Mesothelioma – Diagnosis and Treatment

Diagnosis

Lab Testing of Tissue Samples

Doctors take a tissue sample from the patient and examine it in a laboratory to check for mesothelioma. This process is called a biopsy.

Doctors confirm the presence of cancer mainly through this method. The exact approach depends on where the tumor might be.

• Needle Technique: A thin needle goes through the skin in the chest or abdomen to collect fluid or a small piece of tissue. Imaging like a CT scan or ultrasound often guides this process.

• Surgical Sampling: If more tissue is needed, a doctor makes a small cut and inserts a camera tube to look at the tissue inside the body. Tools passed through the tube take samples from areas such as the pleura or the lining of the abdomen.

After doctors collect the sample, they send it for testing. Lab results show if the tissue changes are from pleural mesothelioma, peritoneal mesothelioma, pericardial mesothelioma, or another condition.

Assessing the Spread of the Disease

Once doctors confirm cancer, they run more exams to see if and how far it has spread. This helps them plan treatment.

Common tests include:

Test Name	What It Checks
CT scan	Images of chest or abdomen for tumors
MRI	More detailed images of soft tissues
PET scan	Shows cancer activity in the body

These imaging tests show if the cancer has spread to the lymph nodes or other organs. They also help identify fluid buildup, such as pleural effusion.

For pleural mesothelioma, scans reveal if the tumor has moved past the lining near the lungs.

Cancer Progression Levels

The stages of pleural mesothelioma range from stage 1 to stage 4.

• Stage 1: Cancer remains close to where it started, like the pleura.

• Stage 2: The cancer may affect nearby tissues or lymph nodes.

• Stage 3: The disease spreads throughout the chest and may involve more lymph nodes.

• Stage 4: Cancer appears in distant organs and other body parts.

Other forms, like malignant peritoneal mesothelioma and pericardial mesothelioma, do not have a set staging system. Instead, doctors measure the spread by how much the disease affects nearby tissues and organs.

Treatment

Surgical Procedures

Doctors may consider surgery, especially when they find mesothelioma early. If they can remove all of the cancer, there is a small chance for long-term control.

More often, surgery helps relieve symptoms or improve quality of life since complete removal is not always possible.

Types of Surgery:

• Fluid Drainage: Doctors remove excess fluid from around the lungs or abdomen to help with breathing or other symptoms.

• Pleurodesis: After draining fluid, doctors may put in a medicine to stop it from building up again. This process attaches the lung to the chest wall.

• Partial Tissue Removal: Surgeons take out the lining around the lungs and ribs to reduce discomfort.

• Lung and Tissue Removal: Removing an entire lung and nearby tissue can provide relief and makes radiation easier since there is no need to protect the lung from radiation harm.

• Abdominal Surgery: For cancers in the abdomen, surgeons try to remove as much cancerous tissue as possible. Sometimes, doctors give chemotherapy before or after surgery.

Doctors discuss a surgical approach with specialists at cancer centers. These procedures are mainly useful for certain stages or types of mesothelioma.

Cancer-Fighting Medicines (Chemotherapy)

Chemotherapy uses strong medicines to kill cancer cells. Doctors may use this approach before or after surgery, or as the main treatment if surgery is not possible.

• How Chemotherapy Works: Medicines may go through an IV or directly into the affected area.

• Special Form: Hyperthermic Intraperitoneal Chemotherapy (HIPEC): For some abdominal cancers, doctors place heated chemotherapy straight into the belly during surgery. This method attacks cancer more directly and can lower side effects elsewhere in the body.

• Combining Treatments: Doctors often use chemotherapy with other therapies as part of a larger treatment plan.

High-Energy Cancer Treatment (Radiation Therapy)

Radiation therapy uses focused beams of energy like X-rays or protons to damage and kill cancer cells.

• Uses for Mesothelioma:
  • After surgery, radiation can kill leftover cancer cells.
  • Before surgery, doctors may use it to shrink tumors and make them easier to remove.
  • When cancer cannot be removed, radiation helps manage symptoms such as pain or trouble breathing.

A radiation oncologist plans and oversees this part of the treatment.

Stimulating the Immune Response (Immunotherapy)

Immunotherapy uses medicines to help the body’s immune system find and destroy cancer cells. Cancer often survives by hiding from the immune system, so immunotherapy makes it harder for these cells to hide.

• When is Immunotherapy Used?
  • After surgery to help prevent cancer from returning.
  • When surgery isn’t possible or the cancer comes back.

Doctors give these medicines by IV, usually at a cancer treatment center. Sometimes, they combine immunotherapy with other treatments.

Special Medicines that Attack Cancer (Targeted Therapy)

Targeted therapy uses drugs that focus on specific traits in cancer cells. These traits are molecules or pathways cancer cells need to grow and survive.

• How it Works: These drugs aim at certain weaknesses found in the cancer cell instead of attacking all fast-growing cells.

