Thursday, July 5, 2007
Introduction
Mesothelioma International is dedicated to the fight against mesothelioma – a worldwide health crisis with roots in humanity's use of asbestos. Although the use of asbestos has now been banned in the European Union, it is estimated that 250,000 workers in Western Europe alone will have died from mesothelioma by 2029. It is our hope that this website will be helpful to those throughout Europe who have been affected by this epidemic.
Mesothelioma is a rare and virulent form of cancer that affects the lining of the lung, lining of the abdominal cavity or lining around the heart. Mesothelioma is caused by exposure to asbestos, and occurs in those who have breathed in asbestos fiber, in many cases 20 to 50 or more years ago. Some were exposed on their jobs; others were exposed secondarily through family members who without their knowledge, brought fiber home on their work clothes or on their hair or skin.
Despite the serious nature of the disease, there is hope. Every year, doctors and scientists worldwide are developing new treatments and making new discoveries that help to improve the chance of survival and the patient’s quality of life. This website, Mesothelioma International, helps patients and their family members connect with the resources they need to be informed and make the best decisions on their potential treatment and care.
The first section of our website answers common questions about mesothelioma and its cause and discusses those at risk. In the next section, the most common symptoms are discussed, as well as the various testing procedures which may be used to come to a diagnosis. The treatment section discusses types of aggressive treatment such as surgery, chemotherapy, radiation and clinical trials being conducted by cancer facilities throughout the world, as well as the palliative care option for those who either can not or choose not to be treated. Every year, progress is being made.
It is Mesothelioma International’s goal to consolidate the most up to date, concise mesothelioma information available today, and our resource co-ordinators are always available to help you and your family find the answers for your particular questions.
MESOTHELIOMA-WHAT IS IT?
Mesothelioma is a rare form of cancer. "Mesothelioma" is the term used to describe a cancerous tumor which involves the mesothelial cells of an organ, usually the lungs or abdominal organs.
The most common type of mesothelioma is the pleural mesothelioma. The pleura is a thin membrane found between the lungs and the chest cavity. It provides a lubricated surface so that the lungs do not chafe against the chest walls. Thus, a pleural mesothelioma is often referred to as a "lung" cancer.
Another form of mesothelioma is the peritoneal mesothelioma. The peritoneum is the membrane that encloses the organs of the abdomen. While peritoneal mesotheliomas are less common than pleural mesotheliomas, they tend to be more invasive, and may thus result in a shorter life expectancy for the patient. Mesotheliomas have also been found in the stomach and other abdominal organs.
HOW MESOTHELIOMA IS DIAGNOSED
Most people begin by seeing their GP when they have symptoms. Your GP will examine you and may arrange for you to have some tests or x-rays. You may be referred to hospital for these tests and for specialist advice and treatment.
At the hospital the doctor will take your medical history and occupational history before doing a physical examination.
* Chest x-ray
* CT scan (computerised tomography scan)
* Pleural or peritoneal aspiration
* Biopsy
Chest x-ray
A chest x-ray will be taken to check for any abnormalities in your lungs, such as thickening of the pleura or fluid around the lungs.
The following tests may also be used to diagnose mesothelioma and your doctor may arrange for you to have one or more of them at the hospital.
back to top
CT scan (computerised tomography scan)
A CT scan takes a series of x-rays, which builds up a three-dimensional picture of the inside of the body. The scan is painless but takes from 10 to 30 minutes. CT scans use a small amount of radiation, which will be very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
CT scans of the chest and of the abdomen will show the size and position of the mesothelioma and whether it has spread to other parts of the body.
You may be given a drink or injection of a dye that allows particular areas of your body to be seen more clearly. For a few minutes, this may make you feel hot all over. If you are allergic to iodine, or have asthma, you could have a more serious reaction to the injection, so it is important to let your doctor know beforehand.
The CT scan is painless but it will mean lying still for about 10–30 minutes. You will probably be able to go home as soon as the scan is over.
Having a CT scan
Having a CT scan
There are other much more common causes of thickening of the pleura and peritoneum, and fluid around the lungs or in the abdomen, so the chest x-rays and scans alone cannot make the diagnosis.
back to top
Pleural or peritoneal aspiration
If there is fluid in your chest or abdomen the doctor can take a sample by using a local anaesthetic and passing a needle through the skin into the fluid. Some of the fluid is then drawn off into a syringe and can be analysed in the laboratory to look for mesothelioma cells.
