Pleural mesothelioma is an extremely dangerous cancer that is accompanied by the appearance and development of a malignant tumor on the pleural membrane of the lungs. Naturally, such an ailment cannot but affect the condition of the lungs and the whole organism. That is why it is so important to get acquainted with the main causes and symptoms of the disease. The sooner a correct diagnosis is made and therapy is started, the more likely it is to achieve remission and prolong a person's life.
What is pleural mesothelioma? Photo and short description
Pleura cancer is a rather rare oncological disease. Despite the fact that it can be diagnosed at any age, the bulk of patients with this diagnosis consists of mature men who are involved in hazardous industries in one way or another. It is also worth noting that the number of people suffering from this disease is growing every year.
Mesothelioma is a tumor that is formed in the process of malignant degeneration of the epithelial cells of the pleura. At first, it looks like small nodules or flakes, the number of which increases as the disease progresses, forming a kind of shell around the lungs.
Types of malignant tumors
In modern medicine, there are several classification systems. Depending on the cell type, pleural mesothelioma can be:
- epithelioid (this type of tumor occurs in 50-60% of cases);
- fibrous, or sarcomatoid (occurs in 10% of cases);
- in 30-40% of all cases, the tumor is biphasic, or mixed (consists of both types of cells).
Acinar, small cell, clear cell and tubopapillary malignant neoplasms are distinguished depending on the structure.
Pathogenesis of disease
Mesothelioma of the pleura is the result of malignant degeneration of the cells of the integumentary epithelium of the pleura (mesothelium). With a nodular form, a tumor forms in any part of the parietal or visceral pleura. Nevertheless, the diffuse form of the disease is most often observed, in which malignant cells diffusely spread through the pleura, enveloping the lung with a sheath. In the event that the pleural cavity remains free, an accumulation of hemorrhagic (with impurities of blood) or serous-fibrinous exudate is observed inside.
Because the pleura is in close contact with the pericardium (the sheath that envelops the heart muscle), malignant cells in later stages can spread to the layers of the pericardium. The tumor can also metastasize tolymph nodes.
Main causes of disease development
An interesting question is the causes of this disease. Naturally, it was not possible to fully study the mechanism of malignant degeneration of cells. Nevertheless, modern researchers managed to find out that there are several risk factors that provoke such a terrible disease:
- Contact with asbestos can be the cause of malignant degeneration of cells. According to statistical studies, 9 out of 10 men who were diagnosed with pleural mesothelioma had previously worked with this material. By the way, asbestos was widely used in industry until about the 1970s.
- Risk factors include human infection with the SV40 virus, which is also known in medicine under a different name, namely the simian virus. From 1955 to 1963, a global vaccination of the population against polio was carried out. Unfortunately, the vaccine was contaminated with viral particles. How exactly this strain is involved in the formation and development of mesothelioma is not fully known, but some connection can be traced.
- The reason for the development of the disease may be exposure to the body of radioactive radiation. For example, mesothelioma can develop when the body comes into contact with thorium dioxide. By the way, this substance was used until the 1950s during X-ray studies. Also, pleural lesions may be associated with previous radiation therapy.
- Contact with certain chemicals can also cause disease. For example, constant work with some typespaints, solvents, aggressive chemicals first leads to damage to the respiratory tract, and then to malignant degeneration of cells.
What are the symptoms of the disease?
Immediately it should be said that malignant pleural mesothelioma develops incredibly quickly. Without timely diagnosis, just a few months later, the disease can lead to the death of a person.
Typically, the first symptoms are pain in the lower chest and sometimes in the back. In addition, patients complain of frequent dry cough, which is also accompanied by soreness. As the disease develops, swallowing difficulties and hoarseness are observed.
There are other signs that accompany pleural mesothelioma. Symptoms include heavy sweating and fever. It is not uncommon for patients to develop anemia. Weight loss is also possible, and without dieting or any dietary change.
Since fluid accumulates in the pleural cavity, shortness of breath is one of the disorders, not only during physical activity, but also at rest. Puncture and extraction of exudate help temporarily alleviate the patient's condition. Nevertheless, the thickened pleura puts pressure on the mediastinal organs, often causing disturbances in the cardiovascular system.
