Mesothelioma

Mesothelioma cancer most commonly develops in the lungs of people exposed to asbestos.

Effective treatments are available to ease symptoms and improve your prognosis.

Mesothelioma is a rare cancer caused almost exclusively by exposure to asbestos. It usually affects the thin, protective membrane surrounding the lungs, heart or abdominal cavity. Doctors diagnose an estimated 3,000 cases of mesothelioma a year in the United States, and the majority of those are traced to job-related exposure.

Although asbestos use declined dramatically in recent decades in this country, the incidence of mesothelioma remains steady. That difference can be traced to the distinct latency period linked to mesothelioma. The disease can take anywhere from 20 to 50 years after exposure to asbestos before it shows obvious symptoms and an oncologist can make a definitive diagnosis. While no cure for the disease exists and the prognosis is typically poor, researchers made significant progress in recent years in understanding mesothelioma and developing new treatment options and alternative therapies.

How Asbestos Causes Mesothelioma

Mesothelioma cancer develops after exposure to asbestos, which most often occurs in the workplace – in industrial settings, shipyards, auto repair shops, old houses, schools and public buildings. It usually takes long-term exposure to put someone at risk, asbestos is highly toxic. Even short-term and one-time exposures are known to cause mesothelioma cancer.

Microscopic asbestos fibers are breathed in or swallowed. The human body has difficulty destroying or getting rid of these fibers. Over decades, the fibers cause biological changes that result in inflammation, scarring and genetic damage. The most susceptible area to these fibers is the lining of the lungs, called the pleura, although fibers also can become trapped in the lining of the abdominal cavity (peritoneum). Once fibers cause biological damage, the stage is set for the decades-long latency period for the development of malignant mesothelioma.

Learn more about the causes of mesothelioma

Types and Symptoms

Pleural mesothelioma is the most common type of mesothelioma, representing about 75 percent of cases. Peritoneal mesothelioma is the second most common type, consisting of about 10 to 20 percent of cases. Approximately 1 percent of cases are of the pericardial variety. Another rare type known as testicular mesothelioma represents less than 1 percent of cases.

Pleural

This type forms in the lining of the lungs. An increased incidence rate led to more studies to improve treatment methods and survival rates.

Learn more

Peritoneal

Developing in the lining of the abdominal cavity, peritoneal mesothelioma responds best to a combination of surgery and heated chemotherapy.

Learn more

Pericardial

Emerging from the lining of the heart, pericardial mesothelioma is the most challenging to treat because of tumor location.

Learn more

Read More

Pericardial Mesothelioma

Pericardial mesothelioma is a cancer that develops in a thin membrane surrounding the heart, known as the pericardium. The membrane has two layers: an outer layer called the parietal layer, heart sac or theca cordis, and an inner layer known as the visceral layer or epicardium.

There are four common forms of mesothelioma, and pericardial and testicular mesotheliomas are the rarest. To date, approximately 200 cases of pericardial mesothelioma are presented in medical literature. That represents around 1 percent of all known diagnosed mesotheliomas.

Almost all mesothelioma cancers can be traced to an exposure to asbestos, but medical researchers continue to study the link between asbestos and pericardial mesothelioma. Studies are clear on how inhaled microscopic fibers reach the lungs to cause pleural mesothelioma, but less clear on how the fibers reach the pericardium.

This form of cancer strikes twice as many men as women, and is most often diagnosed in people between the ages of 50 and 70. Like the other forms of mesothelioma, the disease develops over a long period of time — one to five decades — and is typically discovered in a later stage. Symptoms include chest pain, fatigue and shortness of breath, among others, and they mimic those of other disorders to make diagnosing pericardial mesothelioma difficult.

Treatment options follow that of most other cancers: surgery (if a patient is deemed healthy enough), chemotherapy, radiation therapy and/or a combination of all three modalities. About half of the people who contract pericardial mesothelioma survive longer than six months.

Pericardial Mesothelioma Symptoms

Symptoms for pericardial mesothelioma can be very similar to other heart conditions, making it difficult to diagnose.

The clinical presentation of symptoms isn't always apparent when the cancer initially develops, a fact that contributes to a late-stage diagnosis. The fact that symptoms resemble those of other heart conditions also makes the cancer difficult to accurately diagnose. Most symptoms are caused by the buildup of fluid and the thickening of pericardial layers.

The following symptoms may indicate pericardial mesothelioma:

• Heart palpitations or irregular heartbeat (arrhythmia)
• Chest pain
• Murmurs
• Cough
• Difficulty breathing, even when at rest (dyspnea)
• Orthopnea (dyspnea which occurs when lying down)
• Fatigue
• Fever or night sweats

The presence of any of these symptoms should be followed with a visit to the doctor with recommended screenings such as an X-ray or CT scan.

How Does Asbestos Cause Pericardial Mesothelioma?

Pericardial Mesothelioma occurs when asbestos lodges itself in and around the heart.

The causal relationship between asbestos exposure and pericardial mesothelioma is not fully understood. Researchers confirm that pleural and peritoneal mesotheliomas are primarily caused by exposure to asbestos, yet the etiology of pericardial mesothelioma is less definitive. Some patients with pericardial mesothelioma do have a history of exposure, but the limited number of reported cases prohibits researchers from effectively analyzing the relationship between the two. One 1982 study found a history of asbestos exposure in three of 15 cases and another 1994 study reported asbestos exposure among four of 15 cases.

Asbestos fibers can become lodged in the pericardial membranes that surround the heart. When this occurs — just as it does in the lining of the lungs and the lining of the abdomen — the body experiences extreme difficulty in eliminating the fibers. They can remain stuck in the membranes, and over a long period of time — sometimes up to 50 years — the asbestos fibers cause the cells of the pericardium to undergo changes that may result in cancer.

Once cells become cancerous they begin to divide more rapidly, without the restraint that regulates the growth cycles of normal, healthy cells. As malignant pericardial mesothelioma cells continue to grow, they lead to the thickening of the pericardial membranes, and eventually cause tumors to develop. These changes in the pericardial membrane lead to the buildup of fluid between the pericardial layers, which, combined with the thickening of the layers, puts pressure on the heart.

Pericardial Mesothelioma Diagnosis

To diagnose pericardial mesothelioma, a patient's symptoms, medical history and current medical condition must be cumulatively assessed. Imaging tests can help determine specifically where it is located.

