Mesothelioma vs. Lung Cancer: Which Is More Serious?

One of the rarest forms of cancer is induced by exposure to asbestos. Lung, abdomen, and heart linings can all be affected. The most common causes of lung cancer, however, are smoking and exposure to the environment. It is estimated that 75% of all cases of mesothelioma are malignant pleural mesothelioma.

Mesothelioma vs. Lung Cancer: How Do They Develop Differently?

Toxic exposure to asbestos can lead to both mesothelioma (a cancerous tumor) and lung cancer (a malignant tumor). Mesothelioma, on the other hand, typically originates in the lung’s lining, whereas lung cancer occurs within the lung itself. This cancer can potentially spread to organs such as the heart, abdomen, or testicles. Pleural mesothelioma is the medical term for mesothelioma that develops in the lungs.

They progress in different ways. Nodules, which are discrete growths of cancerous tissue in the lungs, are the most common form of lung cancer growth. It begins as a few small tumor nodules scattered throughout the mesothelial lining, but with time these nodules expand into a sheath-like tumor that surrounds the organ.

Although mesothelioma is a more aggressive illness, lung cancer tends to disseminate or metastasis more quickly to other organ systems.

Also notable is the prevalence of each condition. About 222,500 new instances of lung cancer are diagnosed in the United States each year.

Malignant mesothelioma, which comprises all four kinds of asbestos-related cancer, is diagnosed in approximately 2,800 instances per year.

Tobacco usage and environmental exposures like radon gas and secondhand smoke are primarily responsible for most occurrences of mesothelioma, but asbestos exposure is virtually always the cause of lung cancer.

While smoking does not enhance the risk of acquiring mesothelioma, it dramatically increases the risk of developing lung cancer. A person is more likely to develop lung cancer if they smoke and have a family history of the disease due to asbestos exposure.

Each risk factor destroys lung tissue and makes it more vulnerable to disease when taken in isolation. To put it another way, if you smoke and have asbestos in your home, your risk of developing lung cancer goes up by at least 50 times!

Information on Mesothelioma

Over 80% of occurrences of mesothelioma in the United States are linked to asbestos exposure, according to available data.

The cancer normally develops between 20 and 50 years after the first time the person was exposed to asbestos

Cancer of the Lungs: The Facts

  • Tobacco usage is responsible for 90% of lung cancer deaths.
  • Second only to smoking as a cause of lung cancer is radon exposure.

Since asbestos and tobacco smoke are known carcinogens, the latency period for developing lung cancer is much shorter, typically lasting only 10 to 30 years.

Similarities between pleural and peritoneal cancer and mesothelioma

There is a correlation between mesothelioma and lung cancer death rates in each state. The five states that have the most mesothelioma mortality also have the most lung cancer deaths.

It can take decades for a disease to develop, but just a few months for it to spread to other parts of your body. Both use comparable diagnostic and therapeutic approaches.

The symptoms of mesothelioma and lung cancer are very similar. Chest pain, coughing, trouble breathing, exhaustion, and weight loss are among symptoms that are common in both conditions. Asbestos or smoking history should alert doctors to the possibility of lung cancer or mesothelioma in patients who exhibit these symptoms.

Lung and mesothelioma share a number of similarities, although their physical traits and non-asbestos risk factors are vastly different.

The Diagnosis of Lung Cancer and Mesothelioma

It is necessary to undergo a biopsy in order to diagnose both types of cancer. In order to tell the difference between lung cancer and mesothelioma, a CT or PET scan alone isn’t enough. An endobronchial biopsy can be carried out by means of a bronchoscopy, needle biopsy, or endothoracic surgery.

For the purpose of looking for anomalies like visible tumor growth, a bronchoscopy involves placing a small camera down the throat and into the lungs’ airways. In some cases, doctors may harvest a cell sample and perform a cancer test if they notice abnormal growth.

Using an ultrasound equipment or a CT scan to pinpoint the tumor’s location, a needle biopsy is performed. Using only a local anesthetic, the surgery is completed.

In order to obtain a more substantial sample, a small biopsy procedure under general anesthesia is necessary. By inserting a small camera into the space between the ribs, fluid samples can be taken from the chest. As part of this operation, fluid buildup may be suctioned out and a pleurodesis may be performed in order to prevent it from building up again.

