Wednesday, June 20, 2007

Advanced malignant mesothelioma (stage II, stage III, and stage IV)

Advanced malignant mesothelioma includes stage II, stage III, and stage IV.
. In Stage II, cancer is found in the lining of the chest wall and the lymph nodes on the same side of the chest. Cancer may also be found in the lining of the lungs, the lining of the diaphragm, or the lining of the sac that covers the heart on the same side of the chest.
. In stage III, cancer has spread to any of the following areas:
. The chest wall.
. The mediastinum.
. The heart.
. Beyond the diaphragm.
. The peritoneum. Cancer may have also spread to lymph nodes on the other side of the chest or outside the chest.
. In stage IV, cancer has spread to distant organs or tissues.

Localized malignant mesothelioma (stage I)

In localized malignant mesothelioma, cancer is found in the lining of the chest wall and may also be found in the lining of the lung, the lining of the diaphragm, or the lining of the sac that covers the heart on the same side of the chest.

The stages of malignant mesothelioma are divided into two groups

Malignant mesothelioma stages are grouped into localized and advanced.

After malignant mesothelioma has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body

The process used to find out if cancer has spread outside the pleura or peritoneum is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the spread of the cancer in order to plan treatment. The following tests and procedures may be used in the staging process:
. Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
. CT scan (CAT scan): A procedure that makes a series of detailed pictures of the chest and abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
. MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the chest or abdomen. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Certain factors affect prognosis (chance of recovery) and treatment options

The prognosis (chance of recovery) and treatment options depend on the following:
. The stage of the cancer.
. The size of the tumor.
. Whether the tumor can be removed completely by surgery.
. The amount of fluid in the chest or abdomen.
. The patient's age and general health, including lung and heart health.
. The type of mesothelioma cancer cells and how they look under a microscope.
. Whether the cancer has just been diagnosed or has recurred (come back).

Tests that examine the inside of the chest and abdomen are used to detect (find) and diagnose malignant mesothelioma

Sometimes it is hard to tell the difference between malignant mesothelioma and lung cancer. The following tests and procedures may be used:
.Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits, exposure to asbestos, past illnesses and treatments will also be taken.
. Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
. Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
. The number of red blood cells, white blood cells, and platelets.
. The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
. The portion of the blood sample made up of red blood cells.
. Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube.
. Biopsy: The removal of cells or tissues from the pleura or peritoneum so they can be viewed under a microscope by a pathologist to check for signs of cancer. Procedures used to collect the cells or tissues include the following:
. Fine-needle aspiration biopsy: The removal of part of a lump, suspicious tissue, or fluid, using a thin needle. This procedure is also called a needle biopsy.
. Theracoscopy: An incision (cut) is made between two ribs and a thoracoscope (a thin, lighted tube) is inserted into the chest.
Peritoneoscopy: An incision (cut) is made in the abdominal wall and a peritoneoscope (a thin, lighted tube) is inserted into the abdomen.
. Laparotomy: An incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease.
. Theracotomy: An incision (cut) is made between two ribs to check inside the chest for signs of disease.
. Bronchscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.
. Cytologic exam: An exam of cells under a microscope (by a pathologist) to check for anything abnormal. For mesothelioma, fluid is taken from around the lungs or from the abdomen. A pathologist checks the cells in the fluid.

Possible signs of malignant mesothelioma include shortness of breath and pain under the rib cage

Sometimes the cancer causes fluid to collect around the lung or in the abdomen. These symptoms may be caused by the fluid or malignant mesothelioma. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
. Trouble breathing.
. Pain under the rib cage.
. Pain or swelling in the abdomen.
. Lumps in the abdomen.
. Weight loss for no known reason.