Symptoms of Mesothelioma

Presenting symptoms of pleural mesothelioma can be as nondescript as a chest pain, slight fatigue, or a shortness of breath during physical activity. Symptoms often mirror signs of less serious respiratory issues and are hardly unusual for a senior.

Pleural mesothelioma cancer may take decades to develop after exposure to asbestos, but it attacks quickly once taking hold. The microscopic asbestos fibers that are inhaled can lodge in the thin lining around the lungs and trigger physiological cellular changes that lead to this rare but aggressive cancer.

Many people with pleural mesothelioma are unaware of their own condition for months or even years because initial symptoms are often mistaken for less threatening illnesses. Anyhistory of asbestos exposure, or even suspected asbestos exposure, should be discussed with a physician, who can refer a patient to a specialist right away. An early diagnosis is critical to survival because it can lead to more effective therapy options.

Symptoms Can Be Confusing

Most symptoms of pleural mesothelioma involve the respiratory system and often are misdiagnosed because most medical professionals rarely see this disease. It's estimated that more than 2,000 people in the United States are diagnosed annually with this cancer. By comparison, an estimated 150,000 Americans are diagnosed with lung cancer each year.

Initial symptoms of pleural mesothelioma often are confused with pneumonia or asthma or another respiratory ailment. Even a specialist will need considerable time — in addition to results of various, complex tests — to provide a definitive diagnosis.

According to a 2011 study of 221 pleural mesothelioma patients, many reported similar symptoms in the early stages, often before it was diagnosed.

They included:

• 79 percent experienced shortness of breath
• 64 percent suffered chest pain
• 36 percent had a chronic cough
• 90 percent presented with pleural effusions (excess fluid around lungs)
• 30 percent experienced significant weight loss

If any of these symptoms appear, and there is a history of asbestos exposure, it is important to see a specialist.

Many patients diagnosed in stage I have no symptoms and the cancer is accidentally detected through routine X-ray or other tests. In this early stage, the tumor burden is relatively minimal and may not cause any noticeable symptoms. The two most common presenting symptoms of pleural mesothelioma are shortness of breath and chest pain. These symptoms usually develop as a result of pleural effusion or tumors pressing against the lung and chest wall, which can happen in in stages I through III.

In stage II, as tumors spread beyond the pleural lung lining and into the lung and diaphragm, pain may increase and may be felt in the shoulder or upper abdomen in addition to the chest. Difficulty breathing and coughing may arise or worse at this stage.

During stage III, tumors spread more thoroughly throughout the chest, placing pressure on the lungs and chest wall. These physical changes can lead to an increase in pain and difficulty breathing, dry cough, tightness in the chest, fatigue and weight loss.

By stage IV, tumors have spread throughout the chest and rarely spread to distant locations. The degree of tumor burden in the chest can severely worsen pulmonary symptoms like shortness of breath. Others symptoms may include lumps of tissue under the skin on the chest, pain in the lower back, fever and night sweats. Some patients experience a hoarse voice and difficulty swallowing. At this stage, patients often need help breathing and require continuous oxygen.

Recognizing Symptoms

Because a pleural mesothelioma diagnosis is often not made until after the cancer has spread, the prognosis can be grim. The process of recognizing the symptoms and turning them into a definitive diagnosis so treatment can begin usually involves multiple procedures with different medical professionals and often takes several months.

During the diagnostic process, a patient may see a pulmonologist, a radiologist, a pathologist and a surgeon, as well as an oncologist and a primary care physician. Patients might also then opt for a second opinion. Early symptoms could lead to imaging tests that include X-rays, an MRI, CT scans and PET scans. If one of the scans reveals an irregularity, a biopsy is needed to confirm the presence of mesothelioma. Although it can take 10 to 50 years after exposure to asbestos before cancer develops and symptoms appear, the survival time after symptoms are diagnosed can be short. The majority of patients are given a prognosis of six to 18 months to live.

Early diagnostic methods, more awareness and improved treatments have allowed some patients to live well beyond their initial prognosis. The most important thing is to find a specialist who understands the disease and understands all the intricacies and treatment options.

Source : https://www.pleuralmesothelioma.com/cancer/symptoms.php

Asbestosis Treatment

In Severe Asbestosis Cases, Supplemental Oxygen is Required

Due to the accumulating damage caused by asbestos fibers, asbestosis and asbestos pleural disease are slowly progressive asbestos diseases. They may be treated, but not cured. The physician will try to ease the patient's symptoms and to prevent further medical complications.

