Do you have persistent chest pain or difficulty breathing? You may think it's normal. However, sometimes these symptoms can be a sign of a more serious health condition that we haven't heard much about. Today, we're going to talk about a rare, and often unknown, cancer.
What exactly is Pleural Mesothelioma?
Simply put, Pleural Mesothelioma is a rare type of cancer that develops in the thin membrane, or lining, that surrounds our lungs and the inner wall of our chest. This lining is medically called the pleura . It protects our lungs like an envelope.
This cancer gets its name from the membrane called mesothelium. This is a protective covering that surrounds many of the organs inside our body. So, cancer that develops anywhere in this mesothelium membrane is commonly called mesothelioma. Because it develops in the lungs, it is called Pleural Mesothelioma.
The main and most directly related cause of this is exposure to asbestos . You may have heard that asbestos sheets were used in the past even for the roofs of houses in our country. This asbestos is a type of mineral that was used in the past for many things such as building materials and the automotive industry. When we breathe in the tiny fiber-like particles in it, they go into the lungs and get deposited. Our body cannot digest or destroy these particles. Over time, these particles can cause inflammation in the lungs, cell abnormalities, and eventually develop into cancer.
The important thing is that intact asbestos materials are not dangerous. However, it is when the material breaks down, breaks down, and becomes airborne as dust that the greatest risk arises from inhaling those particles.
What are the main types of this cancer?
The World Health Organization (WHO) has divided this cancer into three main types, depending on the type of cell it starts in. Some types of cancer spread quickly and are difficult to treat. Knowing which type you have can help your doctor decide what treatment is best for you and how your disease will progress.
| Cancer type | Description |
|---|---|
| Epithelioid Mesothelioma | This is the most common type (between 60% and 80% of all patients). It is the easiest to treat compared to the other two types. |
| Sarcomatoid Mesothelioma | This is the rarest type (about 10% of all patients). This type grows very quickly and is difficult to treat. |
| Biphasic Mesothelioma | This is also a rare type (between 10% and 15%). It has a mixture of both of the above cell types. |
What could be the symptoms of this disease?
One of the most dangerous things about this disease is that the symptoms appear very slowly. It can take 15, 20, or even 50 years after exposure to asbestos for symptoms to appear. The early symptoms are as minor as a common cold, so many people ignore them. As a result, by the time they see a doctor, the cancer may be quite advanced.
The two main symptoms are:
- Persistent chest pain
- Difficulty breathing (shortness of breath)
In addition to this, the following features can also be seen:
- Persistent cough and hoarseness
- Difficulty swallowing (Dysphagia)
- Lower back pain
- Swelling of the face and hands
- Weight loss without any reason
- Night sweats
- Frequent fatigue
- Fever that comes on for no reason
Who is at higher risk of developing this disease?
Many people who develop this disease are exposed to asbestos for years through their jobs. Think of a former bass player. He worked in construction sites and shipbuilding for years. He only started to develop symptoms when he was 65 or 70.
The jobs most at risk are:
- Building construction and factory workers
- Shipbuilding and repair workers (especially those who served in the navy)
- People who demolish old buildings
- Auto mechanics and railway workers
- Insulation manufacturers and installers
- Firefighters
- Plumbers
- Miners
Not only this, you may also be at risk:
- If someone in your family does this kind of work, these asbestos particles can come into the house on their clothes and shoes.
- If you live near an asbestos mine, or near a place where old buildings containing asbestos are being demolished.
How does a doctor accurately diagnose this disease?
When you tell your doctor about your symptoms, he or she will examine you, ask about your job, your environment, etc. to see if you have any risk factors. After that, they may do several tests to confirm the diagnosis.
- Imaging Tests: A chest X-ray will be done first. This can look for things like thickening of the lining of the lungs, pleural effusion, etc. In addition , a CT scan, MRI scan , or PET scan may be done to see exactly where the cancer is and whether it has spread.
- Blood Tests: Some blood tests can check for elevated levels of certain substances associated with this cancer (such as fibulin-3 and soluble mesothelin-related peptides) in the blood.
