Pleural Mesothelioma, also known as malignant mesothelioma of the pleura, is a very rare form of cancer that is found in the mesothelium.

The mesothelium is the thin layer of tissue covering most internal organs. Mesothelioma is categorized by the location of the mesothelium affected. The type of cancer affecting the mesothelium around the lungs is called pleural mesothelioma. This is the most common form of mesothelioma.

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Symptoms

The symptoms for pleural mesothelioma may be caused by the cancer itself or by the fluid buildup caused by the cancer. The symptoms are very much like those of other conditions and require proper diagnostic tests to determine the underlying cause.

• Pain beneath rib cage
• Pain in the chest
• Pain in the abdomen
• Shortness of breath
• Pleural effusion—a buildup of fluid between the linings of the lungs and chest
• Swelling in the abdomen
• Unexplained weight loss

Tests

Pleural mesothelioma is quite similar to other forms of lung cancer and it can be difficult to distinguish between the two. There are several procedures which help physicians determine which type the patient has.

Bronchoscopy – A bronchoscope is inserted into the body through the mouth or nose down the trachea and into the lung. This thin instrument carries a lens and light to allow the physician to examine the airways for atypical areas. It may also be equipped with a tool to take samples which can then be examined in a lab.
Chest X-ray – a picture of the bones inside the chest
Complete blood count – also known as a CBC, this test looks for the types and numbers of red and white blood cells and platelets, as well as, the amount of hemoglobin in the red blood cells
Cytologic exam – The examination of cells or fluid under a microscope to look for abnormalities.
Fine-needle aspiration biopsy– also known as a FNA biopsy, fluid or tissue is removed with a thin needle and examined for abnormal cells.
Physical exam – this will include an oral history which will indicate patient exposure to asbestos
Sedimentation rate – a blood test that determines how quickly red blood cells fall to the bottom of a test tube
Thoracotomy – an incision between two ribs which allows the physician to look for additional evidence of the disease

Risk Factors

The primary risk factor for developing pleural mesothelioma is working or living in a location that allowed the patient to inhale or ingest asbestos. Other risk factors include living with a person who was exposed to asbestos in a work environment. It is possible that an individual could bring the asbestos home with them on their clothing and body, allowing others to inhale the particles in the home.

Treatment

There are a number of factors that must be considered before choosing the appropriate treatment regimen for pleural mesothelioma. The stage of the cancer, size of the tumor, amount of fluid in the chest, age and overall health of the patient, type of cancer cells, whether this is the first instance of mesothelioma or a reoccurrence, and the ability of the tumor to be removed.

Treatment Types

Chemotherapy – The type of chemotherapy offered depends on the stage of the disease but may include intraplueral chemotherapy which is applied directly to the affected area or systemic chemotherapy which is administered to the entire body orally or via injection.
• Clinical trials
Radiation Therapy – Radiation can be introduced to the body with high energy beams or radioactive substances can be introduced directly into the body.
• Surgery

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Stages

There are four stages of pleural mesothelioma. The first stage is sometimes classified as limited while the remaining three stages are considered advanced.

• Stage I – The cancer is localized to one area
• Stage II – The cancer is located in the lining of the chest wall as well as in the nearby lymph nodes. It may also be in the lining of a lung, diaphragm, or the sac that covers the heart.
• Stage III – The cancer has spread to any of the following: mediastinum, chest wall, heart, past the peritoneum and diaphragm.
• Stage IV – The cancer has spread to distant areas of the body.

Resources

http://mesothelioma.allenstewart.com/types-of-mesothelioma/pleural-mesothelioma
http://www.mayoclinic.com/health/mesothelioma/DS00779
http://www.cancer.gov/cancertopics/types/malignantmesothelioma
http://www.cancer.org/Cancer/MalignantMesothelioma/OverviewGuide/index
https://secure.ssa.gov/poms.nsf/lnx/0423022275