Taking fluid from between the pleura is known as a pleural aspiration and taking fluid from the abdomen is known as drainage of ascites (or peritoneal aspiration).
back to top
Biopsy
Your doctor will usually need to take a sample of tissue from the thickened pleura or peritoneum. A local anaesthetic is used to numb the area and a special type of needle is passed through the skin into the tumour. The needle has a tip that can cut out a sample of the tumour. The doctor may use ultrasound or a CT scanner to position the needle accurately. An ultrasound uses sound waves to build up a picture of the organs in a part of the body. A small device is passed over the skin to show the doctor where the tumour is and guide the needle into the right place.
Sometimes the doctor will want to look at the area of the pleura or the peritoneum directly to get a sample of tissue from the right area. This is done by using a thin flexible tube with a light and camera at the end. The tube (endoscope) can be passed through the skin of the chest, where it is called thoracoscopy, or the abdomen, where it is called laparoscopy. The procedure is done under a general anaesthetic by a surgeon. You will usually be able to go home the same day.
Analysing the biopsy in the laboratory is the only way your doctor can make the diagnosis of mesothelioma. Sometimes, even after taking a biopsy, the doctors may not be sure of the diagnosis, because mesothelioma can be very difficult to distinguish from other illnesses. In this situation, the biopsy samples may be sent to other laboratories to confirm the diagnosis, some of your tests may need to be repeated or you may be referred to another hospital for a second opinion.
It will probably take several days for the results of your tests to be ready and a follow-up appointment will be arranged for you before you go home. Obviously, this waiting period will be an anxious time for you and it may help to talk things over with a close friend or relative. You may want to ring Cancerbackup's Cancer Support Service to ask any questions you may have.
SYMPTOMS OF MESOTHELIOMA
Mesothelioma often starts as many tiny lumps (nodules) in the pleura, which may not show up on scans or x-rays until they are quite large. The main symptoms of pleural mesothelioma are pain in the chest and breathlessness. Some people also notice that their voice becomes hoarse and they have a cough that does not go away.
Peritoneal mesothelioma often causes swelling and pain in the abdomen.
General symptoms
Both types of mesothelioma can cause other general symptoms, such as loss of appetite, sweating (especially at night), weight loss and tiredness. As many of these symptoms can also be caused by other illnesses, your doctor will need to do a series of tests before a diagnosis can be made.
PLEURAL MESOTHELIOMA
The term Mesothelioma is used to describe a cancerous tumor that involves the “mosothelial” cells of an organ, usually the lungs, heart or abdominal organs. The most common type is pleural mesothelioma, a very agresive form of lung cancer. The “pleura” is a thin membrane found between the lungs and the chest cavity, which serves as a lubricant to prevent the lungs from chafing against the chest walls. When pleural mesothelioma cancer spreads, the cells of the mesothelium become abnormal. These malignant cells begin to divide and spread without order and can begin to affect organs and tissues in the immediate area. This often leads to complications in the surrounding organs.
There are two types of Pleural Mesothelioma, diffuse and malignant (cancerous), and localized and benign (non-cancerous). Benign mesotheliomas can often be removed surgically, are generally not life-threatening, and are not usually related to asbestos exposure. Malignant mesotheliomas, even though rare, are very serious and require more aggresive treatments.
The most serious type of mesothelioma, diffuse malignant mesothelioma, is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs and accounts for about 75% of all cases. Fluid build-up from the pleural effusion can generally be seen on a chest x-ray and heard during a physical examination, but a firm diagnosis of mesothelioma can only be made through a biopsy and pathological testing. This is important because there are also benign pleural effusions and other tumors that have a similar appearance to mesothelioma. Diagnosing mesothelioma can be quite difficult; it requires special lab stains, and often considerable experience by the pathologist interpreting the results.
The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle. With the lungs restricted, they get smaller and less functional, and breathing becomes more difficult. At first a person with mesothelioma may be breathless only when he or she exercises, but as lung function drops, he or she can become short of breath even while resting.
The tumor spreads by direct invasion of surrounding tissue. As it spreads inward it can compress the lungs. As the tumor spreads outward it can invade the chest wall and ribs, and this can be extremely painful.
Current medical science does not know exactly how and why, at a cellular level, asbestos fibers cause mesothelial cells to become abnormal (malignant or cancerous.) Thus it is not known whether only one fiber causes the tumor or whether it takes many fibers. It seems that asbestos fibers in the pleura can start a tumor as well as promote its growth; the tumor does not depend on any other processes for its development.
