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Diagnosing Mesothelioma: MRI


Mesothelioma is not always an easy disease to diagnosis, especially if the patient is unsure about his or her past exposure to asbestos. The symptoms of mesothelioma can be very similar to those of other diseases that affect the lungs and respiratory system and can easily be confused with those diseases or disorders. A definitive link to asbestos, however, is usually the factor that helps doctors make the diagnosis along with a variety of testing.

An x-ray is almost always the first step towards making the diagnosis, but an x-ray - the least sophisticated form of diagnostic imaging available - is often not precise enough to make a definitive determination. A sure-fire diagnosis usually involves at least one other form of diagnostic imaging, including Magnetic Resonance Imaging, more simply known as the MRI.
 
What is an MRI?

Magnetic Resonance Imaging, originally known as Nuclear Magnetic Resonance Imaging, is a medical imaging technique that provides very detailed images of any part of the body. More sophisticated than the CT scan, the use of MRIs began in the mid 1970s and the scans are still an important diagnostic tool today, especially in the diagnosis of cancer.

By use of a powerful magnetic field, the MRI clearly shows the contrast of different soft tissues in the body. By changing exam parameters, the MRI can cause these tissues to take on different appearances. When this occurs, the radiologist who is observing the MRI can simply tell whether something inside the body is abnormal by the way it appears on the screen.

Unlike other diagnostic procedures, the MRI does not rely on radiation, making it an even safer procedure than most. Instead, when the body is inside the machine, radio waves redirect the axes of spinning protons, which are the nuclei of hydrogen atoms, in a strong magnetic field. This field is produced by allowing an electrical current to pass through wire coils inside the machine. Other coils that encircle the body send and receive radio waves, producing signals that are received by a computer. The signals generate images that each show a thin "slice" of the body. These images are then interpreted by a radiologist experienced in reading MRI results.

What to Expect ?
 

While the idea of having an MRI may make an individual nervous, mainly because they are frightened about what the doctor will find, there is nothing scary or painful about the MRI itself. This totally painless procedure is simple and is usually accomplished within just an hour or two at a hospital or some other sort of imaging center. Knowing what to expect helps the whole process go more smoothly and greatly reduces any fear.

Little needs to be done to prepare for an MRI. Some eating and drinking guidelines may apply before the test but, usually, patients may eat and drink as usual and may take their daily medications. In some cases, you may be asked to swallow a contrast dye, known as gandolinium. Fortunately, this dye does not contain iodine, which can cause an allergic reaction. Some health issues preclude the use of a contrast dye, so always be sure your doctor knows if you have kidney disease or other serious disorders.

When you arrive, you'll most likely need to fill out some paperwork and be asked to identify anything in your body that that may contain metal, like cochlear implants or screws or pins placed during surgery for broken limbs, etc. You'll be asked to remove jewelry and other metal items.

Once all paperwork is reviewed and appropriate items are removed, you'll be ready to begin. In the scanning room, patients are asked to lie on a large table. The technician will see that you're comfortable before the procedure begins. Once you are ready to begin, the technician will slide the table into the machine and leave the room.

At that point, the test starts. Usually, it is broken up into several different sequences, and the technician, who can still communicate with you, will tell you how long each will last - generally no longer than about 2 or 3 minutes. During that time, patients will hear banging noises, which is a normal part of the procedure and does not indicate any troubles. The entire test can range from 15 minutes to a few hours. When all is complete, the table will slide back out.

Some people get claustrophobic while undergoing an MRI, especially if it's a long procedure. This can be solved in a few different ways. First of all, your doctor can prescribe a mild sedative if you let him/her know in advance that you have an issue with claustrophobia. Secondly, some facilities offer open MRI machines that reduce that closed-in feeling. Some MRI machines have music piped in to help patients relax. Also, the technician may offer ear plugs to reduce noise.
 
After the MRI

Individuals undergoing an MRI should feel normal after the procedure though if contrast dye is used, it may cause temporary flushing or other minor reactions until it leaves the body.

Patients do not receive immediate results from an MRI. Technicians are not qualified or permitted to interpret images and cannot and should not offer any comments to the patient. The images will be viewed by a licensed radiologist and that individual will send results to the patient's doctor, who will then call to set up an appointment to review them.

If the MRI does show that mesothelioma is present, your doctor will refer you to an oncologist - a cancer doctor - who will instruct you on your options for treatment.
Do the Benefits Outweigh the Risks?

There are many benefits to undergoing MRI in the diagnosis of mesothelioma and other diseases. First of all, it does not expose patients to radiation as do other diagnostic procedures and the contrast dye used in MRIs is much safer than that used for CT scans. Furthermore, it is the most likely of all imaging tests to identify abnormalities and focal lesions on soft-tissue structures of the body, including the heart, liver, and other organs. 


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Diagnosing Mesothelioma: CT Scans


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During the mesothelioma diagnostic process, patients will undergo a variety of medical imaging procedures. One such imaging exam is a CT scan, which provides highly detailed information about the type of disease that is involved and how far it has advanced.

Along with the results of other tests, such as PET scan, MRI scan, and x-ray, the results of a CT scan are used by cancer doctors to diagnose and stage the cancer. This information is used to determine the best and most appropriate course of cancer treatment, and to provide a prognosis, which is a general idea of how doctors expect the disease to progress. CT scans and other tests may be carried out after diagnosis. In these cases the tests are used to determine how effective your current treatment is.

The CT Scan Procedure

A CT scan is almost like an x-ray, in that a series of several separate x-ray images are taken during the procedure. However, the major difference is that a CT scan takes a large number of images, rather than just one or two. Using a CT scan to take many different images allows technicians and doctors to construct a three-dimensional image of the inside of the body.

If you undergo a CT scan you may be given an intravenous injection of dye that helps produce a more detailed picture by increasing the contrast of the images that are taken. The injection might be slightly uncomfortable, but unless you have an unexpected allergic reaction to the dye that is used, there is no danger.

In some cases you may receive a CT scan at the same time as another procedure called a PET scan. Carrying out both tests at the same time allows specialists to get additional information about the location of mesothelioma and whether it has spread to other locations.
Test Results

In most cases, test results for a CT scan will be available within a few days. The scan images are interpreted by a doctor who is specialized in reading the detailed images produced by CT equipment. After the results have been read, your doctor will receive a summary of the findings and will review the results with you and what they mean.

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Mesothelioma Imaging Scans

Mesothelioma is a form of cancer that affects, in most cases, those with long-term exposure to asbestos fibers. This kind of cancer is typically hard to diagnose because the mesothelioma symptoms displayed in the patient are similar to a number of other illnesses and conditions. For this reason, it is important to use advanced imaging technology to assist with proper diagnosis.
Diagnosing Mesothelioma with Imaging Scans

Because the symptoms match those of many other diseases, mesothelioma can be difficult to diagnose and locate. The tumors that are produced may show up in any part of the mesothelium and can even be found between organs. A cancer doctor is going to begin any patient examination with a thorough review of the patient's medical history. As the diagnosis process progresses, there may be several tools used simultaneously to get the most accurate results. Along with blood tests and others, a medical professional may use one or more of several body scans to detect any abnormalities.

X-Rays
 
 The first and most basic imaging scan is an x-ray. This scan is limited, but may be able to detect certain areas that show damage or abnormalities in the body. One of the biggest drawbacks in the x-ray is it can only produce a flat, two-dimensional image. When an x-ray is taken, electromagnetic radiation is sent through the body with a photographic film on the other side. The way the waves, or rays, behavior changes as they pass through the body and different kinds of tissue, thus creating a representative image.

