The Stages Of Pleural Mesothelioma

Mesothelioma is a type of cancer  that affects the mesothelial tissues of some organs of the body such as the lungs which is called pleural mesothelioma. On the other hand, the mesothelioma cancer in the abdomen is medically termed as peritoneal mesothelioma and in the heart it is known as pericardial mesothelioma.The mesothelium is the layer of cells that line the covering of internal organs and body cavities.

This type of cancer is almost exclusively associated with exposure to asbestos dust or fibres.The unfortunate aspect of mesothelioma is that it is rarely diagnosed on time and takes a long time from exposure to asbestos to development of the disease. This can take from ten to fifty years or longer.The treatment options depend on the stage at which it is diagnosed. 

Stages of Pleural Mesothelioma

Cancer staging refers to the extent of the cancer cells. The higher the stage, the poor the prognosis is. Staging is based on the size of the tumour(primary mass),how far it has spread(metastasis) and involvement of the lymph nodes.Treatment options and management of pleural mesothelioma depends on the stage at which it is diagnosed.

Stage 1. This is the earliest stage of pleural mesothelioma. The cancer is localized on one side of the chest,left or right.It may have spread to the lung,the pericardium or diaphragm on the same side.There is no involvement of lymph nodes at this stage.Treatment involves surgery to remove the tumours and a small amount of surrounding tissue.This is followed by chemotherapy and/or radiation to kill off any remaining cancer cells.Prognosis for stage 1 is good.

Stage 2. In this stage,the cancer has spread from its point of origin to affect the pleural membrane on the other side of the chest.It may have affected the other lung,the heart covering or the diaphragm.Lymph nodes may have become involved.Treatment options include surgery to remove tumours and affected lymph nodes depending on the size and location and the extent of involvement of nearby organs.This is followed by radiation or chemotherapy to kill the remaining cancer cells.Prognosis is not as good as in stage 1.

Stage 3. During this stage, the cancer has spread to multiple locations within the chest.Organs such as both lungs,the heart,ribs,oesophagus,diaphragm, including lymph nodes are affected.Treatment options are limited at this stage.Surgery is only considered if the patient is sufficiently healthy enough to withstand the physical strain associated with such extensive surgeries.Large tumour masses are removed to ease the pressure on nearby organs.Treatments are generally palliative.Thoracentesis is used to drain fluid built up in the chest.Chemotherapy and radiation may be employed to shrink tumours and provide symptomatic relief.Prognosis is poor.

Stage 4. This is the end stage of the disease. The cancer has penetrated deeply into nearby organs and the tumours are large.Spread has occurred to other parts of the body.Surgery cannot be performed at this stage.Treatments are palliative such as thoracentesis to drain fluid from the chest cavity to ease pain and discomfort.Chemotherapy and radiation may be used to shrink tumours to provide some relief.Prognosis is very poor.

Those are the four stages of pleural mesothelioma. So if you think you have been long exposed to asbestos, visit your doctor right away and get checked because the earlier pleural mesothelioma is detected,the better it can be handled and the greater the chances of survival.

How Does Asbestos Cause Mesothelioma?

Mesothelioma is a highly aggressive form of cancer that is difficult to diagnose and treat.About two to three thousand cases are diagnosed annually in the United States alone and account for about three percent of all diagnosed cancer cases.

The condition affects the mesothelial cells lining the covering of internal organs and body cavities.It is called pleural mesothelioma when it affects the lungs and chest cavity;pericardial mesothelioma when it involves the covering of the heart;peritoneal mesothelioma when it occurs in the peritoneum and testicular mesothelioma when the tunica vaginalis covering the testis is affected.  Mesothelioma is almost exclusively associated with inhalation or ingestion of asbestos fibers  and most victims come down with the disease after some ten to fifty years after exposure though it can progress more rapidly in a few cases.

The question to ask is:how does exposure to asbestos cause mesothelioma?The exact mechanism by which asbestos causes mesothelioma is still being researched into but four different theories have been advanced by medical professionals:

v  Asbstos fibers cause irritation and inflammation of the mesothelium leading to irreversible scarring,damage to cells and eventually cancer.

v  Asbestos fibers enter cells and disrupt the normal function of cellular structures that control cell division,causing changes that lead to cancer.

v  Asbestos causes the production of free radicals which damage the DNA,causing mutations which lead to the cells becoming cancerous.

v  Asbestos enters cells causing them to produce abnormal proteins called oncoproteins.These molecules are thought to cause mesothelial cells to ignore the normal restraint on cell division,thereby leading to uncontrolled cell division and ultimately cancer.

The underlining  factor common to the four theories is the fact that asbestos causes cellular damage which causes cells to lose control over the normal cycles of cell division causing them to divide uncontrollably.In health,cells follow cycles of division that ensure that tissues and organs do not grow beyond their normal sizes.In cancer cells however,all such natural restraints are lost.

In cases of mesothelioma,the membranes(mesothelium) in the affected region begin to thicken with fluid building up between the membrane spaces.As the cancer cells continue to divide and pile on top of one another,tumours begin to form.The uncontrolled division of the cancer cells and increase in the size of the tumours lead to impaired function of the organs and systems involved primarily from pressure caused by the tumours and inadequate nutrition of the normal cells.

Asbestos exposure is as at date the only proven cause of mesothelioma.However,researchers have shown that smoking can aggravate a less serious asbestos-related condition like asbestosis and prompt the formation of tumours and onset ofmesothelioma.Asbestos exposure and smoking have been shown to have a synergistic effect and can greatly increase the risk of developing lung cancer.It is therefore advised that individuals with history of asbestos exposure should abstain from smoking.They should also present themselves for regular screening checks by their doctors so that any histological changes can be detected on time for better management and increased chances of survival.