Unfortunately there is as yet no known absolute cure for malignant mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment. The treatment options for people with mesothelioma have improved significantly, especially for those whose cancer is diagnosed early and treated vigorously.
Some of the treatments currently available for pleural mesothelioma include:
•Chemotherapy
•Radiation Therapy
•Surgery
•Intra-operative photodynamic therapy
Peritoneal Mesothelioma
Peritoneal mesothelioma is a tumor of the peritoneum membrane. This thin membrane of mesothelial cells surrounds and protects many of the organs in the abdomen. Asbestos exposure is the only known cause of peritoneal mesothelioma in the U.S. However, it can take decades before initial symptoms of this disease appear. Peritoneal Mesothelioma accounts for about one-fifth of all mesotheliomas diagnosed in the US each year.
While peritoneal mesotheliomas are less common than pleural mesotheliomas, they tend to be more invasive, and thus often result in a shorter life expectancy for the patient. Mesotheliomas have also been found in the stomach and other abdominal organs.
Like all cancers, peritoneal mesothelioma can be either benign or malignant. Even though symptoms of peritoneal mesothelioma take years to develop, it is sometimes diagnosed by mere coincidence and before any symptoms actually appeared.
Typical symptoms of peritoneal mesothelioma include abdominal pains, weakness, weight loss, loss of appetite, nausea, and abdominal swelling. Sometimes fluid accumulates in the peritoneal space, which results in a condition known as Ascites. Most often than none, the symptoms of peritoneal mesothelioma start of gradually, but over time the symptoms can become more and more severe.
Although the first step towards detecting peritoneal mesothelioma involve X-rays and CT scans, a definitive diagnosis is only achieved through a biopsy, which usually involves removing a tiny piece of tissue. However, this is generally only done if the doctor finds an abnormality when viewing the peritoneum using a precedure called peritoneoscopy. The tissue sample is then examined by a pathologist who makes a diagnosis using microscopic analysis of specialized stains
At this time, even though there are various treatment options available, there is no known cure for peritoneal mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, its extent, the cell type, and whether or not the tumor responds to treatment. However, an early diagnosis is important and because of it relief and treatment of people with peritoneal mesothelioma have improved dramatically.
Some of the treatments currently available for peritoneal mesothelioma include:
•Chemotherapy
•Radiation Therapy
•Surgery
TREATMENT OF MESOTHELIOMA
The treatment for mesothelioma depends on whether it is only in one place or has spread. Currently, there is no cure for mesothelioma, unless it can be removed by an operation. Unfortunately, when mesothelioma is diagnosed, it has usually already spread beyond the point where it could be removed by an operation.
The usual treatment for mesothelioma in this situation is called active symptom control.
* Multidisciplinary team
* Benefits and disadvantages of treatment
* Giving your consent
Multidisciplinary team
If your tests show that you have mesothelioma, you will be looked after by a multidisciplinary team. This is a team of staff who specialise in treating lung cancer and mesothelioma and in giving information and support. It will normally include:
* surgeons who are experienced in chest surgery
* specialist nurses who give information and support
* oncologists – doctors who have experience in mesothelioma treatment using chemotherapy and radiotherapy
* symptom control specialists
* radiologists who help to analyse x-rays
* pathologists who advise on the type and extent of the cancer.
Other staff will also be available to help you if necessary, such as:
* physiotherapists
* counsellors and psychologists
* social workers.
back to top
Benefits and disadvantages of treatment
Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. Some people ask what would happen if they did not have any treatment.
Although cancer treatments can cause side effects, these can usually be controlled with medicines.
Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. In people with early-stage mesothelioma, surgery, radiotherapy and chemotherapy may be given with the aim of curing the cancer.
However, in most people with mesothelioma, the cancer is at a more advanced stage and any treatment given is with the aim of controlling it, which for some people may lead to an improvement in symptoms and a better quality of life. However, for some people in this situation the treatment will have no effect upon the cancer and they will get the side effects of the treatment without any of the benefit.
When a cure is not possible and aim of treatment is to control the cancer for a period of time, it may be difficult to decide whether to go ahead with treatment. Making decisions in these circumstances is always difficult, and you may need to discuss your treatment and symptom control in detail with your doctor.
back to top
Giving your consent
Before you have any treatment, your doctor will explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:
* the type and extent of the treatment you are advised to have
* the advantages and disadvantages of the treatment
* any possible other treatments that may be available
* any significant risks or side effects of the treatment.
If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.