 


 CT Scans

Computed tomography scans, referred to as either CT Scan or "CAT scan," still utilizes x-rays to capture images from inside the body. The x-ray machine and the film travel around the body on one axis and take a large number of images. The images can then be collated and combined to give doctors an excellent idea of what different tissues are found in the area(s) of concern. The data can even be manipulated to show different slices of the tissue and can be rendered into three-dimensional representations. Though an incredibly valuable tool for the medical industry, a CAT scan is still only able to present its data in various shades of light and dark.

  MRI Scans

Magnetic resonance imaging scans use electromagnetic radiation to develop images of the body. Hydrogen atoms in the body respond to the magnetic signals by putting out a very weak radiowave, which a computer can analyze. With a few exceptions, MRI scans are not harmful to the human body, while excessive exposure to x-rays can be. These scans offer all that a CAT scan does and more. The biggest bonus to MRI scans is the ability of the computer to differentiate between tissues in the body and assign them various colors. This lets doctors get a very clear picture of the interior of the body, which can help locate tumors much earlier than the other two kinds of scans. The earlier mesothelioma is discovered and operated on, the better odds a patient has for survival.

PET Scans

One of the best and most widely used scans for detecting and diagnosing mesothelioma and other kinds of cancer is the positron emission tomography scan, known as a PET scan. These scans use tracers and cameras to develop a detailed image of the body and even detect changes in biological processes, allowing doctors to find even the smallest tumor. PET scans involve an injection of a radioactive tracer isotope, combined with some form of glucose, into the blood stream of the patient. After a short waiting period, the scanners are able to detect gamma radiation produced by the tissues in the body that are interacting with the tracer isotope. The scans can produce very accurate representations of the body and can even display what is happening chemically in the tissues.

The most powerful scanning technique combines at least two of the above. Many scanning machines are coming to medical facilities with PET scanners and CAT scanners in the same casing, and some are combined with MRI. The advantage to this is that biochemical processes, which show up in a PET scan, can be compared to what the anatomy that appears in the CAT scan. Both scans can happen almost simultaneously, so the body does not have to be moved during the scan. This ensures that the images are accurate and align with each other. The advantage to this is that biochemical processes, which show up in a PET scan, can be compared to what the anatomy shows in the CAT scan.

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miRview Meso test

Every day, advances are being made in the diagnosis and treatment of mesothelioma in the hopes that someday doctors may be able to make early definitive diagnoses that allow treatment of the disease to be more successful. Historically, mesothelioma has been difficult to diagnose and equally as difficult to treat, generally because it has such a long latency period, often up to 50 years. The latency of the disease means a diagnosis is not always apparent and, by the time it is made, the disease has progressed to its later stages.

However, thanks to the ingenuity of researchers, more tests are evolving that aid in earlier and more definitive diagnosis of this aggressive form of cancer. Such tests include the miRview Meso test, developed by Philadelphia-based Rosetta Genomics. Rosetta, established in 2000, is well known for its minimally-invasive diagnostic tests and doctors view the miRview Meso test as a big step in the right direction towards the proper diagnosis of malignant mesothelioma.

How Does it Work?

miRview Meso is a microRNA-based molecular diagnostic tool that helps to differentiate malignant pleural mesothelioma from peripheral adenocarcinomas of the lung or metastatic carcinomas involving the lung pleura. More simply put, this test can assist doctors in determining whether a patient has mesothelioma or some other form of lung cancer. Currently, this is the only “single” test available to definitively diagnose malignant pleural mesothelioma.

The test uses highly-sensitive technology to measure the microRNA in a sample of tissue taken from a tumor. Specifically, it measures the expression level of three microRNA biomarkers. The test can be done in a doctor’s office or hospital setting. The sample is then sent to a lab for processing, and by use of cutting-edge technology, lab technicians are able to determine whether or not the patient has mesothelioma. Reports are generally received by the ordering doctor in about 10 days.

Benefits of the Test

The miRview Meso test is extremely accurate. As a matter of fact, the sensitivity and specificity of this test have been shown to be about 95 percent and 96 percent. No other test is known to be this accurate in the diagnosis of mesothelioma. This is especially important because different sub-types of lung cancer can be very difficult to diagnose, even under a microscope.

Furthermore, diagnosing mesotheliom is often a laborious process involving numerous tests such as chest X-rays, CT scans, MRIs, biopsies and more. Because the miRview test is a single one-step diagnostic procedure, results are available quickly and treatment can commence immediately, providing the patient with a better chance of survival and more treatment options.

Obtaining the Test

Rosetta Genomic’s miRview Meso test is widely available. Most oncologists who specialize in the treatment of mesothelioma and/or other lung and thoracic cancers will probably be familiar with this diagnostic procedure. For those who are not, further information is available from Rosetta Genomics and doctors can order collection kits, sample preparation instructions, and shipping instructions from the company by phone or online.

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Mesothelioma Post Mortem

Thousands of individuals were directly exposed to asbestos throughout the twentieth century, both while on the job and through other means such as home remodeling projects. Secondary asbestos exposure was also a significant issue, as many were subjected to exposure through someone else who worked with the substance on a regular basis. Unfortunately, most individuals who worked with asbestos were unaware of the dangers that were affiliated with it. As a result, masks and other protective gear were rarely worn to prevent those working with asbestos from being exposed.

Asbestos-related diseases have a long latency period ranging from 10 to 50 years, which is why so many individuals are diagnosed when the disease has already reached an asbestos by the time mesothelioma symptoms arise. This is especially true for those who only worked with the toxic mineral for a short period of time. Because of this, a number of mesothelioma cases are either undiagnosed or misdiagnosed, only to be discovered later during an autopsy.

This is why it is essential that a post mortem examination be ordered after every death where asbestos is suspected. During a post mortem, tissue samples are taken to determine if asbestos fibers are present. If these fibers are discovered, they can provide a definitive link to asbestos and determine whether or not the individual passed away from mesothelioma.
Next Steps

A mesothelioma post mortem examination can be requested by the family of the deceased at the time of death. Family members who need proof of asbestos exposure in addition to the post mortem may be able to gather such information from former co-workers who might be finding themselves in the same predicament. Post mortem examinations can usually be completed within a few days from the time of death. If you are opposed to autopsies for religious beliefs or other reasons, you can request a limited post mortem, which examines only the parts of the body affected by disease.

If a mesothelioma post mortem is performed and there is a definitive link to asbestos, it may be time to contact an experienced mesothelioma lawyer who can examine the options available for filing a lawsuit against the company or individual responsible for the exposure. Compensation for the deceased person's pain and suffering may be in order and the settlement from a successful suit can help pay medical bills.

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Mesothelioma Pathology

Pathology, the process of evaluating tissues or blood, plays a significant role in the diagnosis of mesothelioma. A sample, often called a biopsy, will be taken from a tumor that is thought to be cancerous. The biopsy will be sent to a laboratory for inspection under a microscope. Pathologists visually and chemically analyze these samples to determine the exact type of disease a patient is dealing with.
Mesothelioma Biopsy and Pathology

When a biopsy is obtained to confirm a mesothelioma diagnosis, pathology is used to determine whether the extracted cells are cancerous. After several small sections of a tumor have been extracted and sent to a pathologist, they will be examined for visual characteristics that indicate mesothelioma.

Pathologists can look for certain biomarkers in biopsied tissue and blood samples. The presence or absence of proteins such as osteopontin and mesothelin can differentiate mesothelioma cells from healthy ones. Pathologists typically conduct the histopathological (visual) examination and the biomarker testing in the same sample to determine if the cells in question are malignant or benign.

Pathology Report

After a pathological examination has been conducted on a tissue sample, a mesothelioma pathology report will be assembled and provided to the patient’s doctor. This document will include basic personal information and medical history as well as clinical descriptions that a patient may wish to discuss with his or her physician.

