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Pleural cancer and mesothelioma: survival and life expectancy
via Cancer Mesothelioma Lawyer - Attorneys, Stages and treatments ift.tt/2CuOI2o
In medicine, "mesothelioma" is a rare tumor that represents less than 1% of all oncological diseases and affects the "mesothelium", the thin tissue that covers most of the internal organs.
The most frequent form (almost 80% of cases) is pleural mesothelioma, i.e. that which affects the pleura, while the peritoneal mesotheliomas and the testicles' mesotheliomas are rarer.
The pleura is a membrane that covers the lung, composed of two sheets: the visceral one (that covers the lung) and the parietal one (that covers the inside of the thoracic cavity), divided by a space called "pleural cavity", which contains pleural fluid.
The pleura is especially important to allow the expansion and flow of the lung during inhalation.
Pleural tumors can be of four types:
malignant pleural mesothelioma;
solitary fibrous tumor;
lymphomas;
metastasis
Mesothelioma and pleural cancer
Commonly the terms "mesothelioma" and "pleural cancer" are used as synonyms, but in reality, this is a mistake for at least two reasons.
First, because, as we have seen, a mesothelioma can affect other organs and not just the pleura so it would be more correct to speak of "pleural mesothelioma" when referring specifically to pleural mesothelioma. Secondly, using "pleural mesothelioma" as a synonym for "pleural cancer" is also a mistake because, as we have seen, not all pleural cancers are necessarily mesotheliomas.
Pleural mesothelioma, life expectancy
Causes
Generally, the tumor develops due to genetic alterations in the mesothelial cells, which lead to uncontrolled growth of the cells themselves. The cause of this process has not yet been clarified, but there are known risk factors that increase the risk of mesothelioma.
Risk factors
The most important risk factor for mesothelioma is exposure to asbestos: most of these cancers affect people who have come into contact with this substance, at home or at work, or who live with people who work with it.
Asbestos is a mineral that, due to its particular resistance to heat, has in the past been widely used for covering and insulating roofs (in a material known as Eternit), ships and trains; in construction (tiles, floors, paints...); in firefighters' suits; in cars (mechanical components and paints) and in other sectors.
When this mineral is fragmented, for example during the process of mining or removal of the insulating material, a dust is produced which, if inhaled, can damage mesothelial cells, in some cases causing cancer, even decades after exposure. Other risk factors for mesothelioma are:
a monkey virus, SV40, used in polio vaccinations between 1955 and 1963;
a radioactive substance, thorium dioxide, used between the 1920s and 1950s;
radiation to the chest and abdomen;
cases of mesothelioma in the family.
Diagnosis
Mesothelioma is often difficult to diagnose because its symptoms are similar to those of many other diseases. It often begins with the appearance of breathing difficulties associated with the presence of a spill, which in some cases may be accompanied by chest pain. The diagnostic approach should include the collection of information about possible exposure to asbestos in previous years and then instrumental examinations such as chest x-ray, CT and thoracentesis.
Thoracentesis
If a liquid is present in the thoracic cavity, it is possible to take a sample by introducing a thin needle into the intercostal space: a cytological examination thus determines the possible presence of neoplastic cells. If there is an abundance of liquid present, this procedure can also be used to remove sufficient liquid to improve the patient's breathing.
Histological diagnosis
In order to obtain a certain histological diagnosis of mesothelioma, it is necessary to take tissue samples using different methods and depending on the extent of the disease:
Video-assisted thoracoscopy (VATS): Under general anesthesia, a micro-camera is introduced through a small incision in the thorax to visualize the pleural surface and take tissue samples. In case of pleural effusion, it is possible to carry out the total aspiration of the liquid in order to induce the adhesion of the mesothelium (pleurodesis or talcage), thus preventing the formation of new fluid.
Guided CT biopsy: In case of advanced disease or in patients with anesthetic contraindications a sample for histological examination can be obtained using the TAC guide, under local anesthesia.
Once the material for histological diagnosis has been obtained, the anatomopathological ascertains the type of tumor, its extent, and biological aggression.
Staging
Once the diagnosis is made, the physician determines the extent (staging) of the tumor using CT and PET with FDG in order to locate the site and activity of the tumor within the body and to select the most effective treatment.
Read also:
Cable, liquid and pleural effusion: physiology and pathology
Pleura: anatomy, functions, and pathologies at a glance
Inflamed pleura: symptoms, contagion, and pain in pleurisy Therapies
The treatment of mesothelioma depends on the location of the tumor, the stage of the disease, the age and the overall health of the patient. Standard treatment options include surgery, radiotherapy, and chemotherapy. In selected cases, these treatments can be combined to increase therapeutic efficacy (trimodal treatment).
Surgery
Mesothelioma surgery is complex and should, therefore, be performed in highly specialized centers. Surgery with curative intent should be performed as part of multimodal treatments (chemotherapy, surgery, radiotherapy). The techniques used are:
total pleurectomy: total removal of the pleura (both parietal and visceral pleural leaflets); extrapleural pneumonectomy: removal not only of the pleura but also of the lung, pericardium, and diaphragm.
