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Published on: December 21, 2019
Epidemiology and Clinical Aspects of Malignant Pleural Mesothelioma
Fraser Brims1,2,3
1Curtin Medical School, Curtin University, Perth, WA 6845, Australia.
Abstract:
Mesothelioma is a cancer predominantly of the pleural cavity. There is a clear association of exposure to asbestos with a dose dependent risk of mesothelioma. The incidence of mesothelioma in different countries reflect the historical patterns of commercial asbestos utilisation in the last century and predominant occupational exposures mean that mesothelioma is mostly seen in males. Modern imaging techniques and advances in immunohistochemical staining have contributed to an improved diagnosis of mesothelioma. There have also been recent advances in immune checkpoint inhibition, however, mesothelioma remains very challenging to manage, especially considering its limited response to conventional systemic anticancer therapy and that no cure exists. Palliative interventions and support remain paramount with a median survival of 9-12 months after diagnosis. The epidemiology and diagnosis of mesothelioma has been debated over previous decades, due to a number of factors, such as the long latent period following asbestos exposure and disease occurrence, the different potencies of the various forms of asbestos used commercially, the occurrence of mesothelioma in the peritoneal cavity and its heterogeneous pathological and cytological appearances. This review will describe the contemporary knowledge on the epidemiology of mesothelioma and provide an overview of the best clinical practice including diagnostic approaches and management.
Insights
Mesothelioma, a cancer linked to asbestos exposure, presents diagnostic and management challenges. This review covers current knowledge on its epidemiology, diagnosis, and clinical management.
Area of Science:
- Oncology
- Epidemiology
- Public Health
Background:
- Mesothelioma is a rare but aggressive cancer, primarily affecting the pleura, strongly associated with asbestos exposure.
- Historical asbestos use patterns and occupational exposures influence mesothelioma incidence, predominantly in males.
- Despite diagnostic advances, mesothelioma remains difficult to treat, with limited response to conventional therapies and no cure.
Purpose of the Study:
- To review contemporary knowledge on mesothelioma epidemiology.
- To provide an overview of current best clinical practices for mesothelioma diagnosis and management.
- To discuss challenges in mesothelioma diagnosis due to long latency and varied presentations.
Main Methods:
- Literature review of epidemiological data on mesothelioma.
- Analysis of diagnostic advancements, including imaging and immunohistochemistry.
- Evaluation of current management strategies, including palliative care and emerging therapies.
Main Results:
- Asbestos exposure is a significant dose-dependent risk factor for mesothelioma.
- Incidence rates correlate with historical asbestos use and occupational exposures.
- Median survival remains poor (9-12 months) despite therapeutic advances.
Conclusions:
- Mesothelioma diagnosis and management require a comprehensive understanding of its epidemiology and varied presentations.
- Palliative care is crucial for patients with mesothelioma.
- Further research is needed to improve treatment efficacy and patient outcomes.
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