Perhaps the most important function of the body, and one without which our organs can simply not survive, is breathing. Even mundane tasks like talking, singing, and walking can become extremely tough if you are struggling with respiratory issues. It is well said that the quality of our lives is only as good as the quality of our lungs. 

According to the American Cancer Society, lung cancer is the 3rd most common cancer amongst both men and women. It has the highest mortality rate accounting for above 25% of all cancer deaths. In 2018, nearly 2.1 million cases were diagnosed worldwide, of which 1.8 million resulted in fatalities. The increase of pollutants, toxins, and carcinogens in our environment is one of the biggest reasons behind severely degraded air quality and, thus, an increase in relevant illnesses. 

One such illness is mesothelioma.

What is Mesothelioma?

It’s a type of cancer that can severely weaken the integrity of your lungs by affecting mesothelial cells that form the protective lining covering most of the internal organs. Mesothelioma is highly aggressive and although treatment is available, a complete cure isn’t possible. Depending on the region of the mesothelium affected, it can be classified into two types: 

Pleural Mesothelioma

The most common region that this cancer develops is within the pleura, a thin layer of tissue that surrounds lungs. Although it affects the lining of the lungs, it must be treated differently as compared to regular lung cancer. Pleural mesothelioma accounts for nearly 90% of all mesotheliomas. 

Peritoneal Mesothelioma: 

This type affects the peritoneum, a protective membranous covering surrounding the abdomen and the heart. It is the second most common type of mesothelioma to be diagnosed. 

Causes

Like all other cancers, mesothelioma too begins with a series of mutations within the DNA of healthy mesothelial cells. Disrupted DNA causes the cells to divide excessively and multiply out of control, eventually leading to the development of a malignant mass. While what causes the cells to behave abnormally is still unknown, researchers believe it is a combination of genetic, environmental, and lifestyle factors. Studies have often linked mesothelioma to excessive asbestos exposure, a mineral naturally found in the environment. 

Asbestos is used to make shingles, brakes, and flooring and has numerous other applications due to its strong fibers and heat resistance. When these fibers disintegrate, they form toxic dust that can settle within the lungs and stomach causing irritation and eventually leading to mesothelioma. 

Stages Of Mesothelioma

There are four stages of this cancer, depending on its progression. While symptoms are less aggressive initially, if diagnosed at stage 1, there is a much higher chance of recovery. Stage 4 has the shortest average life expectancy, and the hope of survival is significantly less. 

Let’s look at the progression of these stages.

Stage 1A: 

Cancer starts developing within the mesothelial cells of the parietal pleura (the external layer) on one side of the lungs only. In the early stages, it doesn’t spread to or affect any organs beyond the outer lining of the lungs. Removal through surgery is the first obvious option. 

Stage 1B:

Cancer develops further and spreads to the visceral pleura (the internal layer). Although it is still restricted to one side of the chest, it starts affecting immediate surrounding organs. There’s also a possibility of it growing further in the mesothelial cells of the diaphragm (a muscle that helps the ribcage expand and contract) as well as the mediastinum (central space between the two lungs). 

• Symptoms at this stage are barely visible as the damage isn’t bad enough to cause difficulties in breathing.

Stage 2:

The symptoms are more visible at this stage as it spreads beyond the mesothelial lining and affects the nearby lymph nodes. It may also grow on a larger chunk of the diaphragm of the mediastinum and starts progressing towards distant organs, but the tumor is still small enough to be contained and removed surgically. 

• Symptoms resemble that of the common cold.

Stage 3A: 

Although the tumor is significantly widespread, some patients may still qualify for surgery if it hasn’t fully developed within the lymph nodes. At this stage, cancer has likely grown fully into both layers of the pleura (one side of the chest) and diaphragm. It is also fully developed within the mediastinum, the tissue between the two lungs, and starts progressing towards the second side of the chest. 

Stage 3B:

At this stage, most patients become ineligible for surgery and are required to undergo several bouts of chemotherapy. Cancer isn’t spread too far and but invaded at least one or more of the following regions: 

• The peritoneum – tissue lining the abdomen
• The pericardium – the membrane surrounding the heart
• The ribcage and ribs
• The spine

 

• Patients at this stage suffer from fever and excessive sweating especially at night. They have trouble breathing, while other symptoms include wheezing, chest pain, nausea with vomiting, bloating, and diarrhea.

Stage 4:

This is the end-stage of this deadly cancer. The tumor spreads far beyond its origin—past the mediastinum and affects both the lungs—and cannot be contained. 

Through the nodes, it manages to spread towards other distant organs like the abdomen, liver, bone, or even the brain. There are negligible chances of recovery at this stage. 

Treatment

The treatment plan depends largely on the stage at which the issue is diagnosed. For patients with stage 1 or stage 2 mesothelioma, doctors recommend surgery along with radiation therapy and chemotherapy. 

Life expectancy is significantly higher than in the initial stages as there are chances that the tumor can be completely resected. However, beyond stage 2, patients usually don’t qualify for surgery. Doctors will either recommend chemotherapy or immunotherapy, depending on the individual’s situation. Some patients even enroll in clinical trials and volunteer to test out new forms of therapy and receive experimental chemotherapeutic drugs. 

At the last stage of mesothelioma, even chemotherapy doesn’t help much. Patients receive palliative treatment or supportive care to help tackle the symptoms and delay the progression of this disease. It helps increase chances of survival and keep patients comfortable during this already stressful time. Some palliative care procedures include:

• Thoracentesis – removal of excess fluid buildup by inserting a needle in the pleura
• Pleurodesis – removal of the space between two layers of pleura to prevent fluid accumulation
• Radiation – used along with chemotherapy to reduce the symptoms, pain and help shrink the size of the growing tumor
• Paracentesis – like thoracentesis, but instead a needle is used to remove fluid buildup in the peritoneum and reduce pressure on the abdomen
• Pericardiocentesis – removal of fluid accumulating in the pericardium to decrease the pressure on the heart

Takeaway

Mesothelioma is a deadly form of cancer that causes many fatalities all around the globe. So far, the treatment options are quite limited, so prevention is extremely important. Research is still ongoing to develop more effective drugs and procedures to efficiently tackle this illness.