Extrapleural pneumonectomy is an extremely demolishing operation and is reserved for the most advanced cases of the disease.
Radiotherapy
Radiotherapy for mesothelioma is administered by means of external beams, with volumetric intensity modulation technique (IMRT), as part of trimodal treatment (chemotherapy, surgery, radiotherapy) after surgery with curative intent. Radiotherapy can also be used for palliative purposes, in advanced forms, on areas that cause pain.
Chemotherapy
Chemotherapy is a form of pharmacological therapy that can be administered by intravenous infusion (IV). It can be used, in selected cases, to reduce the disease, favoring the radical surgical approach (trimodal treatment); alternatively, to block the growth of the disease and promote the improvement of symptoms related to it.
Prevention
There are no specific ways to prevent the disease from occurring, but the risk of developing it can be reduced by avoiding the main risk factor, namely exposure to asbestos.
Pleural cancer: can it be cured?
Although it is a very serious type of cancer, it is possible to heal from pleural mesothelioma, but the chances of recovery are strongly conditioned by various subjective parameters:
age of the patient;
the general condition of the patient;
possible pathologies (arterial hypertension, diabetes, heart disease...);
staging at diagnosis (diffusion, lymph node involvement, the presence of metastases);
timeliness of the diagnosis;
response to therapies;
surgeon's skill set.
Prognosis, survival, life expectancy by stage
The survival time and life expectancy after mesothelioma diagnosis (which usually occurs about 15-30 years after exposure to asbestos) is unfortunately on average 12-18 months or less in the absence of therapy or in the case of late diagnosis at an advanced stage. One of the main factors influencing life expectancy, beyond the parameters listed above, is the staging of the disease:
Stage I: In the initial phase, the mesothelioma is located on a layer of the pleura and the tumor may have spread to the pericardium or diaphragm.
The life expectancy of the patient with first stage mesothelioma is about 2 years (21 months). Studies show that 50% of patients diagnosed with mesothelioma can live another 5 years with aggressive treatment.
Stage II: In the second stage, the involvement of both layers of the pleura is observed, only on one side of the body. Life expectancy at this stage may be about 1-2 years after diagnosis.
Stage III: In the third stage, cancer spreads to the chest wall, esophagus and lymph nodes on one side of the body. The life expectancy for this phase can be about 16 months.
Stage IV (last stage, terminal tumor): In the fourth stage of pleural mesothelioma, there is spread to other organs of the body and bone metastases are formed, to the liver, lymph nodes, brain or other areas of the body. At the fourth stage of mesothelioma, life expectancy is less than 12 months.
Pleural cancer and mesothelioma: survival and life expectancy
via Cancer Mesothelioma Lawyer - Attorneys, Stages and treatments ift.tt/2CuOI2o
In medicine, "mesothelioma" is a rare tumor that represents less than 1% of all oncological diseases and affects the "mesothelium", the thin tissue that covers most of the internal organs.
The most frequent form (almost 80% of cases) is pleural mesothelioma, i.e. that which affects the pleura, while the peritoneal mesotheliomas and the testicles' mesotheliomas are rarer.
The pleura is a membrane that covers the lung, composed of two sheets: the visceral one (that covers the lung) and the parietal one (that covers the inside of the thoracic cavity), divided by a space called "pleural cavity", which contains pleural fluid.
The pleura is especially important to allow the expansion and flow of the lung during inhalation.
Pleural tumors can be of four types:
malignant pleural mesothelioma;
solitary fibrous tumor;
lymphomas;
metastasis
Mesothelioma and pleural cancer
Commonly the terms "mesothelioma" and "pleural cancer" are used as synonyms, but in reality, this is a mistake for at least two reasons.
First, because, as we have seen, a mesothelioma can affect other organs and not just the pleura so it would be more correct to speak of "pleural mesothelioma" when referring specifically to pleural mesothelioma. Secondly, using "pleural mesothelioma" as a synonym for "pleural cancer" is also a mistake because, as we have seen, not all pleural cancers are necessarily mesotheliomas.
Pleural mesothelioma, life expectancy
Causes
Generally, the tumor develops due to genetic alterations in the mesothelial cells, which lead to uncontrolled growth of the cells themselves. The cause of this process has not yet been clarified, but there are known risk factors that increase the risk of mesothelioma.
Risk factors
The most important risk factor for mesothelioma is exposure to asbestos: most of these cancers affect people who have come into contact with this substance, at home or at work, or who live with people who work with it.
Asbestos is a mineral that, due to its particular resistance to heat, has in the past been widely used for covering and insulating roofs (in a material known as Eternit), ships and trains; in construction (tiles, floors, paints...); in firefighters' suits; in cars (mechanical components and paints) and in other sectors.
When this mineral is fragmented, for example during the process of mining or removal of the insulating material, a dust is produced which, if inhaled, can damage mesothelial cells, in some cases causing cancer, even decades after exposure. Other risk factors for mesothelioma are:
a monkey virus, SV40, used in polio vaccinations between 1955 and 1963;
a radioactive substance, thorium dioxide, used between the 1920s and 1950s;
radiation to the chest and abdomen;
cases of mesothelioma in the family.
