Mesothelioma Symptoms - Malignant Mesothelioma of the Pleura
Causes of Mesothelioma
Each year in the United States, about 2500 people discover that they have mesothelioma, and almost every one of them remembers being exposed to asbestos. Almost all cases of mesothelioma are linked to asbestos exposure. It usually takes between 10 and 40 years to develop mesothelioma after being exposed to asbestos, so asbestos is especially dangerous to children. The younger the person is at the time of asbestos exposure, the higher their risk for developing mesothelioma.
Photodynamic therapy of malignant mesothelioma of pleura
3. RESULTS
There was no perioperative mortality. One patient presented a surgical complication by persisting leakage from ductus thoracicus, the patient therefore was reoperated after 21 days without further complications. One incidence of skin photosensitivity was observed, this consisted of localized skin necrosis and was treated by split-skin grafting. The event occured in an area close to the thoracotomy and was caused by the light from lamps in the surgical theatre.
One patient developed an acute respiratory distress syndrome due to Pseudomona aeroginousa infection. Short transient periods of cardiac arythmia related to statural changes were seen during the first 2 weeks in patients who had undergone complete diaphragmatic (and pericardial) resection. This was surprisingly well tolerated by the patients. Hyperthermia and chest pain was observed during the first weeks. The patients did not develop neither neural and vascular alterations nor bronchial suture insufficiency.
Patients were discharged from the hospital from 10 to 90 days postoperatively, the average hospitalization period was 25 days. The patients were controlled by CT-scans every 3 months. In one patient (no. 1) no sign of recurrency has been found 18 months after treatment. One patient (no. 2) presented after 12 months an implantation metastasis in the thoracic wall. The tumour was located far from the incision, in an area of multiple punctures for evacuation of pleural effusion prior to operation. The metastasis was resected by thoracotomy and there was no sign of intrathoracic tumour. Additional radiotherapy towards the affected area was given post-operatively.
The patient has since been free of disease for 32 months after the initial treatment. These two long term disease-free patienes had initially presented highly differentiated tumours with homogenious distribution of high intensity of the fluorescent photosensitiser.
Patient no. 6 presented after 12 months a retroperitoneal metastasis located around the aorta, vena cava inferior and portal vein. The tumour was resected and PDT again performed with light fluence of 50 Joules/cm2. The fluorescence intensity of the initial pleural tumour and the metastasis was 104 and 43 grey level per pixel, respectively (Table 1). At control 3 months later multiple metastases were detected within the abdomen and mediastinum, as well as in other areas distant from treated tumour sites.
Two patients (no. 4 and 5) presented multiple metastases 9 and 13 months after treatment. These metastases were initially located within the abdomen and controlateral hemithorax and were 3 months later found within the treated hemithorax. Both patients had a long history of known mesothelioma and large tumour masses at time of actual treatmenL Tumours were highly differentiated and showed fluorescence intensities ranging from 176 to 248 grey level per pixel. Patient no. 3 developed recurrency after 3 months and distant metastases 5 months after treatment. The history of disease, size of tumour and its level of fluorescence intensity were identical as for the above mentionned patienes, only the differentiation grade was lower.
Three patients (no. 7, 8 and 9) presented generalized disease 4-5 months after treatment, showing manifestations within the treated hemithorax as well as contralateral and intraabdominal metastases. In two of those patients the tumour had low fluorescence intensity and in the third patient, who had a tumour of mixed type with differentiation grade I, the fluorescence was of high intensity but unevenly distributed within the tumour tissue.
Prior to treatment all patients complained of chest pain. Most patienes had pleural effusion that was frequently drained. During the first week after treatrnent patients had a severe chest pain, this was reduced during the following months and the surviving persons do not complain of any particular chest pain. No pleural drainage was to be performed in a late postoperative period for any patient.
Mesothelioma Information
Malignant mesothelioma is a rare type of cancer that affects the serous membrane that lines three of the body's largest cavities: the pleura (lung cavity), the peritoneum (abdominal cavity) and the pericardium (heart sac). There are three distinct types of mesothelioma, each one affecting a different section of mesothelial tissue:
- Pleural mesothelioma
- Peritoneal mesothelioma
- Pericardial mesothelioma
Mesothelioma symptoms vary dependent on the type of mesothelioma one is suffering from, but can typically include chronic chest pain, fever, nausea and abnormal breathing.
Mesothelioma treatment options have thus far been unable to thwart the deadly disease, though researchers believe that scientific advances are paving the way to a future breakthrough.