Mesothelioma is a rare cancer of pleura, pericardium, and peritoneum followed by around forty years of exposure to asbestos usually among workers in construction sites, shipyards, veterans, mine workers. Centre for Disease Control’s 2017 survey states that around 3000 new patients are diagnosed with mesothelioma every year.
The serous lining of visceral organs, i.e., the membranes that cover our heart(pericardium), lungs(pleura), and abdominal organs(peritoneum) is developed from the mesothelium; hence, it gives cancer its name. It is a fatal disease with poor prognosis hence demands early recognition and treatment.
Risk Factors for Mesothelioma:
• Asbestos exposure: The statistics claim that around 80% patients of mesothelioma have had exposure to Asbestos, the disease may develop following 10-50 years of exposure.
• Studies have suggested that those people who have a history of this cancer in their family and having mutations in BAP1 gene have a higher risk of developing cancer followed by exposure to asbestos.
This is important because companies need to ensure workers are not exposed to Asbestos and develop this cancer, this can lead to lawsuits, where proof of negligence has to be provided, the settlements usually tend to be in millions.
Mesothelioma What is it? / How it develops:
The development of disease occurs mainly by inhalation of asbestos; the tiny asbestos fibers are more dangerous. These asbestos fibers will get deposited in the visceral pleura attracting the immune cells of our body, like macrophages. Asbestos is a known carcinogenic(cancer-causing) agent; it has a high chance of developing a malignant tumor however the exact mechanism is not yet known. Then this disease can be spread to peritoneum by the lymphatic channels.
These fibers cause a lot of intracellular changes as well; the macrophage engulfed fibers may make contact with the chromosomes in the nucleus and get entangled in them, This interaction causes a lot of abnormalities including interference in the normal physiology of the cell.
Our cells have an inherent tendency to suppress the tumors and kill off the cells that have abnormal DNA. But due to this interaction, these mechanisms get compromised. Tumor-suppressing genes are inactivated, activation of cancer-causing oncogenes, apoptosis is also inactivated( the natural process by which malignant cells are killed off), thus causing accumulation of harmful cells that have the potential to develop into Mesothelioma.
Stages of Cancer:
There are actually 4 stages of this cancer that help physicians in identification and classification of the severity and progression of this disease when the diagnosis was
This staging depends on the extent of disease in a patient’s body.
An important point to note that even if cancer recedes or progresses, the staging at the time of diagnosis remains same. It requires a lot of diagnostic tests, to exactly figure out the shape, location, and size of the tumor mass.
Treatment programs also depend initially on the staging and then can be varied according to the recession or progression of the disease.
As this disease is rare the staging is present only for the pleural mesothelioma.
When the tumor is present at one location and lymphatic spread to other sites hasn’t occurred.
Treatment option: Surgery
Larger tumor, invaded adjacent organs,-diaphragm or lung, and lymph node involvement may be present.
Treatment option: Surgery, still possible but may be difficult.
Invasion of the chest wall, or esophagus and lymph node by mesothelioma tumor.
Treatment option: Surgery at this stage is not a viable curative option; other treatments must be tried.
Spread of mesothelioma tumor to multiple sites, across other organs and tissues.
Treatment option: Surgery is not practical, the treatments focus on analgesics and comfort(pain reduction).
It’s important to remember that these are not hard set rules but, just guidelines. And each case will actually depend upon cell type location and the patient’s age, sex, and health.
Types of Mesothelioma:
Its classification is location-based hence:
- Pleural- affecting the lungs
- Pericardial- affecting the heart (very rare)
- Peritoneal- affecting the abdomen
- Testicular (very rare)
Symptoms of Mesothelioma:
The most common symptoms include:
Dry coughing, shortness of breath, respiratory complications, weakness, night sweats and fever, pain in chest or abdomen.
If these symptoms occur along with the history of Asbestos exposure, don’t wait and consult a doctor.
Diagnosis is mainly made by biopsies; an x-ray may detect abnormal growth. Blood tests aren’t competent to diagnose it yet research is underway.
Mesothelioma Treatments :
Surgery is the most common treatment option. Chemotherapy and Radiotherapy may be required. In the later stages, more focus is on the provision of comfort and pain relief to the patient, because of the widespread nature of the tumors.
Mesothelioma would be a deadly disease with low survival rate and poor prognosis hence if you/any family member were, at any point exposed to asbestos and experiencing symptoms as mentioned above head to a doctor. The earlier the detection, the more the chances, of survival. The companies dealing with asbestos should ensure that workers aren’t getting exposed to it as it can lead to deadly diseases like mesothelioma, adequate safety precautions must be provided even for fibers that can be inhaled.