1.Pleural Mesothelioma

2.Peritoneal Mesothelioma

Pericardial mesothelioma is an extremely rare form of cancer that develops in the lining around the heart (the pericardium). Caused by asbestos, pericardial mesothelioma has an extremely poor prognosis, with most cases being diagnosed only after an autopsy.

Mesothelioma Causes

A cause is a contributing factor that leads to a disease or health condition.The inhalation or ingestion of microscopic asbestos fibers is responsible for most cases of mesothelioma. In rare cases, radiation exposure and exposure to zeolite — another type of fibrous mineral similar to asbestos —have been identified as causes of mesothelioma.

A risk factor, in this case, is anything that increases the chances of developing mesothelioma or asbestos-related cancers.

Factors that increase the risk of Mesothelioma

• Working at an asbestos mine or asbestos processing plant
• Working in a high-risk occupational setting, such as the construction or automotive industries
• Serving on military ships or facilities built with products containing asbestos
• Living in a residential area near an asbestos mine
• Disturbing asbestos products during a home renovation without proper safety measures.

Diagnosing Mesothelioma Symptoms

Mesothelioma symptoms can take 20 – 50 years to appear after the first exposure to asbestos. The signs of mesothelioma often look like those of other diseases, which can lead to misdiagnosis. When someone exhibits mesothelioma symptoms, doctors perform a variety of tests to rule out other diseases. It normally takes weeks or months for doctors to arrive at an accurate mesothelioma diagnosis.

Symptoms of Mesothelioma Type

While a few symptoms are common to all types of the disease, mesothelioma symptoms are strongly tied to the location of the mesothelioma tumors in the body.

Pleural Mesothelioma Symptoms

The most common form of mesothelioma, pleural mesothelioma develops in the linings of the lungs and accounts for approximately 75 percent of all cases of the disease. Symptoms of pleural mesothelioma often affect breathing and the thoracic cavity(chest), and they can often be taken for problems related to other diseases, such as pneumonia, flu, or even lung cancer.

Symptoms of pleural mesothelioma include:

• Chest pain and general body aches
• Chronic coughing
• Pleural effusion – a buildup of fluid linings of the lungs
• Weight loss – especially if sudden and/or unexplained
• Fatigue
• Fever and night sweats

Peritoneal Mesothelioma Symptoms

The lining of the abdomen is known as the peritoneum, and this is where peritoneal mesothelioma develops, accounting for approximately one quarter of mesothelioma cases. Because the abdomen contains many different organs, symptoms can vary significantly, depending on where within the abdomen tumors occur and which organs may be affected. Symptoms such as loss of appetite, swelling, and abdominal pain can often be confused for diseases related to specific organs or systemic problems, rather than mesothelioma.

Symptoms of peritoneal mesothelioma include:

• Abdominal pain and swelling
• Loss of appetite (anorexia)
• Weight loss – especially if unexpected or sudden
• Ascites – a buildup of fluid in the abdomen
• Anemia – most often in women
• Bowel obstruction
• Fever
• Nausea

Pericardial Mesothelioma Symptoms

Fewer than 1 percent of mesothelioma cases affect the lining of the heart (the pericardium), and unfortunately, in many cases the disease is not diagnosed until after the patient dies. As with other forms of the disease, symptoms of pericardial mesothelioma can often mimic other conditions, such as coronary heart disease, heart failure, or pericarditis (an inflammation of the pericardium).

Symptoms of pericardial mesothelioma include:

• Chest pain
• Pericardial effusion – fluid buildup between the heart and pericardium
• Arrhythmia – an irregular heartbeat or palpitations
• Heart murmur
• Dyspnea – shortness of breath
• Fever and night sweats

What If You Have Symptoms of Mesothelioma?

Whenever your body is showing signs of sickness, it is best not to ignore it, regardless of whether you have a rare disease, such as mesothelioma, or a common sickness like the flu. This is especially true if you are experiencing symptoms such as difficulty breathing, abdominal pain, or chest pain, which could point to mesothelioma or another severe condition.

The best thing to do in such cases is to start by talking with your family doctor. Explain to your doctor in as much detail as possible the symptoms you are experiencing, without leaving anything out. The more information your doctor has, the better he or she can diagnose the problem or refer you to a specialist.

If your doctor believes you may have mesothelioma, they will typically refer you to an oncologist, a type of doctor who specializes in cancer diagnosis and treatment. (Since most mesothelioma cases affect the linings of the lungs, this is usually a thoracic oncologist.) Your oncologist will perform a series of diagnostic tests, which may include imaging scans, blood tests, or biopsies, to determine whether you mesothelioma or another form of cancer. Once a diagnosis is confirmed, the oncologist will work with you and your family doctor to develop a treatment plan.

