Targeted drug therapy uses drugs that attack specific abnormalities in cancer cells, but such therapies have not yet been sufficiently investigated. In general, cancer occurs because of a series of genetic mutations that occur within the cell, causing cell growth and uncontrolled reproduction. It is unclear what causes the initial genetic mutations that lead to mesothelioma, although scientists have identified factors that may increase the risk. Cancer is thought to occur due to the interaction of various factors such as hereditary conditions, environment, health conditions and lifestyle choices.
Biphasic mesothelioma consists of a minimum of 10% of epithelial cells and a minimum of 10% of sarcomatoid cells. Each patient with this form of mesothelioma has a different ratio of epithelial to sarcomatoid cells, which is important for prognosis. The higher the percentage of epithelial cells, the better the prognosis and the greater the percentage of sarcomatoid cells in the tumor, the worse the prognosis.
Mesothelioma stages according to TMN classification:
I. Mesothelioma localized in the primary region where asymptomatic or only mild symptoms occurred, localized only to the pleura (IA) or spread to surrounding nearby tissue but without involvement of nearby lymph nodes
II. Mesothelioma spread to nearby lymph nodes
III . Mesothelioma has spread into the distal lymph nodes
IV. Mesothelioma has spread to distant organs
Forecast- The prognosis for this disease is still poor, mesothelioma is very aggressive and cure is almost impossible. Therapy allows longer survival. The key factors on which the prognosis depends are the stage of the disease, the histological type, the size of the tumor mass and the general condition of the patient. Those who are diagnosed at an early stage have greater therapeutic options and chances, so nearly half of them survive for 2 years, while those at a late stage rarely survive the same period. The five-year survival rate is rather poor and it is mainly the persons who started the treatment in the early phase I who have epithelial form. People in Stage 4 rarely survive more than a year. Median survival is thought to be 18 months from the first symptoms and 12 months from diagnosis.
Determining the stage of a cancerous tumour is an essential condition:
Understanding the level of spread of the tumour and its localization;
Selection of patient treatment methods;
Assessment of the results of therapy;
Prediction of survival and monitoring the effectiveness of the treatment process.
Currently recognized TNM classification, taking into account 3 components:
T – Determines the prevalence of the neoplasm, its size, germination in the surrounding tissue (T0 – T4).
N – Informs about the presence of metastases in the lymph nodes (N0 — N3).
M – Indicates the presence of metastases in various organs (M0 – M1).
Based on the classification of the tumour according to TNM, the diagnosis of the cancer stage as a whole is carried out. However, for each location of the tumour, there are additional requirements for examining the patient and determining specific parameters.
Stage 0. (“Cancer is in place”). Does not go beyond the boundaries of the epithelium, the tumour is located at the site of formation.
Stage I. The boundaries are extended within the tissue of the affected organ, the tumour does not penetrate into the nearby lymph nodes / tissues.
Stage II – III. The tumour penetrated deep into the tissues and regional lymph nodes, but other parts of the body are not yet affected.
Stage IV. The terminal stage with organ damage. Metastases appear in distant organs, distant lymph nodes are affected.
The estimated survival of patients at one stage or another of the disease is estimated from reliable data from statistical studies. Statistical data allow us to estimate the total / relative median survival and the average duration of remission. Oncologists never tire of repeating that in the detection of cancer in the early stages, in many cases it is treatable.