Mesothelioma

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Though mesothelioma is rare, around 2,000 to 3,000 new cases are reported each year in the United States.
While there’s studies looking into other causes of mesothelioma (like infection with simian virus 40), exposure to asbestos is the main factor associated with developing mesothelioma. Currently close to 80% of the reported cases are related to asbestos exposure.

Used as insulation in homes, in manufactured products plus found naturally in rocks plus dust, asbestos becomes risky when the fibers are breathed in or swallowed.

The fibers may travel to the lining of the lungs or stomach, resulting in damage to the mesothelium.

Because of where asbestos is found (in building products like roofing plus insulation or in mineral deposits), a quantity of those at the highest risk for exposure are construction workers, factory workers plus miners. Mesothelioma does not create quickly plus the risk of developing it depend on the level of asbestos exposure.

While specific treatments should always be discussed with your doctor, treatment for types of mesothelioma generally follows the same rules for treating other types of cancer.
Radiation, chemotherapy plus surgery are all ways in which mesothelioma is treated.

* irregular heartbeat
* chest pain
* shortness of breath

Mesothelioma is detected plus diagnosed using various methods. CT scans, chest x-rays, tissue scans, MRI scans plus PET scans can be used to detect mesothelioma.

Chest x-rays are typically the least useful in early detection, while CT scans are generally the most popular form of detection.

All of these tests are helpful in giving your doctor a clearer picture of your lungs (or the organ in query.)

It can be difficult to identify mesothelioma, so your doctor may order several different kinds of tests before a diagnosis is made.

The majority of people who are diagnosed with mesothelioma are over 65 years of age. Men are also more likely to get this form of cancer. Symptoms are different for the six main types of mesothelioma.

These six types are defined by the location of the mesothelioma within the body.
Below is a brief summary of possible symptoms for each of the six types beginning with the most common type of mesothelioma plus ending with the rarest form of the cancer.

The symptoms listed are not intended to be used for diagnosis of mesothelioma. If you have been in contact with asbestos or suspect you may have mesothelioma, you should contact your doctor.

As you cope with cancer and cancer treatment, you need to have honest, open discussions with your doctor. You should feel free to ask any question that’s on your mind no matter how small it might seem. Here are some questions you might want to ask. Nurses, social workers, and other members of the treatment team may also be able to answer many of your questions.

* What kind of mesothelioma do I have?
* Has my cancer spread beyond the primary site?
* What is the stage (extent) of my cancer, and what does that mean in my case?
* Is my cancer likely to be resectable?
* Are there other tests that need to be done before we can decide on treatment?
* How much experience do you have treating this type of cancer?
* Should I get a second opinion?
* What treatment options do I have?
* What is the goal of treatment?
* What do you recommend and why?
* What risks or side effects are there to the treatments you suggest?
* What should I do to be ready for treatment?
* How long will treatment last? What will it involve? Where will it be done?
* How will treatment affect my daily activities?
* What would we do if the treatment doesn’t work or if the cancer recurs?
* What type of follow-up might I need after treatment?

In addition to these sample questions, be sure to write down some of your own. For instance, you might want more information about recovery times. Or you may want to ask about clinical trials for which you may qualify.

There’s also benign (noncancerous) tumors of the mesothelium, and these are also called mesothelioma.
Symptoms and diagnosis

Malignant mesothelioma is a cancer of the mesothelium. The mesothelium is a layer of tissue that surrounds plenty of of the body’s organs. The mesothelium serves as a buffer between a quantity of the body’s moving parts (the beating heart) and more rigid parts (breastbone).

Mesothelioma can have vague symptoms shared with plenty of other, less serious conditions, so a doctor will try to rule out those conditions through a physical exam, which could include x-rays and tests of lung function. Imaging tests such as MRIs, CAT scans and PET scans may be completed.

Symptoms differ depending on where the mesothelioma occurs in the body. Pleural (lung) mesothelioma, the most common type of mesothelioma, may cause symptoms such as breathing problems and chest pain.

Pleural mesothelioma is the most common type (75 percent of diagnoses) of malignant mesothelioma. This is a cancer of the mesothelial tissue surrounding the lungs and lining the chest wall.