• Physical Examination
• Imaging Tests
• Biopsy

Computed tomography, or CT scans, provides sensitivity towards the detection of the pericardial tumor, making it a preferred diagnostic tool. Magnetic resonance imaging (MRI) can also yield extremely successful results in identifying and assessing the cancer. Pericardial tumors generally are not localized, and they tend to cover most of the heart. Furthermore, this mesothelioma type accounts for approximately half of all pericardial tumors.

Radionuclide imaging, an advanced detection method that involves the injection of radioactive material to help identify cancerous cells, was reportedly used to detect at least one case of pericardial mesothelioma. When using Radionuclide imaging to detect this cancer, the radioactive chemical radiogallium is required.

A biopsy can be more suitable in determining the cancer's point of origin. This procedure involves the removal of tissue or fluid from the pericardium, followed by laboratory tests of the tissue or fluid to confirm the presence of cancer.

Between 10 and 20 percent of pericardial mesothelioma cases involve a diagnosis that is made before a patient dies. Conversely, 80 to 90 percent of the diagnosed cases are made post-mortem. Some of the challenges with early and accurate diagnosing of pericardial mesothelioma include the minuscule number of people with the disease and the delayed presentation of symptoms.

Pericardial Mesothelioma Treatments

Treatment options for pericardial mesothelioma patients are limited because the heart lining rests so closely to the heart itself that treatment can easily damage the heart. Most of these cancer patients are not ideal candidates for surgery, which is often the most effective way to treat mesothelioma. However, there are rare cases where the cancer is diagnosed early and surgery can be carried out to remove small, localized tumors. Still, this surgery is extremely dangerous because of the close proximity to the heart, arguably the body's most critical organ.

If a patient is considered a good candidate for a surgery, they will be treated with a pericardiectomy, the surgical process of removing part of or the total pericardium. A pericardiectomy can relieve pressure and minimize fluid buildup, allowing the heart to continue functioning properly. A pericardiocentesis removes excess fluid from the pericardium to relieve pressure around the heart.

Get Help Now

Chemotherapy is an option that is normally considered for mesothelioma, but the clinical benefits seen in pericardial patients who received this treatment were minimal. Similarly, radiation therapy, which is considered one of the primary therapies for most peritoneal and pleural mesothelioma cases, is considered minimally effective for pericardial cancer.

Palliative treatment options are the most viable and common treatments, which aim to minimize pain and reduce the symptoms caused by the buildup of fluid in the pericardium. Essentially, palliative care can improve a patient's quality of life and make them more comfortable. Palliative treatments can include therapies that relieve pain and pressure around the heart, such as a pericardiocentesis or pain medication.

Another treatment that removes excess fluid from the pericardium is known as a fine needle aspiration. This palliative procedure is more commonly used as a diagnostic method for pleural mesothelioma patients, but can provide comfort for certain patients.

Pericardial Mesothelioma Prognosis

The common prognosis for pericardial mesothelioma is shorter than that of peritoneal or pleural mesothelioma. Nearly 50 to 60 percent of all pericardial patients pass away within six months of receiving a diagnosis. However, this is not the case for everyone.

Hope exists for some pericardial patients because researchers have cited positive results through surgical excision of localized tumors. Partial pericardial resection with radiation therapy improved survival in two patients; one patient lived a year after treatment and another was alive five years after treatment. Smaller, less impactful benefits were demonstrated from chemotherapy.

As with other types of mesothelioma, an early diagnosis can yield a more optimistic prognosis, often resulting in more treatment options. This is rare though because the onset of symptoms is often gradual and inconspicuous, and not accurately detected until the cancer has further developed.

Want to Talk to a Patient Advocate?

Would you like more information about mesothelioma? Please contact our Patient Advocates at (800) 615-2270 or fill out this form for a free informational packet filled with information about treatment options, doctors and legal options.

Read More

Peritoneal Mesothelioma

Peritoneal mesothelioma is the second-most common type of mesothelioma, accounting for 10 to 20 percent of all mesothelioma cases. About 3,000 new cases of mesothelioma are diagnosed annually in the United States and approximately 300 to 600 of these are peritoneal mesothelioma. Asbestos exposure is its primary cause and most cases take more than two decades to develop once asbestos fibers are inhaled or ingested. X-rays and other tests are used to detect peritoneal mesothelioma, but biopsies help confirm a diagnosis. Although the cancer is usually diagnosed in the later stages of development, treatment options are available to combat symptoms and improve prognosis.

Overall prognosis for peritoneal mesothelioma patients is less than one year. However life expectancy can increase with effective treatment and early detection. Some patients may be candidates for surgery that can send the cancer into remission, while others may elect to receive palliative measures that improve symptoms and quality of life. Working with a mesothelioma specialist can help patients receive the best possible care for their cancer and potentially improve prognosis.

Get Yours Now

Mesothelioma of the Peritoneum

The peritoneum is a membranous layer that is made up of two sub-layers called the parietal and visceral layers. The parietal layer covers the abdominal cavity, while the visceral layer surrounds abdominal organs. Together these two layers provide support and protection for abdominal organs and the abdominal cavity as a whole.

There are two main theories regarding how asbestos exposure leads to the development of peritoneal mesothelioma:

• Asbestos fibers are ingested and these fibers work their way from digestive organs into the peritoneal membrane.
• Asbestos fibers are inhaled and travel to the peritoneal membrane via the lymphatic system.

Regardless of how asbestos fibers actually enter the peritoneal layers, the body experiences difficulty in expelling them. Trapped asbestos fibers eventually cause changes in mesothelial cells, leading to irritation and inflammation. The exact way in which asbestos fibers cause these changes is uncertain, but researchers believe such changes are responsible for cancer development.

Peritoneal Mesothelioma Symptoms

A patient with peritoneal mesothelioma may not demonstrate symptoms for 20 to 50 years following asbestos exposure. Once asbestos fibers have irritated and caused mesothelial cells to become inflamed, the peritoneum starts to thicken. The buildup of fluid, known as ascites, is the next phase of cancer progression for some patients. Overtime, mesothelioma tumors form and this places pressure on internal organs.

Peritoneal mesothelioma symptoms usually include:

• Abdominal pain or swelling
• Changes in bowel habits (such as diarrhea or constipation)
• A feeling of fullness
• Night sweats or fever

• Unexplained weight loss
• Nausea or vomiting
• Fatigue
• Anemia

Peritoneal Mesothelioma Diagnosis

X-rays are the most common scans used to help diagnose peritoneal mesothelioma.