Diagnosis of disease
On examination, an experienced doctor may suspect that the patient has mesotheliomapleura. Diagnosis is complemented by chest x-ray. But the pictures show only a few signs. Therefore, more research is needed:
- The main diagnostic method is computed tomography. During the examination, one can notice the presence of effusion into the pleural cavity, nodular thickening of the pleura, tumor masses that surround and compress the lung, mediastinal displacement.
- Magnetic resonance imaging gives a more accurate picture of the extent of tumor spread. You can also determine the degree of damage to the diaphragm and the spread of the disease to the surrounding soft tissues.
- If indicated, positron emission tomography is also performed, which allows you to determine the presence of distant metastases and the degree of damage to the lymph nodes.
Some procedures for morphological confirmation of the diagnosis
After the above procedures, morphological confirmation of the diagnosis is also required. This means that it is necessary to determine whether the tumors found are indeed malignant mesothelioma.
First of all, exudate from the pleural cavity is taken for analysis, which is then sent for cytological examination. Unfortunately, the sensitivity of this technique is only 25-50%, and therefore other tests are needed. Sometimes a histological examination is also carried out, the accuracy of which, unfortunately, is also not very high and is about 60%. Nevertheless, these procedures are the most accessible and cheapest, and therefore they are prescribed in the first place.queue.
Invasive methods are more accurate, in particular mediastinoscopy and thoracoscopy (includes a diagnostic opening of the chest).
What does the treatment process look like?
Unfortunately, the effect of drugs that are used in modern medicine for chemotherapy is only 20%. The use of "Cisplatin", "Mitomycin", "Etoposide", "Gemzar" and some other medicines can reduce the size of the tumor and achieve objective improvements in the patient's condition. However, combination chemotherapy is the gold standard. For example, a regimen might look like this: Gemcitabine + Alimta or Gemcitabine + Cisplatin.
If there is a pleural effusion, then the patient may be prescribed the introduction of cytostatics directly into the pleural cavity. Sometimes interferon is used for the same purpose. This helps to slow down or completely stop the accumulation of exudate and, accordingly, greatly facilitate the patient's breathing.
Naturally, today there are active studies of a variety of anti-cancer drugs. The most promising drugs are inhibitors of vascular endothelial growth factor. Unfortunately, the survival rate among patients leaves much to be desired.
Necessary surgical procedures
This disease does not leave much room for maneuver, especially when it comes to the later stages of the disease. SoIs surgery possible if the patient is diagnosed with pleural mesothelioma? Surgical treatment, as a rule, is carried out only if the tumor is localized in one place. In such cases, the pleura is removed, sometimes along with part of the lung. Such procedures are carried out in approximately 11-15% of cases. Life expectancy even after such radical therapy is 9-22 months, at best, several years. Combination therapy, in which operations are combined with chemotherapy, gives the most effective result.
Pleural mesothelioma: prognosis
Cancer is dangerous anyway. So what can a patient who has been diagnosed with pleural mesothelioma expect? The prognosis, alas, is not very encouraging. Naturally, it all depends on the stage at which the disease is diagnosed. It is worth taking into account the age and general he alth of the patient, the effectiveness of the drugs used, etc. In general, with the right therapy in the early stages of the development of the disease, remission can be achieved, sometimes even saving the patient's life for 5-6 years.
Unfortunately, quite often patients are diagnosed with more advanced pleural mesothelioma (stage 4). How many people live with this disease? Unfortunately, even with the use of all methods of modern medicine, it is rarely possible to save a patient's life for longer than 2-8 months.
Are there measures to prevent the disease?
Pleural mesothelioma is an incredibly dangerous disease that often becomescause of a person's death. Unfortunately, there is no effective preventive measure. Nevertheless, it is worthwhile to carefully study the main factors that can provoke malignant degeneration of cells, and, if possible, try to avoid them. For example, pulmonologists strongly advise against working with asbestos, living in adverse conditions, etc.
Naturally, you should stop smoking, as this bad habit can provoke a lot of diseases of the respiratory system, including this one. And it is also important to undergo a preventive X-ray examination of the lungs (fluorography) every year, because the earlier a particular disease is diagnosed, the greater the chance for successful treatment. Particular attention should be paid to workers in hazardous industries, whose he alth is in great danger.