If you have been diagnosed with asbestosis, you will be advised to avoid further contact with asbestos and to quit smoking. Patients run an increased risk of respiratory infections, so you may be treated with antibiotics for other respiratory ailments. It is wise to avoid large crowds where you may be exposed to such ailments, and to keep influenza and pneumococcal immunizations up to date.
Treating Asbestosis and Other Asbestos Diseases

Your doctor can instruct you on how to perform bronchial drainage for your asbestosis. At home, you may also use an ultrasonic, mist humidifier to loosen bronchial secretions so that they can be expelled through coughing. Respiratory therapists can use chest physical therapy techniques to further aid in removing secretions (Complete Guide to Symptoms, Illness & Surgery, Asbestosis, H. Winter Griffith, M.D.).

Shortness of breath is treated with bronchodilators, inhaled or oral medications that open up the bronchial tubes and allow the passage of air. In more severe asbestosis cases, supplemental oxygen may be required.

Productive cough is treated with humidifiers and chest percussion. For minor discomfort, you can take over-the-counter drugs such as acetaminophen or ibuprofen to reduce chest pain.

Unfortunately, patients with asbestosis and asbestos pleural disease have an increased chance of developing mesothelioma,asbestos lung cancer, and a variety of malignancies. Your physician will monitor you for these asbestos diseases.

Source : http://www.asbestosnetwork.com/Health-Issues/Asbestosis/Asbestosis-Treatment.shtml

Non-Small Cell Lung Cancer Treatment

Surgery, radiation, chemotherapy, targeted treatments and immunotherapy—alone or in combination—are used to treat lung cancer. Each of these types of treatments may cause different side effects.
Surgery

Most stage I and stage II non-small cell lung cancers are treated with surgery to remove the tumor. For this procedure, a surgeon removes the lobe, or section, of the lung containing the tumor.

Some surgeons use video-assisted thoracoscopic surgery (VATS). For this procedure, the surgeon makes a small incision, or cut, in the chest and inserts a tube called a thoracoscope. The thoracoscope has a light and a tiny camera connected to a video monitor so that the surgeon can see inside the chest. A lung lobe can then be removed through the scope, without making a large incision in the chest.
Chemotherapy and Radiation

For people with non-small cell lung tumors that can be surgically removed, evidence suggests that chemotherapy after surgery, known as “adjuvant chemotherapy,” may help prevent the cancer from returning. This is particularly true for patients with stage II and IIIA disease. Questions remain about whether adjuvant chemotherapy applies to other patients and how much they benefit.

For people with stage III lung cancer that cannot be removed surgically, doctors typically recommend chemotherapy in combination with definitive (high-dose) radiation treatments. In stage IV lung cancer, chemotherapy is typically the main treatment. In stage IV patients, radiation is used only for palliation of symptoms.

The chemotherapy treatment plan for lung cancer often consists of a combination of drugs. Among the drugs most commonly used are cisplatin (Platinol) or carboplatin (Paraplatin) plus docetaxel (Taxotere), gemcitabine (Gemzar), paclitaxel (Taxol and others), vinorelbine (Navelbine and others), or pemetrexed (Alimta).

There are times when these treatments may not work. Or, after these drugs work for a while, the lung cancer may come back. In such cases, doctors often prescribe a second course of drug treatment referred to as second-line chemotherapy.

Recently, the concept of maintenance chemotherapy has been tested in clinical trials, either as a switch to another drug before the cancer progresses; or to continue one of the drugs used initially for a longer period of time. Both of these strategies have shown advantages in selected patients.
Chemotherapy Before Other Treatments (Neoadjuvant Treatment)

Receiving chemotherapy before radiation or surgery may help people with lung cancer by shrinking the tumor enough to make it easier to remove with surgery, increasing the effectiveness of radiation and destroying hidden cancer cells at the earliest possible time.

If a tumor doesn’t shrink with chemotherapy, the medication can be stopped right away, allowing the doctor to try a different treatment. In addition, research shows that people with lung cancer are much more able to cope with the side effects of chemotherapy when it is given before surgery.

