Mesothelioma

Mesothelioma is a rare form of cancer that affects the cells lining a person's body cavities such as chest, abdominal area or the region around the heart. The incidence of Mesothelioma has been linked to asbestos exposure. In most cases of mesothelioma, the association with asbestos exposure has been documented and proved.

Asbestos is a fibrous mineral that is mined all over the world. It was extensively used for insulation and fire resistance. Light asbestos fibers tend to remain airborne for long and travel far too. Employees working in such an environment tend to breathe in these fibers everyday without realizing it. These fibers are entrapped in the lining of the lungs and other organs. This reduces the lung capacity due to increased scarring of the lung tissues. This results in symptoms such as shortness of breath and chest pain. Typically, symptoms of mesothelioma tend to appear decades after the exposure to asbestos. The symptoms of asbestos mesothelioma tend to be mistaken for other less serious conditions.

Common symptoms of mesothelioma include dyspnoea (difficulty in breathing), pleuritic pain, lasting cough, fatigue, and weight loss. CT scans and MRI can help in diagnosis. Surgery is an option that doctors sometimes resort to but this can be done at an early stage of diagnosis. Mesothelioma treatment, including oxygen, drugs and other procedures is expensive. The location of the Mesothelioma cancer and the stage of the disease play a vital role in determining the treatment for Mesothelioma. Doctors sometimes combine surgery and radiation along with chemotherapy. With surgery, they will remove the cancerous part, be it a part of the lining of the chest or abdomen or even a lung. Radiation therapy uses high-energy rays to kill the cancerous cells. Sometimes chemotherapy is also used. The anti-cancer drugs are injected intravenously to kill cancerous cells throughout the body. Sometimes the physician may drain the fluid that has built up in the chest or abdomen. Drugs are also used to prevent the fluid from accumulating further.

Progressive Massive Fibrosis

Progressive massive fibrosis is a lung disease that is predominantly reported in people who work in mines. Hence it is also called Coal worker's Pneumoconiosis. Fibrosis is a nodular formation in different regions of the body. Often lungs are the most vulnerable. This is because of aerosol initiation, which has a faster chance of nodule formation causing tissue damage.

Clinical Manifestations

Most conditions associated with massive fibrosis are coherent to silicosis and pneumoconiosis. Lesions are caused due to tissue necrosis, which leads to hardening of the tissue forming nodular structures. In case of progressive fibrosis, massive scars are noticed because of dense agglomeration of the thickened nodules. These nodules predominantly appear in the upper lobes causing respiratory difficulties.

The onset of this disease is triggered by macrophage proliferation in the respective regions. The macrophages engulf the inhaled silicon particles causing the production of interleukin -I which facilitates the chemical mediation for tissue necrosis. Silica is commonly found in these necrotic nodules. The adverse effects of these silica particles are the onset of Pulmonary Alveolar Proteinosis (PAP) causing the accumulation of large particles, which can be noticed as spaces on radiological examination. Along with the affected upper lobe, the interstitial zones of the lower lobe are also obstructed and bronchial regions are damaged with the infiltration of the nodules. Honeycomb lung or asbestos bodies are common references for progressive massive fibrosis as both these conditions have giant cells upon pathological examination. Bronchogenic carcinoma and mesothelioma are the associated adverse conditions of progressive massive fibrosis.

The evaluation of patients suffering progressive massive fibrosis includes the understanding of the type of chemical or particle inhaled as it enables the physicians to rule out diagnostic errors. In cases such as pleural plaques, calcified regions of the lungs are noticed which is another cause of asbestosis. The lower region of the lungs are predominantly affected. In case of interstitial fibrosis, the bronchus and alveoli are affected with characteristic nodules of the upper and mid region. The evaluation is based on the type of chemical and the respective interleukins it releases. Most patients associated with these conditions are miners, shipyard workers, automobile mechanics and petrochemical employees.

Diagnosis and Treatment

Most diagnostic evaluations are radiological in origin as the MRI provides detailed description about the zones of the fibrosis and the size of each nodule. Histopathological analysis studies the intensity of the necrosis, giant cell presence and the macrophagic proliferation patterns. The treatment pattern is based on symptomatic analysis. Since the condition includes both lower and upper lobes, any associated mycobacterial infection has to be treated. Oxygen is given as a critical care measure in patients with hypoxemia. Surgical interventions are applicable in case of intense and irreversible tissue necrosis. Patients with progressive massive fibrosis are advised to quit smoking if as it causes intense damage.

Lung Cancer

Lung cancer has been commonly associated with cigarette smoking and use of tobacco. Lung cancer can surface in any part of the lung, though most instances of lung cancer are noticed in the epithelial lining. Smoking is the cause for nearly 90%of the cases of lung cancer. Tobacco smoke contains carcinogens that contribute towards the development of lung cancer. Women smokers are at greater risk of lung cancer than men smokers. Even passive smoking is fraught with risks. Another cause for lung cancer is exposure to asbestos fibers. This gives rise to mesothelioma. A small percentage of lung cancer cases are attributed to radon gas exposure. Persons suffering from COPD (chronic obstructive pulmonary disease) at at increased risk for lung cancer. Air pollution arising from vehicular and industrial effluents can increase the risk of lung cancer.

Symptoms of lung cancer include coughing and wheezing and chest pain. A patient suffering from lung cancer may notice blood while coughing. There might be extreme fatigue and unexplained weight loss. Lung cancer patients are more likely to face repeated respiratory infections such as bronchitis and pneumonia. Other symptoms of lung cancer include difficulty in swallowing and enlargement of lymph nodes on the neck.

The physician will look into the lungs with a bronchoscope. Tissue samples are often taken for biopsy. Sputum cytology is also conducted to detect presence of lung cancer cells. Chest x-ray and examination is done. Tissue biopsy of lymph nodes is done to diagnose lung cancer. Chemotherapy and radiotherapy are used in the treatment of lung cancer.