Mesothelioma (Asbestos-related Lung Cancer)
mesothelioma
Mesothelioma or malignant mesothelioma is a rare form of cancer that is found in the lining of the chest and lung, the abdomen, or the saclike space around the heart. It is usually diagnosed in an advanced stage.
Pathophysiology:
Fibrosis caused by asbestos, asbestos fibers accumulated around terminal bronchioles, surrounds fibers with iron rich tissues, forming asbestos bodies as more fibers are inhaled, after 20-30 years of exposure fibrosis begins in lungs, interstitial fibrosis develops. Dyspnea, basal crackles and decreased in vital capacity, are early manifestation.
Types of mesothelioma:
- Pleural Mesothelioma – found in the chest and lungs
- Peritoneul Mesothelioma – found in the abdomen
- Pericardial Mesothelioma – found in the saclike around the heart
Approximately 75% of the cases start in the chest cavity, about 10% to 20% begin in the abdomen and the least occurrence are that developed from the lining of the heart.
Three types of mesothelioma according to the forms of cancer cells:
- Epithelioid – most frequent type about 50% to 70% of most cases, it has the best prognosis among the three
- Sarcomatoid – makes 7% to 20% of mesotheliomas; has a very unpredictable pattern.
- Biphasic – mixed type of mesotheliomas, which makes up 20% to 35%
Risk Factors of Mesothelioma:
- Exposure to asbestos – greatest risk; most people are prone to these occupational asbestos exposure include factory workers, ship builders, brake repair worker, construction workers, insulation manufacturers and instalments, asbestos miners.
- Personal history of asbestos exposure – if an individual directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.
- Living with someone who works with asbestos.
- A monkey virus used in polio vaccines. Some research indicates a link between mesothelioma and simian virus 40 (SV40), a virus originally found in monkeys.
- Radiation. Some research links mesothelioma to the radioactive substance thorium dioxide, which was used along with X-rays to diagnose various health conditions from the 1920s to the 1950s.
- Family history. A family history of mesothelioma may increases the risk of mesothelioma, but more research is needed to understand this theory.
Signs and symptoms of mesothelioma:
- Latency period – between 25 to 40 years; due to this length of time that it is noticed people aging 50 to 70 years old are usually being diagnosed
- Presence of fluid (pleural effusion), thickening of the pleura and specific nodules or tumors – most common symptoms
- Chest pain – usually located low in the chest and towards the back and side
- Dyspnea – difficulty in breathing
- Fatiguability
- Hemoptysis – coughing of blood
- Ascites – seen in patients with peritoneal mesothelioma
- Weight loss
Diagnostic examination:
- Complete Blood Count – white blood cell count and platelet count, serum is partially compromised of dissolved proteins
- Biomarkers – Soluble mesothelin related protein (SMRP) and osteopontin
- X-ray evaluation – x-rays show areas of fluid accumulation, scarring of the lungs, masses in the chest
- CAT or CT scan (computerized axial tomography scan of the chest and abdomen
Medical Management:
- Radical pleurectomy
- Pneumonectomy
- Preventive measures include enforcement for regulations governing mining milling and use of asbestos.
- Protective masks may be used when working with asbestos
Nursing Management:
- Assessment of social, emotional, physical, financial and spiritual needs
- Emotional support of patient and family in coming to terms with the diagnosis and coping with the treatments that may have unpleasant side-effects
- Education and information about lung cancer and the treatments that have been offered
- Monitor symptoms and manage it as early as possible such as breathlessness and pain
- Effective physiotherapy to assist mucus clearance from the lungs
- Administration of a combination of oral, nebulized and intravenous bronchodilators to control infection
- Administration of anti-inflammatory medications (oral or inhales steriods)
- Monitoring disease progression (oxygen saturation and weight)
Photo credits: mesothelioma-the-lung-cancer.blogspot.com, malignantpleuralmesotheliomaasbestos.com
Daisy Jane Antipuesto RN MN
Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.