It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.
Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.
You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.
Mesothelioma International is dedicated to the fight against mesothelioma – a worldwide health crisis with roots in humanity's use of asbestos. Although the use of asbestos has now been banned in the European Union, it is estimated that 250,000 workers in Western Europe alone will have died from mesothelioma by 2029. It is our hope that this website will be helpful to those throughout Europe who have been affected by this epidemic.
Mesothelioma is a rare and virulent form of cancer that affects the lining of the lung, lining of the abdominal cavity or lining around the heart. Mesothelioma is caused by exposure to asbestos, and occurs in those who have breathed in asbestos fiber, in many cases 20 to 50 or more years ago. Some were exposed on their jobs; others were exposed secondarily through family members who without their knowledge, brought fiber home on their work clothes or on their hair or skin.
Despite the serious nature of the disease, there is hope. Every year, doctors and scientists worldwide are developing new treatments and making new discoveries that help to improve the chance of survival and the patient’s quality of life. This website, Mesothelioma International, helps patients and their family members connect with the resources they need to be informed and make the best decisions on their potential treatment and care.
The first section of our website answers common questions about mesothelioma and its cause and discusses those at risk. In the next section, the most common symptoms are discussed, as well as the various testing procedures which may be used to come to a diagnosis. The treatment section discusses types of aggressive treatment such as surgery, chemotherapy, radiation and clinical trials being conducted by cancer facilities throughout the world, as well as the palliative care option for those who either can not or choose not to be treated. Every year, progress is being made.
It is Mesothelioma International’s goal to consolidate the most up to date, concise mesothelioma information available today, and our resource co-ordinators are always available to help you and your family find the answers for your particular questions.
MESOTHELIOMA-WHAT IS IT?
Mesothelioma is a rare form of cancer. "Mesothelioma" is the term used to describe a cancerous tumor which involves the mesothelial cells of an organ, usually the lungs or abdominal organs.
The most common type of mesothelioma is the pleural mesothelioma. The pleura is a thin membrane found between the lungs and the chest cavity. It provides a lubricated surface so that the lungs do not chafe against the chest walls. Thus, a pleural mesothelioma is often referred to as a "lung" cancer.
Another form of mesothelioma is the peritoneal mesothelioma. The peritoneum is the membrane that encloses the organs of the abdomen. While peritoneal mesotheliomas are less common than pleural mesotheliomas, they tend to be more invasive, and may thus result in a shorter life expectancy for the patient. Mesotheliomas have also been found in the stomach and other abdominal organs.
HOW MESOTHELIOMA IS DIAGNOSED
Most people begin by seeing their GP when they have symptoms. Your GP will examine you and may arrange for you to have some tests or x-rays. You may be referred to hospital for these tests and for specialist advice and treatment.
At the hospital the doctor will take your medical history and occupational history before doing a physical examination.
* Chest x-ray
* CT scan (computerised tomography scan)
* Pleural or peritoneal aspiration
* Biopsy
Chest x-ray
A chest x-ray will be taken to check for any abnormalities in your lungs, such as thickening of the pleura or fluid around the lungs.
The following tests may also be used to diagnose mesothelioma and your doctor may arrange for you to have one or more of them at the hospital.
back to top
CT scan (computerised tomography scan)
A CT scan takes a series of x-rays, which builds up a three-dimensional picture of the inside of the body. The scan is painless but takes from 10 to 30 minutes. CT scans use a small amount of radiation, which will be very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
CT scans of the chest and of the abdomen will show the size and position of the mesothelioma and whether it has spread to other parts of the body.
You may be given a drink or injection of a dye that allows particular areas of your body to be seen more clearly. For a few minutes, this may make you feel hot all over. If you are allergic to iodine, or have asthma, you could have a more serious reaction to the injection, so it is important to let your doctor know beforehand.
The CT scan is painless but it will mean lying still for about 10–30 minutes. You will probably be able to go home as soon as the scan is over.
Having a CT scan
Having a CT scan
There are other much more common causes of thickening of the pleura and peritoneum, and fluid around the lungs or in the abdomen, so the chest x-rays and scans alone cannot make the diagnosis.
back to top
Pleural or peritoneal aspiration
If there is fluid in your chest or abdomen the doctor can take a sample by using a local anaesthetic and passing a needle through the skin into the fluid. Some of the fluid is then drawn off into a syringe and can be analysed in the laboratory to look for mesothelioma cells.