Peritoneal mesothelioma is not an easy cancer to diagnose. It often takes several months from the initial presentation of symptoms to confirm a diagnosis. This delay, combined with the speedy progression of mesothelioma tumors, usually results in a late-stage diagnosis for most patients.

A peritoneal mesothelioma diagnosis cannot be made on the basis of symptoms alone. The process begins with a thorough examination of a patient’s medical history and physical condition, followed by CT scans and other X-rays. Any incidence of asbestos exposure in a patient’s history should alert doctors to the possibility of mesothelioma cancer.

Imaging scans are useful for detecting abnormalities and may even help with staging, but only a biopsy can confirm a mesothelioma diagnosis. Doctors often use the imaging scans as a guide for where the biopsy should be performed. Biopsies are minor surgical procedures that involve the removal of fluid or tissue samples from areas of the peritoneum.

Peritoneal Mesothelioma Treatments

There are several treatment options for peritoneal mesothelioma patients. Surgery that attempts to remove the entire cancerous tumor produces better results than any other traditional treatment option, but this approach is only feasible during an early stage of peritoneal mesothelioma. Because mesothelioma is often diagnosed at a late stage, most surgical attempts only remove sections of the tumor. Common surgical procedures for peritoneal mesothelioma include peritonectomy, cytoreductive surgery, bowel resection and removal of other organs.

Treatment uses chemotherapy drugs to shrink tumors and slow down cancerous growth. It can be used before, during or after surgery and is sometimes implemented as a standalone treatment option. Beneficial chemotherapy drugs for peritoneal mesothelioma include pemetrexed, cisplatin, carboplatin, and gemcitabine.

Doctors are now finding positive results with heated chemotherapy, which utilizes warm chemotherapy drugs and administers them directly into the abdominal cavity. This treatment is usually combined with cytoreductive surgery and works best for early stage patients. There is a solid rationale for this treatment as removal of large amounts of tumor is likely associated with residual microscopic disease. The addition of intraperitoneal chemotherapy to the cytoreductive surgery is to treat the cells that may be left behind.

Radiation therapy is not typically recommended to slow cancer growth in peritoneal mesothelioma patients because it’s considered too risky with vital abdominal organs nearby, but studies show it can slightly improve survival when combined with surgery and chemotherapy.

Alternative treatments and emerging therapies for peritoneal mesothelioma are available but these have less predictive outcomes. Immunotherapy is sometimes used to boost the body’s immune system to help fight off cancer, but this approach is more common for the pleural mesothelioma variety. Clinical trials provide patients with the opportunity of trying experimental treatments. If a poor prognosis is expected, patients can elect to receive palliative care to simply relieve symptoms and improve quality of life.

Peritoneal Mesothelioma Prognosis

Although doctors are diagnosing peritoneal mesothelioma at earlier stages, life expectancy remains close to one year. There are cases of patients surviving several years after diagnosis, but these are quite rare.

Perhaps the best achievement in improving prognosis was the recent introduction of cytoreductive surgery followed by hyperthermic intraoperative intraperitoneal chemotherapy. This treatment approach utilizes chemotherapy during or directly after surgery. In addition to available treatments, a patient’s age, gender, cell type of the tumor and tumor size play a role in prognosis.

Get Help Now

Explore Your Options

If you think you may have peritoneal mesothelioma, or if you’ve already been diagnosed, your first step is finding a mesothelioma specialist. A specialist will explain all available treatments and discuss your options. The Mesothelioma Center’s complimentary Doctor Match Program can pair you with a top doctor in your area.

Omental Mesothelioma

Omental mesothelioma develops in the omentum, a sheet of fatty tissue in the abdomen that hangs in front of the intestines like an apron. In addition to storing fat and protecting organs, the omentum holds nutrients and prevents internal infections from spreading. The peritoneum covers the omentum, and both contain mesothelial cells that can turn cancerous.

Peritoneal mesothelioma is usually the cause of omental mesothelioma because the cancer spreads into the omentum. It’s also possible for the opposite to occur, for cancer in the omentum to cause peritoneal mesothelioma. But to date, medical literature documents fewer than five of those cases.

Symptoms of both cancers are similar, although one omental mesothelioma patient experienced lower back pain and no other symptoms. Because omental cancer is so rare, it is difficult to diagnose and effectively treat. But in some cases, surgery and chemotherapy have proven successful.

It’s unclear if the prognosis for omental mesothelioma patients is better, worse or the same as it is for someone with peritoneal mesothelioma. The disease is simply too rare to apply enough data. Some evidence suggests a reason for optimism.

In a 2009 case, an omental mesothelioma patient was treated successfully with chemotherapy. When the study was published 14 months after initial diagnosis, the patient was alive and well. In a case reported in 2004, surgeons removed an omental mesothelioma tumor, and the patient recovered fully. Nearly three years later, the patient remained in good health.

Read More

Mesothelioma Causes

Mesothelioma - a cancer that typically attacks the lungs and abdomen - was profoundly rare until the industrial and commercial use of asbestos expanded in the 20th century. Medical researchers have spent decades investigating the disease and what causes it, and their findings are that asbestos exposure is the primary culprit.

Through studies aimed at pinpointing the exact causes of mesothelioma, researchers gradually learned how being exposed to asbestos triggers cancer.

In March 2009, the International Agency for Research on Cancer reconfirmed that all forms of asbestos can cause mesothelioma - and asbestos exposure is the foremost cause of mesothelioma.

Where Does Asbestos Exposure Occur?

Until the 1980s, asbestos was everywhere in homes and businesses and in many forms. It was used in thousands of industrial and household products.

Work-related exposure delivered the most potential for exposure, but it also can occur at home, at the office, in public buildings, in industrial settings, and even in urban areas that are generally considered environmentally friendly because asbestos occurs naturally.

With so many materials once manufactured with asbestos, there are a number of ways a person could have experienced exposure, including:

Working at an asbestos mine or asbestos processing plant

Living in a residential area near an asbestos mine

Working in a high-risk occupational setting such as the construction or automotive industry

Renovating an asbestos-containing home without adequate safety measures

Serving on military facilities or ships where asbestos was used in construction

It generally takes repeated, heavy exposure to asbestos in an occupational setting to be at risk for asbestos-related disease. Once asbestos fibers accumulate in the body, they can trigger a number of biological changes that may lead to mesothelioma.

