Mesothelioma: symptoms, treatment and prognosis of life
Mesothelioma (code according to ICD-10 C45) is a neoplasm of the soft tissues arising from pleura cells – mesothelium. The disease is characterized by:
- Obsessive cough;
- Chest pain;
- The exhaustion of the body.
The malignant process affects the pleura, abdominal cavity, pericardium, male and female genital organs. Pleural mesothelioma occurs in 80 out of 100 patients. After the tumor affects the serous layer of the pleural sheets, it can occur in other organs of the chest. Peritoneal mesothelioma occurs in 15% of cases of the disease.
The disease develops rapidly. The neighboring organs are involved in the process. Having reached stage 3, metastasis progresses, which leads to the death of the patient.
Etiology of Mesothelioma
The disease can occur in people whose work is related to asbestos. Almost all patients with mesothelioma came into contact with this substance during its extraction or use. Such a neoplasm develops in women extremely rarely due to professional characteristics.
People who live near asbestos mines and inhale harmful dust daily are especially prone to mesothelioma. The disease can be asymptomatic for up to 5 years. Asbestos is found in some roofing and building materials, so you need to be careful about their composition when choosing.
When ingested through the respiratory tract or esophagus, asbestos settles on the walls of organs. It provokes the development of cancer, in which the mesothelial cell becomes atypical. Such cells are connected, a nodal tumor is created.
Other causes of cancer:
- Accommodation in places with increased radiation background.
- Chronic lung diseases of various origins.
- Hereditary factors.
- Genetic developmental abnormalities.
- Infection with SV40 polyomavirus.
Types of tumors
The classification of forms of cancer divides mesothelioma into 2 types:
- Benign neoplasm. It is fibrous in nature. It is localized in one place, does not spread secondary foci. The symptomatic picture is not expressed.
- A malignant tumor is diffuse and localized. Diffuse neoplasms are found in 75% of cases. The tumor membrane is fuzzy, the mesothelium is thickened, it is covered with papillary growths. The neoplasm sprouts in the tissue and deforms them.
Depending on the affected area, diffuse mesothelioma is divided into types:
- Epithelioid. It has the most positive outlook.
Despite the fact that the morphology of the tumors is different, both species require treatment.
The degree of development of pathology
The oncological process has 4 stages of development:
- In stage I, cancer affects one side of the parietal pleura.
- Stage II is characterized by the spread of the focus into the visceral region, lung parenchyma or the muscle layer of the diaphragm.
- Stage III is characterized by damage to the lymph nodes, adjacent soft tissues, and pericardium.
- With the onset of stage IV, metastasis of neighboring organs begins. The oncological process affects the tissue of both lungs, the spine, ribs, myocardium and abdominal organs.
The clinical picture of mesothelioma
Symptoms of the disease occur depending on the location of the tumor. Typically, patients noted:
- A significant increase in body temperature.
- Unreasonable fatigue.
- Weight loss.
- Iron-deficiency anemia.
The symptom that occurs with tumor growth is pain in the affected area. Increases over time. Not observed in the early stages of the development of the disease.
When neoplasms in the lungs occur, respiratory function is impaired, coughing is accompanied by pain in the chest. The general condition of the patient is rapidly deteriorating. Due to the fact that lung tissue cannot normally participate in oxygen metabolism, the skin becomes blue, the tissues swell, and cardiovascular failure occurs. Oxygen starvation provokes an increase in symptoms.
When the disease affects the mesothelial layer of the peritoneum, there are pains of unknown origin, constipation, and diarrhea, bloating and a feeling of fullness in the abdomen, weight loss, belching, spontaneous hiccups. Large tumors are felt through the abdominal wall. The neoplasm disrupts tissue metabolism, fluid accumulates in the sterile cavities of the peritoneum. The abdomen swells, ascites progresses.
The development of a tumor in the pericardium is manifested by pain in the region of the heart, hemorrhagic pericarditis, an increase in the volume of the heart, tachycardia, hypotension, angina pectoris and other disorders. There is a risk of heart failure, which provokes edema of the lower extremities, pallor of the skin, increased sweating and blue shade of the lips. For this condition, periodic attacks of suffocation and fainting are relevant. If untreated, a heart attack occurs.
