About Malignant Pleural Mesothelioma

Malignant mesothelioma of the pleura (malignant mesothelioma) - a rare, but extremely dangerous cancer. Most often it is diagnosed in people who, because of their professional activities have contact with asbestos. More than 70 percent of cases - men, however, the disease occurs among women, and children 2-4 years at a poisoning asbestos.

Symptoms of malignant pleural mesothelioma long time occur in a latent form and can occur in 20-30 and sometimes 60 years, making it difficult to diagnose and treat. Diagnosis of pleural mesothelioma. Conducting diagnosis of pleural cancer is complicated due to the slow onset of the disease. Most patients go to the oncologist to have unresectable stage where none of the methods can have a significant impact on the development of cancer cells.

For the correct diagnosis used visual inspection, X-ray, and gistogologicheskoe endosokopicheskoe study. This should eliminate asbestny pleural effusion, pleural fibrosis, asbestosis and lung metastatic adenocarcinoma.



Ultrasound diagnosis allows to detect in patients with mesothelioma pleural effusion, as well as to determine the extent of tumor and its sprouting in the neighboring organs and peritoneum. X-ray examination confirms the presence of thickened lesions in the pleura, preload one of the lungs and pleural effusion. MRI and positron emission tomography are used as helper methods to determine the condition of organs and systems in the vicinity of the affected lung.

Pleural puncture is performed in order to collect pleural effusion and its further analysis. Changes in its structure downward glucose and increasing amounts of hyaluronic acid confirms the diagnosis of cancer of the pleura. The use of biopsy is ineffective, since cancer cells are found mainly in remote areas for the blind biopsy of the pleura.

Endoscopy (thoracoscopy) - method, enabling accurate diagnosis, through direct visual control. In addition, prior to radical surgery, it is possible to determine the zone targeted biopsy. Diagnosis using madiastinoskopii allows in most cases to detect lymph nodes affected by cancer cells, which can not be detected using MRI.

The use of the whole complex of available diagnostic methods allow accurate diagnosis and determine the stage of cancer of the pleura.

The initial stage is characterized by single nodes and plaques. Malignant formation without affecting deep-lying tissue and lymph nodes.
The second stage is characterized by having multiple nodes and deep penetrating into the underlying layers.
At the third stage are concerned, in addition to the pleura, the regional lymph nodes and located beside Orany.
The fourth stage is characterized by the presence of metastases in distant organs and systems, and the overall defeat of the whole organism

Pleural mesothelioma. Modern treatment tactics

Mesothelioma is a malignant tumor was first described in 1870. It is more common lesion Pleven-ry, than the peritoneum, with a predominance of right-sided. Men suffer more than women, in co-ratio of 8: 1. Mesothelioma can occur at any age, even in children 2-4 years. In the etiology of mesothelioma primary importance is the duration of exposure to asbestos and erionite mineral used in construction practice. Etiological factors are genetic predisposition, as well as simian virus SV40.

According to the histological WHO classification (1999), malignant mesothelioma are divided into epithelial-WIDE, sarkomatoidnye and mixed (biphasic). The most unfavorable is frequent sarcoma tumor-toidny option. Pleural effusion occurs in 60-80% of patients, but gradually growing tumor can cause complete obliteration of the pleural cavity.

The prognosis of pleural mesothelioma unfavorable, the median survival of patients (symptomatic treatment) is 7 months. Surgical treatment in the amount of pleurectomy or plevropnevmonektomii is rare, with localized forms, only in 7-10% of patients. After plevropnevmonektomy operative mortality reaches 14-15%, significantly higher than the (minimum) plevrektomy mortality. Expectancy-sti life do not differ after these operations: the median survival corresponds to 9-21 months .; 2-year survival rate is 11-45% (Giaccone G., 2002; Rahman M. et al, 2003.). Improving long-term results of surgical treatment (primarily plevropnevmonektomy) associated with adjuvant chemotherapy.