- Thoracentesis: This involves removing some of the fluid (fluid) that has collected around your lungs with a syringe and testing it for cancer cells. This can help relieve chest tightness and shortness of breath.
- Biopsy: This is the only way to confirm the diagnosis 100% of the time. In this, a small piece of tissue is taken from the lining of the lung and examined under a microscope to see if there are any cancer cells. This can be done using techniques such as bronchoscopy, thoracoscopy , or video-assisted thoracic (VATS) surgery .
How are cancer stages classified?
Like any cancer, there are stages. The stage is determined by how far the cancer has spread. This is very important for your doctor to plan your treatment.
- Stage 1: The cancer is only in the lining of the lungs (pleura). At this stage, surgery may be performed to try to remove the cancer completely.
- Stage 2: The cancer has spread a little beyond the lining of the lung, but is still close to where it first started.
- Stage 3: The cancer has spread to nearby organs and lymph nodes.
- Stage 4: The cancer has spread to distant organs (such as the liver, bones, or brain). This is called metastasized .
What are the treatments for this?
Pleural mesothelioma is a difficult cancer to treat because it can spread easily through nerves, blood vessels, and tissues. Therefore, oncologists usually recommend a combination of treatments.
- Surgery: Surgery may be performed in the early stages of cancer. An operation called an extrapleural pneumonectomy (EPP) removes the lung and surrounding tissue. A surgery called a pleurectomy with decortication (P/D) removes only the lung lining and the tumor without removing the entire lung.
- Radiation Therapy: High-energy X-rays are used to destroy cancer cells. This can be done in conjunction with surgery or chemotherapy. It is sometimes used to reduce symptoms (such as chest pain).
- Chemotherapy: This involves giving the body drugs that kill cancer cells or stop them from growing. Pemetrexed, carboplatin , and cisplatin are the most commonly used drugs.
- Immunotherapy: This is a new treatment method that works by strengthening our own immune system, helping it recognize and attack cancer cells.
- Palliative Care: The goal of this is not to cure cancer. Instead, it is to control the patient's symptoms (pain, difficulty breathing), make daily life easier, and provide relief.
- Clinical Trials: These are studies that test the latest treatments and drugs. You may have the opportunity to get the latest treatments, such as new chemotherapy and immunotherapy drug combinations, gene therapy , and photodynamic therapy .
Although this disease cannot be completely cured, these treatments can help you extend your life, control your symptoms, and live a more comfortable life.
How to prevent it? And when to see a doctor?
The best way to prevent Pleural Mesothelioma is to avoid breathing asbestos particles in the air. Now, the use of asbestos has been restricted in Sri Lanka as well. However, these can still be found in houses and buildings that are more than 20-30 years old.
- If you are renovating an old house, especially if you are changing things like the roof or ceiling, have someone knowledgeable check it for asbestos.
- If removing asbestos, entrust the task to a company trained for the purpose.
- If you work in a hazardous job, always wear proper protective masks and clothing . Avoid bringing those particles home on your clothes.
If you have a history of asbestos exposure and experience any of the following symptoms, be sure to see a doctor immediately:
- Back or chest pain
- Persistent cough or hoarseness
- Difficulty breathing or swallowing
- Facial swelling
- Weight loss for no reason
Ask your doctor about these things:
- What type of Pleural Mesothelioma do I have?
- What stage of cancer am I in?
- What treatment is best for me?
- Will these treatments prolong my life? Will they relieve my symptoms?
- How to control the side effects of treatment?
- Are there any clinical trials I can participate in?
Take-Home Message
- Pleural mesothelioma is a rare cancer that develops in the lining of the lungs. The main cause of this is the inhalation of asbestos particles.
- Symptoms (chest pain, difficulty breathing) can take years to appear, so don't ignore them.
- If you have a history of exposure to asbestos (especially in jobs such as construction or auto mechanics) and are experiencing the above symptoms, seek medical advice immediately.
- Although this disease cannot be completely cured, surgery, radiation therapy, chemotherapy, and new treatments can control symptoms and extend life.
- Prevention is best. Protect yourself from asbestos dust as much as possible.
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