A sample pathology report for a frozen specimen sample is provided in “Pathology of Malignant Mesothelioma.”This specimen report included patient information as well as details about the examination itself, including the date of the surgery, the date the laboratory received the sample for testing, and the time from surgery to examination at the lab. It also outlined information about the sample, such as its origin and what type of specimen it was. A microscopic report of the analyzed sample and a histological report that explained cell type and malignancy were also included.

A mesothelioma pathology report may also include information about other related tests that were performed on the extracted tissue. Immunohistochemistry results and electron microscopy results may be added to the document along with a doctor’s original clinical diagnosis.

Once an oncologist has reviewed a patient’s pathology report, they can then arrive at a final diagnosis. In the case of mesothelioma, doctors can interpret the pathology report to understand what type of cells make up the patient’s tumor and how it can best be treated. Although this document is primarily for clinical use, patients should request a copy for their own medical records. 

Histopathology - Determining the Type of Mesothelioma

Doctors and pathologists use histopathology to more easily determine the type of mesothelioma. The medical staff first removes a tissue sample from the body, called a biopsy. They then examine the tissue samples under a microscope to identify the physical characteristics of the cells to establish whether mesothelioma cells are present amongst healthy cells.

Cancer cells produce specific proteins that help identify the presence of tumors. These proteins are called oncoproteins. Doctors are able to easily differentiate cancerous cells from healthy cells in the mesothelium, the protective layer that surrounds the vital organs in the body. Medical professionals can also use histopathology to differentiate epithelial mesothelioma from mucin-producing adenocarcinoma.

Immunohistochemistry - Determining Histological Types

Treatment options may be affected by the type of mesothelioma that is found through immunohistochemistry testing. Mesothelioma tumors are determined by three histological types, epithelial, biphasic and sarcomatoid. Immunohistochemistry involves the study of specific antibodies to proteins found in cancerous cells in order to diagnose the mesothelioma cell type.

According to The Royal College of Pathologists of Australasia, immunopathology is a medical specialty where immunologists study the immune system’s relationship with the pathology of a disease. When doctors are examining potential cancer cells, they will inject staining agents into the cells in order to better identify the proteins that can determine which type of mesothelioma a patient has developed.


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Mesothelioma Immunohistochemistry


In general terms, immunohistochemistry (IHC) involves the process of locating proteins in tissue cells. The process uses staining to identify proteins, as well as the principle that antibodies bind to specific antigens in human tissue. Immunohistochemical staining is widely used in the diagnosis of cancerous cells and other abnormal cells. Mesothelioma immunohistochemistry is used to diagnose the histological type of a mesothelioma tumor, such as epithelial or sarcomatoid mesothelioma, which can effect treatment options.

Mesothelioma immunohistochemistry can be most useful in differentiating epithelial mesothelioma from other types of epithelial tumors. It has shown to be less effective for sarcomatoid mesotheliomas, but can be helpful when distinguishing sarcomatoid mesothelioma from sarcomatoid carcinoma.

Professionals in the field of mesothelioma note that immunohistochemistry data should be used in context with other diagnostic data. In other words, the results of a mesothelioma immunohistochemistry analysis should not be considered a primary indicator for a mesothelioma diagnosis. Contributing expert to the book Malignant Mesothelioma, Betta Peir-Giacomo, M.D. writes, "As for the capacity of IHC to provide possible clues to a more accurate diagnosis of MM (malignant mesothelioma), first it is necessary to underline that the contribution of IHC cannot be generalized, but differs in relation to each diagnostic setting, each with its own peculiar set of morphologic and immunophenotypic variables."

BerEP4

BerEP4 is a human antibody that can be expressed in epithelial cells. Antibodies, also known as "immunoglobulins," are specific proteins found in the blood which are used by the immune system to identify and neutralize foreign and unwanted objects, such as viruses and bacteria.

In the case of mesothelioma, BerEP4 has shown to be helpful in the diagnosis of epithelial mesotheliomas. However, immunohistochemists are still researching the efficacy of BerEP4 as a diagnostic indicator for mesothelioma, as this antibody has appeared both in mesotheliomas and other similar tumors. Thus, the presence or lack of BerEP4 does not always indicate a malignant mesothelioma.

Vimentin

Vimentin is a protein, more specifically a filament protein. Research has shown that vimentin proteins attach to the nucleus (and two other organelles) of a cell and help to anchor the position of the nucleus and other organelles. The dynamic structure of vimentin is important to the flexibility of a cell and it is generally accepted that this protein is important to maintaining cell integrity.

Like the antibody BerEP4, vimentin has shown to help diagnose mesothelioma, but the protein also appears in other tumors aside from mesotheliomas. Because vimentin appears in mesotheliomas as well as other malignant tumors, it is not considered a discriminatory marker for mesothelioma, but rather a piece of the diagnostic puzzle.


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Mesothelioma Tumor Markers

There are a number of different methods used to diagnose various types of cancer. Examining the levels of certain tumor markers is one such diagnostic method that may help mesothelioma patients live longer.

Tumor markers are best described as substances produced by tumor cells (or sometimes other cells) in the body in response to certain cancerous and non-cancerous conditions. They are usually found in the blood, urine, or tissue of patients. Using tumor markers to diagnose cancer can be difficult because tumor marker levels are not altered in all patients with cancer. Even levels of the same tumor marker can be altered in more than one type of cancer. Some of these substances can also found at elevated levels when other non-cancerous diseases are present.

Are Tumor Markers a Reliable Diagnostic Tool?


Tumor markers are a good starting point in the detection of cancer. While an elevated level of a particular tumor marker does not necessarily indicate the definite presence of cancer, it does indicate the need for further testing. The additional tests may include a biopsy, CT scan, or MRI.

In addition to being used for the diagnosis of cancer, tumor markers can also be measured to determine how a patient is responding to treatment. Marker levels will often be measured before treatment begins to determine the correct course of action when addressing the cancer. Tumor marker levels can further be used to determine whether a patient has suffered a recurrence of their cancer.
 

Are Tumor Markers Used to Screen for Cancer?

Screening is a process during which a cancer can be detected before symptoms are evident. Many researchers believe tumor markers aren't sensitive enough to be used for screening, yet one tumor marker, the prostate-specific antigen (PSA), has been used in the screening of prostate cancer among men for several years and has shown much success. However, an elevated PSA level does not necessarily indicate cancer, but does indicate the need for further testing.
 

Tumor Markers and Mesothelioma

A test approved last year by the Food and Drug Administration (FDA) is now being used to screen for mesothelioma among individuals at risk for the disease. Because mesothelioma symptoms do not usually surface until after a long latency period, this new test, called Mesomark, could make the difference between life and death for mesothelioma patients.

Mesomark measures the amount of Soluble Mesothelin-Related Peptides (SMRP) in human serum. SMRP is a tumor marker that is produced by mesothelioma cells. This tumor marker may be elevated in mesothelioma patients even in the very early stages of the disease.




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Mesothelioma Blood Test

During the diagnostic process, many patients will undergo blood tests to help determine if they have mesothelioma. Blood tests focus on the presence or absence of specific biomarkers in the blood. Often used in conjunction with tissue biopsies or imaging scans, blood tests are a minimally invasive method of diagnosing mesothelioma. Blood tests are also used to screen at-risk individuals for the cancer.

Blood-Based Mesothelioma Biomarkers

Soluble Mesothelin-Related Peptides (SMRP) are one of the most frequently investigated blood-based biomarkers for mesothelioma. Malignant mesothelioma cells release these substances into the bloodstream. Although they are still the subject of intensive testing, these peptides are thought to be the most promising diagnostic biomarker for mesothelioma.

