DIAGNOSIS

The diagnosis of pleural mesothelioma is often difficult because the symptoms are similar to many other conditions. The diagnosis begins with a review of medical history, followed by a complete physical examination including a chest radiograph and pulmonary function studies. CT and MRI can be useful in determining the extent and location of the lesion.

To confirm the diagnosis requires a biopsy can be done by thoracoscopy or, if this is not possible through conventional surgery. Once the existence diagnosis, determine that the stage of the disease in order to proceed with the best treatment for mesothelioma.

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Surgery
Using 3 types of surgery in the treatment of mesothelioma. Diagnostic surgery to obtain a sample for biopsy is performed by thoracoscopy (*), or laparoscopic surgery or pleural mediatinoscopia open. Secondly, palliative surgery include partial pleurectomy pleurodesis, thoracoscopy with pleurodesis and more rarely, pleuroperitoneal shunt. The third is curative surgery involving extrapleural pneumonectomy in order to remove much of the tumor. In most centers, this is surgery followed by adjuvant therapy. Not all patients are suitable for this procedure, which otherwise has a 6% mortality

Chemotherapy
Although there have been several chemotherapy regimens, none has proven to be curative. The two most useful (in the sense of reducing the tumor mass and improve the symptoms) are cisplatin + pemetrexed and gemcitabine cistaplatino +. In both cases, dexamethasone is recommended to add folic acid supplements and vitamin B12

Radiotherapy
Radiation therapy has been used for many years with disappointing results due to the diffuse nature of the tumor and can cause radiation pneumonitis. Just found some effectiveness when applied locally in the scar area after surgery to avoid the spread of tumor cells remains

Radiotherapy involves using high energy X-rays to kill cancer cells and tumors retract. It can be used aggressively with surgery to help eliminate microscopic metastases that can cause disease recurrence or palliation for pain caused by tumors that press on nerve endings or other body. Radiation therapy has proven effective in preventing the spread of tumor biopsies or in areas of chest tube drainage.

Other treatments under investigation include immunotherapy, gene therapy, photodynamic therapy and some anti-angiogenic agents

The purpose of the trials is to involve patients in finding new and better treatments for mesothelioma diseases. Several clinical studies have different objectives, which may include the study of new drugs compare different ways of treating a disease or the study of various techniques for preventing cancer. Clinical trials are divided into three phases. Here, we show brief summaries of the goal of each phase of the trial.

The Phase I clinical studies are the first phase of clinical trial system. At this stage, the drugs have only been tested in the laboratory, but have had an effect on the destruction of cancer cells. These trials enroll only a limited number of participants and only made in limited centers specializing in the study of cancer. The objective of Phase I clinical studies is to find the maximum tolerated dose of the drug that causes no significant side effects, knowing the most common side effects if the drug continues to exhibit anticancer activity when administered to humans. If it is demonstrated that the drug has an effect on cancer using a safe dose, then the drug is examined in phase II clinical studies.

The Phase II clinical studies continue to study the safety of drugs or procedures, but also begin to study more closely its efficacy in specific types of cancer. These trials enroll a larger number of participants and can be performed in more centers. These trials may be “randomized”, which means that a computer, not a doctor, select different groups of participants.

The Phase III clinical studies comparing new drugs or procedures with current standard treatment. In these clinical trials enroll large numbers of participants from many areas and receive the new treatment or usual treatment. One of the primary objectives of Phase III clinical studies is to determine whether drugs have reduced or slowed the cancer, how long patients remain stable without progression of disease and as drug treatment affects quality of life for patients.

If you are interested in (a) to participate in a clinical study on mesothelioma, your doctor should be able to offer information on eligibility and availability in your area.

The easiest way to understand the difference between lung cancer and mesothelioma is that lung cancer is in the lung tissue, while pleural mesothelioma occurs in the layer of tissue lining the outside of the lung.

Smoking is considered the primary cause of lung cancer, and asbestos as the primary cause of mesothelioma. Asbestos can also cause lung cancer. Smoking does not cause mesothelioma. People who have been exposed to asbestos and who also smoke have up to 90 times more likely to be affected with lung cancer than those who do not smoke.

Asbestos is a mineral that occurs naturally in the environment and is typically divided into two mineralogical groups, but not all varieties have commercial use.

The family of amphibolites include crocidolite (also known as “blue asbestos”), the amosite (known as “brown asbestos), tremolite, anthophyllite and actinolite. Within the different types of amphibole fibers, only crocidolite and amosite are used commercially. However, the asbestos “noncommercial” (as tremolite, anthophyllite and actinolite) are also present as contaminants in commercial products include chrysotile asbestos, vermiculite and talc.

The other group of asbestos is the serpentine group that includes only the variety chrysotile asbestos. Despite its dangerous properties, chrysotile was immensely popular in the industry and represents 90% of the commercial use of asbestos in the United States.