Mesothelioma is a cancer of the mesothelium, that is, the membranes that line various organs in the body. This condition is classified as a dangerous type of cancer and can be fatal.

Mesothelioma is classified as an aggressive type of cancer, but it is quite rare. This condition does not cause symptoms until decades after the patient is exposed to asbestos. In the vast majority of cases, patients diagnosed with mesothelioma are aged 60–80 years.

Although it can be treated, most cases of mesothelioma are already at an advanced stage, making it difficult to treat. Therefore, it is important to carry out prevention and regular examinations to prevent this condition.

Types of Mesothelioma

There are four types of mesothelioma cancer, namely:

  • Pleural mesothelioma (pleural mesothelioma), which is a cancer that attacks the membranes of the lungs (pleura) and is the most frequent type
  • Mesothelioma peritoneum (peritoneal mesothelioma), that is, cancer of the membrane of the abdominal cavity (peritoneum)
  • Mesothelioma pericardium (pericardial mesothelioma), that is, cancer in the protective layer of the heart organ
  • Testicular mesothelioma (testicular mesothelioma), which is a cancer that attacks the protective layer of the testicles or testicles

In addition to the above types, there is also benign mesothelioma in the lungs and chest cavity called solitary fibrous tumors. However, this condition does not belong to the type of mesothelioma that will be discussed.

Causes of Mesothelioma

The causes of mesothelioma are not yet known for certain. However, mesothelioma is often related to exposure to asbestos or asbestos. Asbestos is a mineral that is widely used as a building construction material, such as roofing, due to its heat-resistant and fire-resistant properties.

Destroyed asbestos, both in the process of mining and renovating buildings, will produce fine fibers or dust. The fiber is very easy to inhale, then enters and settles in the organs of the body, especially the lungs.

If ingested, asbestos fibers can also spread through the lymphatic system, then settle and cause cancer in the membrane of the abdominal cavity (peritoneum).

Risk factors for mesothelioma

Mesothelioma can occur in anyone, but the risk is higher in people with the following factors:

  • Work in fields vulnerable to asbestos exposure, such as mineral mines, construction sites, automotive industry, power generation, textile industry, and steel mills
  • Residing in an old building or neighborhood whose soil contains asbestos
  • Have family members working in an environment that is prone to exposure to asbestos so that asbestos dust sticks to the skin or clothing and is carried into the house
  • Have a family suffering from mesothelioma or a genetic disorder that increases the risk of developing cancer
  • Exposure to erionite minerals or radiation from thorium dioxide
  • Infected with simian virus (SV40)

Symptoms of Mesothelioma

Mesothelioma develops gradually and usually takes 20–60 years for symptoms to appear. Therefore, the patient may not feel any symptoms when mesothelioma is still in its early stages. However, cancer cells will develop over time and put pressure on nerves or other organs so that symptoms arise.

Symptoms of mesothelioma depend on the affected organ. In pulmonary mesothelioma, symptoms that may appear include:

  • Fever and sweating, especially at night
  • The body feels very tired
  • Cough accompanied by unbearable pain
  • Shortness of breath due to fluid buildup in the lungs
  • Weight loss for no apparent reason
  • Chest pain
  • Hoarseness
  • Difficult to swallow
  • Pain in the shoulder or upper arm
  • Swelling or deformation of the fingertips (finger tabuh)
  • Lumps appear on the tissues below the surface of the chest skin
  • While abdominal mesothelioma (peritoneal) can cause the following symptoms:
  • Fever or night sweats
  • Loss of appetite
  • Weight loss
  • Diarrhea
  • Constipated
  • Abdominal pain
  • Nausea and vomiting
  • Lumps or swelling in the abdominal area
  • Defecation and urination disorders

Pericardium and testicular mesothelioma is a very rare type of mesothelioma. Pericardial mesothelioma usually causes symptoms in the form of chest pain and respiratory problems, while testicular mesothelioma is characterized by swelling or lumps in the testicular area.

When to see a doctor

Symptoms of mesothelioma may resemble those of other conditions. Therefore, immediately take an examination to the doctor if you experience the above symptoms, especially if you have a history of exposure to asbestos.

Diagnosis Mesothelioma

In order to determine the diagnosis of mesothelioma, the doctor will conduct questions and answers related to the patient's symptoms and medical history, especially the possibility of exposure to asbestos. A physical examination will also be performed to detect lumps or other symptoms.

To confirm the diagnosis, the doctor will perform a scan, such as:

  • X-ray photo, to detect thickening in the lining of the lungs, fluid in the pleural cavity, or deformation of the lungs
  • CT scan, to check the chest and abdomen area, as well as detect the presence of cancer and check if the cancer has spread to other organs of the body
  • PET scan, to get a detailed picture of tissues suspected of cancer
  • MRI, to get a more detailed picture of the organ and determine the location of the tumor

Based on the test results, the doctor may also suggest further examinations in the form of:

Blood test

A blood test is performed to detect an increase in the level of fibulin-3, osteopontin and peptide in the blood. Levels of these three substances are usually higher in people with mesothelioma.

Examination of liquid samples

If the patient experiences a buildup of fluid in the body due to mesothelioma, the doctor will take a sample of the fluid and examine it in the laboratory to detect the presence of cancer cells.