Pleural mesothelioma patients typically have either pleural thickening (a lot of scarring in the lining of the chest) or pleural effusion (fluid accumulation in the chest). In order to confirm a diagnosis, this fluid might be examined for cancer cells.

With lung cancer, the lining of the chest cavity is not always thickened. The diagnosis of lung cancer can be complicated if the patient has pleural effusions, which are common in individuals with lung cancer.

Treatment of the Following Cancers

There are many different treatment choices for both mesothelioma and lung cancer, but which one is best depends on how far the illness has gone. Surgical procedures, radiation therapy, and chemotherapy are all common components of most treatment strategies.

An operation to eliminate all of the tumor growth may be an option if the cancer is limited to the lungs. Surgery, on the other hand, varies according on the type of cancer being treated.

Examples:

In order to cure pleural mesothelioma, surgeons can either remove the entire diseased lung and its linings or just a section of it.

For the most part, surgery to treat lung cancer involves the removal of a lobe, a section of the lung, or even the entire lung.

Additional treatment options for both types of cancer include chemotherapy and radiation therapy. Localized mesothelioma and lung cancer can both be treated to slow tumor growth and possibly eliminate all tumor cells. Combining these treatments with surgery is common when utilized in this potentially curative manner. Even if the cancer has spread from its original site, these treatments may still be of benefit. As a result, palliative care is used in these circumstances.

A clinical trial published in 2021 found that mesothelioma is more effectively treated with radiation than lung cancer. Focal radiation was also found to be more effective in treating mesothelioma when used to treat disease progression following a round of systemic therapy, according to the research.

Both tumors are being studied in clinical trials for new treatments. Biotechnology-based treatments like immunotherapy and gene therapy can also be found here. Unlike mesothelioma, photodynamic therapy is more commonly employed in the treatment of lung cancer.

Prognosis

lung cancer and mesothelioma have similar one-year survival rates: 42% for lung cancer and 39% for mesothelioma patients. After a few years, survival rates begin to vary, with lung cancer patients having a long-term advantage.

It’s not just the statistics that are important, but the fact that someone with an asbestos-related lung cancer or mesothelioma needs a correct diagnosis. The next stage would be to come up with a treatment strategy tailored to each patient’s specific needs.

Antibodies are used in immunohistochemistry to detect certain antigens (markers) in a patient’s tissue. Antibodies are frequently fused with enzymes or fluorescent dyes to enhance their visibility.

A specific enzyme or dye is activated once the antibodies bind to an antigen in the tissue sample, and the antigen may be viewed under a microscope. Cancer can be diagnosed with this type of test, which can also be used to distinguish between different forms of the disease.

Laboratory test that uses a high-powered microscope to examine the cells in a sample of tissue for specific alterations. The smallest of features can be seen clearly using an electron microscope.

Patients’ prognosis and treatment options are influenced by a variety of variables.

The following factors affect the prognosis and treatment options:

The extent of the disease.

It’s size.

Whether or if surgery can entirely remove the tumor.

How much fluid there is in the lungs, abdomen, or chest
The patient’s chronological age.

It is important to note the patient’s degree of physical activity.

Health of the patient’s lungs and heart, as well as general health.

  • Under a microscope, the appearance of mesothelioma cells.
  • White blood cell count and hemoglobin content in the blood
  • When it comes to gender, it doesn’t matter
  • No matter if you’ve just been diagnosed or if the cancer has returned (come back).

Mesothelioma Cancer Stages

Important Points

As soon as the cancer has been detected, testing are carried out to see if the disease has spread elsewhere in the body.

In the body, cancer can spread in three different ways.

There’s a chance that cancer will spread beyond where it started to other places of your body.
Malignant mesothelioma of the lung is divided into the following stages:

  • stage one stage two stage three stage four stage five
  • After treatment, malignant mesothelioma might return.
  • Testing is done to see if cancer cells have spread to other places of the body after malignant mesothelioma is diagnosed.

Staging is the process of determining if cancer has gone beyond the pleura or peritoneum. The disease’s stage is determined by the information obtained during the staging phase. To plan treatment, it is critical to establish if the cancer has spread.

A variety of diagnostic methods and tests are available for staging:

Images of the chest and abdomen are acquired from various angles using a CT scan (CAT scan). A computer coupled to an x-ray machine generates the images. To see organs and tissues more clearly, a dye can be injected into a vein or ingested. Computed tomography, computerized tomography, or computerized axial tomography are all names for this treatment.