Osteopontin has also been found to be a valuable blood-based biomarker for distinguishing mesothelioma from non-malignant diseases. This glycoprotein is overexpressed by many mesothelioma patients, and high levels often indicate tumor invasion and metastasis in advanced stages of the disease.

Other blood serum-based biomarkers have been explored for the diagnosis of mesothelioma, but these proteins, notably CA125 and CYFRA 21, were moderately sensitive at best. Although elevated biomarker levels may not always indicate the presence of cancer, positive blood tests results can certainly raise flags that lead to further testing.

Blood Tests and Early Diagnosis

Although mesothelioma has historically been a hard-to-detect disease, newly emerging blood tests have provided doctors with a means of accelerating diagnosis. Symptoms usually remain dormant for 20 to 50 years; yet, innovative blood tests can screen high-risk individuals for the illness and potentially discover it before symptoms emerge in its later stages.

SMRP can be elevated years before mesothelioma is diagnosed. Osteopontin, another blood-based biomarker, was also found to be higher in mesothelioma patients, especially those with a very early stage of the disease. The results of an osteopontin-based screening project conducted by renowned mesothelioma specialist Harvey Pass determined that 9.5 ng of osteopontin per milliliter of blood could guarantee a diagnosis of Stage 1 mesothelioma with 100 percent sensitivity.

Blood tests using biomarkers that predate symptoms may revolutionize the way mesothelioma is diagnosed. By making a diagnosis as early as possible, blood test results may offer a wider range of treatment options to mesothelioma patients' range of treatment options and improve the average prognosis for the disease.
Mesomark Test for Mesothelioma

Mesomark, a mesothelioma blood test developed by Fujirebio Diagnostics, was approved by the Food and Drug Administration in 2007. The Mesomark assay is the world's first blood test designed to monitor mesothelioma. Laboratory tests calculate the levels of the biomarker in a blood sample by measuring antibodies that bind exclusively to SMRP.

A study conducted by researchers at New York University established the test's validity as a screening tool for mesothelioma patients. The study confirmed that high levels of SMRP are typically associated with a positive mesothelioma diagnosis; conversely, low SMRP levels often indicate the absence of mesothelioma.

While the assay offers a more advanced option for diagnosing mesothelioma, it can also be used to measure a patient's response to therapy. If Mesomark reveals that SMRP levels are increasing, malignant tumors may still be thriving. Decreasing or constant SMRP levels, however, are typically indicative of shrinking or steady tumors. 


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Mesothelioma Detection

Mesothelioma is almost exclusively caused by asbestos exposure. A patient is commonly diagnosed with the cancer 20 to 50 years after initial exposure to asbestos occurs since it may take decades for a patient to demonstrate symptoms of the disease. Mesothelioma is an aggressive cancer that can be difficult to treat and early mesothelioma detection can greatly help a patient’s prognosis.
Early Symptoms of Mesothelioma

Understanding mesothelioma symptoms may aid in early detection of mesothelioma since a doctor should be contacted immediately at the first sign of any unusual developments. Many mesothelioma patients and their doctors are initially unaware of the severity of their condition as symptoms often resemble other common illnesses such as influenza or pneumonia.

Though there are four different types of mesothelioma, the most common form is pleural mesothelioma, which affects the lining of the lungs. Several symptoms demonstrated by pleural mesothelioma patients include persistent cough, difficulty breathing and swallowing, chest pain and fatigue.

Understanding that asbestos exposure can lead to the development of mesothelioma, and informing a doctor of asbestos exposure during a visit following unusual symptoms, can alert a doctor to the possibility of mesothelioma.

Detecting Mesothelioma Early

Once a doctor suspects the possibility of mesothelioma, the diagnostic process begins. Initially a complete medical history of the patient is reviewed and a doctor will take note of symptoms expressed. Mentioning past exposure to asbestos can be very helpful since a doctor may then take asbestos-related diseases into consideration.

A physical examination will follow and a doctor will typically recommend further testing. An X-ray is a crucial part of the diagnostic process and is then conducted to indicate the tumor’s location and determine whether or not it had spread to other areas of the body.

Imaging tests such as a, CT scan, PET scan or MRI scan will often be conducted to provide more detailed information about the developmental level and progression of the cancer. In a CT scan, a series of x-ray images are taken to see a three-dimensional image of the inside of the body. During a PET scan, a patient’s body is scanned searching for the presence of previously injected radioactive glucose, which is absorbed and used by cancerous cells more quickly than healthy cells. An MRI uses a powerful magnetic field to produce an image that a radiologist will view to determine whether or not something in the body appears abnormal.

A biopsy, also known as a fluid and tissue test, may also be requested to collect a sample of fluid to test for cancerous cells. Several types of biopsies exist in the mesothelioma diagnostic process. An excisional biopsy is performed to remove a significant portion of the sensitive lining around major organs. This is a long surgery and the lining is removed and tested after one procedure. Doctors do not remove a small portion to test, only to have to perform another procedure to remove infected areas should cancer be present, but rather remove the entire effected area at once.

A needle aspiration biopsy is a quick procedure that utilized a long, hollow needle to remove a sample of cells to test for the presence of mesothelioma. Cells are tested by a pathologist who specializes in disease diagnosis.

Thoracoscopy is a procedure performed when pleural or pericardial mesothelioma is suspected and involves a small incision in the chest wall. A sample of tissue is removed and tested for cancerous cells. Bronchoscopy and laparoscopy are similar to the thoracoscopy surgery but the bronchoscopy procedure is used to view the trachea whereas laparoscopy removes cells in the peritoneal tissue. Mediastinoscopy is performed to see if cancer has spread to the lymph nodes in the chest and neck.

Another test available to help with early mesothelioma detection is the miRview™ meso test. This test is the first molecular test that can accurately differentiate malignant pleural mesothelioma from other cancers involving the lungs and pleura using microRNAs. 


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Mesothelioma Biopsy



To reach a conclusive diagnosis, a doctor must confirm that any cells in question are actually mesothelioma. One of the most definitive ways to gain confirmation and ensure an accurate diagnosis is to perform a biopsy. Biopsies are considered the most important part of the mesothelioma diagnostic process.

Simply put, a biopsy is the removal of tissue or fluid samples and the follow-up analysis of what was removed. The removed sample, under a microscope, can reveal the presence of cancer, the activity and interaction of cells as well as the type and amount of cancer. It can also reveal that there is no mesothelioma.

There are a number of biopsy procedures for doctors to choose from and the location and type of mesothelioma involved will dictate which biopsy should be used. For example, peritoneal mesothelioma patients may undergo a fine-needle aspiration biopsy while pleural mesothelioma patients are more likely to undergo a thoracoscopic biopsy. The thoracoscopic biopsy has earned a reputation among medical professionals as being the most effective biopsy for pleural mesothelioma. Because 75 percent of mesothelioma cases are pleural, the majority of mesothelioma patients undergo a thoracoscopic biopsy.

Thoracoscopy

A thoracoscopy has shown very accurate results in diagnosing mesothelioma. This procedure, also known as open pleural biopsy, allows inspection of the pleural space and multiple biopsies under direct vision. Several studies have reported that when a thoracoscopy is used an accurate diagnosis can be achieved in up to 98 percent of mesothelioma patients. This direct examination of the pleura may also help in staging the cancer and determining prognosis.

A 2008 study of 45 malignant mesothelioma patients found that an open pleural biopsy provided an accurate diagnosis with sensitivity (amount of true positives) of 95 percent and specificity (amount of true negatives) of 100 percent. CT-guided pleural biopsies were accurate in 100 percent of cases.

