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Thursday, May 10, 2007

What Is Mesothelioma?

Mesothelioma is a cancer of the smooth lining of the chest, lungs, heart, and abdomen. This skin layer is made up of mesothelial cells, hence the name mesothelioma. Mesothelioma is a diffuse but solid tumor that begins as a result of insult to the tissues caused by asbestos particles. These have penetrated into the pleural cavity of the chest or into the abdomen. Mesothelioma is either called pleural mesothelioma or peritoneal mesothelioma based on where it appears.

In its early stages mesothelioma has few symptoms, but given sufficient time it will grow thicker. Eventually it forms bumps and nodules which coalesce into a crust that compresses the organs of the space within which it grows. Over time, pleural mesothelioma may penetrate through the pleura into the chest wall or through the diaphragm into the abdomen. In Peritoneal mesothelioma it may attach itself onto the omentum or penetrate the abdominal wall. In either case it may begin to invade organs like the lungs, heart, stomach, and liver as it spreads. It may even attach itself to key blood vessels, the esophagus or bowels, making it hard or even impossible to remove surgically.

Figure E: Right Pleural Epithelial Mesothelioma on chest wall and lung. Click here. for enlargement. Photo courtesy K. Brauch

For the vast majority of patients, as the tumor mass grows, once subtle symptoms will give way to weight loss, cough, respiratory infections, fatigue, shortness of breath, digestive and bowel problems and pain in the chest or belly, depending upon whether it is pleural or peritoneal. It may begin to weep fluid into the intracavitary space. For pleural patients this is called an effusion and it fills the space where the lobes of the lung reside, next to the lining of the chest cavity. In peritoneal patients it is called ascites and it fills the abdomen with fluid that surrounds the visceral organs.

Figure F: Epithelial mesothelioma on the diaphragm. Click here. for enlargement. Photo courtesy K. Brauch.

The symptoms gradually become more noticeable until the patient seeks medical help. By this time the progression of the disease may already be too advanced since the tumor may have spread to the lymph nodes and/or begun to metastasize to remote organs of the body like the brain, spleen, liver or kidneys. Metastatic mesothelioma is considered late stage and incurable, given the current state of treatments.

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