How Does Mesothelioma Develop?

A person can be exposed to asbestos by inhaling or ingesting microscopic asbestos fibers. The fibers can become lodged in the mesothelial lining of primary organs, such as the lungs. Over time, damage caused by the fibers can result in the development of cancerous tumors.

The exact method by which asbestos causes mesothelioma is still being researched, but medical professionals have formulated several theories for further exploration:

Inflamed cells

Asbestos causes mesothelial cells to become irritated and inflamed, which leads to irreversible scarring, cellular damage and cancer.

Genetic changes

Asbestos fibers enter mesothelial cells and disrupt the natural functions of cellular division, resulting in genetic changes that lead to cancer.

Cancerous mutations

Asbestos causes the production of free radicals, which are molecules that damage DNA and cause healthy cells to undergo cancerous mutations.

Uncontrolled growth

Asbestos can trigger cellular production of oncoproteins, which cause mesothelial cells to ignore normal cell division restraints and become cancerous.

The factor uniting these theories is that asbestos leads to cellular damage that disrupts the natural cell cycle. Once normal function of the cell cycle is lost, cells begin to divide and grow uncontrollably. These cells then accumulate into tumors that trigger mesothelioma symptoms.

In a 2010 study conducted by the National Cancer Institute and the Mesothelioma Applied Research Foundation, researchers may have confirmed a primary way that asbestos causes mesothelioma. The study reported that asbestos damages cells through a process researchers dubbed "programmed cell necrosis." This process involves the release of a molecule known as "high-mobility group box 1 protein" (HMGB1), which triggers a chronic inflammatory reaction that causes tumor growth.

Have You been Diagnosed Recently?

If you or a family member recently was diagnosed with mesothelioma, a second opinion may shed more light on what should come next for your treatment. Getting a second opinion is common for anyone who receives mesothelioma diagnosis. Specialists can clarify the diagnosis and sometimes can afford more treatment options. If you do seek a second opinion, feel free to contact the Mesothelioma Center's Doctor Match Program.

Other Potential Risk Factors

Although asbestos exposure is the primary cause of mesothelioma, other risk factors may be involved in the development of the disease.

These potential risk factors include:

• Non-asbestos mineral fibers such as erionite and taconite
• Radiation exposure (noted in approximately 45 recorded cases in history)
• Simian virus 40, a contaminant of polio vaccines administered in the 1950s and 1960s
• Chest injuries, chronic inflammation, genetics and organic chemicals

Smoking has not been found to cause mesothelioma. Researchers have, however, found that smoking can weaken the body's lungs and reduce the body's ability to expel the fibers once they are inside the body. Smoking can also aggravate other asbestos-related conditions such as asbestosis.

If you feel that you may be at high risk for developing mesothelioma because of past asbestos exposure or other potential causes, an experienced doctor can schedule the appropriate screenings to detect this cancer. To obtain assistance with choosing a qualified physician in your area, contact the Mesothelioma Center's Doctor Match Program.

Mesothelioma Prevention

The best way to prevent mesothelioma is to take a proactive stance on your health and seek regular medical exams to check for signs of asbestos-related disease. If a previous job or project exposed you to asbestos, an experienced doctor can schedule the appropriate screenings to detect mesothelioma or another asbestos-related disease. Those with a history of asbestos exposure should not wait for symptoms to arise; monitoring development of asbestos-related disease offers the most opportunity for effective treatment.

View Article Sources

Read More

Mesothelioma Symptoms

What are the most common warning signs of mesothelioma?

Mesothelioma is difficult to diagnose because the early signs and symptoms of the disease can be subtle or mistaken. Symptoms are all too frequently ignored or dismissed by people who are inclined to attribute them to common every day ailments. Sometimes patients live with symptoms for up to 6 months before being diagnosed but usually the symptoms are present for two to three months prior to a mesothelioma diagnosis.

About 60% of patients diagnosed with pleural mesothelioma experience lower back pain or side chest pain, and there are frequent reports of shortness of breath. Lower numbers of people may experience difficulty swallowing, or have a persistent cough, fever, weight loss or fatigue. Additional symptoms that some patients experience are muscle weakness, loss of sensory capability, coughing up blood, facial and arm swelling, and hoarseness.

Peritoneal mesothelioma originates in the abdomen and as a result, symptoms often include abdominal pain, weight loss, nausea, and vomiting. Fluid buildup may occur in the abdomen as well as a result of the cancer.

Asbestos exposure is considered the primary risk factor for the development of the cancer. Anyone previously exposed to asbestos displaying any of these symptoms should seek medical attention from their doctor first, only to be referred to a doctor who specializes in the treatment of mesothelioma and thoracic oncology after receiving a positive diagnosis.

How long does it take for mesothelioma symptoms to appear?

One of the most unique facts about mesothelioma is that the disease is characterized by a long latency period that is very often associated with the disease. The latency period is the amount of time that elapses from the first point of asbestos exposure to the point where symptoms begin to appear so that a diagnosis can be made. In some mesothelioma cases the latency period is reported to be 10 years but the average latency for the majority of cases is between 35 and 40 years. As a result, the cancer often progresses to later stages before a diagnosis is made. When diagnosed in the later stages, mesothelioma treatment options become more limited and are less effective.

Symptoms of Mesothelioma

Provided below is a list of symptoms that mesothelioma patients may experience. Please click on a symptom to learn more about it.

Anemia

Mesothelioma patients diagnosed with anemia have a lower than normal red blood cell count or hemoglobin in the blood.

Blood Clotting Disorder

A symptom experienced by many mesothelioma patients that can lead to anemia and other serious complications if not given appropriate medical attention.

Bowel Obstruction

Bowel obstructions can be a direct effect of the cancer. It is a very painful symptom that can sometimes develop in peritoneal mesothelioma patients.

Chest Pain

Often experienced in pleural mesothelioma and pericardial mesothelioma patients, chest pain can develop as the tumor grows and places strain on the lungs and heart.

Dysphagia

Pleural mesothelioma patients often develop difficulty swallowing (esophageal dysphagia) as the mesothelium continues to grow on the lungs.