A 2011 study performed by the Imperial College of London confirmed that the high specificity and sensitivity rates of an open pleural biopsy make it the preferred diagnostic technique for malignant pleural mesothelioma. Other, less accurate biopsies may use long needles to extract tissues samples.
Additional Biopsies for Diagnosing Mesothelioma

Although a thoracoscopy yields superior results in comparison to other biopsies, this procedure is not always possible due to specific tumor location and other complications. Additional biopsies that can be used to diagnose mesothelioma include:

Fine-Needle Aspiration (FNA) Biopsy - A quick and safe procedure, FNA biopsies use a long, hollow needle to remove up to 10,000 sample cells for testing. This procedure is preferred for its ability to access hard-to-reach areas without requiring anesthesia. FNA biopsies of a pleural or peritoneal effusion can diagnose mesothelioma with an accuracy of up to 84 percent.

Thoracentesis - This procedure extracts fluid from the lungs and pleura using a hollow needle. The fluid is then analyzed to determine if any disease is present.

Thoracotomy - A thoracotomy is a type of surgery used to access the lungs, heart, aorta, diaphragm and trachea. For mesothelioma patients, a segmentectomy, also known as a wedge resection, is the preferred type of thoracotomy since it leaves most of the affected lung intact. During the surgery, a wedge-shaped piece of the lung is removed for examination.

Endoscopic Biopsy
- An endoscopic biopsy is one of the most commonly used forms of biopsy. This procedure involves a fiber optic endoscope that shows the surgeon the area being sampled. Small forceps attached to the endoscope are used to remove small slivers of tissue from the tumor in question.

Excisional Biopsy - During an excisional biopsy, the entire tumor or organ is removed for diagnosis. This can eliminate the need for a second surgery to remove the tumor if testing shows it is malignant.

Incisional (Core) Biopsy - During an incisional biopsy, only a small section of suspicious tissue is removed. This is a common procedure when the tissue sample is easy to collect. Unfortunately, mesothelioma tumors typically do not develop at an easy-to-reach location.




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Testicular Mesothelioma

Testicular mesothelioma is the rarest form of malignant mesothelioma, a cancer caused by asbestos exposure. To date, less than 100 cases of this type of mesothelioma have been reported.

Testicular mesothelioma develops in the membranous lining that surrounds the testicle, the tunica vaginalis, which provides protection and support for the reproductive organ.

To learn more about testicular mesothelioma, get a copy of the Mesothelioma Center's free informational packet. It will educate you on how to fight mesothelioma cancer with various treatments and how to find doctors and treatment centers. Get your complimentary copy mailed to you overnight by filling out the form below.

Symptoms and Diagnosis of Testicular Mesothelioma

Due to the rarity of testicular mesothelioma, there is no recognized set of symptoms for this form of cancer. In the majority of the few reported cases of the disease, noticeable symptoms have been confined to the appearance of testicular lumps and swelling of the scrotum.

Testicular mesothelioma is not usually diagnosed until these lumps appear. In some cases, testicular mesothelioma has been detected when a patient undergoes surgery for another reason (such as hernia repair). In these cases, a sample of tissue may be removed (or biopsied) for diagnostic purposes, or the entire tumor may be removed.


Treatment for Testicular Mesothelioma

Testicular mesothelioma treatment typically involves removal of a portion of one testicle, or even an entire testicle if necessary, depending on the extent of the cancer. Treatment may be followed by chemotherapy or radiation therapy to kill any remaining cancer cells.

Because testicular mesothelioma is often a secondary tumor, and the primary tumor is located within the peritoneum (the membrane lining the abdominal cavity), treatment may not be as simple as removing testicular tumors. In these cases, the primary tumors must be treated as well.

When a patient undergoes chemotherapy they typically receive chemotherapy medications through an IV. The drugs target and kill rapidly dividing cancerous cells, preventing their growth. Radiation therapy is also used to kill existing cancerous cells and prohibit the growth of new harmful cells by radiating the infected area.

It should be noted that both peritoneal and testicular mesothelioma are classified as being clinically aggressive types of asbestos cancer . This means they can spread rapidly and invasively. In addition, testicular mesothelioma tends to recur within a few years, even in cases where tumors are surgically removed.
 

How Does Asbestos Cause Testicular Mesothelioma?

Because testicular mesothelioma is extremely rare, very little is known about how it develops. Most researchers theorize there are two possible points of origin for testicular mesothelioma. The tunica vaginalis, the membrane where testicular mesothelioma develops, is composed of mesothelial cells, which are present in most of the body's membranous linings. The tunica vaginalis is made up of two layers, known as the parietal (outer) and visceral (inner) layers.

Firm white-yellow nodules can be found on the serosal surface of the tunica. The nodules can eventually encase the contents of the scrotum, and cause the tunica vaginalis to thicken.

While there is currently no theory to explain why asbestos exposure might cause a primary tumor to develop in the testicles, it is understood that once the asbestos fibers are in the body, they can become lodged in organs and cause inflammation or infection that can result in the development of mesothelioma. The fibers cause cancerous cells to divide abnormally, causing buildup of fluid and the development of tumors.

Once cells have become cancerous, they are no longer able to regulate their own cycles of growth and division. A primary tumor that develops in the testicle is formed from cancerous cells that divide without restraint, which causes the thickening of the tunica vaginalis and can eventually lead to the formation of tumors. 




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pericardial mesothelioma


Pericardial mesothelioma is rare, accounting for only about 1 percent of all mesotheliomas, according to researchers from various mesothelioma studies. To date, fewer than 150 cases of pericardial mesothelioma have been presented in medical literature, and only about 200 cases have been reported worldwide. The disease does account for approximately half of all pericardial tumors. Pericardial tumors are typically diffuse (not localized) and tend to cover most of the heart.

The disease develops in the pericardium, a membrane that surrounds the heart and provides protection and support to the heart. The membrane has two layers: an outer layer called the parietal layer (called the heart sac or theca cordis), and an inner layer known as the visceral layer (called the epicardium). The parietal layer is part of a larger membrane that lines the entire chest cavity, while the visceral layer is the pericardial membrane that lines the heart.

 Pericardial Mesothelioma Prognosis
 
Pericardial mesothelioma has an average prognosis significantly worse than peritoneal or pleural mesothelioma. Studies have found that as many as 50 to 60 percent of all patients die within six months of diagnosis. Only one patient has ever been reported to live five years.
Pericardial Mesothelioma Symptoms
Symptoms for pericardial mesothelioma can be very similar to other heart conditions, making it difficult to diagnose.

An additional problem is that the symptoms of pericardial mesothelioma resemble symptoms of other heart conditions, and this makes the cancer relatively difficult to diagnose quickly. Because of the similarity of symptoms, a doctor may perform a variety of tests to confirm the presence of pericardial mesothelioma cancer.

As with all other forms of mesothelioma, symptoms do not arise until later stages of cancer development. All asbestos-related diseases exhibit a latency period while the asbestos fibers slowly cause cellular damage within the exposed person's body. It typically takes decades for the lodged asbestos fibers to cause enough cellular damage to result in disease. Once cancerous changes have taken place in the cells, reporduction of those cells can lead to the accumulation of tumors and onset of symptoms.

Most pericardial mesothelioma symptoms are caused by the build-up of fluid and the thickening of pericardial layers. The following symptoms may indicate pericardial mesothelioma.
  • Heart palpitations or irregular heartbeat (arrhythmia)
  • Chest pain
  • Murmurs
  • Cough
  • Difficulty breathing, even when at rest (dyspnea)
  • Orthopnea (dyspnea which occurs when lying down)
  • Fatigue
  • Fever or night sweats

Pericardial Mesothelioma Treatments

Most people diagnosed with this form of mesothelioma are not good candidates for cancer surgery. However, there are rare cases where the cancer is diagnosed early, and surgery can be carried out to remove small, localized pericardial tumors. This type of surgery carries great risk, simply due to the proximity of the heart.

