Mesothelioma

Mesothelioma
Current Treatment & Experimental Treatment Trials at the Columbia University - Herbert Irving Comprehensive Cancer Center.

What is Mesothelioma? Mesothelioma from the (Greek meso+ thelioma, tumor of middle lining tissue) is an uncommon cancer, originating from the cells which form the membrane lining the abdominal cavity (peritoneal membrane or peritoneum) which houses the intestines, or the chest (pleural membrane or pleura) cavity housing the heart and lungs, in which the cells making up those tissues begin to grow out of control.Mesotheliomas most often are seen in older patients, more often men that have a history of occupational exposure to asbestos, although other causes such as radiation and certain viruses have occasionally been implicated. In a proportion of cases, no asbestos exposure can be identified.Mesotheliomas involving the lung and pleura characteristically present as progressive shortness of breath due to the thickening of the lining membrane of the lung with gradual contraction of the breathing space; often, fluid accumulates in the lung spaces as well, further interfering with breathing, Mesotheliomas involving the abdominal cavity present with digestive symptoms, and abdominal swelling due to thickening of the lining membranes of the gut, and accumulation of large amounts of fluid in the abdomen.How serious is it ? Mesotheliomas are serious and potentially life-threatening. Survival of patients with mesothelioma is usually short if effective treatment is not found, especially those with tumors that can be shown to be growing aggressively. Because mesotheliomas have usually spread throughout the pleural or peritoneal cavity before the diagnosis is made, complete surgical removal is only rarely possible. Moreover, mesotheliomas are not as sensitive to radiation therapy or chemotherapy as are many other tumors.How are mesotheliomas diagnosed? In all cases, the diagnosis of mesothelioma must first be unquestionably established by biopsy of affected or suspicious tissues, and by definitive microscopic examination by a trained pathologist. Biopsy almost always requires an invasive procedure such as thoracoscopy and pleural biopsy, or laparotomy or laparoscopy, The removed tissues may be treated with special biological or chemical stains which are used to help the pathologist establish a firm diagnosis. The pathologist usually also comments upon the rate of growth and biological virulence of the tumorSecond, the tumor must be staged if possible by X-ray, CAT scan, MRI or other types of scans to clarify its location within the body, and to estimate the likelihood of effective curative or palliative therapy. Staging of mesothelioma by x-ray measurements, however, is difficult and often unreliable.How are mesotheliomas treated? A treatment plan is devised depending upon the mesothelioma type, aggressiveness, primary location, and degree of local (rarely, distant) spread. The treatment of pleural mesothelioma is difficult. Treatment with surgery, radiation therapy or chemotherapy used alone or in combination may be proposed, depending upon the potential benefits and risks of each modality. Surgery is rarely used alone, but sometimes suffices when only a small pleural patch of mesothelioma is detected, thus allowing visually complete removal of the tumor. More often, mesotheliomas of the left or right pleural cavity cannot be completely removed without taking the entire lung (pneumonectomy) on the same side as well. In such cases, radiation therapy and/or chemotherapy is given postoperatively to help eradicate any residual mesothelioma that may have escaped the surgeon.The treatment of peritoneal mesotheliomas is even more problematic; until recently no consistent treatment was available. At our institution, peritoneal mesotheliomas have been managed in the experimental setting with combined modality treatment consisting of extensive (usually not complete) debulking surgery, followed by intraperitoneal and systemic chemotherapy followed in turn by whole abdominal radiation therapy.Because mesotheliomas now represent less than one percent of cancers and and are infrequently seen in the practice of most community oncologists, finding the correct treatment can be very difficult. Proper management of mesotheliomas often requires evaluation at larger tertiary hospitals or Comprehensive Cancer Centers by specialists in medical, surgical and radiation oncology with experience in all aspects of the clinical care of mesothelioma patients, including the newest experimental treatments.

What mesothelioma is

1.What mesothelioma is

Mesothelioma is a type of cancer. It is a cancer of mesothelial cells. These cells cover the outer surface of most of our internal body organs, forming a lining that is sometimes called the mesothelium. So this is where this type of cancer gets its name. Mesothelioma cancer can develop in the tissues covering the lungs or the abdomen.

2.Mesothelioma in the chest

The tissues lining (or covering) the lungs are called the pleura. There are two pleura. These can be called pleural membranes. The gap between them is called the pleural space. The pleura are fibrous sheets. They help to protect the lungs. They produce a lubricating fluid that fills the gap between the two pleura. This helps the lungs to move smoothly in the chest when they are inflating and deflating as we breathe.

Mesothelioma is most often diagnosed in the pleura. This is known as pleural mesothelioma. Because it is so close, pleural mesothelioma can also affect the sheet of tissue covering the heart - the pericardium. Doctors call the pericardium the lining, although it is on the outside of the heart. It protects the heart and allows it to move smoothly within the sac that surrounds it. So it does much the same job for the heart as the pleura do for the lungs.


Mesothelioma in the abdomenThe tissue lining the abdomen is called the peritoneum. It helps to protect the contents of the abdomen. It also produces a lubricating fluid. This helps the organs to move smoothly inside the abdomen as we move around.Mesothelioma of the tissues lining the abdominal cavity is known as peritoneal mesothelioma. It is much less common than pleural mesothelioma.It is unusual for mesothelioma to spread to other parts of the body. But if it does, it does not usually cause troublesome symptoms.
Benign mesotheliomaThere is a form of non cancerous (benign) mesothelioma that can develop in the lining of the lungs, or in the lining of the reproductive organs. It can occur in either men or women. These non cancerous tumours are very rare and we don't cover them in this section of CancerHelp UK.