The diagnosis
If you have signs and symptoms that might indicate mesothelioma, your doctor will conduct a physical examination to check for any lumps or other unusual signs.
Your doctor may order imaging scans, such as a chest X-ray and a computerized tomography (CT) scan of the chest or abdomen, to look for any abnormal sign..
Biopsy
Biopsy, which is a procedure to remove a small piece of tissue for laboratory examination, is the only way to determine if you have mesothelioma. Depending on the area of your body affected, your doctor chooses the right biopsy for you.
Options include:
- Inserting a needle through the skin. The doctor may remove the fluid or a piece of tissue with a thin needle inserted through the skin on your chest or abdomen.
- Collecting a sample of tissue during surgery. A sample of fluid or tissue may be collected during the procedure. The surgeon may make a small incision and insert a tube with a video camera to see inside your chest or abdomen. Special tools can be passed through the tube to collect a sample of tissue.
The tissue sample is analyzed under a microscope to see if the abnormal tissue is mesothelioma and to see what types of cells are involved. The type of mesothelioma you have determines your treatment plan.
Determine the extent of the cancer
Once your diagnosis of mesothelioma is confirmed, your doctor will perform a series of tests to find out if the cancer has reached your lymph nodes or anywhere else in your body.
The tests may include:
- CT scan of the abdomen and chest
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET)
The doctor will select the necessary tests for you. Not everyone needs all of these tests.
The doctor relies on the results of these tests to determine the stage of the cancer. The stages of pulmonary mesothelioma are indicated using Roman numerals I through IV. The smaller the number, the more that the cancer is located in the area around the lungs, and the higher the number, the higher the number, the more the cancer has spread to other areas of the body.
The cancer staging system continues to evolve and becomes more complex as doctors improve cancer diagnosis and treatment. Doctors choose the appropriate treatment based on the stage of the cancer.
There are no specific stages for other types of mesothelioma.
treatment
The treatment you receive for mesothelioma depends on your health and specific aspects of the cancer, such as its stage and location.
Unfortunately, mesothelioma is often an aggressive disease and for most people a cure is not possible. Mesothelioma is re-diagnosed at an advanced stage - when it is not possible to remove the cancer through an operation. Instead, your doctor may work to control the cancer to make you more comfortable.
Discuss treatment goals with your doctor. Some people want to do everything they can to treat their cancer, even if it means continued side effects for a slight chance of improvement. Others prefer treatments that make them feel comfortable so that they can live the time remaining for them without symptoms as much as possible.
Surgery
Surgeons work to remove mesothelioma when diagnosed at an early stage. In some cases, cancer can be cured.
Sometimes it is not possible to remove the entire cancer. In those cases, surgery can help reduce signs and symptoms caused by mesothelioma that has spread to your body.
Surgical options might include:
- Surgery to reduce fluid buildup. Pleural mesothelioma can cause fluid to build up in your chest, causing difficulty breathing. Surgeons insert a tube or catheter into your chest to drain the fluid. Doctors may also help inject medicine into your chest to prevent fluid from backing up (pleural adhesion).
- Surgery to remove the tissue surrounding the lungs. Surgeons may remove the tissue that lines the ribs and lungs (pleurectomy). This procedure does not cure mesothelioma, but it can relieve signs and symptoms.
- Surgery to remove the lung and surrounding tissue. Removing the affected lung and surrounding tissue can relieve the signs and symptoms of pleural mesothelioma. If you will be receiving radiotherapy to the chest after surgery, this procedure also allows doctors to use higher doses; Since there is no need to worry about protecting the lung from damaging radiation.
- Mesothelioma surgery. The membrane surrounding mesothelioma may sometimes be treated with surgery to remove as much of the cancer as possible. Other treatments may be used before or after surgery.
Chemotherapy
Chemotherapy uses chemicals to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of a mesothelioma that cannot be removed surgically. Chemotherapy may also be used before surgery (adjuvant preliminary treatment) to make surgery easier, or after surgery (adjuvant chemotherapy) to reduce the chance that the cancer will recur.
Chemotherapy drugs may be heated and administered directly into the abdominal cavity (intraperitoneal chemotherapy) in peritoneal mesothelioma.
Radiation therapy
Radiation therapy focuses high-energy rays, such as X-rays and protons, at a specific spot or spots on your body. Radiation therapy may be used after surgery to kill any cancer cells that remain. It may also help reduce advanced cancer signs and symptoms in situations where surgery is not an option.
Other treatments
In some cases, other treatments may be used to treat mesothelioma. Other treatments include:
- Immunotherapy. Immunotherapy uses your immune system to fight cancer. Your disease-fighting immune system might not attack the cancer. Because cancer cells produce proteins that blind the cells of the immune system. Immunotherapy works by disrupting this process. This treatment may be an option if other treatments have not worked.
- Targeted therapy. Targeted therapy uses drugs that attack specific vulnerabilities in cancer cells. These drugs are not commonly used to treat mesothelioma, but your doctor may recommend targeted therapy based on the results of the tumor DNA test.
Clinical trials
Clinical trials are studies of modern methods of treating mesothelioma. People with mesothelioma may participate in clinical trials to have a chance to try new types of treatment. However, a cure is not guaranteed. Think seriously about treatment options and talk to your doctor about clinical trials available to you. Your participation in clinical trials can help your doctor better understand how to treat mesothelioma in the future.