Taking fluid from between the pleura is known as a pleural aspiration and taking fluid from the abdomen is known as drainage of ascites (or peritoneal aspiration).
back to top
Biopsy
Your doctor will usually need to take a sample of tissue from the thickened pleura or peritoneum. A local anaesthetic is used to numb the area and a special type of needle is passed through the skin into the tumour. The needle has a tip that can cut out a sample of the tumour. The doctor may use ultrasound or a CT scanner to position the needle accurately. An ultrasound uses sound waves to build up a picture of the organs in a part of the body. A small device is passed over the skin to show the doctor where the tumour is and guide the needle into the right place.
Sometimes the doctor will want to look at the area of the pleura or the peritoneum directly to get a sample of tissue from the right area. This is done by using a thin flexible tube with a light and camera at the end. The tube (endoscope) can be passed through the skin of the chest, where it is called thoracoscopy, or the abdomen, where it is called laparoscopy. The procedure is done under a general anaesthetic by a surgeon. You will usually be able to go home the same day.
Analysing the biopsy in the laboratory is the only way your doctor can make the diagnosis of mesothelioma. Sometimes, even after taking a biopsy, the doctors may not be sure of the diagnosis, because mesothelioma can be very difficult to distinguish from other illnesses. In this situation, the biopsy samples may be sent to other laboratories to confirm the diagnosis, some of your tests may need to be repeated or you may be referred to another hospital for a second opinion.
It will probably take several days for the results of your tests to be ready and a follow-up appointment will be arranged for you before you go home. Obviously, this waiting period will be an anxious time for you and it may help to talk things over with a close friend or relative. You may want to ring Cancerbackup's Cancer Support Service to ask any questions you may have.
SYMPTOMS OF MESOTHELIOMA
Mesothelioma often starts as many tiny lumps (nodules) in the pleura, which may not show up on scans or x-rays until they are quite large. The main symptoms of pleural mesothelioma are pain in the chest and breathlessness. Some people also notice that their voice becomes hoarse and they have a cough that does not go away.
Peritoneal mesothelioma often causes swelling and pain in the abdomen.
General symptoms
Both types of mesothelioma can cause other general symptoms, such as loss of appetite, sweating (especially at night), weight loss and tiredness. As many of these symptoms can also be caused by other illnesses, your doctor will need to do a series of tests before a diagnosis can be made.
PLEURAL MESOTHELIOMA
The term Mesothelioma is used to describe a cancerous tumor that involves the “mosothelial” cells of an organ, usually the lungs, heart or abdominal organs. The most common type is pleural mesothelioma, a very agresive form of lung cancer. The “pleura” is a thin membrane found between the lungs and the chest cavity, which serves as a lubricant to prevent the lungs from chafing against the chest walls. When pleural mesothelioma cancer spreads, the cells of the mesothelium become abnormal. These malignant cells begin to divide and spread without order and can begin to affect organs and tissues in the immediate area. This often leads to complications in the surrounding organs.
There are two types of Pleural Mesothelioma, diffuse and malignant (cancerous), and localized and benign (non-cancerous). Benign mesotheliomas can often be removed surgically, are generally not life-threatening, and are not usually related to asbestos exposure. Malignant mesotheliomas, even though rare, are very serious and require more aggresive treatments.
The most serious type of mesothelioma, diffuse malignant mesothelioma, is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs and accounts for about 75% of all cases. Fluid build-up from the pleural effusion can generally be seen on a chest x-ray and heard during a physical examination, but a firm diagnosis of mesothelioma can only be made through a biopsy and pathological testing. This is important because there are also benign pleural effusions and other tumors that have a similar appearance to mesothelioma. Diagnosing mesothelioma can be quite difficult; it requires special lab stains, and often considerable experience by the pathologist interpreting the results.
The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle. With the lungs restricted, they get smaller and less functional, and breathing becomes more difficult. At first a person with mesothelioma may be breathless only when he or she exercises, but as lung function drops, he or she can become short of breath even while resting.
The tumor spreads by direct invasion of surrounding tissue. As it spreads inward it can compress the lungs. As the tumor spreads outward it can invade the chest wall and ribs, and this can be extremely painful.
Current medical science does not know exactly how and why, at a cellular level, asbestos fibers cause mesothelial cells to become abnormal (malignant or cancerous.) Thus it is not known whether only one fiber causes the tumor or whether it takes many fibers. It seems that asbestos fibers in the pleura can start a tumor as well as promote its growth; the tumor does not depend on any other processes for its development.