Fluid Effusion

An effusion can occur in mesothelioma patients when there is fluid buildup affecting either the pleura or pericardium. This may need to be drained in a relatively limited surgical procedure to control the effusion and associated symptoms.

Hemoptysis

Hemoptysis, or the symptom of coughing up blood, can have its origins in the lungs, bronchi or trachea of mesothelioma patients.

Nausea

Nausea is experienced in a number of cancer patients, as it is often a side effect of chemotherapy treatment and sometimes the underlying cancer. Those diagnosed with peritoneal mesothelioma may also experience nausea as a result of increasing abdominal pressure.

Peritoneal Effusion

Peritoneal mesothelioma patients may experience a buildup of fluid in the peritoneum as the tumor continues to grow. This can result in an effusion which can inhibit the function of abdominal organs.

Peritoneal Effusion

In pleural mesothelioma patients, pleural effusion may develop when there is a large amount of fluid present in the pleura, the lining between the lungs and chest cavity.

Weight Loss

Weight loss can occur in mesothelioma patients as a side effect from cancer treatment or as the result of other symptoms that may also be present, such as difficulty swallowing or nausea.

Read More

Pleural Mesothelioma

Pleural mesothelioma is a rare cancer often diagnosed in people who have been exposed to high levels of asbestos. The malignancy affects the pleura, a thin membrane of lubricating cells that lines the lungs and chest wall. It sometimes takes 10 years or more for changes to appear that are indicative of pleural disease, and even long for symptoms to manifest. These differences can include a thickening or calcification of the pleural lining, a condition commonly diagnosed as pleural plaques. Conditions like pleural calcification or the development of pleural plaques often serve as pre-cursor to mesothelioma.

Get This Image For Your Site

In most instances, pleural disease is not considered fatal but it can cause diminished lung function and may confirm that a person has sustained significant asbestos exposure. Those diagnosed with pleural conditions are generally considered to be at a higher risk for developing the more severe pleural mesothelioma.

Pleural mesothelioma originates in the pleura but can quickly spread to the outer chest wall, abdomen, and heart. Pleural mesothelioma is typically fatal within 1 year of diagnosis. However, understanding and recognizing key risk factors, like asbestos exposure, will typically lead to early detection of the cancer. Those who are fortunate to receive an early diagnosis are likely to be more eligible for life-sustaining treatments such as surgical resection of the cancer. This type of treatment can extend a patient’s life years beyond that of a typical mesothelioma patient.

While there is no cure for pleural mesothelioma, treatment options do exist for the cancer. There are ways for patients to manage the disease through tumor management including traditional radiation and chemotherapy methods, which can ease symptoms of the disease and make a patient more comfortable. In patients where a diagnosis is made of early stage disease, mesothelioma surgery can extend the survival rate far beyond previous levels in untreated disease.

Treatment and Tumor Management

Nearly all patients diagnosed with pleural mesothelioma are able to receive some form of treatment for their illness. While there is currently no cure for mesothelioma, patients have been able to extend initial prognosis through advanced mesothelioma treatment regimens currently being developed at clinics and cancer centers across the United States.

Surgery

Surgical resection is difficult in pleural mesothelioma patients when the disease is diagnosed in later stages because at that time the tumor has typically metastasized to other areas of the body like the abdominal cavity and lymph nodes. However, in early stage diagnoses, surgery can absolutely be utilized to slow the advance of mesothelioma disease.

Common surgical procedures utilized in the management of malignant mesothelioma are pneumonectomy and extrapleural pneumonectomy. Pneumonectomy is a general procedure utilized not only in patients of malignant mesothelioma, but also for those battling lung cancers or related lung conditions. Pleurectomy involves the removal of a either a portion of or the entire affected lung in patients. Extrapleural pneumonectomy is a more comprehensive procedure that is more tailored to mesothelioma patients and involves the removal of the entire affected lung, the pleura, the diaphragm, and the pericardium, which is the mesothelial lining that surrounds the heart cavity.

Chemotherapy

Chemotherapy is likely the most prevalent treatment utilized by patients of malignant pleural mesothelioma. While several different chemotherapy drugs have been utilized to varying degrees of effectiveness for the management of malignant pleural mesothelioma, only one has been approved by the Food and Drug Administration as a prescribed therapy for the treatment of malignant pleural mesothelioma. A combination of Alimta(Pemetrexed) and Cisplatin is currently the only drug combination in approved status. However, several other clinical trials are currently active attempting to determine the effectiveness of other drugs including Gemcitabine, Navelbine, and Onconase.

Radiation Therapy

Radiation therapy has been utilized in the treatment of many types of cancer and pleural mesothelioma is no different. Often, radiation is not able to manage cancer by itself so it is combined with either surgery, chemotherapy, or both to augment the treatment plan as a whole. Radiation therapy for pleural mesothelioma utilizes external beam radiation to mutate tumor cells within the body and slow their growth and spread.

Alternative and Complementary Therapies

A growing school in cancer care involves integrative approaches to the treatment of cancer. Integrative oncology utilizes not only the conventional therapies discussed above, but also untraditional therapies such as acupuncture, massage, and reflexology to assist the patient in managing pain, anxiety, and restlessness. Patients battling pleural mesothelioma have effectively utilized alternative therapies like these to increase the effectiveness of their treatment program overall. Generally, patients who are able to withstand the difficult side-effects of more potent chemotherapy and radiation treatments will be best able to extend their prognosis. Patients of pleural mesothelioma who have utilized alternative therapies have been able to do just that. However, most of these therapies are preferential and will depend on the health of the patient as to whether or not they will be able to engage in them. As with any treatment, patients should seek the consultation of their oncologist or cancer specialist before engaging in any alternative therapy.

What Causes Pleural Mesothelioma?

Pleural mesothelioma is known only be caused by exposure to asbestos. Asbestos is a naturally occurring and microscopic mineral that was used for hundreds of years in a number of different industrial compounds. Asbestos fibers are extremely durable, but also extremely difficult to expel from the body once introduced to the internal tissue.

Upon inhalation, asbestos fibers will lodge on the outer layers of the lung tissue and within the pleura, a thin membrane of mesothelial cells which lines the chest cavity. This lining allows for the free movement of the body’s internal body structures because it provides a special lubrication to the surface of these structures. The pleura, like other mesothelial membranes, is a delicate structure and microscopic asbestos fibers can cause pleural plaques to form on its surface. Pleural plaques may eventually develop into pleural mesothelioma tumor cells. Generally, it takes many years between asbestos exposure and the development of adverse health complications, as the fibers will slowly irritate and inflame the internal tissue over time until symptoms appear.