Sometimes, a short trial period of treatment with the drug shrinks the tumor before surgery. If that is the case, then continued treatment with the same drug after surgery is more likely to benefit the patient. Because many lung cancer specialists around the world are giving chemotherapy to their patients before surgery, patients should discuss it with their doctor.
Targeted Treatments

One of the most exciting developments in lung cancer medicine is the introduction of targeted treatments. Unlike chemotherapy drugs, which cannot tell the difference between normal cells and cancer cells, targeted therapies are designed specifically to attack cancer cells by attaching to or blocking targets that appear on the surfaces of those cells. People who have advanced lung cancer with certain molecular biomarkers may receive treatment with a targeted drug alone or in combination with chemotherapy. These treatments for lung cancer include:

Erlotinib (Tarceva and others). A targeted treatment called erlotinib has been shown to benefit some people with non-small cell lung cancer. This drug blocks a specific kind of receptor on the cell surface—the epidermal growth factor receptor (EGFR). Receptors such as EGFR act as doorways by allowing substances in that they can encourage a cancer cell to grow and spread. Lung cancer cells that have a mutation on the EGFR are likely to respond to treatment with erlotinib instead of chemotherapy. For patients who have received chemotherapy, and are in need of additional treatment, erlotinib can be used even without the presence of the mutation.

Afatinib (Gilotrif). In 2013, the FDA approved afatinib for the initial treatment of metastatic NSCLC in patients with the same EGRF gene mutations or deletions as those who can be treated successfully with erlotinib.

Gefitinib (Iressa). In 2015, the FDA approved gefitinib for the first-line treatment of patients with NSCLC whose tumors harbor specific types of EGFR gene mutations, as detected by an FDA-approved test.

Bevacizumab (Avastin). Just like normal tissues, tumors need a blood supply to survive. Blood vessels grow in several ways. One way is through the presence of a substance called vascular endothelial growth factor (VEGF). This substance stimulates blood vessels to penetrate tumors and supply oxygen, minerals, and other nutrients to feed the tumor. When tumors spread throughout the body, they release VEGF to create new blood vessels.

Bevacizumab works by stopping VEGF from stimulating the growth of new blood vessels. (Because normal tissues have an established blood supply, they are not affected by the drug.) When combined with chemotherapy, bevacizumab has been shown to improve survival in people with certain types of non-small lung cancer, such as adenocarcinoma and large cell carcinoma.

Crizotinib (Xalkori). A treatment that has shown benefits for people with advanced non–small cell lung cancer who have the ALK gene mutation. Crizotinib works by blocking ALK and stopping the growth of the tumor.

Ceritinib (Zykadia). This was approved in 2014 for people with metastatic ALK-positive lung cancer who cannot tolerate crizotinib or whose cancer continued to grow while being treated with crizotinib.

Because the genes of cancer cells can evolve, some tumors may become resistant to a targeted treatment. Medications to meet those challenges are being studied now in clinical trials, which often offer important treatment options for people with lung cancer.
Immunotherapy

Immunotherapy has recently emerged as a new treatment option for certain lung cancers. While any cancer treatment can cause side effects, immunotherapy is generally well-tolerated; this is in part due to its mechanism of action.

Our immune system is constantly working to keep us healthy. It recognizes and fights against danger, such as infections, viruses, and growing cancer cells. In general terms, immunotherapy uses our own immune system as a treatment against cancer.

In March 2015, the FDA approved the immunotherapy nivolumab (Opdivo) for the treatment of metastatic squamous NSCLC which was unsuccessfully treated with chemotherapy. Nivolumab works by interfering with a molecular “brake” known as PD-1 that prevents the body’s immune system from attacking tumors.

Additional approaches to immunotherapy for lung cancer have shown promise in early clinical trials and are now in late-phase development. Treatments for NSCLC have advanced the furthest; however, a number of new immune-based treatments for SCLC are also in clinical development. These treatments fall into four main categories:
Monoclonal antibodies are lab-generated molecules that target specific tumor antigens (a substance that the immune system sees as being foreign or dangerous).
Checkpoint inhibitors target molecules that serve as checks and balances in the regulation of immune responses.
Therapeutic vaccines target shared or tumor-specific antigens.
Adoptive T-cell transfer is an approach in which T-cells (a type of white blood cell) are removed from the patient, genetically modified or treated with chemicals to enhance their activity, and re-introduced into the patient with the goal of improving the immune system’s anticancer response.