Mesothelioma Attorneys California

Mesothelioma Attorneys California

Mesothelioma Attorneys California

hello my name is dr. Alex Farber and I a thoracic surgeon in Swedish cancer Institute in medical center in Seattle Washington I would like to talk to you today about tumors that involve the pleura and in specific malignant pleural mesothelioma in this podcast we will talk about what pleura is and possible cancer treatment options involving pleura with respect to anatomy of the pleura each lobe of the the lung is covered by a double layer coat we call pleura this covers the lung align the thoracic wall diaphragm and mediastinum we call the layer that covers the lung visceral pleura we call the layer that covers the chest parietal pleura wall pleura too align the diaphragm and the pericardium the SAC around the heart of the the space between the two plural layers is called the pleural space there are approximately two or three thousand new cases of primary pleura cancers or malignant pleural mesothelioma that they are diagnosed every year in the states States that we know that remote exposure to asbestos is a risk factor to develop mesothelioma pleura tumors may Also be in our most often secondary to cancer metastasis involving distant parts of the body like the colon prostate and ovary, while the primary plural malignant tumors and this is defined as tumors that arise from the pleura itself they are quite uncommon, therefore, doctors tend to have difficulty doing initial diagnosis of mesothelioma we continue to learn more about evil pleural mesothelioma with respect to diagnostic and possible management treatment options now we know that for a multimodality patient subgroup therapy or the combined use of chemotherapy, radiation and surgery is associated with better results than the use of any of those treatments options only therefore the survival of our Mesothelioma patients is large need to improve up to eighty percent of Mesothelioma cases are associated with asbestos exposure the rest cases may be related to family contact as well as causes not related to asbestos most people are diagnosed with mesothelioma and its 50 to 70 years and men are affected more often than

women can be difficult to differentiate a malignant pleural mesothelioma of a different type of cancer we call metastatic adenocarcinoma these are two completely different types of cancer with lots of different treatment options like me mentioned before pleural tumors are more often metastatic cancers that mesothelioma and that's why we use many different tests to do that accurately distinction is crucial that we have sufficient or large enough tissue sample biopsy sample for properly characterize not only the tumor as a mesothelioma but also to distinguish what subtype of mesothelioma do we have in specific epithelioid sarcoma toid o mixed epithelioid mesothelioma is the most favorable subtype of mesothelioma and carries a greater chance of survival after surgery and multimodality therapy is sarcomatoid mesothelioma compound of spindle-shaped cells and these tumors tend to have less favorable result part of the difficulty in making a diagnosis of mesothelioma are your subtle symptoms that our the patient has dyspnea or difficulty with breathing is the most common symptom and that is usually due to the presence of pleural effusion characterized in blue this accumulates in the spaces between the visceral pleura and parietal pleura in between the lung and the chest wall chest pain can also be common other symptoms include cough, loss of appetite weight loss night sweats and even hemoptysis or spitting blood in physical exam may have decreased breathing sounds on the affected side that It can also be a chest wall mass and this could be painful there are a number radio

logical tests that we ask when trying establish a diagnosis of the stage that It tells us how advanced cancer can be in determining if surgery is feasible and in the best interest of the CT patient Chest scans are usually one of The first tests we ask for is easily available and provides some PET scans of very useful data help determine if there is any suggestion of disease in the other lung in the abdomen or in other areas of the body sometimes MRI may suggest an invasion in the chest mediastinum of the wall or through the diaphragm in the abdomen this usually indicates that surgery would not be an option that would benefit the patient all the information we collect, including CT MRI PET, as well as tissue histology The biopsy is used to get a better idea of the anatomy of mesothelioma and if surgery will be potential benefit for the patient the first invasive tests used in an attempt to making a diagnosis of mesothelioma is typically a thoracentesis or when there is fluid it is removed from the pleural space to thoracentesis is the use of a small catheter to drain the pleural fluid that is sent for analysis to a pathologist to see if cancer cells are really present it's not uncommon for the pleural the liquid is analyzed and does not indicate a diagnosis of mesothelioma or even cancer at all, even if cancer is present in that space many times the next step is the use of a CT scan to guide a plural biopsy

this cures a diagnosis of mesothelioma approximately thirty to fifty percent of the best time but still not great with regarding making a definitive diagnosis of mesothelioma finally an operation can It is usually done through a single small incision in the chest wall a video scope is introduced into the pleural space and multiple biopsies of pleural surfaces this is often a diagnostic intervention that results in a definitive diagnosis of malignant pleural mesothelioma at this point the patient is usually referred to a thoracic surgeon with experience in treat patients with mesothelioma as it's true with any cancer we treat Stage each patient with mesothelioma in other words we determine how advanced we believe that cancer is when we try to determine the best treatment option possible we use all the data available to us, including CT PET CT MRI biopsy and eventually add operating room procedure called a cervical mediastinoscopy this is a procedure where a small incision is made at the base of the neck and mediastinal the lymph nodes biopsy now we know that if the mediastinal nodes are negative for cancer, which means there is no cancer keep in mind that these patients live longer that if the nodes are involved with cancer if we suspect the possibility of mesothelioma existing in the abdomen we you can perform a laparoscopy to evaluate this involves going to the operating room where there is a small incision and cameras used to obtain tissue to test the presence or absence of mesothelioma in the abdomen there are two operations that thoracic surgeons may consider acting for patients with mesothelioma these are called plur ectomy and decortication or plural plural pneumonectomy plur ectomy and decortication is a surgical procedure that implies extracting both viscera and parietal pleura this leaves the lung in place this may be a potential option for patients with very minimal or very advanced disease an extra plural

pneumonectomy is the complete elimination of the lung with its visceral pleura the parietal pleura the diaphragm and the SAC around the end of the heart pericardium then we rebuild both the pericardium and diaphragm using prosthetic material we believe extra plural pneumonectomy to be the best choice for people who are strong They are younger or have more volume disease there is no gold standard therapy for mesothelioma your treatment the plan depends on the anatomy of your tumor in its general state sometimes Chemotherapy is performed before our surgery Swedish thoracic group has a recent publication that describes our treatment philosophy and results and patients with mesothelioma treated with chemotherapy first followed by surgery and then radiation patients with mesothelioma are better managed in centers where there are experience and treatment of this type of cancer as well as with the complex surgical procedures necessary for extraction of the entire tumor just by centralizing caring for the small number of new Mesothelioma patients seen every year to a limited number of doctors centers we can continue studying learn and improve the results for our patients fighting this cancer in the past mesothelioma was considered as a disease that could not be treated in that only pain management should be offered we have come a long way since those days now we know that there are interventions that can help certain patients live longer and longer comfortably the surgeries we offer to patients have improved our ability to make an accurate diagnosis before heading to the operating room continue experiencing do research and study our results critically thanks to hear the plug in your podcast program on health cancer mesothelioma and malignant pleural problems in thoracic surgeries for more information please contact your thoracic surgeon