Thursday, June 3, 2010

The Prognosis of Advanced Stage Mesothelioma

There is an array of features in the advancement of a patient's mesothelioma prognosis and specific variations in these features may have a significant impact on the development of the disease. The statistical models used in mesothelioma usually overlook the exceptional differences between a patient's prognosis or diagnosis and how the cancer actually influences the patient's life.

Similar to other types of cancer, staging is essential to determine the prognosis of mesothelioma. Although, statistical data for mesothelioma are quite difficult to find and the data currently existing today are unreliable. Early diagnosis and treatment of mesothelioma is imperative for a favorable prognosis. One problem is that mesothelioma is usually diagnosed at an advanced stage, thus the five year survival rate is statistically often unreliable. Stage IV mesothelioma cancer has distant organ metastasis and is untreatable at this stage thus giving it a poor prognosis. Treatment at this terminal stage usually consists of pain management and supportive care.

Mesothelioma's latency period is usually about 10 to 30 years with symptoms such as breathing problems and a decrease of lung elasticity. For approximately two thirds of mesothelioma patients, pleural and peritoneal effusion is a main symptomatic problem. For stage II mesothelioma patients, single agent and combined chemotherapy have resulted in increased response rates, although causing higher levels of toxicity. Also, there is minimal evidence of which combination treatments results in longer survival or better control of the symptoms.

The diagnostic procedure of malignant mesothelioma starts with a systematic medical history to record the patient's symptoms and any possible exposure to asbestos, continued with a thorough physical examination. Diagnosis is continued with additional examinations such as chest or abdominal X-ray, computed tomography scan (CT scan) or magnetic resonance imaging (MRI). One important aspect to consider is that signs and symptoms of mesothelioma are quite similar to other cancers and lung diseases.

The level of symptomatic severity varies for each individual, although in a majority of cases the development of Pleural Mesothelioma is quite slow with symptoms localized in the chest such as chest pain. At times, the chest pain is accompanied by severe breathing problems or shortness of breath. Symptoms such as breathlessness, coughing, and chest pain shows advancement of asbestosis and this usually causes the sufferer to seek medical care. After taking the patient's history and general physical examinations, the physician will usually order chest imaging studies such as X-rays, MRI, CT scan to assess the lungs.

Patients suffering from mesothelioma have symptoms similar to other lung diseases which the physician may not even think to be correlated to asbestos let alone malignant mesothelioma. Usually, malignant mesothelioma develops within 10 to 30 years and during this period of latency patients suffering from this disease may have minimal to no symptoms. Several of these signs and symptoms develop in an advanced stage of the cancer which maybe accompanied with distant metastasis to other organs of the body. Men have a higher risk to develop this disease and the risk increases with age.

Although surgery is quite successful for palliative control of the symptoms, it only has a minimal effect on the median survival rate since it is a radical form of treatment. Pleurectomy or decortications can be done to alleviate the symptoms in pleural mesothelioma. Several other procedures, like thoracentesis can be done to drain pleural effusion and prevent them from recurring. Extrapleural pneumonectomy which is known as a radical treatment approach will have an average survival rate of approximately 15-24 months.

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