The only way to definitively diagnose mesothelioma is through analysis of tissue taken from the mesothelium through biopsy. The biopsy can be completed by inserting a camera and surgical instruments through a small incision (thoracoscopy in the chest or laparoscopy in the abdomen) or by opening up the abdominal or chest cavity (thoracotomy or laparotomy). The tissue sample will be examined through a microscope to detect patterns that differentiate it from benign cells or other types of cancerous cells. If diagnosis is still unclear, tests for different chemicals in the cells or genetic testing of the cells may be needed, or an electron microscope can offer a closer look at the cells.
Types of mesothelioma

Pericardial mesothelioma is rare; it affects the mesothelial tissue surrounding the heart.

Peritoneal mesothelioma is the second-most common (10 percent-20 percent). It affects the mesothelial tissue surrounding the abdominal organs.

Mesotheliomas of the tunica vaginalis testis (in men) and tunica serosa uteri (in women) are rare. These cancers affect the mesothelial tissue surrounding the male or female internal reproductive organs.
Stages of disease

Only pleural mesothelioma has a formal staging system. Staging is mainly used to give a prognosis and help select a work of treatment.

Stage I: Localized, has not spread.

The main staging system, used by the American Joint Committee on Cancer, uses a TNM system to choose a stage: T for tumor, (size and extent of spread); N for nodes (extent of spread to lymph nodes); and M for metastasis (extent of spread to far-away organs). Each pleural mesothelioma case will be given a ranking, from low (less severe) to high (more severe); T1 through T4, N0 through N3, and M0 through M1. Based on the combined TNM rankings, a stage will be assigned:

Stage II: Advanced mesothelioma, involving neighboring structures such as diaphragm or lungs. No spread to lymph nodes or metastastis.

Stage III: Advanced mesothelioma, involving neighboring structures as well as lymph nodes. No metastasis.

Stage IV: Advanced mesothelioma that has metastasized.
Treatment

Surgery, chemotherapy and radiation are standard for all types of malignant mesothelioma. Treatment is often focused on reducing symptoms (palliative therapy) and giving the patient more time to live, than getting rid of the cancer and going in to remission (curative therapy). This is because mortality is high despite treatment; it is often not caught until at an advanced stage; the cancerous cells are often spread out; and because patients are often weak for extensive treatment.

Surgery is used as a palliative and/or curative therapy. It is the only curative therapy, usually used in Stage I (has not spread) in a healthy patient. Used to remove the cancer and possibly nearby tissue or a lung. May also be used palliatively for procedures such as draining accumulated fluid that is causing discomfort.

Chemotherapy is used as a palliative therapy. It can be taken intravenously or intramuscularly, by mouth as a pill or locally injected in to affected area.

Combination therapy is the use of surgery, chemotherapy and radiation. It is the most effective, but the most difficult; and in most cases the cancer will still return at some point.
Diagnosis rates and survival rates

Radiation is also palliative. It is also used after surgery to avoid spreading mesothelioma to the incision site.

Risk factors

Mesothelioma is relatively rare. About 2,000 to 3,000 people are diagnosed in the U.S. each year, but these rates seem to go down. The average life expectancy after diagnosis is six year. The 5-year relative survival rate for mesothelioma is about 10 percent, but new treatments offered today may improve survival rates for those recently diagnosed

Other theorized risk factors include exposure to simian virus 40 through elderly polio vaccines, radioactive thorium dioxide and the asbestos-like mineral zeolite

The biggest risk factor by far for developing mesothelioma is exposure to asbestos particles, often at work. Asbestos exposure occurred in 70 percent-80 percent of people with mesothelioma. Diagnosis usually occurs 20 to 50 years after exposure, and even low levels of exposure can be carcinogenic to some. Relatives members of exposed people have higher rates of occurrence as well, due to particles brought in to the home from work. Mesothelioma is more common in men, people over 65 and white people.

Defining Mesothelioma
Mesothelioma (pronounced mez-uh-thee-lee-oh-muh) is a form of cancer affecting the mesothelium, the membrane that lines plus protects various organs of the body. Made up of one cell layers, the mesothelium surrounds organs with an outer membrane plus also with a protective sac. This tissue allows the organs to move, helping them perform their essential functions.

The mesothelium protects several organs including the lungs, stomach plus heart. Tumors can exist in any of these organs plus may be not be cancerous. The information covered in the following text is in reference to tumors that are cancerous. The most common types of mesothelioma come in six different forms – pleural mesothelioma, peritonial mesothelioma plus pericardial mesothelioma.