With testicular mesothelioma, the organ grows, pain is noted, the rough surface of the neoplasm is palpated. Pain in the groin and thigh.
If the malignant process affects the fallopian tubes, women complain of aching pain from the lower abdomen. Through the lymphatic system, cancer cells spread into the abdominal cavity.
The oncological process in the first stages has no clinical manifestations. It is usually diagnosed with severe organ damage. Any signs of impaired functioning of organs and systems should be examined by a specialist.
Diagnosis is a comprehensive study. Laboratory diagnostics include
- General blood analysis;
- Blood chemistry;
- Analysis of urine.
In malignant processes, the ESR index increases, significant changes in the leukocyte formula occur, thrombocytosis and a decrease in hemoglobin levels are noted.
Interventional radiology allows for non-invasive studies:
- To detail the picture, a chest x-ray is prescribed. With mesothelioma, the images will show massive hydrothorax, the parietal pleura is sometimes thickened, the volume of the chest cavity is reduced, and the chest organs are displaced.
- Then conduct ultrasound diagnostics of the pleural cavity and determine the volume of the contained fluid (exudate). After the fluid is removed, inspect the internal appearance and condition of the lungs. Ultrasound is also prescribed for the study of the heart, organs of the genitourinary system, thyroid gland, and digestive tract organs.
- The findings of magnetic resonance imaging and computed tomography are fundamental for making a diagnosis.
On CT and MRI results, an enlarged and detailed lesion focus is available for specialists to consider. Such diagnostics show:
- The size and exact location of the neoplasm.
- The presence of metastases in bone and soft tissues, in organs and systems of the human body.
- The presence of fluid in the cavities.
MRI and CT can help you think through a plan of surgery and find a convenient and safe approach to the tumor.
Scintigraphy and positron emission tomography are also performed.
When studying tumors of the abdominal cavity, colonoscopy, gastroscopy, and laparoscopic diagnosis is performed.
For a detailed study of the condition of the tracheobronchial tree, the method of fiber bronchoscopy is used. The procedure is carried out on an empty stomach. A flexible endoscope is introduced through the nose to the patient to assess the condition of the mucosa, bronchi, and trachea. Spirography is then performed to determine respiratory function.
To determine the nature of the tumor, a biopsy of the tumor is performed. The node tissue is taken using laparoscopy or thoracoscopy. The second method opens internal access to the pleura. Cytology and histology make it possible to establish a final diagnosis.
Tactics for the treatment of mesothelioma
Treatment depends on the type, location and stage of the disease. To remove mesothelioma relevant:
- Surgical intervention provides full access to the tumor and allows you to remove it completely along with neighboring healthy tissues. The likelihood of relapse is reduced. With a large-scale lesion, the organ is completely removed (if possible). In cases of inability to conduct a complete excision of the tumor, the maximum available part is removed.
- In the early stages of the disease, pleurectomy is performed. In this case, it may be necessary to remove part of the lung, diaphragm, and pericardium.
- With damage to the abdominal cavity, there is a high probability of removal of the genitals and omentum.
- Heart surgery is less effective. They are quite complex, so only the pericardium is removed to the patient. The tumor continues to develop, the prognosis for life is disappointing.
- If there is fluid in the cavities, shunting is performed.
- With mesothelioma, several chemotherapeutic drugs are effective. For example, Cisplatin and Pemetrexed. They are prescribed before and after tumor resection.
- Radiation therapy helps smooth out the postoperative period. It reduces pain and achieves atypical cells.
- Immunotherapy is used as an additional treatment method. The patient takes immunostimulants to activate the body’s natural protective functions. It is used only in combination, does not independently affect the malignant process.
- Photodynamic therapy allows you to fight the tumor without opening the organs. A sensitizer is introduced into the patient’s body through a vein or orally, which settles in the neoplasm cells. After that, light waves of a certain length are sent to the tumor. Under their action, necrosis of malignant nodes occurs.
- With an inoperable neoplasm, the patient is prescribed radiation and chemotherapy to smooth out the painful symptoms. Continuous monitoring of the tumor. If it decreases, an operation is prescribed.
During and after treatment, a balanced diet is drawn up for the patient. Mandatory intake of prescribed drugs. Clinical recommendations and treatment methods are based on improving the patient’s condition and prolonging his life.
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