Mesothelioma Diagnosis

Mesothelioma Diagnosis

Determining the type of mesothelioma involves analyzing the cells involved. Pathologists play a crucial role in reaching a diagnosis by studying the affected cells. They use a process called immunohistochemistry to identify cells based on the proteins they contain. This process includes staining the tissue sample with a substance that changes color when a specific protein is present. By acting as a dye, this substance makes it easier to detect and differentiate the proteins within the cells under a microscope. To obtain a tissue sample, your oncologist will need to perform a biopsy.

Mesothelioma Treatment

At UPMC Hillman Cancer Center, our dedicated care team collaborates closely to develop a comprehensive treatment plan tailored to your specific type and stage of lung cancer. Treatment options for mesothelioma may include surgery, chemotherapy or other medical oncology therapies, radiation oncology, and participation in clinical trials when appropriate.

Mesothelioma Types, Risks, Diagnosis, and Treatment

Mesothelioma is a rare form of lung cancer, affecting fewer than 20,000 individuals annually in the United States. It originates in the cells lining the heart, lungs, and abdomen. Pleural mesothelioma develops in the lining of the lungs, while peritoneal mesothelioma begins in the lining of the abdomen. This aggressive and challenging-to-treat cancer requires a comprehensive approach, which is precisely what the Mesothelioma Specialty Care Center at UPMC Hillman Cancer Center provides. Our center brings together experts in thoracic surgical oncology, pulmonology, pathology, radiology, pain management, and medical and radiation oncology.

Types of Mesothelioma

There are three primary types of mesothelioma categorized by the cells of origin:

1. Epithelioid mesothelioma, accounting for approximately 70% of cases, is the most treatable type. It typically arises when healthy epithelioid cells are exposed to asbestos. This form of lung cancer develops rapidly due to the quick division of epithelial cells. However, the tendency of these cells to stick together makes this type of mesothelioma less likely to spread. Symptoms may include chest pain, difficulty breathing, and fluid accumulation in the lungs.

2. Sarcomatoid mesothelioma is a rare form, representing only 10 to 15% of cases. It is the most challenging to treat and more prone to spreading. Symptoms may include breathing difficulties, fatigue, and weight loss.

3. Mixed mesothelioma is a combination of epithelioid and sarcomatoid mesothelioma, involving both types of cells. Prognosis depends on the percentages of each cell type. Cases with a higher proportion of epithelioid cells tend to grow more rapidly but spread slower. Conversely, cases with more sarcomatoid cells spread more quickly. Symptoms may include chest pain, breathing problems, and fluid accumulation in the lungs.

Mesothelioma Risk Factors

Several factors may increase the risk of developing mesothelioma, including age (with adults aged 45 and older being at the highest risk) and asbestos exposure. Asbestos, once commonly used in construction and chemical industries, can significantly elevate the risk of lung cancer. Studies indicate that asbestos workers have a lifetime risk of developing mesothelioma as high as 10%.

Surgical Oncology for Mesothelioma

UPMC Hillman Cancer Center surgeons are at the forefront of pioneering treatments to improve quality of life and extend survival for mesothelioma patients. One such treatment involves chemoperfusion, which combines pleurectomy with the direct application of concentrated heated chemotherapy into the tumor. For pleural mesothelioma, pleurectomy surgery involves removing part of the pleura, while pneumonectomy may be necessary to remove all or part of the lung. For peritoneal mesothelioma, chemoperfusion directs concentrated heated chemotherapy into the affected area, and peritonectomy surgery removes the cancerous part of the abdominal lining. Resection surgery aims to remove as much of the tumor as possible.

Radiation Therapy for Mesothelioma

Radiation therapy may be recommended as an additional treatment option after surgery or as the primary treatment for those who are not surgical candidates. Our radiation oncologists possess extensive expertise in utilizing advanced approaches, such as intensity-modulated radiation therapy and 4D computed tomography, to effectively treat mesothelioma.

Chemotherapy for Mesothelioma

Our medical oncologists specializing in mesothelioma offer a comprehensive range of chemotherapy and biologic therapies. Additionally, patients have access to clinical trials through UPMC Hillman Cancer Center, the only National Cancer Institute-designated Comprehensive Cancer Center in western Pennsylvania.

Mesothelioma Treatment at Mount Sinai

Malignant pleural mesothelioma is a rare form of cancer that affects the lining of the lungs and chest wall. Approximately 3,000 new cases of mesothelioma are diagnosed each year, with the primary risk factor being exposure to Asbestos. Asbestos has historically been used for insulation in homes and buildings, putting construction workers, pipe fitters, and shipyard workers at the highest risk due to their long-term exposure. The development of mesothelioma can take several decades after exposure to Asbestos, making it difficult to detect early on. Symptoms such as coughing and shortness of breath may be subtle, and many individuals may not experience any symptoms at all. As the disease progresses, it causes a restrictive pattern in the affected area of the chest.

To provide the least invasive and personalized treatment plans, a team of specialists led by Dr. Raja M. Flores, Chairman of the Department of Thoracic Surgery, reviews each case at Mount Sinai. This team consists of thoracic surgeons, medical oncologists, radiation oncologists, pulmonologists, radiologists, and pathologists. The best outcomes are achieved through a multi-modality approach, combining surgery, chemotherapy, and radiation therapy. At Mount Sinai, treatment plans are tailored to each patient, taking into account their individual needs and optimizing their quality of life. Dr. Flores, a renowned expert in mesothelioma treatment with over 15 years of experience, advocates for lung-sparing techniques whenever possible during surgery. The coordination of care between different specialties is seamless, as all aspects of treatment are centralized in one location.

Mount Sinai is also actively involved in mesothelioma research. Dr. Flores and his team have conducted extensive studies comparing different surgical approaches, such as extra pleural pneumonectomy and pleurectomy or decortication. Additionally, they participate in various research studies, ranging from molecular research to treatment protocols and clinical trials. Mount Sinai is a member of national consortiums that utilize tissue specimens to gain a better understanding of the disease and improve treatment options for their patients.