  • There are several types of examination of liquid samples, namely:
  • Thoracentesis, that is, the sampling of fluid in the chest cavity
  • Paracentesis, that is, the taking of fluid in the abdominal cavity
  • Pericardiocentesis, that is, the taking of fluid in the layers (membranes) around the heart

Biopsy

Biopsy is performed by taking a sample of tissue from a specific part of the body for later analysis in the laboratory. There are several types of biopsy examinations, namely:

1. Needle biopsy

A needle biopsy is performed by piercing a long needle into the chest or abdominal cavity.

2. Thoracoscopy, laparoscopy and mediastinoscopy

This biopsy is performed by inserting a studded elastic tube and a special surgical instrument through one or more small incisions. The type of biopsy performed depends on the area of the body being examined, namely:

  • Thoracoscopy, to examine the inside of the chest
  • Laparoscopy, to examine the inside of the abdominal organs
  • Mediastinoscopy, to examine the area around the heart

3. Biopsy through surgery

In some conditions, the doctor will perform an invasive procedure to take a larger tissue sample to confirm the diagnosis. The doctor can also simultaneously remove the entire tumor if possible.

There are two types of biopsy procedures through surgery, namely:

  • Thoracotomy, which is performed through open surgery in the chest
  • Laparotomy, which is performed through open surgery in the abdomen

4. Bronchoscopic biopsy

This biopsy is performed by inserting a thin tube through the throat to detect tumors in the respiratory tract. If there is, the doctor will take a tissue sample from the tumor for research.

Stage Mesothelioma

Based on its size and degree of spread, mesothelioma is divided into four stages. This division of stages helps the doctor to know the development of cancer cells and the life expectancy of the patient, as well as determine the appropriate method of treatment.

The following are the stages and life expectancy of people with mesothelioma:

Stage 1

The tumor is still in one area of the body and has not spread to other tissues or organs. At this stage, the life expectancy of the sufferer is 21 months or more.

Stage 2

Cancer cells enlarge and begin to spread to nearby areas, with a life expectancy of 19 months or less.

Stage 3

Cancer cells have spread to surrounding organs, with a life expectancy of about 16 months.

Stage 4

Cancer cells have spread to different areas throughout the body through the bloodstream. At this stage, the life expectancy of sufferers is very low, which is about 12 months.

Treatment of Mesothelioma

Mesothelioma is one of the types of malignant cancer and cannot yet be cured. The treatment carried out is limited to relieving symptoms and extending the life expectancy of the patient. The method of its treatment is determined based on the following factors:

Based on the above considerations, some of the treatment steps that can be recommended by a doctor are:

1. Chemotherapy

Chemotherapy is the administration of drugs to kill or inhibit the growth of cancer cells. This therapy can be done before surgery to shrink cancer cells for easy removal, or after surgery to reduce the risk of cancer reappearing.

2. Radiotherapy

Radiotherapy or radiation therapy is performed by firing X-rays or proton beams at areas of the body affected by cancer. This therapy is usually carried out after surgery to remove the remaining cancer cells.

Radiotherapy can also be performed to relieve symptoms of advanced cancer in patients who cannot undergo surgery.

3. Operation

The operation can be performed on early-stage mesothelioma. There are several options for surgery that a doctor can perform, namely:

  • Surgery to remove as many cancer cells as possible from the patient's body. This action can be supported by radiotherapy to relieve pain and inhibit the growth of cancer.
  • Surgery to suck out fluid in the chest that interferes with breathing. This action may be accompanied by pleurodesis, that is, the injection of the drug into the chest to prevent fluid from re-accumulating.
  • Surgery to remove the tissue around the abdominal cavity, ribs, or lungs affected by cancer cells.
  • Surgery to remove the affected part of the lungs and surrounding tissues. The procedure is usually continued by radiotherapy.

4. Multimodality therapy

This therapy is a combination of three or more treatment methods, for example surgical, postoperative chemotherapy, and radiation therapy, to increase the success rate of treatment.

To help the treatment process, the doctor will advise the patient to do the following:

Breathing exercises, to control breathing when experiencing symptoms of difficulty breathing

Body relaxation exercises, to reduce tension in the muscles of the respiratory tract in order to be able to breathe more easily

Complications of Mesothelioma

Mesothelioma that has enlarged or spread can compress surrounding organs or tissues. This can lead to a variety of complications.

In pleural mesothelioma, complications that can occur are:

  • Difficulty breathing
  • Chest pain
  • Difficulty swallowing
  • Pain due to pressure on the nerves and spinal cord
  • Pleural effusion

While the complication due to peritoneal mesothelioma is intestinal obstruction, which can be characterized by nausea, vomiting, constipation, and loss of appetite or feeling full quickly.

Prevention of Mesothelioma

The main way to prevent mesothelioma is to avoid contact with everything that contains asbestos. If you work in an environment that is at high risk of exposure to asbestos, then follow the occupational safety regulations that have been set by the company, for example:

  • Use personal protective equipment while in work areas that are vulnerable to exposure to asbestos
  • Dispose of residual asbestos material in a safe place and does not harm the surrounding environment
  • Do not bring home clothes and shoes used during work

In addition, there are several other things that can be done to reduce the risk of mesothelioma, namely:

  • Conduct periodic health checks to detect symptoms or signs of diseases associated with exposure to asbestos
  • Quit smoking, because cigarettes can increase the risk of developing various types of cancer, including mesothelioma

Follow instructions on how to handle asbestos safely

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