Sunday, January 22, 2012

mesothelioma


What is Mesothelioma?
 Mesothelioma (or specifically, malignant mesothelioma) Mesothelioma is a rare type of cancer that occurs in the thin layer of cells lining the body's internal organs, known as the mesothelium. In other words Mesothelioma is a tumour of the mesothelium. This is the thin membrane that lines the chest and abdomen (tummy) and surrounds the organs in these areas.

The most common anatomical site for the development of mesothelioma is the pleura Mesothelioma Cancer
Image courtesy of the Mesothelioma Cancer Alliance.
(the outer lining of the lungs and internal chest wall), but it can also arise in the peritoneum (the lining of the abdominal cavity), and the pericardium (the sac that surrounds the heart), or the tunica vaginalis (a sac that surrounds the testis).
 Most people who develop mesothelioma   have worked in jobs where they inhaled asbestost(a substance that does not burn easily that was used in building materials in the past. It is now known to cause cancer and is no longer used), or were exposed to asbestos dust and fibers in other ways Some people who were exposed to asbestos have collected damages for asbestos-related disease, including mesothelioma.
Mesothelioma is an aggressive and deadly form of cancer. Mesothelioma treatments are available, treatment for mesothelioma is often focused on keeping you as comfortable as possible.

mesothelioma lawyer:
As i explain above Asbestos exposure has been conclusively linked to mesothelioma and other fatal diseases .For 100 years, asbestos was one of the most commonly used materials in industries such as construction, shipbuilding and manufacturing.The disease of mesothelioma cancer can drastically change your finances.The biggest expense coming your way will be a share of medical bills. Even with good medical insurance, some expenses will not be covered. If you have an asbestos-induced disease,seriously consider contacting a qualified mesothelioma lawyer immediately. These types of cases are time sensitive, and only a lawyer trained in asbestos litigation should help you decide if and when to pursue a lawsuit against a company who may be responsible for exposing you to asbestos. Each state limits the time you have to file a lawsuit after you diagnosed with mesothelioma cancer. A mesothelioma lawyer can help you file your claim before the statute of limitations expires.In a mesothelioma lawsuit, the attorney will deal with actual filing of the case and then all aspects of it after that.

Symptoms of Mesothelioma:

  •  shortness of breath             
  • heavy feeling in the chest area
  •       
these two symptoms is caused by fluid build up in the lungs. These two symptoms should be taken seriously 89.9% of all patients will notice these two symptoms. However, because the symptoms do not seem serious many choose not to seek out medical care. Some symptoms common with pleural mesothelioma include back, chest or side pain, difficulty swallowing, cough, fatigue and weight loss. Peritoneal mesothelioma is often is often accompanied by abdominal pain, nausea and vomiting, back pain, anemia and bowel obstruction.


Types of Mesothelioma:

There are three main types of Mesothelioma.

  • Pleural mesothelioma
  • Peritoneal mesothelioma
  • Pericardial mesothelioma
Pleural mesothelioma:
The pleura is the outer lining of the lung. It has two layers; the inner (visceral) layer, which is next to the lung, and the outer (parietal) layer, which lines the chest wall. The two layers of the pleura are usually in contact and slide over each other as we breathe. The layers produce fluid, which allows them to move smoothly over each other.
When mesothelioma develops in the pleura (pleural mesothelioma), the delicate linings thicken and may press inwards on the lung. Fluid may also collect between the two layers of the pleura: this is known as a pleural effusion. Around 3 out of 4 of cases of mesothelioma develop in the pleura.
Peritoneal mesothelioma:
The outer lining of the abdomen is known as the peritoneum. It also has two layers: the inner (visceral) layer, which is next to the abdominal organs, and the outer (parietal) layer, which lines the abdominal wall. Mesothelioma in the peritoneum is called peritoneal mesothelioma. It causes thickening of the linings surrounding the abdominal organs and a collection of fluid in the abdomen. The collection of fluid is called ascites and causes swelling of the abdomen. Around 1 in 4 cases of mesothelioma develop in the peritoneum.

Pericardial mesothelioma:
Pericardial mesothelioma is the rarest form of the three main forms of mesothelioma, affecting the protective layer covering the heart.The membrane has two layers: an outer layer called the parietal layer, heart sac or theca cordis, and an inner layer known as the visceral layer or epicardium. Exposure to asbestos is the main cause of this condition. It is not clearly understood how these tiny fibers make their way to the pericardium.