Prognosis for those with pericardial mesothelioma is grim and palliative treatment is usually the only option for people diagnosed with pericardial mesothelioma. This type of treatment is performed to improve a patient's quality of life, and reduce the severity of symptoms caused by the build-up of fluid in the pericardium. Fine needle aspiration may be carried out to remove excess fluid as well. In some cases, radiation therapy may be an option. Unfortunately, the proximity of the heart and lungs make this a risky prospect.

Treatment for this type of mesothelioma is almost purely palliative. Roughly 50 to 60 percent of pericardial mesothelioma patients are claimed by the disease within six months of diagnosis. One patient survived five years following treatment of partial surgical resection and radiation. One other patient survived one year after a similar treatment approach.

Pericardial Mesothelioma Diagnosis

A fast and accurate diagnosis of pericardial mesothelioma is difficult, due to the non-specificity of the symptoms of this type of cancer.
To diagnose pericardial mesothelioma, a patient's symptoms, medical history, and current medical condition must all be assessed. The initial stages of diagnosis involve taking a medical history and undergoing a thorough physical examination.
Following these initial steps, a variety of imaging tests may be required to determine exactly where cancer is located. Magnetic resonance imaging (MRI) has been found to be the most effective at assessing the disease and determining the extent of its development. The final stage of diagnosis typically involves a biopsy to confirm the point of origin of the cancer. A biopsy involves the removal of tissue or fluid from the pericardium, followed by laboratory tests of the tissue and fluid to confirm the presence of mesothelioma.
In sum, medical professional typically take a comprehensive approach to diagnosing this disease, recommending analysis of gross appearance, proteins of cancerous cells and electron microscopy.
How Does Asbestos Cause Pericardial Mesothelioma?
It has long been known that pleural mesothelioma , which develops in the lining of the lungs, is caused by inhalation of asbestos fibers. However, the way in which asbestos causes the development of pericardial mesothelioma is not very well understood. Scientific research has yet to reveal a clear correlation between this disease and exposure to asbestos, but a number of patients with pericardial mesothelioma have a history of asbestos exposure.
Some experts believe that inhaled asbestos fibers travel via the bloodstream from the lungs to the heart, although there is no conclusive evidence to support this theory.
What is known is that asbestos fibers somehow become lodged in the pericardial membranes that surround the heart. When this occurs, the body experiences extreme difficulty in eliminating the asbestos fibers and they can remain stuck in the membranes. Over a long period of time, sometimes two decades or more, the asbestos fibers cause the cells of the pericardium to undergo changes that may result in cancer.
Once cells become cancerous they begin to divide more rapidly, without the restraint that regulates the growth cycles of normal healthy cells. As these malignant pericardial mesothelioma cells continue to grow they lead to the thickening of the pericardial membranes, and eventually cause tumors to develop. These changes in the pericardial membrane lead to the build-up of fluid between the pericardial layers, which, combined with the thickening of the layers, puts pressure on the heart. 



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Peritoneal Mesothelioma

Peritoneal mesothelioma is the second-most common type of mesothelioma and accounts for 10 to 20 percent of all mesothelioma cases. The cancer develops in the abdomen over a course of decades after asbestos fibers are inhaled or ingested. Modern diagnostic tests are used to detect peritoneal mesothelioma. Although the disease is usually diagnosed in the later stages of development, treatment options are available.

Some patients may be good candidates for curative treatments such as surgery, while others may elect for palliative measures alone. Overall prognosis for peritoneal mesothelioma patients is less than one year. However, life expectancy can increase with effective treatment. Working with a mesothelioma specialist helps patients receive the best possible care for their cancer, which could have a significant impact on a patient's prognosis.

If you've been diagnosed with peritoneal mesothelioma and would like to learn more about improving your prognosis, complete the form below. The Mesothelioma Center will mail you a personalized packet overnight with information about top doctors and the latest treatments.

Peritoneal Mesothelioma Prognosis

Some studies have found that men live an average of seven months after being diagnosed with peritoneal mesothelioma, with some patients living up to 100 months. Women, on the other hand, generally live for about nine months after diagnosis, with some living up to 49 months. Prognosis is generally better in patients whose mesothelioma is diagnosed early and whose symptoms are less severe. The cell structure of the tumors can also play a part in life expectancy, as well as treatments selected.
Mesothelioma of the Peritoneum
The peritoneum is a membranous layer that is made up of two sub-layers called the parietal and visceral layers. The parietal layer covers the abdominal cavity, while the visceral layer surrounds abdominal organs. Together these two layers provide support and protection for abdominal organs and the abdominal cavity as a whole.

There are two main theories regarding how asbestos exposure leads to the development of peritoneal mesothelioma:

- Asbestos fibers are ingested, and these fibers work their way from digestive organs into the peritoneal membrane.
- Asbestos fibers are inhaled, and travel to the peritoneal membrane via the lymphatic system.

Regardless of how asbestos fibers actually enter the peritoneal layers, once they do enter the membrane, the body experiences difficulty in expelling them. The fibers become trapped in the peritoneal membrane, and over a period of two or more decades, cause certain changes in the mesothelial cells of the peritoneum.

The exact way in which asbestos fibers cause changes in these mesothelial cells is uncertain. However, some researchers believe asbestos fibers cause long-term inflammation and irritation that eventually causes mesothelial cells to become cancerous. Cancerous mesothelial cells divide and grow without restraint, and this uncontrolled cell growth causes thickening of the peritoneum, and the build-up of fluid in the peritoneal layers.

Peritoneal Mesothelioma Symptoms

A patient with peritoneal mesothelioma may not demonstrate symptoms of the cancer for 20 to 50 years after initial asbestos exposure since it often takes years for mesothelioma to manifest. In the case of peritoneal mesothelioma, asbestos fibers travel into the peritoneal layers where they cause irritation and inflammation and the development of cancerous cells which divide and grow uncontrollably. The cells cause thickening of the peritoneum and fluid build-up in the peritoneal layers. As the cancerous cells continue to divide overtime, tumors start to form. Most peritoneal mesothelioma symptoms are caused by this membrane thickening, fluid build-up, and eventual tumor development - all of which put pressure on internal organs.

Peritoneal mesothelioma symptoms include:

- Abdominal pain or swelling
- Changes in bowel habits (such as diarrhea or constipation)
- Development of lumps under the skin on the abdomen
- Night sweats or fever
- Unexplained weight loss
- Nausea or vomiting
- Fatigue
- Anemia

Peritoneal Mesothelioma Diagnosis

 

A peritoneal mesothelioma diagnosis cannot be made on the basis of symptoms alone. The process begins with a thorough examination of a patient’s medical history and physical condition, followed by sophisticated diagnostic testing such as imaging and fluid and tissue tests.

Imaging tests such as x-rays or CT scans are used to detect any abnormalities in the body and a biopsy is usually performed to confirm that the cannosiscer involved is indeed mesothelioma. A biopsy is a minor surgical procedure that involves the removal of fluid or tissue from the peritoneum.

After the biopsy, the fluid and tissue is tested in a laboratory for the presence of mesothelioma cells. If the biopsy returned reveals that a patient has peritoneal mesothelioma, the doctor, together with the patient, will detail a treatment plan.
Peritoneal Mesothelioma Treatments

Although treating peritoneal mesothelioma can be difficult since the cancer has typically progressed to later stages of development, doctors typically recommend treatment to patients to combat the cancer and aid in pain relief. Common treatments used for patients with mesothelioma include surgery, chemotherapy and radiation . Chemotherapy medications and radiation therapy target and kill cancerous cells that rapidly divide.

