What is Mesothelioma?

15449380 - lung pleura and pleural cavity
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Mesothelioma is a rare cancer and very aggressive cancer caused by asbestos exposure. The lung membrane is a very thin membrane that covers the inner surface of the ribs and the lungs in the thoracic cavity.

In mesothelioma patients this membrane gradually thickens and in some patients it reaches a thickness of 1-2 cm. This prevents the lung from breathing and causes shortness of breath.

How Many Types of Mesothelioma Are There?

Mesothelioma is divided into three groups. They are:

  • Epithelioid,
  • Biphasic
  • Sarcomatoid

types. The epithelioid membrane originates from the cells that form the sarcomatoid mesothelioma, which originates from the supporting tissue cells near the membrane. In biphasic mesothelioma, there is a cancerous tissue in both cell origins.

Why is Mesothelioma Caused?

The most important risk factor for mesothelioma is asbestos exposure.

Asbestos fibers that enter our body with breath, reach the lung membrane and settle into the cells. Asbestos fibers then break down the DNA, causing normal cells to change and develop the cancer.

What is The Best Mesothelioma Treatment Options?

  • Trimodality treatment for malign pleural mesothelioma
  • Chemotherapy is applied in the majority of patients.
  • Among the drugs, Pemetrexed (Alimta) has achieved significant success. Successful results are obtained in patients taking this drug together with Cisplatin.
  • Since chemotherapy has significant side effects, the oncology specialist is thoroughly evaluated before use.
  • The chemotherapy regimen, which has been applied in the form of the administration of heated chemotherapy drugs into the thoracic cavity, is a method that has begun to be used for approximately 10 years. There is no significant success in long-term results.
  • Surgery is used only in a certain type of mesothelioma (Epithelial type) and in very early stages (Stage I and sometimes Stage II).
  • Radiotherapy is often applied to organs such as bone, brain where the disease metastases. In some cases, mesothelioma patients can receive radiotherapy. However, it should be kept in mind that the application of radiotherapy to a common area may have negative consequences and should be applied with very careful patient follow-up.
  • Cyberknife or IMRT methods are particularly good when applied locally to the relapse of the disease (in terms of reducing the patient’s complaints).

What Are The Mesothelioma Surgery Methods?

Surgical treatment consists of two main groups:

  • Curative treatments, it aims to cure the disease permanently,
  • Palliative treatments, it aims to improve the patient’s quality of life and increase breathing capacity

Curative Mesothelioma Surgery

Curative surgery have two options:

a) Removal of diseased areas of pleura, diaphragm and pericardium. Nowadays it is the most preferred method.

b) Removal of the lung in addition to the above. This method is applied in rare cases.

The method of the surgery should be applied and determined after detailed preoperative examination before the operation.

Palliative Mesothelioma Surgery

Palliative surgery is applied for:

  • In patients with mesothelioma, the fluid collected in the thoracic cavity should be drained if severe dyspnea occurs.
  • This procedure should be performed by endoscopic (VATS) method in all patients whose general condition is appropriate, and treatment should be applied to prevent recurrence of the fluid.
  • After this procedure with VATS, the likelihood of fluid recurrence is extremely low.

What Are The Risks of Mesothelioma Surgery?

  • Risks in therapeutic pleurectomy decortication operations are usually prolonged bleeding drainage, air leakage from the lung, increase in heart rate and heart rhythm disorders. %3 of the patients who undergo surgery have died within 30 days.
  • In the operations where the lung is also taken (Extra Pleural Pneumonectomy), it is necessary to stay in the intensive care unit longer than the above conditions. %5 of patients who undergo surgery have died within 30 days.
  • In the palliative procedure called VATS pleurodesis, the risks are low. The death is almost non-existent.

How Many Days Should I Stay in Hospital After Mesothelioma Surgery?

After curative surgery, hospitalization is required for an average of 6-7 days and after VATS without pleurisy, for an average of 3 days.

Is Radiotherapy / Chemotherapy Needed After Mesothelioma Surgery?

Usually chemotherapy is required. Radiotherapy is not always necessary.

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