Experience of surgical, combined treatment (surgery + chemotherapy + radiotherapy) * allowed to develop the following recommendations for pleural mesothelioma: extrapleural pneumonectomy Execution (plevropnevmonektomii) holding in 4-6 weeks up to 6 cycles of chemotherapy with the appointment of platinum drugs, followed by radiation therapy to the area remote lung and mediastinum. Direct mortality in different comparison groups accounted for 5-22%, median - 21 months, 2-5-year survival -. 45 and 22%, respectively. Factors most favorable prognosis are the type of epithelial tumors, as well as the absence of metastases. Radiotherapy (ODS 50 Gy.) Reduces the pain, but does not increase the duration of life (increased dose, as well as a combination of chemotherapy and radiotherapy does not improve survival).

The efficiency of modern chemotherapy for pleural mesothelioma rarely exceeds 20%. Marked tumor regression and objective improvement in the application of cisplatin, tsikloplatama, mitomycin, raltitreksida (tomudeksa), etoposide, carboplatin, ifosfamide, vinorelbine, gemcitabine (Gemzar), pemetrexed (Alimta).

Combination chemotherapy is carried out under the schemes: doxorubicin + cyclophosphamide, doxorubicin, ifosfamide, doxorubicin and cisplatin + - mitomycin C and cisplatin + kampto mitomycin C, gemcitabine and cisplatin (carboplatin) Gemcitabine + Alimta, Alimta and cisplatin (carboplatin). Last 3 schemes are considered standard treatment for pleural mesothelioma.

In the presence of pleural effusion may intrapleural administration of cytostatic drugs or biotherapy with the aim of halting or slowing the accumulation of fluid. For this purpose, cisplatin, bleomycin, and - interferon and interleukin-2. Possibilities of photodynamic therapy investigated.

In addition, in clinical trials targeted therapies: Avastin, Iressa, Gleevec, thalidomide, and others, which may increase the survival rate.. Among the targeted agents should pay attention to inhibitors of vascular endothelial growth factor. It is noted that for pleural mesothelioma high level expression of vascular endothelial growth factor correlates with increased capillary density and low survival. In this regard, with mesothelioma semaksanib study, bevacizumab (Ava-Springsteen) and thalidomide.

* References: 1. Rice T. W., Adelstein D.J., Kirby T.J, et al. Aggressive multimodality therapy for malignant mesothelioma. Ann Thorac Surg, 1994; 58: 24-9. 2. Sugarbaker D.J., Garcia J. P., Richards W.G. et al. Extrapleural pneumonectomy in the multimodality therapy of malignant pleural mesothelioma. Results in 120 consecutive patients. Ann Surg, 1996; 224: 288-96. 3. Sugarbaker D.J., Garcia J.P. Multimodality therapy for malignant pleural mesothelioma. Chest, 1997; 112: 272-5

Vseobuch. Summary materials:

Pleural mesothelioma - a relatively rare tumor characterized by a diffuse infiltrative growth. The risk is much higher in patients with asbestosis. The epidemiology of Russia this neoplasm is not given enough attention. Meanwhile, according to the literature, in the US, where professionally exposed to asbestos 7-8 million. People, the incidence of malignant mesothelioma is 0.1-0.2 per 100 thousand inhabitants, and increasing every year (peritoneum and pleura are affected equally often). Since 1976 in France, this pathology attributed to occupational diseases (B. Saillard et al., 1977). The latency period of malignant mesothelioma is 20-30 years.

The pathogenesis of pleural mesothelioma has not been studied, however, it found that asbestos fibers have a tropism for the serous membrane. Respiratory they migrate to the pleura, which can accumulate in large quantities and serve as a trigger for the development of tumors. Thanks to lymph flow, directed towards the parietal pleura, the tumor cells are implanted in her and gradually spread over the entire surface. Thus, in the neoplastic process involves both visceral and parietal pleura, which leads to disruption of lymph circulation, the rapid accumulation of fluid in the pleural cavity.

Of course, the diagnosis of pleural mesothelioma is difficult. Its clinical manifestations are non-specific, depending on the extent of tumor and location of the lesion.

