‘Exploring Meso’ is a two-part series designed to give a comprehensive overview of the two most common types of mesothelioma—a rare but sadly terminal form of cancer that can affect any of four major organs by attacking the protective lining that surrounds it.
Part I discusses the symptoms, causes, diagnosis and treatment of pleural mesothelioma.
Pleural mesothelioma is the most common variety of malignant mesothelioma, a particularly aggressive form of cancer that causes tumors to grow within the protective linings of different organs in the body. Mesothelioma of the pleura—which covers the lungs and chest cavity—comprises more than 90 percent of total mesothelioma diagnoses in the U.S. each year, according to the American Society of Clinical Oncology.
Despite increased public awareness of the disease, pleural mesothelioma remains notoriously difficult—both to diagnose and to treat. One reason for this is that its symptoms, which may include persistent coughing, shortness of breath and hoarseness of the voice, are easily ignored or attributed to relatively benign conditions like seasonal allergies or a common head cold. Ambiguous symptomatology is compounded by the long latency period of the disease—sometimes as lingering as 50 years or more. Because of this considerable gap between the exposure that is likely to cause the illness and its actual onset, many people who are ultimately diagnosed were unaware that mesothelioma was even a remote health concern for them personally.
Diagnostic techniques for pleural mesothelioma essentially boil down to one method in totality: a medical biopsy. Though highly advanced screening methods, including various neuroimaging techniques, offer doctors non-invasive means of ruling out mesothelioma—a sample of tissue is usually required to definitively diagnose it. However, physicians generally proceed through a process of elimination when mesothelioma is even suspected (particularly because of its significant rarity—with only 2-3000 new cases diagnosed each year) by first administering a chest x-ray and sometimes also a lung function test.
Once a doctor has gone through all of the steps to diagnosis and mesothelioma has been confirmed, treatment must begin as quickly as possible. With input from the patient, a specially trained physician—usually an oncologist, or specialist in cancer—will select one or more modalities to combat the cancer. In the U.S., chemo and radiation therapy are the most popular choices for mesothelioma treatment, as well as the treatment of most other cancers. In some cases, surgery to remove the tumor and potentially part of the surrounding tissue is also undergone—though the risks of this lengthy and complicated procedure, combined with the lacking of evidence for long-term efficacy, make surgery a less popular option for treatment. Other experimental and alternative options are also available in cancer treatment centers across the U.S.
The most common cause of mesothelioma, by far, is exposure to asbestos—a toxic carcinogen that millions of people came into contact with during the 19th and 20th centuries, when it was used widely across the manufacturing industry. In fact, doctors believe that at least 90 percent of currently diagnosed cases of pleural mesothelioma can be traced directly back to asbestos.