D'Mesothelioma

Malignant mesothelioma is a rare form of cancer that begins in the mesothelium, the membrane that protects most internal organs of the body and covered. In the chest, the mesothelium has two layers, of which surrounds a lung itself and the other forms the inner lining of the chest wall. Between these two layers, usually a small amount of liquid is produced which serves the greater mobility of the organs. If the normal cells of the mesothelium can share uninhibited caused mesothelioma. The most common form of mesothelioma is "pleural" mesothelioma. These occur in the lung lining. Other forms are "peritoneal" mesothelioma, affecting the abdominal lining and pericardial "mesothelioma, affecting the heart lining.

What causes mesothelioma?
Mesotheliomas are caused in 80% of cases by exposure to asbestos fibers. Many people were exposed during their work with these fibers, and still others were secondary at risk through contact with exposed workers. Because the latency of this cancer may occur only 20 to 30 years after asbestos exposure.

How common is mesothelioma?
Mesotheliomas are rare tumors. According to epidemiological studies from the UK will experience the incidence peak between 2010 and 2020 Western Europe. Asbestos is now banned as a material, the effects of the ban will, however, recorded only from 2030 onwards.

Mesothelioma Treatment
The current treatment for mesothelioma is comprised of various options. Patients should discuss each option thoroughly with us before you can make a treatment decision.

Surgical therapy
If the disease is not advanced, and the patient can be performed a radical surgery in good physical condition.

There are two surgical methods for treatment of mesothelioma, the pleurectomy / decortication (PD) and the extrapleural pneumonectomy (EPP), also called pleuropneumonectomy. These are highly specialized operations that are not available in all hospitals. The ultimate goal of these interventions is to remove all tumor tissue, with the knowledge that residual microscopic Tumorgewebsteilchen probably remain in the body. An additional therapy (chemotherapy / o radiation) usually has the goal to eliminate these residual Tumorgewebsteilchen. The timing of additional treatment is determined individually.

The pleurectomy / decortication is the less radical method because it only reflects the removal of the pleura (lung lining) and includes the resection of the underlying lung. In some cases, the pericardium (pericardium) and the diaphragm are also removed, which depends on the size of the tumor. The advantage of this method is generally faster recovery time. Disadvantages include an increased risk of disease recurrence due to the inability to remove all cancerous tissue, as well as the inability to use because of potential harm to the underlying lung high doses probably necessary additional irradiation.

The extrapleural pneumonectomy is a more radical procedure, the removal of the lung, pleura (lung lining), pericardium (pericardium) and the diaphragm includes on the affected side. Pericardium and diaphragm are restored at the end of the operation with a Kunstoffnetz similar or substitute materials. Patients eligible for this operation in question only if they meet certain criteria staging (early stage) and an adequate pulmonary and cardiac function have to be prepared for this procedure.

If the disease progressed u / o the general condition of the patient bad, get radical surgical procedures in the treatment of the question. A Talkpleurodese (bonding of pleural sheets using talcum powder) can at present effusion (fluid in the pleural space) bring about a significant improvement of symptoms.

To the extent and security is to enable the diagnosis of pleural mesothelioma is often a thoracoscopy (chest mirroring) is necessary on this occasion, a Talkpleurodese are also performed. A mediastinal reflection (mediastinoscopy) is necessary to a possible involvement of lymph nodes to determine.

Chemotherapy
Chemotherapy involves the use of drugs that act by preventing the proliferation of cancer cells. In most cases, drug combinations are used to increase effectiveness. Chemotherapy can be used aggressively to shrink the tumor, or palliative, to relieve symptoms such as shortness of breath or pain. Some of the most commonly used drugs in pleural mesothelioma are:

Cisplatin
Carboplatin
Pemetrexed
Gemcitabine

The appropriate treatment for the patient will be developed individually by our colleagues in oncology using the latest scientific information and personal preferences.

Radiotherapy
Radiation therapy involves the use of X-rays with high energy to kill cancer cells. You can be aggressive, be used to remove microscopic tumor tissue is still present or in conjunction with palliative surgery for the treatment of pain. Radiation therapy is therefore particularly as an additional option for local control of the tumor to achieve. It is generally not suitable for the tumor metastasis (spread) to be treated in distant organs, not for the whole body can be irradiated.

Malignancy that involves the mesothelial cells of the human body, including the pleura, peritoneum, pericardium, and testis, known as malignant mesothelioma, either local or diffuse. Most, but not all, cases of malignant mesothelioma (malignant mesothelioma) in the pleural (lung cancer) is usually associated with exposure to asbestos. Patients with malignant pleural mesothelioma, 77% had been exposed to asbestos in the past. Diagnosis of mesothelioma is difficult to enforce because of the results of the analysis of pleural fluid from cancer usually does not diagnostic. Mesothelioma is more common in males than females and it occurs most often in the fifth decade of age until the 7th decade. Most cases (about 90%) of malignant mesothelioma in the pleura.

From histology picture there are 3 types of mesothelioma are sarcomatous mesothelioma, epithelial, and mixed (mixed). Pleural mesothelioma usually begins as plaques and nodules that combine to produce sheetlike neoplasm. Tumor growth usually begins at the bottom of the chest. Tumors can invade the diaphragm and blanketing the surface of the lungs and slit interlobaris.

As the disease progresses, often extends into the lung parenchyma, chest wall and the wall of the mediastinum. Pleural mesothelioma can spread to the esophagus, ribs, spine, brachial plexus, and superior vena cava.

Asbestos, amphibole asbestos, asbestos-crocidolite, and amosite asbestos in particular, is a major carcinogen involved in the pathogenesis. Chrysotile asbestos exposure is associated with a lower incidence of mesothelioma. Industrial area that is often dikaitakan with the occurrence of mesotheliomas due to asbestos exposure include mining industry, ship building which involves the use of asbestos, the manufacture of asbestos cement, ceramics, paper mill, auto parts, and repair factory train.

Clinical manifestations / phenomenon that occurs in mesothelioma clinics are:
-Dyspnea and chest pain nonpleuritic wall is the most common symptom in malignant mesothelioma. (Approximately 60-90% of patients had symptoms of chest pain or dyspnea.

-In patients with malignant mesothelioma, pleural effusions physical findings are usually known by percussion and auscultation.

-In rare cases, malignant mesothelioma manifests as cord compression, brachial plexopathy, Horner syndrome, or superior vena cava syndrome. Death is usually caused by infection or respiratory failure of the development of mesothelioma.

-The main area that often occurs in the pleura (87%), peritoneum (5.1%), and pericardium (0.4%).