• When is it Used?
  Doctors may suggest targeted therapy if other treatments have not worked. Sometimes, they combine it with chemotherapy for better results.

• Examples of Targets:
  • Signaling pathways in cancer cells
  • Proteins that help the cells survive

Participating in Research Studies (Clinical Trials)

Clinical trials study new treatments for mesothelioma. People can join these studies to try new medicines or combinations that are not yet widely available.

• Benefits:
  • Access to new treatment options.
  • Helping researchers find lasting solutions for future patients.
• Things to Consider:
  • Trials are not a guaranteed cure.
  • Patients should discuss risks, benefits, and possible side effects with their healthcare provider.

Cancer centers and some hospitals list ongoing studies. Patients can ask their healthcare team if a clinical trial is a good fit.

Care for Rare Types of Mesothelioma

Certain types, such as those affecting the heart or reproductive organs, are very rare.

• Available Treatments:
  • Surgery may be an option when the cancer has not spread.
  • If surgery is not possible or the cancer is advanced, doctors focus on managing symptoms to help people feel better.

Because these types are so uncommon, there is less information about the best treatments. Specialists can help guide decisions.

Non-Traditional Treatment Options

Alternative medicine has not been proven to cure mesothelioma or stop its growth. Some non-traditional approaches can make symptom management easier, especially when used with a doctor’s care.

These methods focus on helping patients deal with breathing problems and making daily life more comfortable.

Options that might help with symptoms:

Therapy	Purpose
Acupuncture	Relaxation, possible pain relief
Breathing Training	Reduces shortness of breath, calms panic
Relaxation Exercises	Lowers stress, improves comfort
Face Fan	Eases the feeling of breathlessness

• Acupuncture: Very thin needles are placed at certain points on the body. Some people report feeling more relaxed and finding relief from discomfort.
• Breathing Techniques: Nurses or therapists can teach special ways of breathing that may help control breathlessness and keep panic away.
• Relaxation Exercises: Gradually tensing and releasing different muscle groups can lower stress and make breathing easier. Therapists can guide patients on using these techniques at home.
• Fan Therapy: Sitting where a fan blows gently on the face may reduce the sensation of breathlessness.

It is best to speak with healthcare professionals before trying any new alternative methods. They can provide guidance on safe and effective use alongside medical treatments.

Ways to Manage and Find Support

People facing mesothelioma often feel overwhelmed. Practical steps can help improve quality of life.

Learning more about the condition helps patients make informed choices about care. Writing a list of questions for the healthcare team is helpful.

A strong support network is important. Family and close friends can help with daily needs, such as going to doctor visits or treatments. Accepting help can make daily life easier and reduce stress.

Joining support groups is another way to cope. These groups offer a chance to speak with others who have similar experiences.

People can share tips, ask questions, and receive emotional support in a safe space. Both in-person and online groups are available.

Making future plans may bring comfort and reduce worry. Talking with healthcare professionals about advance directives allows people to share their wishes about medical care. This can guide families if a person is unable to speak for themselves.

The table below lists key ways to manage and seek support:

Coping Strategy	Benefit
Gaining knowledge	Better decision-making
Building a support network	Daily help and emotional support
Joining support groups	Shared experiences and advice
Planning ahead	Clear directions for care

Getting Ready for Your Visit

Steps You Can Take Before Your Visit

It is important to be prepared for your meeting with a healthcare provider. Here are some steps to help organize your visit:

• Check for Special Instructions: Call ahead to ask if you need to follow any rules, such as not eating before a test.

• List Your Symptoms: Write down all symptoms, even those that might not seem connected, and note when they started.

• Share Personal History: List any recent life changes or major stress. This helps the doctor understand your situation.

• Bring a Medication List: Include all current and past medicines, vitamins, and supplements, plus their dosages.

• Bring Backup: Having a family member or friend with you can help remember important details or questions.

• Gather Medical Documents: Bring previous records, like past X-rays or test results, that are related to your condition.

• Prepare Questions: Make a list in advance so you do not forget important topics.

Sample Questions to Consider:

Questions to Ask	Notes
What could be causing my symptoms?
Are there other possible reasons?
What tests might I need?
How long will this condition last?
What is the recommended next step?
How do I manage other health issues with this?

Seeking a second opinion can also be useful, especially for rare problems or uncertain diagnoses.

What Questions Your Provider Might Ask

Be ready for questions from the healthcare team. These might include:

• Do your symptoms stay constant or do they come and go?

• How severe are your symptoms?

• What helps or makes your symptoms worse?

• Is breathing painful?

• Do your symptoms limit normal activities, like work or chores?

• Have you worked with or been exposed to asbestos?

Answering honestly and completely helps the healthcare provider get a clear picture of your condition.

What You Can Do While You Wait

While you wait for your visit:

• Avoid anything that makes your symptoms worse.

• If you have trouble breathing, rest and avoid strenuous activity.

• Seek immediate help if you become very short of breath or if your symptoms suddenly get worse.