Clinical trials are currently investigating a number of new approaches to treat mesothelioma, including targeted drug therapy and new approaches to immunotherapy.
Treating other types of mesothelioma
Pericardial mesothelioma and meniscal mesothelioma are rare. The cancer can be removed in the early stages with surgery. However, doctors haven't yet determined the best way to treat cancer in the later stages. Your doctor may recommend other treatments to improve your quality of life.
Alternative medicine
No alternative medicine therapies have been shown to be helpful in mesothelioma. But complementary and alternative therapies may help control mesothelioma signs and symptoms. Discuss options with your doctor.
Mesothelioma (pleuroma) can cause pressure inside your chest; This makes you feel as if you have always been short of breath. Shortness of breath can be bothersome. Your doctor may advise you to use supplemental oxygen or take medications to make you more comfortable, but this is often not sufficient. Combining the treatments your doctor recommends with complementary and alternative approaches may help you feel better.
Alternative treatments that have shown some promise in helping people overcome shortness of breath include:
- Acupuncture. Acupuncture uses thin needles that are inserted into tiny points in your skin.
- Breathing exercises. A nurse or physical therapist can teach you breathing techniques to use when you feel short of breath. Sometimes you may feel short of breath and start to panic. Using these techniques may help you feel in control of your breathing.
- relaxation exercises. Slowly tensing and relaxing different muscle groups may help you feel relaxed and breathe easier. Your doctor may refer you to a therapist who can teach you relaxation exercises to do on your own.
- Sit next to a fan. Pointing a fan to your face may help relieve the sensation of shortness of breath.
Coping and support
A mesothelioma diagnosis can have a devastating impact on not only you but your family and friends as well. In order to feel back in control of the situation, you can try to do the following:
- Knowing enough information about mesothelioma to make decisions about your care. Write down your questions to ask your doctor. Ask your health care team to provide information to help you have a better understanding of your disease. Good sources to start looking for more information include the National Cancer Institute, the American Cancer Society, and the Mesothelioma Applied Research Foundation.
- Surround yourself with a support network.Your close friends or family can help you with everyday tasks, such as scheduling doctor appointments or treatment If you are having trouble seeking help, learn to be honest with yourself and accept help when you need it.
- Find other people with cancer. Ask your health care team about cancer support groups in your community. Sometimes there are questions that can only be answered by individuals with cancer. Support groups offer an opportunity to ask these questions and receive support from people who understand your situation. Online support forums, such as the American Cancer Society's Cancer Survivors Network, can provide similar benefits while allowing for your anonymity.
- Make sure to plan ahead. Ask your health care team for advance directives that provide your family with evidence of your medical wishes in the event that you are unable to speak for yourself.
Get ready for your appointment
If you have lung or abdominal symptoms, start by making an appointment with your family doctor. If your doctor suspects the presence of mesothelioma, you may be referred to a doctor who specializes in lung diseases or abdominal problems (gastroenterologist).
Because appointments can be short, and there is often a lot to cover, it's a good idea to be well-prepared for the appointment. Here's some information to help you get ready and get an idea of what the doctor will do.
What can you do?
- Adhere to any instructions given to you by the doctor before the appointment. When scheduling the appointment, ask about any instructions you need to follow before the visit, such as limiting your food.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down your key personal information, including any major stresses you've experienced or recent life changes.
- Make a list of all medications, vitamins or supplements that you are currently taking or have recently taken.
- Ask a family member or friend to come with you. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something you missed or forgot.
- Write down your questions to ask your doctor.
- Gather any previous medical reports , such as a chest X-ray, that are relevant to your condition.
Your time with your doctor is limited. So preparing a list of questions will help you make the most of your time together. List your questions from most to least important to be prepared in case time does not allow for all of the questions. For mesothelioma, some basic questions to ask your doctor include:
- What's the most likely cause of my symptoms or condition?
- What are other possible causes for my symptoms or condition?
- What tests might I need?
- Can I see my x-rays or tests?
- Is my condition likely temporary or chronic?
- What is the best course of action?
- What are the alternatives to the primary approach you're suggesting?
- I have these other health problems. How can I best manage these conditions together?
- Do I have to follow any instructions?
- Should I see a professional? What will that cost, and will my insurance cover it?
- Are there brochures or other printed material that I can take with me? What websites do you recommend?
- What will determine whether I need to select another follow-up visit?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask any more questions that you may have.
What the doctor can do
Your doctor is likely to ask you a number of questions. Being prepared to answer questions may allow you more time to cover other points you need to discuss. The doctor may ask you the following questions:
- When did you begin experiencing symptoms?
- Are your symptoms constant or occasional?
- How severe are your symptoms?
- What, if anything, improves your symptoms?
- What, if anything, appears to worsen your symptoms?
- Does it hurt to take a deep breath?
- Do symptoms affect your ability to function?
- Have you ever dealt with asbestos?
What can you do in the meantime?
Try to avoid anything that worsens the signs and symptoms. For example, if you are short of breath, try to take it easy until you can see your doctor. If your shortness of breath becomes distressing or uncomfortable, seek immediate medical attention.
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