Many of those exposed to asbestos have successfully received compensation from asbestos product manufacturers for injuries and illnesses such as pleural mesothelioma. If you believe you were wrongfully exposed to asbestos and have developed an asbestos-related health complication, we urge you to complete the brief form on this page. We’ll rush you a complimentary mesothelioma and asbestos exposure information packet detailing advancements in the treatment of pleural mesothelioma, top doctors and cancer centers, and mesothelioma attorney options you may have.

Don't Let Time Get in the Way!

Don't let time prevent you from taking legal action if you have been diagnosed with malignant pleural mesothelioma as a result of asbestos exposure. Every state establishes set timeframes for filing lawsuits for an asbestos related injury. These timeframes are also known as the state statutes of limitation. The deadlines established in the statutes are fixed so it is important to consult with a legal professional soon after the onset of an asbestos related illness to determine what, if any action may be appropriate.

Source

American Cancer Society - Detailed Guide: Malignant Mesothelioma - What Is Malignant Mesothelioma?
(http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_malignant_mesothelioma_29.asp)

D. G. West and W. S. Walker. Staging malignant pleural mesothelioma: additional investigation may not improve accuracy

European Journal of Cardiothoracic. Surgery., May 1, 2011; 39(5): 800 - 800.

De Perrot M, Uy K, Anraku M, Tsao MS, Darling G, Waddell TK, Pierre AF, Bezjak A, Keshavjee S, Johnston MR. Impact of lymph node metastases on outcome after extrapleural pneumonectomy for malignant pleural meso-thelioma. J Thorac Cardiovasc Surg 2007;133(1):111—6.

Ismail-Khan, Roohi. Robinson, Lary D. Malignant Pleural Mesothelioma: A Comprehensive Overview. Cancer Control: Journal of the Moffit Cancer Center. 2006; 13(4):255-263.

Read More

Malignant Mesothelioma

Malignant Mesothelioma is a rare form of cancer that affects the thin cell wall lining of the body's internal organs and structures. This lining is known as the mesothelium. Malignant mesothelioma has three known varieties. They are malignant pleural mesothelioma, malignant pericardial mesothelioma, and malignant peritoneal mesothelioma. Pleural mesothelioma occurs in the pleura, the lung's lining. Peritoneal mesothelioma occurs in the peritoneum, the abdominal cavity wall. And pericardial mesothelioma occurs in the lining of the hearth, known as the pericardium.

Get This Image For Your Site

What Causes Malignant Mesothelioma?

Mesothelioma is known only to be caused by asbestos exposure. Asbestos is a nature, yet toxic mineral that was used commonly in heavy industry. Microscopic asbestos fibers enter the body through the lung or ingestion. Once inside, the durable fibers are unable to be broken down or expelled by the body, causing a harmful inflammation and scarring of the mesothelium. This scarring lays the groundwork for malignant mesothelioma and other respiratory conditions, such as asbestosis.

There is a great deal of latency associated with asbestos exposure and the onset of mesothelioma. Often patients will not encounter mesothelioma symptoms until 30-50 years following exposure to asbestos. In many cases, those diagnosed with mesothelioma are not those who were directly exposed to asbestos in a jobsite setting. Spouses and children of those exposed to asbestos who frequently came into contact with the fibers on the clothing or person of those exposed have also developed malignant mesothelioma as a result.

How is Malignant Mesothelioma Treated?

Malignant mesothelioma prognosis is poor, as often the disease will be diagnosed in its later stages after symptoms have appeared. However, there are several treatment options for the management of the cancer. Among these are mesothelioma chemotherapy, radiation therapy, and surgical resection. Chemotherapeutic and radiation therapy methods are more likely but surgery is often an option for those whose disease is diagnosed early enough.

More aggressive therapies are now possible for patients with mesothelioma diagnosed in its earlier stages. For instance, extrapleural pneumonectomy is now possible in many pleural mesothelioma patients who are deemed eligible for aggressive surgery. Extrapleural pneumonectomy involves the removal of the entire affected lung, the pericardium, the pleura, and the diaphragm. This aggressive surgery is performed frequently in early stage mesothelioma patients by Dr. David Sugarbaker at the Brigham and Women's Hospital in Boston, MA.

Patient's who are eligible to receive an aggressive surgery, like an extrapleural pneumonectomy, will have a far more favorable prognosis than those diagnosed with advanced stage inoperable disease. However, there are treatment options for nearly all mesothelioma patients. Chemotherapy cocktails such as the use of Alimta® in conjunction with Cisplatin, as well as numerous other clinical trial being carried out give mesothelioma patients the ability to slow the advance of the disease and extend survival rates.

Malignant Pleural Mesothelioma

Malignant pleural mesothelioma is the most common type of mesothelioma and occurs in the mesothelial membrane surrounding the chest cavity and lungs. Pleural mesothelioma, because it is more common than other varieties of the malignancy, has had more research invested in it. Pleural mesothelioma represents approximately 70% of all mesothelioma diagnoses.

Malignant Peritoneal Mesothelioma

Malignant peritoneal mesothelioma is less common than pleural mesothelioma and represents approximately 15-20% of all mesothelioma diagnoses. Peritoneal mesothelioma occurs in the lining of the abdominal cavity in the membrane surrounding the organs of this region. Like pleural mesothelioma, peritoneal mesothelioma is known only to be caused by exposure to asbestos.

Malignant Pericardial Mesothelioma

Malignant pericardial mesothelioma is among the rarest of all known malignancies, and represents less than 10% of all mesothelioma diagnoses. Pericardial mesotheliomas occur within the mesothelial lining of the heart. Pericardial mesotheliomas, like those of pleural and peritoneal varieties, are associated with asbestos exposure. Pericardial mesotheliomas differ from the pleural variant in that they are known to occur in younger individuals. While surgery is seen as the preferred method of treatment, mobidity and mortality are almost certain given the region in which the tumor is located.

How is Malignant Mesothelioma diagnosed?