While no known cure for peritoneal mesothelioma exists, patients may elect to undergo a combination of treatments or participate in clinical trials to alleviate pain and increase the quality of life. Clinical trials are studies that qualifying patients may participate to test up-and-coming medications and treatments. All potential treatment options and medications must go through clinical trials before they are deemed safe and effective.

Some peritoneal mesothelioma patients may opt for intraperitoneal chemotherapy, where medications are injected directly into the peritoneum immediately following surgery. In some cases, patients may first go through radiation therapy to shrink tumors before undergoing surgery.

Many patients, however, are not good candidates for surgery since mesothelioma has often spread too extensively or because the patient's general health is too poor to cope with the stress of surgery. These patients may elect to participate in palliative treatment options that do not attempt to cure a patient, but work to relieve symptoms and improve the quality of life for peritoneal mesothelioma patients. 




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Pleural Mesothelioma

Pleural mesothelioma is the most common type of mesothelioma, a rare cancer that develops in the mesothelium (a membrane that lines many of the body's organs and cavities). In the case of pleural mesothelioma, the cancer develops in the lining of the lungs, called the pleura or pleural membrane.

Pleural mesothelioma is caused by the inhaling of asbestos fibers. Once these fibers have entered the lungs, they work their way to the pleural membrane, and the body has great difficulty getting rid of the fibers. Over a long period of time - typically two decades or more - asbestos fibers cause changes in the pleural cells. Those changes may cause scarring of the lungs and, long term, the formation of tumors.

When pleural cells become cancerous, they begin to divide continuously, reducing lung capacity and generating fluid buildup between pleural layers.

The prognosis for pleural mesothelioma patients is generally poor because it often is caught in its later stages. However, an early diagnosis can greatly improve a patient's prognosis and life expectancy.

Find out more about improving your life expectancy. The Mesothelioma Center offers a free packet with information on pleural mesothelioma, its symptoms and the best treatment options. Get your free packet by completing the form below.

Mesothelioma of the Lung

 
The pleura is comprised of two layers, which provide support and protection for the lungs and chest cavity. The outer layer, or the parietal layer, lines the entire chest cavity and the diaphragm. The inner layer, or visceral layer, covers the lungs. Pleural mesothelioma typically develops in one layer, but can metastasize, or spread, to the other layer. If the cancer spreads to distant locations, the mesothelioma prognosis can become poorer.

Like all mesothelioma cancers, pleural mesothelioma is caused by asbestos exposure and develops when the toxic asbestos fibers become trapped in the spaces between the mesothelial cells.







Pleural Mesothelioma Symptoms


Once trapped in the body, asbestos fibers cause cancerous cells to divide abnormally, resulting in the thickening of the pleural membrane. This has the potential to encourage build-up of fluid (called pleural effusion). The fluid begins to place pressure on the lungs and the respiratory system in general, preventing normal breathing. Symptoms of pleural mesothelioma are largely caused by these developments and may include the following:

-  Pleural Mesothelioma Diagram
-  Pleural mesothelioma specifically develops in the pleural lining of the lungs.
-  Persistent dry or raspy cough
-  Coughing up blood (hemoptysis)
-  Difficulty in swallowing (dysphagia)
-  Shortness of breath that occurs even when at rest (dyspnea)
-  Persistent pain in the chest or rib area, or painful breathing
-  Development of lumps under the skin on the chest
-  Night sweats or fever
-  Unexplained weight loss
-  Fatigue


    Pleural Mesothelioma Diagnosis


    As with other types of mesothelioma, pleural mesothelioma is difficult to diagnose because symptoms do not typically arise for some time after initial asbestos exposure occurs. Additionally, since the symptoms of pleural mesothelioma are typical of many illnesses, the condition is often mistaken for less threatening diseases such as influenza and pneumonia.

    A pleural mesothelioma diagnosis is made partly on the basis of symptoms, but additional diagnostic tests are needed to confirm the presence of cancer. Following a medical history review and physical examination, patients typically undergo imaging tests, such as X-rays or CT scans, to confirm the location of cancer. A patient also usually undergoes fluid and tissue tests, known as biopsies, to confirm the type of cancer involved. Once tests and biopsies confirm a diagnosis of pleural mesothelioma, those test results are used to develop a treatment plan.


    Pleural Mesothelioma Treatments

    Pleural mesothelioma is traditionally treated with either surgery, chemotherapy, radiation therapy, or a combination of these options. A patient's general health and stage of their cancer must be evaluated before they are considered candidates for surgery. In most cases, only patients diagnosed with Stage 1 or Stage 2 receive surgery that attempts to cure the cancer. Chemotherapy and radiation may also be effective if tumors have not spread to other locations. Alternative treatments are also available and include photodynamic therapy, immunotherapy and gene therapy.

    Treatments for pleural mesothelioma may be palliative or potentially curative depending on which stage the cancer is in. Patients who are diagnosed after potentially curative treatments are no longer effective may instead receive palliative treatments to relieve pain and improve quality of life. For pleural mesothelioma patients, early detection is key to improving prognosis and expanding treatment options.

    Surgery options for pleural mesothelioma patients typically include pleurectomy/decortication or extrapleural pneumonectomy, which attempts to remove all or part of the affected lung lining. The most common chemotherapy option for pleural mesothelioma involves the drugs cisplatin and pemetrexed (Alimta). Some of the top doctors in the field of mesothelioma treatment that specialize in using these techniques include Dr. David Sugarbaker, Dr. Robert B. Cameron, Dr. Harvey Pass and Dr. Valerie Rusch.

    Understanding available treatment options is very important to patients and their loved ones. We offer a complimentary informational packet detailing treatment options for pleural mesothelioma patients. Click here to receive your packet overnight or call 800-615-2270 to speak with a patient and family advocate available at no charge to answer questions and offer guidance.

    If the disease is diagnosed early enough, surgery to remove localized tumors followed by chemotherapy or radiation therapy can be an effective treatment. Curative surgery candidates must be in a good general state of health, and their cancer must not have spread beyond localized sections of the lungs.
    Pleural Mesothelioma Prognosis

    When pleural mesothelioma is diagnosed before the cancer has greatly progressed, a patient is typically in the first stages of mesothelioma. Doctors typically address the seriousness of cancer in terms of stages ranging from one to four, with the level of the cancer’s progression increasing with each stage. Patients diagnosed with pleural mesothelioma in stage one or two generally have greater treatment options and a better prognosis.

    According to some current studies, approximately 10 percent of all pleural mesothelioma patients will survive for three to five years following diagnosis. Of that 10 percent, half the patients will survive five years or more.

    Pleural mesothelioma patients who are not diagnosed early enough for curative treatment have fewer treatment options, mostly limited to palliative treatments, designed to relieve pain and discomfort to improve a patient's quality of life, rather than their prognosis. Palliative treatments include removal of built-up fluid from the pleural spaces, and surgical removal of tumors to relieve pressure on the lungs.

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    Pet Therapy - Alternative Mesothelioma Treatments

    Pet therapy, also known as animal assisted therapy, employs the use of animals in the treatment of any disease or illness. Pet therapy can range from watching fish swim in an aquarium to petting a dog to caring for livestock. The benefits of working with animals is well documented and many hospital rehabilitation centers and nursing homes have established programs that allow trained service animals into the facility as part of the therapy process.

    The History of Pet Therapy

    There are documented cases of using pets for therapy beginning in the 9th century. During this time, a farm in Gheel, Belgium established the use of farm animals to teach people with disabilities how to care for the animals. In the 1790s, a farm for the mentally ill in England used caring for animals as part of treatment for people afflicted by mental illness.