Unfortunately there is as yet no known absolute cure for malignant mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment. The treatment options for people with mesothelioma have improved significantly, especially for those whose cancer is diagnosed early and treated vigorously.
Some of the treatments currently available for pleural mesothelioma include:
•Chemotherapy
•Radiation Therapy
•Surgery
•Intra-operative photodynamic therapy
Peritoneal Mesothelioma
Peritoneal mesothelioma is a tumor of the peritoneum membrane. This thin membrane of mesothelial cells surrounds and protects many of the organs in the abdomen. Asbestos exposure is the only known cause of peritoneal mesothelioma in the U.S. However, it can take decades before initial symptoms of this disease appear. Peritoneal Mesothelioma accounts for about one-fifth of all mesotheliomas diagnosed in the US each year.
While peritoneal mesotheliomas are less common than pleural mesotheliomas, they tend to be more invasive, and thus often result in a shorter life expectancy for the patient. Mesotheliomas have also been found in the stomach and other abdominal organs.
Like all cancers, peritoneal mesothelioma can be either benign or malignant. Even though symptoms of peritoneal mesothelioma take years to develop, it is sometimes diagnosed by mere coincidence and before any symptoms actually appeared.
Typical symptoms of peritoneal mesothelioma include abdominal pains, weakness, weight loss, loss of appetite, nausea, and abdominal swelling. Sometimes fluid accumulates in the peritoneal space, which results in a condition known as Ascites. Most often than none, the symptoms of peritoneal mesothelioma start of gradually, but over time the symptoms can become more and more severe.
Although the first step towards detecting peritoneal mesothelioma involve X-rays and CT scans, a definitive diagnosis is only achieved through a biopsy, which usually involves removing a tiny piece of tissue. However, this is generally only done if the doctor finds an abnormality when viewing the peritoneum using a precedure called peritoneoscopy. The tissue sample is then examined by a pathologist who makes a diagnosis using microscopic analysis of specialized stains
At this time, even though there are various treatment options available, there is no known cure for peritoneal mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, its extent, the cell type, and whether or not the tumor responds to treatment. However, an early diagnosis is important and because of it relief and treatment of people with peritoneal mesothelioma have improved dramatically.
Some of the treatments currently available for peritoneal mesothelioma include:
•Chemotherapy
•Radiation Therapy
•Surgery
TREATMENT OF MESOTHELIOMA
The treatment for mesothelioma depends on whether it is only in one place or has spread. Currently, there is no cure for mesothelioma, unless it can be removed by an operation. Unfortunately, when mesothelioma is diagnosed, it has usually already spread beyond the point where it could be removed by an operation.
The usual treatment for mesothelioma in this situation is called active symptom control.
* Multidisciplinary team
* Benefits and disadvantages of treatment
* Giving your consent
Multidisciplinary team
If your tests show that you have mesothelioma, you will be looked after by a multidisciplinary team. This is a team of staff who specialise in treating lung cancer and mesothelioma and in giving information and support. It will normally include:
* surgeons who are experienced in chest surgery
* specialist nurses who give information and support
* oncologists – doctors who have experience in mesothelioma treatment using chemotherapy and radiotherapy
* symptom control specialists
* radiologists who help to analyse x-rays
* pathologists who advise on the type and extent of the cancer.
Other staff will also be available to help you if necessary, such as:
* physiotherapists
* counsellors and psychologists
* social workers.
back to top
Benefits and disadvantages of treatment
Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. Some people ask what would happen if they did not have any treatment.
Although cancer treatments can cause side effects, these can usually be controlled with medicines.
Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. In people with early-stage mesothelioma, surgery, radiotherapy and chemotherapy may be given with the aim of curing the cancer.
However, in most people with mesothelioma, the cancer is at a more advanced stage and any treatment given is with the aim of controlling it, which for some people may lead to an improvement in symptoms and a better quality of life. However, for some people in this situation the treatment will have no effect upon the cancer and they will get the side effects of the treatment without any of the benefit.
When a cure is not possible and aim of treatment is to control the cancer for a period of time, it may be difficult to decide whether to go ahead with treatment. Making decisions in these circumstances is always difficult, and you may need to discuss your treatment and symptom control in detail with your doctor.
back to top
Giving your consent
Before you have any treatment, your doctor will explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:
* the type and extent of the treatment you are advised to have
* the advantages and disadvantages of the treatment
* any possible other treatments that may be available
* any significant risks or side effects of the treatment.
If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.
It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.
Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.
You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.
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