Malignant Mesothelioma will typically be suspected if the patient complains of chest pain, difficulty breathing, shortness of breath, chronic cough, or difficulty swallowing. While any of these could indicate mesothelioma, they are also associated with many other respiratory conditions so further diagnostic procedures are typically warranted before an accurate malignant mesothelioma diagnosis can be made. These may include imaging scans, such as computer topography or magnetic resonance imaging. A diagnostic biopsy is also required for cancer specialist to examine the behavior of these cells before a diagnosis is determined.

Misdiagnosis is not uncommon in patients of the malignant mesothelioma, because the disease's symptoms so closely resemble those of other related conditions, including lung cancer, and other respiratory ailments. For this reason those who are at high-risk of mesothelioma (including those with asbestos history) should consult with physicians and cancer centers well versed in the treatment and diagnosis of malignant mesothelioma.

What options do patients of Malignant Mesothelioma have?

Unfortunately, many of those diagnosed with malignant mesothelioma have incurred illness as a result of a negligent exposure to asbestos. It is now clear that many asbestos manufacturers were well aware of the hazards of asbestos and asbestos exposure. Hundreds of thousands of laborers and workers have been exposed in shipyards, power plants, factories, and other jobsites- thousands of which develop malignant mesothelioma each year.

Patients of malignant mesothelioma or any other asbestos related health complications should consult their physician regarding the many mesothelioma treatment options that are available.  Also, patients may be eligible for compensation if they were wrongfully exposed. All those seeking further information should fill out the brief contact form on this page to receive a mesothelioma and asbestos information packet detailing treatment and legal options.

Source

National Cancer Institute - Malignant Mesothelioma
http://www.cancer.gov/cancertopics/types/malignantmesothelioma

Read More

Mesothelioma Diagnosis

How do medical professionals diagnose mesothelioma?

If you believe that you may have mesothelioma, a qualified medical professional will use a variety of diagnostic tests and methods to confirm the presence of the disease.

The first step that mesothelioma doctors will take in evaluating an asbestos related disease is to obtain a full medical history to determine the level and severity of mesothelioma risk factors and presenting mesothelioma symptoms. This interview will consider among other things, where asbestos exposure occurred, the length of exposure and the amount of asbestos that you were exposed to.

In addition, he/she will perform a medical exam to look for signs and symptoms of various types of mesothelioma. For example, if pleural mesothelioma is suspected the doctor will look for fluid in the chest, peritoneal mesothelioma often shows fluid in the abdomen and pericardial mesothelioma presents with fluid in the area of the heart.

Diagnostic Tests

Imaging Scans

Diagnostic image tests like x-rays, CT scans and MRI's are useful in obtaining more information about the cancer including how far it is progressed. Each method provides another piece of information for your doctor to assist him/her in making an accurate diagnosis. Chest x-rays are used to identify abnormalities in the lungs including unusual thickening, mineral deposits and fluid in the chest area. CT scans are capable of providing images of the same location from many different angles. MRI technology uses magnetic fields rather than x-ray to provide additional views.

• PET Scan - Positron Emission Tomography, more commonly referred to as a PET scan, is a nuclear medicine diagnostic technique. Nuclear medicine involves introducing a small amount of radioactive material into the body (in this case, intravenously) to help doctors determine if the body is functioning properly. PET scans in mesothelioma patients are often used in conjunction with CT scans. PET scans can be particularly helpful in determining if the cancer has metastasized beyond its point of origin.
• CT Scan - A Computer Tomography scan or CT scan, as it is more often referred to, is a commonly utilized method for locating the tumor in the body and determining the extent of the disease. Doctors will often prescribe a CT scan if mesothelioma is suspected because it offers more detail than a traditional X-ray. The CT scan provides cross-sectional imaging of the internal body structures that can be reconstructed on a computer monitor.
• MRI - A magnetic resonance image, more commonly referred to as an MRI, is a noninvasive method used for diagnosing mesothelioma within the body. The MRI uses a magnetic field and radio frequency pulses, transmitting them to a computer. Traditional MRI equipment consists of a cylinder within which the patient lies. The MRI poses no risk for patients, though some find the enclosed spaces uncomfortable. These patients may request a mild sedative to allow them to remain still and calm during the procedure.
• X-Ray - An x-ray is a commonly utilized mechanism not only for cancer diagnosis but for many different respiratory abnormalities, including bronchitis and pneumonia. Nevertheless, given that the symptoms of these respiratory disorders closely mimic those of malignant mesothelioma, often a chest x-ray is the first imaging technique used in a mesothelioma diagnosis. X-rays are particularly adept at identifying the proliferation of fluid within the pleural cavity, a symptom of mesothelioma known as a pleural effusion. If effusion is detected in the pleural cavity, doctors will often prescribe a surgical biopsy to test the fluid for malignant mesothelioma cells.

Biopsies

A biopsy is an important diagnostic procedure recommended by doctors for patients presenting with signs and symptoms of mesothelioma that have a history of asbestos exposure. Fine needle aspiration (FNA) is the less invasive type of biopsy that can be performed. FNA biopsy may be done on a pleural-based solid lesion, or cancer-associated fluid may be extracted through a syringe and then tested for the presence of malignant cells. Upon determining the presence of malignant cells, cancer specialists will determine the cellular classification of the malignancy and if mesothelioma is, in fact, present. However, it is not uncommon for there to be no cancer cells in the fluid or an insufficient number to make a definitive diagnosis even when cancer is present.

• Needle Biopsy- The needle biopsy is considered the less invasive biopsy procedure. Commonly, a more substantial biopsy of cancer tissue is generally recommended for patients in whom mesothelioma is suspected, such as a core biopsy. This may be done as a CT-guided biopsy from outside of the chest, or sometimes a small lung surgery such as a video-assisted thoracoscopic surgery (VATS), in which a surgeon uses small surgical tools with cameras and biopsy equipment to look inside the chest along the pleural surface (pleuroscopy) with a minimally invasive approach. It is often helpful and sometimes necessary for a surgeon to do a VATS and directly biopsy suspicious nodules in order to establish the diagnosis
• Surgical Biopsy - A surgical biopsy is a far more extensive procedure than needle biopsy. Nevertheless, these procedures are sometimes necessary to make a conclusive diagnosis of mesothelioma. Surgical biopsy can be particularly useful once a diagnosis has already been established. Once cancer is effectively staged, treatment recommendations can be made based on the best possible scenario for each individual patient’s circumstances.

Read More

Mesothelioma Risk Factors

What are the risk factors for malignant mesothelioma?