Diagnosis
Mesothelioma is often difficult to diagnose because its symptoms are similar to those of many other diseases. It often begins with the appearance of breathing difficulties associated with the presence of a spill, which in some cases may be accompanied by chest pain. The diagnostic approach should include the collection of information about possible exposure to asbestos in previous years and then instrumental examinations such as chest x-ray, CT and thoracentesis.
Thoracentesis
If a liquid is present in the thoracic cavity, it is possible to take a sample by introducing a thin needle into the intercostal space: a cytological examination thus determines the possible presence of neoplastic cells. If there is an abundance of liquid present, this procedure can also be used to remove sufficient liquid to improve the patient's breathing.
Histological diagnosis
In order to obtain a certain histological diagnosis of mesothelioma, it is necessary to take tissue samples using different methods and depending on the extent of the disease:
Video-assisted thoracoscopy (VATS): Under general anesthesia, a micro-camera is introduced through a small incision in the thorax to visualize the pleural surface and take tissue samples. In case of pleural effusion, it is possible to carry out the total aspiration of the liquid in order to induce the adhesion of the mesothelium (pleurodesis or talcage), thus preventing the formation of new fluid.
Guided CT biopsy: In case of advanced disease or in patients with anesthetic contraindications a sample for histological examination can be obtained using the TAC guide, under local anesthesia.
Once the material for histological diagnosis has been obtained, the anatomopathological ascertains the type of tumor, its extent, and biological aggression.
Staging
Once the diagnosis is made, the physician determines the extent (staging) of the tumor using CT and PET with FDG in order to locate the site and activity of the tumor within the body and to select the most effective treatment.
Read also:
Cable, liquid and pleural effusion: physiology and pathology
Pleura: anatomy, functions, and pathologies at a glance
Inflamed pleura: symptoms, contagion, and pain in pleurisy Therapies
The treatment of mesothelioma depends on the location of the tumor, the stage of the disease, the age and the overall health of the patient. Standard treatment options include surgery, radiotherapy, and chemotherapy. In selected cases, these treatments can be combined to increase therapeutic efficacy (trimodal treatment).
Surgery
Mesothelioma surgery is complex and should, therefore, be performed in highly specialized centers. Surgery with curative intent should be performed as part of multimodal treatments (chemotherapy, surgery, radiotherapy). The techniques used are:
total pleurectomy: total removal of the pleura (both parietal and visceral pleural leaflets); extrapleural pneumonectomy: removal not only of the pleura but also of the lung, pericardium, and diaphragm.
Extrapleural pneumonectomy is an extremely demolishing operation and is reserved for the most advanced cases of the disease.
Radiotherapy
Radiotherapy for mesothelioma is administered by means of external beams, with volumetric intensity modulation technique (IMRT), as part of trimodal treatment (chemotherapy, surgery, radiotherapy) after surgery with curative intent. Radiotherapy can also be used for palliative purposes, in advanced forms, on areas that cause pain.
Chemotherapy
Chemotherapy is a form of pharmacological therapy that can be administered by intravenous infusion (IV). It can be used, in selected cases, to reduce the disease, favoring the radical surgical approach (trimodal treatment); alternatively, to block the growth of the disease and promote the improvement of symptoms related to it.
Prevention
There are no specific ways to prevent the disease from occurring, but the risk of developing it can be reduced by avoiding the main risk factor, namely exposure to asbestos.
Pleural cancer: can it be cured?
Although it is a very serious type of cancer, it is possible to heal from pleural mesothelioma, but the chances of recovery are strongly conditioned by various subjective parameters:
age of the patient;
the general condition of the patient;
possible pathologies (arterial hypertension, diabetes, heart disease...);
staging at diagnosis (diffusion, lymph node involvement, the presence of metastases);
timeliness of the diagnosis;
response to therapies;
surgeon's skill set.
Prognosis, survival, life expectancy by stage
The survival time and life expectancy after mesothelioma diagnosis (which usually occurs about 15-30 years after exposure to asbestos) is unfortunately on average 12-18 months or less in the absence of therapy or in the case of late diagnosis at an advanced stage. One of the main factors influencing life expectancy, beyond the parameters listed above, is the staging of the disease:
Stage I: In the initial phase, the mesothelioma is located on a layer of the pleura and the tumor may have spread to the pericardium or diaphragm.
The life expectancy of the patient with first stage mesothelioma is about 2 years (21 months). Studies show that 50% of patients diagnosed with mesothelioma can live another 5 years with aggressive treatment.
Stage II: In the second stage, the involvement of both layers of the pleura is observed, only on one side of the body. Life expectancy at this stage may be about 1-2 years after diagnosis.
Stage III: In the third stage, cancer spreads to the chest wall, esophagus and lymph nodes on one side of the body. The life expectancy for this phase can be about 16 months.
Stage IV (last stage, terminal tumor): In the fourth stage of pleural mesothelioma, there is spread to other organs of the body and bone metastases are formed, to the liver, lymph nodes, brain or other areas of the body. At the fourth stage of mesothelioma, life expectancy is less than 12 months.