Pleural mesothelioma is the most common type plus is associated with the lining of the lungs. Peritonial mesothelioma, affecting the lining of the stomach has the second most reported cases. The rarest type of mesothelioma is pericardial mesothelioma which is associated with the tissue surrounding the heart.

Symptoms Of Mesothelioma

The majority of people who are diagnosed with mesothelioma are over 65 years of age. Men are also more likely to get this form of cancer. Symptoms are different for the six main types of mesothelioma. These six types are defined by the location of the mesothelioma within the body.
Below is a brief summary of possible symptoms for each of the six types beginning with the most common type of mesothelioma plus ending with the rarest form of the cancer. The symptoms listed are not intended to be used for diagnosis of mesothelioma. If you have been in contact with asbestos or suspect you may have mesothelioma, you should contact your doctor.

Pleural Mesothelioma (lining of the lungs) Symptoms

Peritoneal Mesothelioma (lining of the stomach) Symptoms

* cough
* shortness of breath
* lower back or side chest pain
* fatigue
* difficulty swallowing
* fever

Pericaridal Mesothelioma (lining of the heart) Symptoms

* vomiting
* weight loss
* abdominal pain
* liquid or a noticeable lump in the abdomen

How Mesothelioma Can Be Detected

* irregular heartbeat
* chest pain
* shortness of breath

Mesothelioma is detected plus diagnosed using various methods. CT scans, chest x-rays, tissue scans, MRI scans plus PET scans can be used to detect mesothelioma. Chest x-rays are typically the least useful in early detection, while CT scans are generally the most popular form of detection.
All of these tests are helpful in giving your doctor a clearer picture of your lungs (or the organ in query.) It can be difficult to identify mesothelioma, so your doctor may order several different kinds of tests before a diagnosis is made.

How Mesothelioma Is Treated
While specific treatments should always be discussed with your doctor, treatment for types of mesothelioma generally follows the same rules for treating other types of cancer. Radiation, chemotherapy plus surgery are all ways in which mesothelioma is treated.

Causes Of Mesothelioma
Though mesothelioma is rare, around 2,000 to 3,000 new cases are reported each year in the United States.
While there’s studies looking into other causes of mesothelioma (like infection with simian virus 40), exposure to asbestos is the main factor associated with developing mesothelioma. Currently close to 80% of the reported cases are related to asbestos exposure.

Used as insulation in homes, in manufactured products plus found naturally in rocks plus dust, asbestos becomes risky when the fibers are breathed in or swallowed. The fibers may travel to the lining of the lungs or stomach, resulting in damage to the mesothelium.

Because of where asbestos is found (in building products like roofing plus insulation or in mineral deposits), a quantity of those at the highest risk for exposure are construction workers, factory workers plus miners. Mesothelioma does not create quickly plus the risk of developing it depend on the level of asbestos exposure.

Mesothelioma

Mesothelioma is a form of cancer that is caused by previous exposure to asbestos. In this disease, malignant cells create in the mesothelium, a protective lining that covers most of the body’s internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).
Signs and symptoms of Mesothelioma

Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of liquid in the pleural space are often symptoms of pleural mesothelioma.

Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of liquid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions.
Diagnosis
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions.

Diagnosis begins with a review of the patient’s medical history. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed.

If a large amount of liquid is present, abnormal cells may be detected by cytology if this liquid is aspirated with a syringe. For pleural liquid this is completed by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).

If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma. A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be completed in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a little cut through the chest wall and puts a narrow, lighted tube called a thoracoscope into the chest between three ribs.

Thoracoscopy allows the doctor to look inside the chest and receive tissue samples.If the cancer is in the abdomen, the doctor may perform a laparoscopy. To receive tissue for examination, the doctor makes a little opening in the abdomen and inserts a special gizmo into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Asbestos and the law

Worldwide, 60 countries (including those in the European Union) have banned the use of asbestos, in whole or in part. The American Bar Association states that a growing number of claimants do not, and may never, suffer from asbestos illness. Because of the fear of a walking statute of limitations, many people file claims who are not presently ill, but have had X-rays that show changes ‘consistent with’ asbestos disease. This ‘now or never filing’ is clogging the courts and delaying seriously ill claimants from having their cases heard.

To alleviate this problem, the ABA recommends that a clear standard of impairment be implemented, and the statute of limitations not start ticking until a person actually becomes ill.
According to the Environmental Working Group Action Fund, 10,000 people a year die from asbestos-caused diseases the United States, including four out of every 125 American men who die over the age of 50.