The diagnosis of pleural mesothelioma is set with pleural biopsy, electron microscopy and immunohistochemistry. Surgical treatment of mesothelioma is rare (in 7-10% of patients), and 2-year survival rate after surgery is only 10-35%. Radiation therapy is commonly performed to reduce pain and has no effect on survival. Among cytostatic active against mesothelioma, note platinum derivatives, gemcitabine, anthracyclines. The use of these drugs leads to the objective effect in 20-48% of patients. Note the combination of gemcitabine and cisplatin (carboplatin), doxorubicin and cisplatin + mitomycin C; cisplatin and Alimta. Perspective can also be a combination of new cytostatic agents and their combination with targeted agents. Important prognostic factors include young age, epithelioid type of tumor, as well as the effect of adjuvant chemotherapy after radical plevropnevmonektomii.

Mesothelioma Attorney

When the shock of the diagnosis of mesothelioma has passed, the first thing that most patients and their families think about is how to pay the medical bills, make up for lost wages, and deal with the financial stress that this illness inflicts on families. Fortunately, you can turn to the services of a qualified mesothelioma attorney and find relief.

Why Choose a Mesothelioma Attorney?

Mesothelioma is a cancer that is caused almost exclusively from exposure to asbestos materials over a long period of time. This means that the company which exposed its workers to the asbestos that lined the walls and ceiling of factories and facilities are liable for the damage they have caused. However, to receive due compensation under the law from the company usually requires taking them to court.

This is one way an attorney skilled in the laws governing how compensation is provided for those suffering from mesothelioma. Another method is accessing forms of financial assistance that has been provided for those suffering from this disease. Currently, there are nearly $40 billion set aside as compensations for those who qualify. If you are a military veteran, you can file for a disability claim with the US Department of Veterans Affairs even if the cause of your mesothelioma was from your civilian life.

Whatever option you choose, your mesothelioma attorney is there to help you make the best informed decision. A lawyer with the knowledge and experience in mesothelioma cases can help you from start to finish in finding the right course of action that will provide the funds needed to cover your medical needs. This will help you pay for the proper treatment and protect your family from the financial hardships that this disease causes. 

How to Find the Right Mesothelioma Cancer Lawyer

If you are looking to hire a mesothelioma cancer lawyer, then you will need to do a little research in order to find the most qualified attorney. Remember, an attorney that represents you in finding due compensation for the complications that mesothelioma causes will take their fee from the settlement that has been reached so that you do not pay upfront for their services in the case of a lawsuit.

Here are the four items you should focus on when finding an attorney that will provide for you the best representation.

Track Record

You will want to review their track record when it comes to winning lawsuits or settling them with large compensation from mesothelioma cases. This is very important because lawyers who have a successful track record in this regard have the knowledge and experience to handle your case.

Personal Assistance

The attorney should travel with you in order to help gather information about your case. While you might have to do a little leg work, the attorney will know what questions to ask and where to find the right information.

Trust Funds

There are trust funds set up to help compensate those with this disease. A good mesothelioma cancer lawyer will have a record of success in filing claims against the trust funds.

Free Consultation

Your first visit or phone call should be a free one where the attorney will listen and evaluate your case, providing you with options of how they can help.

From that information, you can find the right mesothelioma cancer attorney who can provide the best representation. This will help you get the due compensation that you deserve. 

Mesothelioma Cancer Lawyer

Take a look through the phone book, or perform a search online, and you will find that there are quite literally thousands of lawyers doing business in the area where you live. While this may make it seem as though the act of choosing just one may be difficult, keep in mind that not all of them will be offering the same services. 

For example, a mesothelioma cancer lawyer will have built his entire practice around one specific goal, which is to help as many people as possible who have been afflicted with this particular form of cancer. This is the type of lawyer you should be looking for if you believe you have a claim against a former employer.

Mesothelioma cancer sufferers developed the disease by being exposed to asbestos for prolonged periods of time. In some cases, employers were aware of the dangers of such exposure, yet did nothing to protect the people who worked for them. This type of negligence required that the afflicted parties be compensated, and that is where the mesothelioma cancer lawyer comes into action. 

They can take a look at the details of your case and very quickly decide if you are able to make a claim. The costs of treating cancer can be expensive, so why should you have to pay for that when it was someone else who was responsible for your illness? Talk to a mesothelioma cancer lawyer today to see if you have a case where a claim for compensation can be made.