Mesothelioma: Symptoms, Diagnosis, Treatment

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Mesothelioma show different symptoms. The first symptoms of mesothelioma are generally non-specific. This may lead to a delay in diagnosis. Sometimes resembling viral pneumonia, pleural mesothelioma patients may present with chest pain, shortness of breath and or persistent cough. Some of the mesothelioma patients show no symptoms at all. Often it is effective to have a chest x-ray. This may show a build-up of fluid or pleural effusion (please see below). The right lung is affected around 60% of the time. The involvement of both lungs being seen in approximately 5% of patients at the time of diagnosis of mesothelioma. Much more lLess common symptoms of pleural mesothelioma include  night sweats, fever and weight loss. The symptoms of peritoneal mesothelioma possibly sometimes include pain or swelling in the abdomen due to a build-up of fluid, nausea, anemia or swelling of the feet, weight loss, bowel obstruction. You must keep in mind that these symptoms can be cause by mesothelioma and also by other less serious conditions.

The symptom pleural effusion

Pleural effusion is one of the most common symptoms of mesothelioma. Another common symptom is a pleural effusion or an accumulation of fluid between the parietal pleura (That is the pleura covering the chest wall and diaphragm) and the visceral pleura. All these membranes are covered with mesothelial cells inside, which produce a small amount of fluid that acts as a lubricant between the chest wall and the lung under normal conditions. Any excess fluid is absorbed by blood and lymph vessels. This process maintaining a balance. We will get as a result an effusion when too much fluid forms.

Types of pleural effusion

Pleural effusion has two categories: Transudates and exudates. A transudate effusion is a clear fluid that forms not because the pleural surfaces are diseased. It occurs because of an imbalance between the normal production and removal of the fluid. The reason for transudative fluid sympoms is congestive heart failure. There is an often cloudy exudate. It contains many cells and proteins and results from the disease of the pleura itself. This is common to mesothelioma. If you want to determine whether a fluid is a exudate or  transudate, a diagnostic thoracentesis, in which a needle or catheter is used to obtain a fluid sample, must be done. When he volume of fluid increases more and more, shortness of breath, known as "dyspnea", and sometimes pain, ranging from mild to stabbing, possibly occur. Some of the patients may experience a dry cough. If the doctor listens to the patient’s chest, then normal breath sounds are muted, and tapping on the chest will reveal dull rather than hollow sounds which occur in this case.

The diagnosis 0f pleural effusion

Chest x-ray the the normal diagnosis method of pleural effusion, although CT scans or ultrasound may also be used in some cases. There exist a special x-ray technique which is called a lateral decubitus film. This decubitus film technique may be used to detect smaller effusions or to enable the physician to estimate of the amount of the fluids which are present. If the underlying cause of the pleural effusion is readily apparent. This is the same in the case of severe congestive heart failure.However pleural effusion may be symptomatic of a number of disease processes from malignant to benign, a fluid sample is normally taken. Cells are normally extracted from the pleural cavity (diagnostic thoracentesis), when the possibility of mesothelioma exists. The result is in 85% of cases that the fluid tests are negative or inconclusive even though the cancer is present. a mesothelioma diagnosis. The mesothelioma diagnosis is confirmed ultimately by a needle biopsy of the pleura (lining of the lung) or an open surgical biopsy. 

The pleural effusion can be caused by heart failure or infection. However, when testing has realized no diagnosis, and the fluid continues to build or recur, doctors may recommend chemical pleurodesis and chest tube drainage. Another technique is chemical pleurodesis which a sclerosing agent is used to abrade the pleural surfaces producing an adhesion between visceral pleurae and the parietal. This prevent further effusion by eliminating the pleural space. The most effective agent for pleurodesis appears to be Talc, with a success rate of nearly up to  95%. Talc is highly effective when administered by either slurry or poudrage. Poudrage is the most often used method of instilling talc into the pleural space room. Before the spraying of the talc, the medical team removes all the existing pleural fluid and completely collapse the lung. After that the talc is administered. Then they inspect the pleural cavity to be sure that the talc has been evenly distributed all over the pleural surface. Some of the doctors prefer to use saline solution together mixed with talc which forms a wet slurry.

02.07.2010

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