Pleural mesothelioma (malignant mesothelioma) is a rare malignant tumor originating from the superficial cells of the pleural lining. Sometimes it can also develop in the pericardium and peritoneum. Pleural mesothelioma is most often diagnosed in men over 60 years of age. Unfortunately, due to the low characteristic symptoms, it is diagnosed late and treatment is usually not satisfactory. Can mesothelioma be treated?
In the next 10-20 years there is a likelihood of an increase in the incidence of malignant pleural mesothelioma. Although this cancer is rare, it presents a challenge for doctors due to the still unsatisfactory results of treatment. At the time the diagnosis is made, after many years of exposure to asbestos, malignant pleural mesothelioma is limited to half the chest. However, the extent of the cancer means that complete resection is rarely possible. In addition, the role of both local (surgical and radiation) treatments is not definitively established. The use of chemotherapy has not been satisfactory for many years. Recently, encouraging results have been obtained regarding the use of new generation anti-metabolites. Regardless of the limited effectiveness of each of these methods used singly, combination therapy can improve the survival and quality of life of patients.
Symptoms and diagnostics
Long-lasting chest pain, coughing and shortness of breath are alarming and should be a signal to see a doctor. After understanding the symptoms, the doctor has to use three types of additional tests used to diagnose lung cancer. These are imaging, morphological and laboratory tests. Imaging is performed first, but the most important and decisive are histopathological tests – detecting cancer cells.
Treatable pleural mesothelioma
Total resection, i.e. complete removal of the tumor, is the only chance of complete recovery. However, it is possible in a few patients, only less than 10% of patients qualify for such surgery.
Most often, however, surgery is performed to reduce the tumor mass or reduce the discomfort associated with its growth. These types of operations are called palliative procedures and are not intended to extend life, but to improve its quality.
There are two types of surgery: pleurectomy – surgery to remove the entire pleura, pneumonectomy – surgery to remove the entire lung with the adjacent pleura, part of the diaphragm and pericardium. Other methods of treatment are: radiotherapy, radio-chemotherapy and chemotherapy. Drugs such as anthracyclines (doxorubicin, epirubicin), platinum derivatives (cisplatin, carboplatin), antimetabolites (methotrexate, gemcitabine, pemetrexed) are also used. The combination of pemetrexed and cisplatin seems to be the most effective at present.
A person with pleural mesothelioma has a chance to be cured, but it depends primarily on when the disease was diagnosed. The earlier the stage of development of the disease in which it was detected, the greater the patient’s chance of survival.