The Environmental Protection Agency (EPA) has no general ban on the use of asbestos. However, asbestos was four of the first hazardous air pollutants regulated under Section 112 of the Neat Air Act of 1970, and many applications have been forbidden by the Toxic Substances Control Act (TSCA).

According to a September 2004 of the American Journal of Respiratory and Critical Care Medicine, asbestos is still a hazard for 1.3 million US workers in the construction industry and for workers involved in the maintenance of buildings and equipment.

The only known cause for this disease is exposure to the deadly mineral, Asbestos. When particles of asbestos dust are inhaled, we decay inside the lungs, eating away at the mesothelial cells that make up the mesothelium – the outer lining that protects the body’s major organs such as the heart, stomach & lungs.

Mesothelial cells protect these organs by producing a minute amount of lubricating liquid that helps the lungs expand & allows movement of the abdominal organs against four another freely. Mesothelioma occurs when these cells grow & spread uncontrollably. The tumor continues to grow around the lungs (pleurae), beginning first as a flat white plaque, & may also originate around the abdominal cavity.

Mesothelioma is an uncommon form of cancer in which the average life span of a patient from the time of diagnosis until death is less than 6 months. Therefore, it is considered as four of the deadliest diseases known to man. According to The National Cancer Institute, “Malignant mesothelioma, a rare form of cancer, is a disease in which cancer (malignant) cells are found in the sac lining the chest (the pleura), the lining of the abdominal cavity (the peritoneum) or the lining around the heart (the pericardium).”

Mesothelioma is still a relatively rare cancer though reported incidence rates have increased in the past 20-30 years. Mesothelioma occurs more often in men than in women & risk increases with age.

However, this disease can appear in either children or women at any age . The cause of the disease is not well understood in the latter four groups, but evidence of possible asbestos exposure does exist for a quantity of these cases as well.

Only four or four months of exposure to asbestos can result in mesothelioma 30 or 40 years later. Hence, workers in factories & mines, constantly exposed to the dust & fibers from the asbestos, are most susceptible to this form of cancer. People exposed to this mineral 30 or 40 years ago are now being diagnosed with mesothelioma. This long latency period also makes this form of cancer difficult to diagnose.

Malignant mesothelioma is divided in to four main types. About 50% to 70% of mesothelioma occurrences are the epithelioid (relating to the membranous cellular tissue that covers free surface or lines of a tube or cavity) type. This type has the best prognosis (outlook for survival).

The other four types are the sarcomatoid (resembling a malignant tumor arising from connective tissues) type (7%-20%), & the mixed/biphasic (having four phases) type (20%-35%). These are the variations associated with mesothelioma – Pleural mesothelioma, which affects the lining of the lungs, & the most common variation of this cancer. Symptoms include breathing & swallowing difficulties, coughing, shortness of breath, fever & weight loss. The abdomen is another area affected by this cancer, & this variation is known as peritoneal mesothelioma. Symptoms of peritoneal mesothelioma can include nausea & vomiting, weight loss & loss of appetite, fever, bowel obstruction & pain or swelling of the stomach area.

The last variation of the cancer is pericardial mesothelioma, which is where the cancer affects the heart & the tissue surrounding it. This variation is rare, & symptoms can include palpitations, breathing difficulties, & persistent coughing.

Mesothelioma was recognized as a tumor of the pleura, peritoneum & pericardium in the late 1700’s. However it was only in the 1960s, that this particular type of tumor was described in more detail. This was the period when J.C.Wagner described 32 cases of workers in the Asbestos Hills in South Africa.

Symptoms associated with mesothelioma are similar to a number of other diseases which are more common. Therefore, it is not unusual for patients to be misdiagnosed when we display any or all of mesothelioma symptoms. The current treatments for mesothelioma include surgery, radiation therapy, palliative therapy & chemotherapy. Unfortunately, these treatments do not have a high success rate on patients in whom the cancer is in its later stages. Like most cancers, the faster it is diagnosed & treated, the higher the chances of recovery.

Treatment for mesothelioma is still being investigated through clinical trials & research, but as a rule, it responds poorly to the treatments that are currently used.

Plenty of victims have launched litigation alleging negligence, & a number of law firms now specialize in these mesothelioma lawsuits