Mesothelioma Symptoms
The early symptoms of mesothelioma are generally non-specific, and
may lead to a delay in diagnosis. Sometimes resembling viral
pneumonia, pleural mesothelioma patients may present with shortness of
breath, chest pain and/or persistent cough; some patients show no
symptoms at all. A chest x-ray may show a build-up of fluid or pleural
effusion (discussed below). The right lung is affected 60% of the
time, with involvement of both lungs being seen in approximately 5% of
patients at the time of diagnosis. Less common symptoms of pleural
mesothelioma include fever, night sweats and weight loss. Symptoms of
peritoneal mesothelioma may include pain or swelling in the abdomen
due to a build-up of fluid, nausea, weight loss, bowel obstruction,
anemia or swelling of the feet.
PLEASE KEEP IN MIND THAT THESE SYMPTOMS MAY BE CAUSED BY
MESOTHELIOMA OR BY OTHER LESS SERIOUS CONDITIONS. ONLY A DOCTOR CAN
MAKE A DEFINITIVE DIAGNOSIS.
Pleural Effusions
One of the most common symptoms of mesothelioma is a pleural
effusion, or an accumulation of fluid between the lining of the lung
and the chest cavity. As the volume of fluid increases, shortness of
breath, known as "dyspnea", and sometimes pain may occur. The primary
goal in treating this effusion is to relieve shortness of breath,
prevent recurrence and minimize discomfort.
Doctors use x-rays and CT scans to identify effusions and help
determine a course of treatment. MRIs are used to a lesser extent in
evaluating pleural effusions, but may be helpful in assessing the
extent of chest wall involvement by tumor.
Diagnosis from Pleural Fluid
A diagnostic thoracentesis, in which cells are extracted from the
pleural cavity is many times used as an aid in the diagnosis of
mesothelioma. This is not usually considered a reliable test, however,
since in up to 85% of the cases, the fluid tests negative or
inconclusive even though cancer is present. It is ultimately a needle
biopsy of the pleura (lining of the lung) or an open surgical tissue
biopsy which confirms a mesothelioma diagnosis.
Treatment for Pleural Effusion
One way to treat the symptoms of difficult diseases is called
palliative therapy. This approach is often considered for patients
with malignant pleural effusions and is directed by evaluation of the
symptoms, general health and functional status. Relief of dyspnea is a
major consideration in mesothelioma. For patients who have large
pleural effusions, doctors may recommend chest tube drainage and
chemical pleurodesis. It is important to remember, however, that once
patients have a talc treatment, they may be eliminated from certain
chemotherapy treatments or clinical trials.
Chemical pleurodesis is a technique used to produce an adhesion inside
the pleural cavity. It is used on patients who have significant relief
of symptoms when pleural fluid is drained and show evidence of lung
reexpansion. It is performed with a standard tube thoracostomy. Talc
appears to be the most effective agent for pleurodesis, with a success
rate of nearly 95%. It is highly effective when administered by either
poudrage or slurry. Poudrage is the most widely used method of
instilling talc into the pleural space. Before spraying the talc, the
medical team removes all pleural fluid to completely collapse the
lung. After the talc is admistered, they inspect the pleural cavity to
be sure the talc has been evenly distributed over the pleural surface.
Some doctors prefer to use talc mixed with saline solution which forms
a wet slurry that can roll around the pleural cavity.
Source: Mesothelioma Web |
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