Procedure for detecting malignant tumor cells in the body using PET scan (positron emission tomography scan) A vein is injected with a little amount of radioactive glucose (sugar). Rotating around the body, a PET scanner creates an image of where glucose is being utilized. Because malignant tumor cells are more active and consume more glucose than normal cells, they appear brighter in the image.

Magnets, radio waves, and a computer are used to create detailed images of the inside of the body using an MRI (magnetic resonance imaging). NMR imaging, or nuclear magnetic resonance imaging, is another name for this process (NMRI).

Using an endoscope, endoscopic ultrasonography (EUS) can be performed. An endoscope is a long, thin tube with a light and a lens on the end for examining internal organs and tissues. Ultrasound waves (high-intensity sound waves) are reflected off interior tissues and organs by a probe at the end of the endoscope, creating echoes. A sonogram is an image of the tissues in the body made from the echoes. Endosonography is another name for this surgery. Fine-needle aspiration (FNA) of the lung, lymph nodes, or other locations can be guided by EUS.

Examining the internal organs of the abdomen via laparoscopy to look for signs of disease. Several small slits are made in the abdominal wall, and a laparoscope, a thin, illuminated tube, is inserted. To undertake procedures like as taking tissue samples to be examined under a microscope, other devices may be put into the same or other incisions.

Removal of a lymph node or part of a lymph node for biopsy. Pathologists use a microscope to look for cancer cells in lymph node tissue.
Surgeons use a procedure called mediastinoscopy to examine the organs, tissues, and lymph nodes located between the lungs. A mediastinoscope is put into the chest by an incision on the top of the breastbone. There is a light and a lens at the end of a narrow, tube-like equipment called a mediastinoscope. Tissue or lymph node samples may also be removed and examined under a microscope to detect signs of malignancy.

In the body, cancer can spread in three different ways.

Tissue, lymph, and blood are all routes by which cancer can spread.

Tissue. Nearby locations are also affected by cancer as it spreads outward from the original site.

Mesothelioma Fine-Needle Biopsy

Using a long hollow needle linked to a syringe, a fine-needle aspiration can remove up to 10,000 cells for examination. A tiny needle is placed using images from a CT scan or ultrasound while the patient is under local anesthetic.

For pleural and peritoneal mesothelioma, this biopsy technique is the most commonly used method. Thoracoscopic surgery has an overall diagnostic sensitivity of roughly 80%, while needle biopsies have a sensitivity of around 80% for diagnosing pleural mesothelioma. When blood accumulates in the pleural area between the chest wall and the lung, it is known as a hemothorax.

Procedure for doing a fine-needle biopsy

Skin is cleansed and anesthetic is administered to the needle’s insertion site before a procedure can begin The doctor will be able to conduct the treatment with ease if the patient is positioned correctly.

The location of the needle insertion can be determined using an ultrasound or CT scan. Insert the needle into the chest or abdomen, and the doctor will begin extracting the tissue. Using a syringe containing a vacuum, a needle is used to collect tissue samples. Less than ten minutes are normally required for the process.

The wound is cleansed and bandaged once the needle is removed. There is no need for sutures.

A pathology lab analyzes tissue samples. A few days to a week or more may be required to elicit a response from the experiment.

In the same way…

Thoracentesis and paracentesis are therapies for fluid accumulation around the lungs and belly, respectively, and can produce fluid biopsy samples, although not being considered real biopsy procedures.

Thoracentesis

This treatment removes fluid from around the lungs while the patient is sedated. To remove pleural fluid buildup, a doctor uses an ultrasound probe to guide a small needle between the back ribs. A mesothelioma diagnosis cannot be made because it simply gathers fluid, not tissue. Pleural effusions can be diagnosed with this test to see what’s causing them.

Paracentesis

The peritoneum is cleaned out by doing this surgery. A thoracentesis in the abdomen is conducted in the same manner as a thoracentesis in the lungs. Ascites, or fluid buildup in the peritoneum, can be diagnosed, however mesothelioma cannot be accurately diagnosed because no tissue samples are collected.

Mesothelioma cancer can be diagnosed via fine-needle aspiration, but a thoracentesis and paracentis are fluid biopsies that can only identify the source of the fluid buildup in a thoracic or paracentesis surgery (pleural cytology).