The most important thing, however, is not to ignore any symptoms you may be experiencing. Mesothelioma has a very poor prognosis, and the best thing you can do to improve that prognosis is to catch it early. Telling your doctor about any symptoms as soon as you start experiencing them is the only way to do that.

How Doctors Diagnose Mesothelioma

There are three main types of tests used to diagnose mesothelioma: imaging scans, blood tests, and biopsies. Doctors typically perform the least invasive tests first, followed by more involved tests if they are warranted.

Imaging Scans

Diagnostic imaging tests, like X-rays, CT scans, and MRIs, help doctors obtain information about cancer, including how far it has progressed. Each method has its benefits and limitations.

X-ray

X-rays are commonly used to diagnose many conditions, illnesses, and injuries. They can be particularly helpful in finding fluid in the lungs, often an early sign of mesothelioma.

CT-Scan

Computer Tomography (CT) scans provide a series of X-ray images to form a 3D image, allowing tumors to be spotted more easily.

MRI

Magnetic Resonance Imaging (MRI) scans provide a 3D model with much higher resolution than other imaging methods. This can be helpful in diagnosing metastasis (spreading) of the mesothelioma.

PET Scan

Positron Emission Tomography (PET) scans use a radioactive isotope injection that can be viewed by the scanner. PET scans can help distinguish benign versus malignant tumors.

Blood Tests and Biomarkers

In recent years, a number of blood tests have been developed to identify substances in the blood that can point to the presence of mesothelioma cancer cells. The presence of these substances, known as biomarkers, do not always indicate a mesothelioma diagnosis, but they can provide useful information that can demonstrate a need for a biopsy. Biomarker tests are also known as “assays.”

Mesothelioma is Commonly Misdiagnosed

Mesothelioma is often misdiagnosed, at least initially, partly due to the fact that many mesothelioma symptoms resemble the symptoms of other diseases. Also, because mesothelioma is so rare, doctors may be more inclined to diagnose a more common disease first, thereby delaying treatment. Misdiagnosis can differ depending on the type of mesothelioma a person has. The table below provides common misdiagnoses based on mesothelioma type.

Pleural 

• Pneumonia
• Emphysema
• Asthma
• Bronchial infections
• Chronic Obstructive Pulmonary Disease (COPD)
• Adenocarcinoma and other lung cancers

Peritoneal

• Irritable Bowel Syndrome (IBS)
• Crohn’s Disease
• Hernia
• Ovarian cancer
• Other cancers affecting abdominal organs

Pericardial

• Coronary artery disease
• Heart failure
• Tuberculosis pericarditis
• Other heart-related cancers, such as synovial sarcoma

Mesothelioma Prognosis

The prognosis for mesothelioma is poor, with most patients living less than 1 year. The type of mesothelioma, stage of the cancer, and patient health are the three most important factors used to determine prognosis. Mesothelioma prognosis can be improved by receiving treatment as soon as possible and leading a healthy lifestyle.

What Factors Affect Mesothelioma Prognosis?

There are five primary factors that doctors consider when determining a prognosis for mesothelioma patients.

Location

Peritoneal mesothelioma (in the abdomen) has a slightly better prognosis than pleural mesothelioma (in the lungs). Pericardial mesothelioma (in the heart) has a very poor prognosis.

Cell Type

Of the three primary cell types of mesothelioma, epithelioid mesothelioma is the most common and also has a better prognosis than sarcomatoid or biphasic mesothelioma.

Stage

Mesothelioma patients diagnosed at an early stage will have a better prognosis than those diagnosed at a later stage. By Stage III and Stage IV, generally, only palliative treatments are given to relieve pain and discomfort.

Metastasis

If the mesothelioma has spread to other parts of the body from where it originated (i.e., metastasized), the prognosis is much worse. Once the disease begins to spread, it is much harder to remove the cancer through surgery or kill it with chemotherapy.

Overall Health

Patients who are relatively young and healthy will have a better prognosis because their bodies are better able to handle the treatments. Older patients also tend to have other conditions that can exacerbate the disease or limit treatment options.

Prognosis by Mesothelioma Type

The type of mesothelioma, which is determined by the location where it first develops, can have a big effect on the prognosis of the disease.

• Pleural Mesothelioma

On average, patients who receive some form of treatment live between six and twelve months after diagnosis. Some treatments have been linked to slightly longer survival times, such as chemotherapy using pemetrexed (Alimta®) and Cisplatin.

• Peritoneal Mesothelioma

The average survival period for patients with peritoneal mesothelioma is 1 year. However, patients who are healthy enough to undergo surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) have a much higher average length of survival, with as many as half living more than five years.

• Pericardial Mesothelioma

In most cases, pericardial mesothelioma is not even diagnosed until an autopsy is performed. For patients who are diagnosed while still alive, pericardial mesothelioma presents an extremely poor prognosis.