Pleural mesothelioma (malignant mesothelioma) is a rare malignant tumor originating from the superficial cells of the pleural lining. Sometimes it can also develop in the pericardium and peritoneum. Pleural mesothelioma is most often diagnosed in men over 60 years of age. Unfortunately, due to the low characteristic symptoms, it is diagnosed late and treatment is usually not satisfactory. Can smoking cause mesothelioma?
The observed increase in morbidity and deaths in the last decade most likely results not from actual higher morbidity, but from the improvement of diagnostic methods, both in the possibility of collecting material for testing and precise pathological assessment allowing differential diagnosis with metastatic adenocarcinoma. The availability of computed tomography and videotoracoscopy and the possibility of immunohistochemical assessment have significantly improved the effectiveness of diagnosis, and the awareness of the existence of therapeutic options in the treatment of cancer, including mesothelioma, is an additional stimulus for doctors diagnosing the patient.
Diagnosis of pleural mesothelioma
Diagnosis of lung cancer should aim at diagnosing pleural disease, confirming the neoplastic nature of the lesions and differentiating with metastasis of another cancer, as well as assessing the extent of the disease. Due to diagnostic difficulties of pleural mesothelioma, close cooperation between oncologist, pathologist, radiodiagnostic and clinician is necessary. Appropriate volume of material should also be obtained for molecular diagnostics. In most patients, malignant pleural mesothelioma is diagnosed at the local stage. Metastases in distant organs are rare. Subject examination includes an interview for asbestos exposure and lung cancer symptoms associated with the location of the primary lesion and local spread along the pleural surface (chest wall pain, shortness of breath, symptoms of a threatening cardiac tamponade). The physical examination includes a typical assessment of the respiratory system and chest. Conventional chest X-ray may suggest suspected pleural mesothelioma, but the most accurate imaging method is computed tomography. For patients who are potentially eligible for complete surgical treatment, magnetic resonance imaging may be helpful. PET-CT examination is not applicable.
Does smoking cause mesothelioma?
According to various studies conducted over the past two decades, smoking alone does not lead to mesothelioma, but cigarette smokers exposed to asbestos are about 50 to 84 times more likely to develop asbestos-related lung cancer.
Smoking causes death that is most avoidable in the United States. Almost 500,000 Americans die each year from smoking. The relationship between smoking and lung cancer, lung diseases and other respiratory problems is well known, but the habit may also increase the risk of asbestos-related diseases such as mesothelioma after exposure to a toxin. Smokers have an altered inflammatory response due to lung injury from cigarettes. This imbalance leads to a greater risk of hardening, scars and lung tissue damage after exposure to asbestos.