Diagnosis:
Mesothelioma is difficult for doctors to diagnose because it can be easily confused with other diseases. Even after a cancer diagnosis has been recognized, mesothelioma looks similar to other types of cancer in diagnostic tests.
Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray often lung function tests. he X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytopathology if this fluid is aspirated with a syringe. For pleural fluid, this is done by thoracentesis or tube thoracostomy (chest tube); for ascites, with paracentesis or ascitic drain; and for pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis , heart failure ). Using conventional cytology diagnosis of malignant mesothelioma is difficult, but immunocytochemistry has greatly enhanced the accuracy of cytology.


main treatments types:
  • Surgery
  • chemotherapy
  • radiation

Surgery:

Surgery, by itself, has proved disappointing. In one large series, the median survival with surgery (including extrapleural pneumonectomy) was only 11.7 months. However, research indicates varied success when used in combination with radiation and chemotherapy (Duke, 2008). (For more information on multimodality therapy with surgery, see below). A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed.

Chemotherapy:

Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery.

Radiation:

For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.




Wednesday, January 11, 2012

mesothelioma treatment


Cancer treatment usually focuses upon destroying malignant cells and preserving healthy ones. This can be accomplished in a number of ways. At the present, patients will typically utilize three primary mechanisms for mesothelioma treatment. Either surgery, radiation, and chemotherapy, or some combination of the three are considered the most effective for the treatment of malignant mesothelioma. What course of treatment is recommended will largely depend on these issues.
Once a patient is diagnosed with mesothelioma, an oncologist can go ahead and plan an appropriate path of treatment for the individual. Since every person and their cancer is unique, a tailored form of treatment is necessary to ensure the best prognosis.
There are a number of different types of treatment available for this disease. Among the curative options that are available are surgery, chemotherapy, and radiation therapy. Many patients who have been diagnosed with mesothelioma are given a combination of the three, in what is called a multimodal approach.

 By combining more than one of these rigorous treatments, it is possible to approach a solution to the cancer from various angles.In addition to these options, there are also some more experimental procedures. Among these options are photodynamic therapy, gene therapy, immunotherapy, hormonal therapy, anti-angiogenesis therapy and ozone therapy.  Unfortunately, these options are still in the experimental phase, with little knowledge as to their effectiveness. For this reason they are typically only available to patients as part of a clinical trial. Patients who agree to take part in a clinical trial are not only exposing themselves to treatments that may be beneficial; they are also providing researchers with  the information that they need to develop new treatments and possibly cures for people who are suffering from mesothelioma in the present and future.


Main Treatment Types

Surgery:
There are different forms of mesothelioma surgery and some are proposed as a curative measure, while others are designed to relieve symptoms of the disease that can be quite debilitating and interfere with the patient's quality of life.
Ideally, candidates for these surgeries will be in the early stages of the disease where the tumor is still fairly localized and metastasis has not occurred. In addition, the patient will need to be in overall good health and free of other medical issues that can complicate these procedures and lengthen the recovery period. Extant medical issues - like heart disease, hypertension, and diabetes - are often an issue with older mesothelioma patients, further limiting treatment options and making aggressive surgical procedures a less favorable choice
However,


Curative surgery
curative surgery is a major operation - and, as the name suggests, possibly life-changing. But not everybody who has mesothelioma qualifies for such surgery. Patients who want to consider this surgery generally must have good health on their side.Ideally, candidates for these surgeries will be in the early stages of the disease where the tumor is still fairly localized and metastasis has not occurred. Doctors want to be sure that this kind of patient can withstand the rigors of a difficult surgery and arduous rehabilitation.the patient will need to be in overall good health and free of other medical issues that can complicate these procedures and lengthen the recovery period

Palliative Surgeries:

Palliative surgery for mesothelioma patients may involve the removal of cancerous tissue or the drainage of excess fluid to provide relief from symptoms and alleviate pain. While palliative surgery does not offer a cure, such treatment has improved quality of life and prolonged survival.

Pleurodesis

Pleurodesis is a palliative treatment option for those coping with pleural mesothelioma. This procedure is performed when pleural effusion is present. Pleural effusion is the buildup of fluid in the lungs, which can cause considerable pain and breathing difficulties.