There are several risk factors that increase the likelihood that a person will develop mesothelioma. The primary risk factor is asbestos exposure. Exposure to this very harmful substance can significantly enhance the chances of contracting the disease. Smoking does not have a direct causal relationship with mesothelioma but is a significant compounding factor and increases the chances of developing the disease. Other less common secondary factors include exposure to radiation, zeolite, simian virus 40 (SV40) and erionite. We discuss each of these risk factors in more detail below. Please click on the links to learn more about each mesothelioma risk factor.

Exposure to Asbestos

Exposure to asbestos is the leading risk factor associated with mesothelioma. Asbestos is an insulating material comprised of magnesium-silicate mineral fibers. It was favored by builders and contractors for many years for its low heat conductivity and resistance to melting and burning. Since researchers have identified more and more links between mesothelioma and exposure to asbestos, the material is now less widely used. Prior to this discovery, however, millions of Americans have experienced serious exposure to this harmful substance.

Smoking and Mesothelioma

Smoking alone is not linked to mesothelioma, but smokers who are exposed to asbestos have a much higher chance of developing asbestos lung cancer (as much as fifty to ninety percent higher) and as much as double the risk of developing mesothelioma.

Less Common Mesothelioma Risk Factors

Radiation

Thorium dioxide (Thorotrast), a substance used in x-ray tests in the past has reported links to pleural mesothelioma and peritoneal mesothelioma. The use of Thorotrast has been discontinued for many years due to this discovery.

Zeolite

Some mesothelioma cases in the Anatoli region within Turkey have been linked to Zeolite, a silica based mineral with chemical properties similar to asbestos found in the soil there.

Simian Virus 40 (SV40)

Some scientists have found the simian virus 40 (SV30) in mesothelioma cells from humans and have been able to create mesothelioma in animals with the virus. The relationship between this virus and mesothelioma is still unclear, however, and further research is being conducted to gain clarity on this potential link.

Erionite Exposure

Erionite is a naturally occurring mineral that possesses properties that are very similar to those of asbestos. There have been several documented cases of mesothelioma in indivuduals living near large erionite deposits.

Carbon Nanotubes

Researchers continue to evaluate nanotube exposure as a possible risk factor for mesothelioma even though scientists have not expressed immediate concern.

Source

National Cancer Institute - Fact Sheets: Risk Factors and Possible Causes
http://www.cancer.gov/cancertopics/factsheet/Risk

Read More

Mesothelium

The mesothelium is a membrane that forms the lining of several body cavities: the pleura (thoracic cavity), peritoneum (abdominal cavity including the mesentery) and pericardium (heart sac). Mesothelial tissue also surrounds the male internal reproductive organs (the tunica vaginalis testis) and covers the internal reproductive organs of women (the tunica serosa uteri). Mesothelium that covers the internal organs is called visceral mesothelium, while the layer that covers the body walls is called the parietal mesothelium.
It is a form of simple squamous epithelium.^[1]

Contents

• 1 Origin
• 2 Structure
• 3 Function
• 4 Role in disease
• 5 References
• 6 External links

Origin

Mesothelium derives from the embryonic mesoderm cell layer, that lines the coelom (body cavity) in the embryo. It develops into the layer of cells that covers and protects most of the internal organs of the body.

Structure

The mesothelium forms a monolayer of flattened squamous-like epithelial cells resting on a thin basement membrane supported by dense irregular connective tissue. Cuboidal mesothelial cells may be found at areas of injury, the milky spots of the omentum, and the peritoneal side of the diaphragm overlaying the lymphatic lacunae. The luminal surface is covered with microvilli. The proteins and serosal fluid trapped by the microvilli provide a frictionless surface for internal organs to slide past one another.

Function

The mesothelium is composed of an extensive monolayer of specialized cells (mesothelial cells) that line the body's serous cavities and internal organs. The main purpose of these cells is to produce a lubricating fluid that is released between layers,^[2] providing a slippery, non-adhesive, and protective surface to facilitate intracoelomic movement.
The mesothelium is also implicated in the transport and movement of fluid and particulate matter across the serosal cavities, leukocyte migration in response to inflammatory mediators, synthesis of pro-inflammatory cytokines, growth factors, and extracellular matrix proteins to aid in serosal repair, and the release of factors to promote the disposition and clearance of fibrin (such as plasminogen). Mesothelial cells are capable of phagocytosis and are antigen presenting cells. Furthermore, the secretion of glycosaminoglycans and lubricants may protect the body against infection and tumor dissemination.

Role in disease

• Mesothelioma: (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum. More than 90% of mesothelioma cases are linked to asbestos exposure.

• Intra-abdominal adhesions: Normally, the mesothelium secretes plasminogen, which removes fibrin deposits. During surgical procedures, the mesothelium may be damaged. Its fibrinolytic capacity becomes insufficient and fibrin accumulates, causing fibrous adhesions between opposing surfaces. These adhesions cause intestinal obstruction and female infertility if it occurs in the abdomen, and may impair cardiac and lung function in the thorax.

• Ultrafiltration failure: The peritoneal mesothelium is implicated in the long-term development of ultrafiltration failure in peritoneal dialysis patients. The presence of supra-physiological glucose concentrations, acidity, and glucose degradation products in peritoneal dialysis fluids contribute to the fibrosis of the peritoneal mesothelium, either by epithelial-mesenchymal transition or increased proliferation of existing fibroblasts. A fibrosed peritoneum results in the increased passage of solutes across the peritoneum and ultrafiltration failure.

References

1. Jump up ^ Victor P. Eroschenko (2008). Di Fiore's atlas of histology with functional correlations. Lippincott Williams & Wilkins. pp. 31–. ISBN 978-0-7817-7057-6. Retrieved 28 May 2011.
2. Jump up ^ Leopold G. Koss; Myron R. Melamed (2006). Koss' diagnostic cytology and its histopathologic bases. Lippincott Williams & Wilkins. pp. 124–. ISBN 978-0-7817-1928-5. Retrieved 28 May 2011.

External links

• Mesothelioma: Questions and Answers (National Cancer Institute).
• Histology at KUMC epithel-epith01 "Mesothelium"
• BU Histology Learning System: 00102loa - "Tissues, Layers, and Organs: transverse section of rat gut"
• Mesothelium and mesothelioma news blog

Read More