Mesothelioma | Symptoms, Causes, and Diagnosis

Mesothelioma is a cancer that affects the mesothelium, the tissue that clings to the various organs of the body. There are four types of mesothelioma cancer, namely:

• Pleural mesothelioma (pleural mesothelioma), a cancer that attacks the lining of the mesothelium (pleura). This type is the most common type.

• Mesothelioma peritoneum (peritoneal mesothelioma), namely mesothelioma in the lining of the abdominal cavity (peritoneum).

• Mesothelioma Pericardium (pericardial mesothelioma), the mesothelioma that attacks the protective layer of the heart organ.

• Testicular mesothelioma, a mesothelioma that attacks the protective layer of the testes or testes.

There is a benign tumor in the breast, a solitary fibrous tumor. This condition is not included in the mesothelioma that is discussed.

Causes of mesothelioma

The cause of the mesothelioma is not certain. However, mesothelioma is always associated with exposure to asbestos or asbestos. Asbestos is a mineral that is widely used as building material, such as roofs, because of the heat resistance and fire resistance. The use of asbestos has been officially prohibited since 1999.

When asbestos is destroyed, during the mining or renovation of a building, asbestos produces fibers or suspended particles. Asbestos fibers are very easy to breathe and then penetrate into body organs, especially in the lungs. Swollen asbestos fibers can also move through the lymph system, deposit and infect cells in the lining of the abdominal cavity (peritoneum).

Exposure to asbestos can also affect the function of the reproductive system and the heart. However, the reproductive process is not yet known, because it is very rare.

Generally, there are several factors that increase the risk of mesothelioma, namely:

• Work environments that are sensitive to asbestos, such as mines, construction sites, car industry, power plants, textile industry and steel mills.

• Stay in old buildings or in environments where the land contains asbestos.

• Do you have family members who work in environments that are exposed to asbestos exposure. Asbestos can be attached to skin and clothing so that asbestos can be transported to other houses or environments.

• A history of mesothelioma or genetic diseases that increase the risk of cancer.

In addition to asbestos, there are several other factors that can increase the risk of mesothelioma, although this is rare. These included exposure to erionite minerals, irradiation with thorium dioxide chemicals that were used for X-ray examinations until the 1950s, and monkey virus infection (SV40).

Symptoms of mesothelioma

Symptoms of mesothelioma develop gradually and usually last 20 to 30 years until symptoms appear. Patients may not feel any symptoms when the mesothelioma is at an early stage. Over time, cancer cells develop, suppress nerves or other organs and cause symptoms.

The symptoms of mesothelioma vary depending on the location of the presence of cancer cells. The following symptoms may occur in pulmonary mesothelioma:

• Fever accompanied by sweat, especially at night.

• Excessive fatigue

• Cough accompanied by excruciating pain.

• Shortness of breath due to accumulation of fluid in the lungs, only in the pleural cavity, the space between the two pleural layers along the lungs.

• Weight loss without obvious reasons.

• Chestpain

• Swelling and changes in shape on the fingertips (clubs).

• Lumps appear on the tissue under the skin surface on the chest.

In the meantime, peritoneal mesothelioma has the following symptoms:

• Loss of appetite.

• The weight dropped drastically.

• diarrhea

• Constipation

• Stomach ache.

• Swelling in the abdominal area.

• A belly appears.

• Disorders of bowel movements and urination.

Mesothelioma pericardium and testes are very rare mesotheliomas. Mesothelioma pericardium usually causes symptoms such as chest pain and respiratory disorders, while testicular mesothelioma is characterized by swelling or the appearance of nodules in the area of ​​the testis.

The symptoms of mesothelioma are non-specific and can be caused by other conditions. Therefore, seek immediate medical attention if you experience the above symptoms, especially if you have been exposed to asbestos in the past.

Mesothelioma Diagnosis

The doctor will suspect that a patient has mesothelioma when experiencing symptoms that are exacerbated by a physical examination. To be sure, however, an imaging test is required. Below are:

• X-rays for detecting abnormalities such as thickening in the lung layer, fluid in the pleural cavity or changes in lung form.

• CT scan to examine the breast and stomach area for signs of cancer, to determine the location of the cancer and to see if the cancer has spread to other organs.

• PET (positron emission tomography). Research with compounds containing radioactive atoms injected into the body to obtain a detailed picture of the tissue suspected of having cancer cells.

• MRI to get a more detailed view of the tissue and determine the position of the tumor.

In addition, the doctor can propose a follow-up study in the form of:

• Investigation of liquid samples. When the patient experiences fluid retention in the body associated with mesothelioma, the physician will draw a fluid sample in the area containing the fluid with a needle inserted through the skin. In addition, the fluid is analyzed in the laboratory to detect cancer cells. There are different types of liquid and tissue tests, namely:

1. Thoracentesis, in which fluid samples are taken around the pleural cavity.
2. Paracentesis, take fluid into the abdominal cavity.
3. Pericardiocentesis, fluid in the layer (membrane) around the heart.

• Biopsy is the process by which tissue samples are removed from specific parts of the body to be analyzed in the laboratory. There are different types of biopsy studies, namely:

                - Needle biopsy. This type of biopsy uses a long needle that is inserted through the skin into the chest or abdomen to remove tissue samples.

                - Thoracoscopy, laparoscopy and mediastinoscopy. This type of biopsy uses an elastic tube with a camera and a special surgical device inserted through one or more small incisions to take tissue samples. The type of sampling generally depends on the body location examined, namely:

                - Thoracoscopy to examine the distance between the lungs and the chest wall.
                - Laparoscopy to examine the interior of the abdominal organs.
                - Mediastinoscopy to examine the area around the heart.

• Biopsy by surgery. Under certain circumstances, the physician performs an invasive procedure to remove larger tissue samples to determine the diagnosis. Sometimes the doctor also carries out the entire tumor, if possible. There are two types of biopsy procedures due to surgical procedures:

                - Thoracotomy, a kind of biopsy performed on the chest through open thoracic surgery.

                - Laparotomy, a kind of biopsy performed by open abdominal surgery.

• Bronchoscopic biopsy. Method for removing tissue samples with a long, thin, elastic tube inserted through the neck to examine the airways.

Mesothelioma Stage

Based on the extent of the spread, the mesothelioma is divided into four phases. By dividing this phase, the doctor can identify the development of cancer cells in the body and determine the treatment steps. The four stages of mesothelioma, namely:

• Phase 1: Tumors are still local, ie only in one body area and mesothelioma cells have not spread to other tissues or organs. Surgery is performed to remove the tumor. The life expectancy of patients diagnosed with phase 1 mesothelioma is 21 months or longer.

• Stage 2: Larger tumor size and mesothelioma cells spread to nearby areas. An operation to remove the tumor can still be done, even if the results are not very effective. Life expectancy for patients with stage 2 mesothelioma is 19 months or less.

• Stage 3: Mesothelioma cells have spread to surrounding organs. Surgery is no longer effective because some cancer cells have spread to other areas. The life expectancy of mesothelioma patients in phase 3 is about 16 months.

• Stage 4: Mesothelioma cells are spread throughout the body through the bloodstream. Patients who are still in the research phase are offered to increase the life chances of the patient. The life expectancy of patients with end-stage mesothelioma is very low at about 12 months.

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