Thoracotomy

Thoracotomy is a generic term that refers to lung surgery and the procedure can be performed on patients with pleural mesothelioma. There are three main types of thoracotomy procedures, including wedge resection, lobectomy and pneumonectomy. In cases where only small, localized tumors are present, a wedge resection may be performed to remove the tumor

Pleurocentesis

This procedure is used to address pleural effusion, the build-up of fluid in the pleural area surrounding the lungs. The fluid can make it very painful and difficult for a mesothelioma patient to breathe. The procedure is performed in an outpatient area by means of a long, thin needle that is inserted into the pleural space to withdraw fluid. The patient may return home a few hours after the procedure is complete and when the doctor is satisfied that no adverse reactions will occur.

Radiation Therapy

Radiation therapy is one of the oldest forms of mesothelioma cancer treatment available,

Radiation therapy is a common cancer treatment known to reduce pain among mesothelioma patients. In fact, numerous clinical trials have shown that, on its own, Radiation Therapy does not prolong survival in most mesothelioma patients. Instead, Radiation Therapy is best used with other treatments. radiation is often used together with chemotherapy for optimal results, or may be used after a form of surgery that is designed to remove as much of the cancer as possible.
half of the patients treated with radiation experience some sort of benefit. Side effects are generally easier on a patient than side effects from chemotherapy. The therapy itself is fairly straightforward. A specialist applies ionizing radiation to cancerous tumors. The radiation damages DNA and kills tumor cells.
Radiation therapy is not used to treat all forms of mesothelioma, particularly peritoneal mesothelioma. This type of mesothelioma affects the abdominal area, which contains vital organs and a number of different tissues. Not all of these organs and tissues are afflicted with cancer, so it is not necessary to treat them. But radiation therapy can be toxic to the small intestine, liver, kidneys and other organs. This limits any potential benefit to the therapy.
There are some side effects  of Mesothelioma Radiation i.e:
  • Skin redness
  •  Esophagitis 
  • Fatigue 
  • Nausea 
  • Radiation pneumonitis 
  • Cardiac damage
  •  Radiation myelitis 
  • liver radiation damage

Chemotherapy

Chemotherapy is one of the most widely in use treatments for cancer of all types. Literally meaning "chemical therapy", it was developed in the 1940s. The primary objective of chemotherapy is to kill cancer cells and shrink tumors. It attacks cells which are rapidly dividing and interrupts the division process. While chemotherapy is meant to target cancer cells, it can harm any cells throughout the body that divide quickly. For example, hair follicles are among the fastest growing cells and therefore are easily damaged during chemotherapy treatment, leading many cancer patients to experience temporary hair loss. chemotherapy is used for mesothelioma patients in conjunction with other standard therapies such as mesothelioma radiation. It may also be used in an adjuvant capacity following surgery to eliminate any tumor that remains after the procedure is complete.
Chemotherapy, over the years, has elicited fear in many patients and it is true that this type of treatment can produce unpleasant side effects. It is important therefore, that those with mesothelioma for whom chemotherapy is recommended for palliative reasons, carefully consider these side effects before agreeing to the treatment.
The results of weighing the positive and negative factors of the treatment against the impact on overall quality of life will be different from patient to patient but is necessary to ensure that the best treatment decision is made.


Side effects of Chemotherapy

  • hair loss  
  • Anemia 
  • Nausea and vomiting
  • Loss of appetite 
  • Lower platelet count 
  • Diarrhea 
  • Rash 
  • Body aches 
  • Fatigue 
  • Fever 
  • Compromised immune system 
  • itchy in the feet and hands

 list of some of the chemotherapy drugs a mesothelioma patient may be prescribed:

  • Cisplatin 
  • gemcitabine
  •  Alitma 
  • Navelbine 
  • Onconase
  •  Carboplatin

These drugs may be used on their own or as part of a combination of drugs for more aggressive treatment. 


Multimodal Therapy



In a recent study, 46% of mesothelioma patients showed a 5-year survival rate following multimodal therapy
Multimodal therapy is one of the most common approaches to treating mesothelioma, combining two or more treatments that may be completed simultaneously or in a planned sequence. A mesothelioma specialist can most adequately analyze a patient’s condition and develop a treatment regimen that will best benefit the patient.

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