Mesothelioma is a rare form of cancer, usually with prior exposure to asbestos. In this disease, malignant neoplasms (cancer) cells develop in the mesothelium, a protective lining that covers most of the internal organs of the body. The most common location is the pleura) (outer lining of the lungs and chest, but also in the peritoneum (the lining of the abdominal cavity are produced) or the pericardium (the sac that surrounds the heart).
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles or asbestos dust and fibers in other ways, for example, washing the clothes of a family member who worked with asbestos or by renovation of dwellings exposed to asbestos-cement products.
Symptoms of mesothelioma may not appear until between 20 and 50 after exposure to asbestos. Shortness of breath, cough and chest pain due to accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss and cache, abdominal swelling and pain due to ascites (fluid accumulation) in the abdominal cavity. Other symptoms of peritoneal mesothelioma can intestinal obstruction, abnormal blood clots, anemia and fever. If the cancer has spread through the mesothelium to other parts of the body, symptoms may include pain, difficulty swallowing, or swelling in the neck or face. These symptoms may be caused by mesothelioma or by other less serious conditions.
Treatment of MM using conventional therapies has not proved successful and patients have a median survival of 6 to 12 months after presentation. The clinical behavior of malignant disease caused by several factors including the continuous mesothelial surface of the pleura, which favors local metastasis via the ex foliation of cells affected invasion of underlying tissues and organs in the chest cavity, and the long latency period between asbestos exposure and disease progression.
Surgery alone or in combination with pre-and postoperative adjuvant therapy has proved disappointing with a 5-year survival below 10%. A pleurectomy / skin is the most common operation has eliminated the investment in the chest.
Less often extra pleural pneumonectomy (EPP), in which the lung, the lining of the chest, the semi-diaphragm and the pericardium removed. Although the volume is extremely resistant to radiation therapy, these treatments are sometimes used with the symptoms, reduce the burden of increased volumes, such as obstruction of the large blood vessels as well.
Radiation therapy is generally applied to areas of brain in his chest to prevent an increase in volume along the line of the chest wall.
In February 2004, the Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma.
Figure with immunotherapy have yielded variable. For example, intra pleural inoculation of Bacillus Calumet-Gu rin (BCG) in an effort to improve the immune response, which is found to be beneficial for the patient (although it may be) in patients with bladder cancer benefit. Mesothelioma cells proved susceptible to in vitro solution LAK cells following activation of interleukin-2 (IL-2), but patients with this particular therapy experienced major side effects. In fact, this study was suspended due to an unacceptably high level of IL-2, toxicity and severity of side effects such as fever and cache. However, other studies with interferon-alpha have been encouraging with 20% of patients attended by more than 50% reduction in tumor mass with minimal side effects.
A process for heating intra operative intra peritoneal chemotherapy was developed by Paul Sugar baker at the Washington Cancer Institute known. The surgeon removes as much as possible the volume followed by immediate administration of a chemotherapy agent, heated to 40 with 48 C in the stomach. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of certain drugs in the abdomen and pelvis area. Heating of chemotherapy increases the penetration of drugs into tissues. Even the heat which destroys the malignant cells in normal cells.