    In the United States, soldiers that were injured during World War II were advised to care for farm animals to help in their recovery. While pet therapy was first used as an aid to treat patients suffering from psychiatric illnesses, it was not long before the benefits of pet therapy for physical diseases was recognized.

    The Benefits of Pet Therapy

    There are a variety of benefits to pet therapy. Studies of patients with hypertension have shown a reduction in blood pressure by simply watching fish swim in an aquarium. Studies of heart attack patients show patients that own dogs are more likely to survive one year after their heart attack than patients who do not have dogs. It has also been shown that elderly people with pets are more alert and active.

    In addition to general health benefits, animals can play an active role in the recovery of patients. Stroke victims, who often show a pronounced weakness on one side of the body, can be encouraged to develop that side by stroking or petting a dog or cat. Even speech that has been affected by a stroke can be improved, as the patient, who may be self-conscious of their speech problems around other people, can relax and talk to a pet without concern.


    What Type of Pet Can Be Used for Pet Therapy?

    All types of animals are used for pet therapy. Horses are used in a process called hippotherapy. Patients with disabilities that are taught to ride in hippotherapy sessions show an improvement in muscle tone, coordination, and even speech. Dogs and cats are also commonly used, and many nursing homes have aquariums in common rooms.

    Pets used for therapy must be calm and attentive, and willing to listen to their handler. Because many of the patients a pet will be exposed to may be connected to bulky equipment, may sit in a wheel chair or walker, or behave erratically, it is important for the pet to be calm and well-behaved. A dog that barks or growls, or a horse that becomes scared easily is not a suitable candidate for pet therapy.

    Who Should Use Pet Therapy?

    Pet therapy has been proven through scientific studies to benefit the patient. Lower medication costs, longer life, increased alertness, and an improved mood are just some of the health benefits of pet therapy. While pet therapy should not be considered a replacement for conventional medicine, it is a wonderfully effective compliment to traditional methods. Whether the condition is chronic or acute, the advantages of pet therapy have been undoubtedly proven. Children who are allowed to pet a dog while undergoing a painful medical procedure require less pain medication, and the elderly have higher levels of social interaction when they have a pet. As pet therapy becomes more widespread, an increasing number of hospitals have begun to implement pet therapy programs.

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    Chiropractic Care - Alternative Treatments

    Chiropractic care is administered to treat and prevent pain and disorders pertaining to the musculoskeletal system that controls the body’s movement, including the spine. Chiropractic care is often sought as a form of alternative medicine and complementary care to coincide with traditional medical treatments.

    Chiropractors seek to restore mobility and alleviate pain through a variety of different treatments including spinal adjustment, massage, stretching movements, ultrasound, specific exercises and electrical muscle stimulation.

    The use of chiropractic care has been found in recordings from China and Greece dating back to 2700 B.C. and 1500 B.C. Chiropractic care became utilized in the United States in the late 19th century and gained respect throughout the 20th century as patients and studies supported the benefits of this form of therapy.

    Chiropractic Care for Cancer Patients

    Cancer patients may elect to visit a chiropractor as part of their treatment regimen. According to the American Chiropractic Association, chiropractic doctors “have a deep respect for the human body's ability to heal itself without the use of surgery or medication. These doctors devote careful attention to the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and the role played by the proper function of these systems in the preservation and restoration of health. A doctor of chiropractic is one who is involved in the treatment and prevention of disease, as well as the promotion of public health, and a wellness approach to patient healthcare.”

    Cancer patients have included chiropractic care in their course of treatment to help control pain and alleviate headaches, tension and stress. Patients interested in alternative treatment, who strongly believe in the body’s ability to heal itself, may find chiropractic care particularly appealing. Alleviating severe headaches and movement pains during cancer treatment may make the treatment process more comfortable for cancer patients, including those batting mesothelioma.

    Two studies published in the Journal of Manipulative and Physiological Therapeutics examined the cases of two patients combating cancer. A 57-year-old man diagnosed with terminal pancreatic cancer experienced significant pain relief and was able to reduce the amount of medication needed following chiropractic care. He also reported an increase in his quality of life during his journey with the cancer following a visit to a chiropractor.

    A 54-year-old man diagnosed with lung cancer (a cancer often related to asbestos exposure) began seeing a chiropractor after experiencing little pain relief one year after he underwent surgery to combat his cancer. The man experienced pain relief immediately after beginning chiropractic care and discontinued use of all pain medications after two visits to his chiropractor. The Journal noted, “These clinical examples offer two specific instances of how chiropractic may improve the quality of a cancer patient’s life.” 


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    Meditation - Alternative Mesothelioma Treatments


    Proponents of meditation state it can help with not just spiritual and emotional problems, but physical ones as well. This is based on the idea that meditation works with the body's basic energy processes. Adding meditation to traditional cancer treatment has produced excellent results. Meditation reduces feelings of depression, anxiety, and actual discomfort. Additionally, studies claim that meditation lowers tumor growth by as much as 10 percent. Meditation is also known to prolong survival rates while improving quality of life. Presently, meditation is utilized in countless medical facilities to help cancer patients manage disease by reducing grief and anger. It also teaches those in physical pain how to cope with the extreme discomfort.
    Working Principles of Meditation

    Many types of meditation exist throughout the world, and it takes advanced knowledge and experience to determine which kind is beneficial for various physical conditions. Experts in the field have discovered the best form of meditation for those suffering with cancer involves meditation that is considered "empty" and does not involve imagery.

    "Empty" meditation works on the basis of a person letting go of thoughts to achieve a degree of mental emptiness, and the corresponding stillness allows the body's energy to rise and battle illness. It is further accepted that, in conjunction with the peacefulness of the meditation experience, a person's life force is also activated. This can be readily seen in acupuncture, which moves the chi when obstructed.

    Cancer patients suffer from this affliction, but when their chi travels freely after intense meditation, they can put themselves back onto the road to health. This is accomplished through the release of thoughts or habits that can free up energy to produce healing powers. The body's natural flow of energy, though previously restrained, assumes normality. This reverses the damage of practices which previously inhibited the body's normal energy rhythms.

    Other Types of Meditation

    Often, people think meditation must be visual, as is the case with guided imagery practice. However, researchers have found the best choice for cancer patients is to employ meditation based on little to no conscious brain activity, for at least 20 sessions. But there are other forms to try as well. One Buddhist cancer meditation method is to quiet the body and breathing, and then visualize offering one's dirty flesh to hungry beings. After picturing the flesh gone and consumed, visualization focuses on the body as a white skeleton turning into dust and dissolving into nothingness. After reaching that point, the patient should let go of all thoughts and stay at that level of emptiness for as long as possible. A similar technique involves the imagery of one's body burning, allowing the person to become only a light that slowly becomes emptiness. Any meditation that is based on the absence of discriminative thought is powerfully healing and more beneficial than positive thinking alone. Music meditation and the application of breathing techniques can also aid in the emotional and psychological healing process.
    Can Meditation Be Harmful?

    There should be nothing harmful or dangerous in meditation that is followed under the guidance of an established teacher, or even with professional step-by-step instructions. Becoming conscious of breathing and thoughts, while following medication, diet, and exercise regimens, is an optimum treatment plan. Including meditation in daily life can offer relief from many ailments, such as infertility, skin diseases, high blood pressure, fatigue, anxiety, and stress. It is believed that health benefits result from intentional mental processes affecting brain circuitry. Meditation is calming and cleansing, and cannot hurt the individual practicing. Since every patient's case is different, it is important to discuss all treatment options with a doctor. A medical professional may be able to provide referrals to specialized cancer meditation practices. 



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