Pleural MesotheliomaPleural mesothelioma affects the pleura, or lining that coats the lungs and chest wall, and accounts for about 75 percent of all cases of mesothelioma. Most asbestos-related mesotheliomas are pleural mesotheliomas.
Symptoms of pleural mesothelioma
- Pain in the side of the chest or lower back
- Shortness of breath
- Excessive sweating
- Unexplained weight loss
- Difficulty swallowing
- Swelling of the face and arms
Peritoneal mesotheliomaPeritoneal mesothelioma involves the peritoneum, which lines the inside of the abdomen and many of the abdominal organs. About 25 percent of mesothelioma diagnoses are peritoneal mesotheliomas.
Symptoms of peritoneal mesothelioma
- Abdominal pain
- Swelling or fluid in the abdomen
- Unexplained weight loss
- Nausea and vomiting
Pericardial mesotheliomaPericardial mesothelioma develops in the lining around the heart, and is extremely rare.
Symptoms of pericardial mesothelioma
- Palpitations or irregular heartbeat
- Chest pain
- Heart murmurs
- Difficulty breathing, even at rest
- Orthopnea, or difficulty breathing when lying down
- Fever or night sweats
Tunica vaginalis mesotheliomaTunica vaginalis mesothelioma, also referred to as testicular mesothelioma, affects the sac surrounding the testicles, and is also extremely rare.
Symptoms of tunica vaginalis mesothelioma
- Hydrocele (buildup of fluid in the scrotum)
- Abnormal lump inside the scrotum
- Pain and swelling of the testes
Mesothelioma DiagnosisWhen patients visit a medical professional reporting signs or symptoms of mesothelioma, the doctor will want to get a medical history to learn about symptoms and possible risk factors, such as asbestos exposure. The doctor may perform a series of diagnostic tests – including imaging tests like X-rays, MRIs, CTs and PET scans; blood tests; and biopsies – to accurately diagnose mesothelioma. Which tests are performed often depends on the type of symptoms. Diagnostic tests for mesothelioma include: Chest X-ray A chest X-ray is typically ordered for patients with symptoms such as constant cough or shortness of breath. Findings that might suggest mesothelioma include abnormal thickening of the pleura, calcium deposits on the pleura, fluid between the lungs and chest wall, or changes in the lungs. Ultrasound Ultrasound, or sonography, uses high-frequency sound waves to produce pictures of the inside of the body. Ultrasounds are 90 percent accurate at detecting testicular tumors and are often used to when patients present with symptoms of tunica vaginalis mesothelioma, or testicular mesothelioma. Echocardiogram This test also uses sound waves to capture images of the heart’s chambers, valves, walls and the blood vessels attached to the heart. An echocardiogram can show how well the heart is functioning. Computed tomography (CT) scan CT scans use X-rays to make detailed, cross-sectional images of the body. These X-rays are then combined into images of slices of the body. If mesothelioma is suspected, a CT scan will allow a doctor to determine the exact location of the cancer, whether it has spread to other organs, and whether treatments are effective. Magnetic resonance imaging (MRI) scan Similar to CT scans, MRI scans make detailed images of the body’s soft tissues. But, MRIs use radio waves and strong magnets instead of X-rays. Prior to testing, patients are injected with a contrast material called gadolinium. This provides better contrast in the images captured. MRI scans can help show the exact location and extent of a tumor. Positron emissions tomography (PET) scan During a PET scan, patients are injected with a radioactive substance, typically a type of sugar because cancer cells absorb more sugar than most other cells. The level of radioactivity is very low. During a PET scan, a camera creates a picture of the areas of radioactivity in the body. This test does not give as much detail as a CT or MRI scan, but can help determine whether cells seen in other imaging tests are likely cancerous or not, and to determine whether cancer has spread to other parts of the body. Some machines can do a PET and CT scan at the same time. Blood tests People with mesothelioma may have markers, or higher levels of certain substances, in their blood that helps doctors narrow in on a diagnosis. These substances include osteopontin and soluble mesothelin-related peptides (SMRPs). Fluid and tissue sample tests Test results may strongly suggest a patient has mesothelioma, but the actual diagnosis is made by performing a biopsy. During a biopsy, cells are removed from an abnormal area and looked at through a microscope. Biopsies can be performed in different ways depending on a patient’s situation. Mesothelioma can cause a buildup of fluid in the chest, abdomen, or heart. This fluid is removed and tested for its chemical makeup. If cancer cells are found, special tests can be done to determine if the cancer is mesothelioma or another type of cancer. Biopsies can also be performed by inserting a needle into the tumor, a procedure called a needle biopsy; by using an endoscope during which a small camera is sent down a patient’s throat; or through open surgery. Once mesothelioma is diagnosed, a doctor will determine the type of mesothelioma, the staging, and recommend a course of treatment.
Mesothelioma StagingOnce malignant mesothelioma has been diagnosed, doctors will try to determine whether the cancer has spread and, if so, how far, a process called staging. This helps doctors determine how serious the cancer is and the best way to treat it. Staging ranges from I (1) to IV (4), with the lower number meaning the less the cancer has spread, and the higher number meaning the cancer has spread more. There are different ways cancer is staged. The American Joint Committee on Cancer uses the TNM system based on three key pieces of information – the size of the tumor (T), such as whether it has grown into nearby structures or organs; whether the cancer has spread to nearby lymph nodes (N); and whether it has spread, or metastasized (M) to distant organs. The TNM system groups mesotheliomas into several stages that give a more clear idea of a patient’s prognosis. Staging can also determine whether a cancer is resectable (where all visible sides of the tumor can be removed by surgery) or unresectable. Even if mesothelioma tumors can be surgically removed, in most cases cancer cells can be left behind after surgery. For this reason, doctors may use other treatments, such as radiation and/or chemotherapy. Mesothelioma cell types Mesothelioma is also categorized by cell type. There are three main cell variations which can help determine a patient’s prognosis and treatment options.
- Epithelioid cells are the most common cell type in patients with mesothelioma. Patients with epithelioid cell type tend to have the best life expectancy, because this type of cell variation is most receptive to treatment.
- Sarcomatoid cells are the least common cell type. These cells spread faster than epithelioid cells resulting in a shorter survival and fewer treatment options.
- Biphasic cell types are those with both epithelioid and sarcomatoid cells present. Life expectancy is better in patients with more epithelioid cells present than sarcomatoid cells.