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Published on: December 21, 2019
Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment
Anna C Bibby1,2, Selina Tsim3,4, Nikolaos Kanellakis5,6
1Academic Respiratory Unit, University of Bristol, Bristol ,UK Anna.Bibby@bristol.ac.uk.
Abstract:
Malignant pleural mesothelioma is an aggressive malignancy of the pleural surface, predominantly caused by prior asbestos exposure. There is a global epidemic of malignant pleural mesothelioma underway, and incidence rates are predicted to peak in the next few years.This article summarises the epidemiology and pathogenesis of malignant pleural mesothelioma, before describing some key factors in the patient experience and outlining common symptoms. Diagnostic approaches are reviewed, including imaging techniques and the role of various biomarkers. Treatment options are summarised, including the importance of palliative care and methods of controlling pleural effusions. The evidence for chemotherapy, radiotherapy and surgery is reviewed, both in the palliative setting and in the context of trimodality treatment. An algorithm for managing malignant pleural effusion in malignant pleural mesothelioma patients is presented. Finally new treatment developments and novel therapeutic approaches are summarised.
Insights
Malignant pleural mesothelioma, a cancer linked to asbestos, is a growing global health concern. This review covers its causes, symptoms, diagnosis, and current/emerging treatments.
Area of Science:
- Oncology
- Public Health
- Pathology
Background:
- Malignant pleural mesothelioma is an aggressive cancer of the pleura.
- Asbestos exposure is the primary cause.
- Global incidence is rising, with rates expected to peak soon.
Purpose of the Study:
- To summarize the epidemiology and pathogenesis of malignant pleural mesothelioma.
- To outline patient experience, symptoms, and diagnostic methods.
- To review current and novel treatment strategies, including palliative care.
Main Methods:
- Literature review of epidemiology, pathogenesis, and clinical management.
- Summary of diagnostic techniques (imaging, biomarkers).
- Review of therapeutic evidence (chemotherapy, radiotherapy, surgery, palliative care).
Main Results:
- Detailed overview of malignant pleural mesothelioma's causes and progression.
- Comprehensive summary of diagnostic modalities and their utility.
- Evaluation of established and experimental treatment options, including management of pleural effusions.
Conclusions:
- Understanding epidemiology and pathogenesis is crucial for combating malignant pleural mesothelioma.
- Multidisciplinary approaches integrating diagnostics and tailored treatments are key.
- Ongoing research into novel therapies offers hope for improved patient outcomes.
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