Mesothelioma Lecture Notes

Introduction

• Mesothelioma: A type of cancer arising from the mesothelium.
• Mesothelium: Thin layer of protective tissue covering the outer surface of many internal organs (heart, abdomen, lungs).
• Characteristics: Aggressive, progresses and spreads quickly.

Types of Mesothelioma

1. Pleural Mesothelioma:
   • Occurs in the pleura or lining of the lungs.
   • Most common form.
2. Peritoneal Mesothelioma:
   • Occurs in the lining of the abdomen (peritoneum).
   • Second most common form.
3. Pericardial Mesothelioma:
   • Occurs in the protective layer of the heart.
   • Rarest form.

Prevalence

• Higher incidence in males than females.
• 2015: Approximately 60,800 cases, 32,000 deaths.
• Survival rate: ~9% of diagnosed individuals live longer than 5 years.

Causes

• Primary Cause: Exposure to asbestos.
  • Asbestos: Set of six silicate minerals, heat/fire/chemical resistant.
  • Used in: Insulation, brakes, shingles, flooring, etc.
• Mechanism: Inhalation or ingestion of asbestos fibers leading to irritation and mesothelioma development (20-40 years post-exposure).
• Risk Factors:
  • Personal history of asbestos exposure.
  • Living with an asbestos worker.

Symptoms

• Pleural Mesothelioma:
  • Shortness of breath, unintended weight loss, painful coughing.
  • Chest pain, fatigue, pneumothorax (lung collapse), tumor under chest skin.
• Peritoneal Mesothelioma:
  • Abdominal swelling, pain, weight loss, fever, night sweats, poor appetite, constipation, vomiting.
• Pericardial Mesothelioma:
  • Shortness of breath, low blood pressure, chest pain, extreme fatigue, heart palpitations.
• Advanced Cases:
  • Trouble swallowing, swelling of neck and face.

Diagnosis

• Initial Steps: Imaging scans (chest x-ray, CT scan, MRI), medical history review, physical examination.
• Confirmation: Biopsy.
  • Types: Fine needle aspiration, thoracoscopy, laparoscopy, thoracotomy, laparotomy.
• Staging:
  • Stage 1: Cancer confined to mesothelium.
  • Stage 4: Cancer spread around chest and to different organs.

Treatment

• General Approach: Depends on location, stage, age, patient's general health.
• Challenges: Cure often not possible due to late-stage diagnosis.
• Options:
  • Surgery:
    • Early diagnosis: Tumor removal.
    • Symptom reduction: Fluid build-up decrease, tissue removal (lungs, pleura, abdominal cavity).
  • Radiation Therapy: High-energy beams (e.g., x-rays) to kill cancer cells.
  • Chemotherapy: Medication (intravenously or orally) to kill cancer cells.

Conclusion

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