Biopsies for Surgical Mesothelioma

Surgical biopsies are the medical term for tissue samples obtained during surgery. They’re extremely rare in peritoneal mesothelioma and virtually nonexistent in pleural mesothelioma, respectively.

Mesothelioma Surgical Biopsies: Types Available

Laparotomy

A laparotomy is used in exploratory abdominal surgery to open the abdomen and collect tissue samples and remove abnormal tissue. Some cases of peritoneal mesothelioma have been detected during exploratory surgery, while almost no cases of pleural mesothelioma have been discovered through surgery.

Thoracotomy

Tissue samples can be obtained using a thoracotomy, which opens the patient’s chest for surgery. Patients with pleural mesothelioma or other suspected chest cancer are generally not candidates for this surgery.

For patients with pleural cancer, doctors aim to remove as much of the cancerous tissue as feasible during surgery. The most tissue is obtained during this treatment, and this tissue can be used to determine the type of cells that make up a mesothelioma tumor.

Because tumors have grown all around the lung and there is no pleural space, thoracoscopic biopsy is not an option in some cases. Percutaneous needle biopsy is an option if it happens, although it will only produce a small sample.

Open pleural biopsy by a small incision (mini-thoracotomy / 2-4 cm) is an alternative option. Identifying the histologic subtype (epithelioid vs. sarcomatoid) is critical in patients who are young or in good performance status, as they may be able to benefit from more aggressive treatment.

General anesthesia is commonly used, but IV sedation and local anaesthetic can also be used as a day operation. In most cases, the thoracic surgeon will use preoperative CT or ultrasound to determine the optimal incisional region for the short incision.

Mediastinoscopy

Lymph nodes around the windpipe can be sampled by a surgeon using an endoscope inserted into the neck at its base This can aid in the diagnosis of pleural mesothelioma and provide evidence for determining the stage of the disease.

Laparoscopy

An abdominal incision is made, and an endoscope is inserted to gather samples of questionable tissue from the abdominal cavity. To diagnose peritoneal mesothelioma, the patient’s abdomen is punctured.

Thoracoscopy assisted with a video camera (VATS)

To accurately diagnose pleural mesothelioma, clinicians employ a technique called thoracoscopic biopsy, which allows them to see into the pleural cavity and collect numerous tissue samples.

Using 45 patients with malignant mesothelioma, researchers examined the accuracy of numerous biopsy procedures. Thoracoscopy had the best diagnostic accuracy, with a diagnosis being confirmed in 95% of individuals with the condition using this procedure.

An Anticancer Research research released in 2021 reaffirmed the accuracy of thoracoscopy in identifying pleural mesothelioma.

Let your doctor or a mesothelioma specialist know if you have symptoms of mesothelioma and have been exposed to asbestos. A physical examination will be the first step in the diagnosis process. There is only one method to know for sure if you have mesothelioma, and that is through a biopsy.

What Is the Prognosis for Mesothelioma?

Doctors will run a variety of tests to narrow down the underlying reason based on the patient’s symptoms. Mesothelioma may be discovered during imaging examinations for a different disease. Biopsies may be necessary if a patient has a history of asbestos exposure.

Every patient’s road to a mesothelioma cancer diagnosis is unique.

It is critical that you provide your doctor with a detailed work history to aid in the diagnosis. In most cases, doctors won’t suspect asbestosis unless a patient tells them about their work history. Symptoms of mesothelioma often begin to appear between 20 and 50 years after the initial exposure to asbestos, according to the American Cancer Society.

Every year, more than 3,000 people are diagnosed with mesothelioma. Mesothelioma is an extremely rare disease, and doctors sometimes mistake it for a different illness or a different form of cancer because it has many symptoms with other ailments.

Misdiagnosis of mesothelioma patients is widespread. Pleural mesothelioma is frequently misdiagnosed as pneumonia or lung cancer by doctors. A more prevalent form of abdominal cancer, peritoneal mesothelioma can mimic its appearance. Imaging scans, biopsy data, and other testing are used by a mesothelioma specialist to make a correct diagnosis.

A Mesothelioma Diagnosis Is Possible Through What Process?

Although not all patients will require these tests, the path to diagnosis for most mesothelioma patients is essentially the same.

The signs and symptoms of mesothelioma can be difficult to pin down, making a definitive diagnosis difficult. Pleural mesothelioma symptoms include coughing and shortness of breath, while peritoneal illness symptoms include abdominal pain or digestive problems.

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