BRIEF DESCRIPTION OF TESTICULAR MESOTHELIOMA:
Testicular mesothelioma is a very rare kind of cancer caused by contact with asbestos fibres. Abnormal cells multiply and accumulate in the sac surrounding the testes, known as the tunica vaginalis. Testicular mesothelioma results for less than 1% of all mesothelioma occurrence. Signs include a buildup of fluid and painful swelling.
MAJOR CAUSES OF TESTICULAR MESOTHELIOMA:
Both pleural and peritoneal mesothelioma, which can easily be traced to contact with asbestos fibres, specialists are yet to understand how contact with asbestos can result in a primary tumor to develop on the tunica vaginalis, the pouch of serous membrane that covers the testes.
It appears as firm, white-yellow nodules on the surface of the tunica vaginalis. The nodules can eventually encase the contents of the scrotum and cause the membrane to thicken.
Local trauma and inflammation also may play a role in its development. Some cases present without any identifiable risk factors.
TESTICULAR MESOTHELIOMA AND ITS SURVIVAL RATES:
Only men are identified with this type of cancer and have a significantly better prognosis than most people with other types of mesothelioma.
Almost 49% of people with testicular mesothelioma survive five years after diagnosis, and 33% survive 10 years, according to a 2019 study published in the journal of Urology.
People with the biphasic cell type of the cancer were identified with worse overall survival rates compared to other mesotheliomas and the epithelioid subtypes.
Out of the 113 testicular mesothelioma samples from patients in the study, 75% of cases had the epithelioid cell type. Aged patients and those with tumors greater than or equal to 4 centimeters in size were identified with a worse survival rate.
DIAGNOSIS AND SIGNS OF TESTICULAR MESOTHELIOMA:
No particular signs have been identified to be unique to testicular mesothelioma cancer. Most patients with this cancer usually receive the wrong diagnosis because doctors misquote it for a more common condition such as a hernia.
The most widely known testicular mesothelioma symptom is a hydrocele, a buildup of fluid in the scrotum.
Majority of the patients present in the 2019 Urology study had a hydrocele. About one-third of patients present had a painless scrotal mass.
Because testicular cancer is hard to see and doesn’t present a particular symptoms, testicular mesothelioma is often diagnosed during or after surgery.
The most appropriate method of confirming a cancer diagnosis is to carry out a biopsy. This involves collecting a tissue sample from the tumor and sending it to the laboratory for experimental proceedings.
Carrying out a laboratory testing with the sample using a technique known as immunohistochemical staining makes it more easier for doctors determine if the patient has testicular mesothelioma or another disease.
AVAILABLE TREATMENTS FOR TESTICULAR MESOTHELIOMA:
The most commonly available treatment methods for testicular mesothelioma is surgery. Almost every one of the 113 testicular mesothelioma patients (98.2%) present in the 2019 study underwent surgical resection of the tumor.
This laboratory technique removes the area of the testicle that is affected and the whole spermatic chord. Assuming the testicular mesothelioma has spread to nearby lymph nodes, physicians will remove them as well with a surgery called lymphadenectomy.
Another research study that was carried out in 2021 revealed that testicular mesothelioma needs extensive resection together with metastatic surgery if complete resection is possible. The study suggested a multimodality treatment plan for the malignancy, similar to a multimodal approach to pleural mesothelioma, offers the best patient outcomes.
Surgery may be followed by chemotherapy with cisplatin and pemetrexed, the longstanding standard-of-care treatment for mesothelioma. Doctors may offer radiation therapy next to kill any remaining cancer cells and prevent the cancer from returning.
Only 5.3% of patients received radiation therapy in the 2019 study. Researchers could not determine if adjuvant therapy has an impact on overall survival, given such a small cohort.
In some cases, testicular mesothelioma is a secondary tumor, with the primary tumor located within the peritoneum (the membrane that lines the abdominal cavity). For situations like this, doctors have to treat the patient for peritoneal mesothelioma as well.
The most common treatment for mesothelioma involves a combination of surgery, chemotherapy and radiation therapy. Supportive treatments can help relieve symptoms and improve quality of life for many mesothelioma patients.
MAJOR WAYS TO TREAT MESOTHELIOMA:
Current recommendations for treating mesothelioma come from The American Society of Clinical Oncology. This group reviews and implements evidence-based updates on an ongoing basis. Specialists follow these clinical practice guidelines when treating asbestos-related diseases.
Patients diagnosed in the early stages benefit most from mesothelioma surgery. It offers them the best chance at living longer lives. These procedures, often performed with chemotherapy, remove all visible tumors from the chest area and improve quality of life.
Doctors may recommend chemotherapy to mesothelioma patients deemed ineligible for surgery. Chemotherapy also helps extend survival rates. A 2016 Wayne State University study found patients given a chemo drug combination lived three times longer than patients without it.
Radiation therapy controls symptoms when surgery is not an option. It eases symptoms such as chest pain and discomfort. Radiation can also reduce the risk of local recurrence when combined with surgery, and it can be used as a palliative procedure.
4. Multimodal Therapy:
Multimodality treatment is the combination of two or more conventional treatments to treat the pleural and peritoneal types of mesothelioma. This combined approach controls cancer growth better than using only one treatment.
5. Tumor Treating Fields:
Tumor Treating Fields, or TTFields, uses alternating electrical fields to disrupt cancer cells and limit growth. FDA approved, and ASCO recommended, a portable battery device delivers this treatment for malignant pleural mesothelioma through the skin via insulated adhesive pads.
Bevacizumab is an ASCO-recommended immunotherapy drug for mesothelioma that uses antibodies to limit tumor growth. Other types of immunotherapy for treating mesothelioma, such as the FDA-approved pembrolizumab (Keytruda), help the immune system identify and kill cancer cells.
CLINICAL TRIALS OF NEW TREATMENT METHODS:
Mesothelioma doctors and researchers are testing these emerging treatments in clinical trials to ensure safety and efficacy.
The goal of clinical trials is to find a mesothelioma cure or improve life expectancy. At some point, these experimental therapies could become conventional options.
Cryotherapy is a minimally invasive surgical procedure that freezes cancer cells to kill them. Patients may receive the therapy before surgery to shrink tumors, after surgery to treat recurrences or as a palliative treatment to control symptoms.
2. Gene Therapy:
Genetically modifying cells and viruses can help control cancer. For example, repairing the defective tumor-suppressing p53 gene kills cancer cells before they can replicate out of control.
3. Photodynamic Therapy:
After injecting a light-sensitive drug into the patient, doctors use laser light energy to activate the drug and kill cancer cells.
Virotherapy is a cancer treatment that uses viruses to find and attack cancer cells. Some types of virotherapy involve gene therapy or immunotherapy to make the treatment more effective