacizumab improves survival. However, this is usually only a matter of a few months. In rare cases, however, life expectancy has been extended by several years. The therapies are palliative measures. A cure cannot be assumed.

prevention

A pleural mesothelioma can only be effectively prevented by preventing exposure to asbestos or mineral fibers. People with previous exposure should also definitely refrain from smoking, as it increases the risk of developing pleural mesothelioma even further.

aftercare

In most cases, those affected by pleural mesothelioma have only very few or only very limited direct follow-up measures available. Those affected are primarily dependent on a quick and early diagnosis so that further complications or further symptoms cannot occur. If the tumor has already spread in the body, this disease can sometimes no longer be completely cured.

In this case, the life expectancy of the patient can be significantly reduced by the pleural mesothelioma. Those affected usually need chemotherapy to remove the tumor. Most of those affected also need the support and care of their own family and friends.

Among other things, loving and intensive conversations have a very positive effect on the further course of the disease and can also prevent depression or other mental upsets. Even after successful therapy, regular check-ups by a doctor are very important in order to identify other tumors at an early stage. However, the further course depends very much on the time of diagnosis, so that a general prediction cannot be made.

You can do that yourself

Due to the generally late diagnosis of the pleural mesothelioma, the patient himself can usually hardly contribute anything to the healing. For him, the focus is therefore on improving his own quality of life and well-being.

On the one hand, the patient is recommended to avoid additional stress on the diseased lung. These include smoking , staying in inner-city locations polluted with fine dust and intensive sporting activities. On the other hand, it makes sense, if still possible, to take trips to regions with very good air quality. These can also reduce unnecessary stress , which would put additional strain on the already weakened body. The patient is also advised to learn special breathing exercises to strengthen the lungs.

On the other hand, it is advisable to also seek psychological support. A tumor disease is a serious turning point in life, which is demonstrably easier to cope with for the patient with qualified therapy or a visit to a self-help group. Possible prejudices or even shame should be discarded against the background of the severity of the illness.

You should also pay attention to your well-being when it comes to nutrition . You can eat what tastes good. Due to the mostly existing lack of appetite, only a sufficient calorie and nutrient intake is important.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.