We're always providing new and informative resources regarding mesothelioma treatment including: Clinical Trials, Conventional Treatments, Experimental Treatments, and more. Check back often for the most recent advances in mesothelioma treatments.
Despite Onconase Trial Results Quintessence Moves Ahead
In an article posted in this column a few weeks ago, it was reported that researchers at Madison-based Quintessence Bioscience were waiting for the results of a Phase IIIb clinical trial from Alfacell Corp., a significant East Coast competitor, on an anti-cancer therapeutic compound, Onconase. QBI-139, Quintessence's lead drug candidate, is very similar to Onconase but has not yet gone through clinical testing. - 6/6/08
A Case Report: Malignant Mesothelioma with Unexpected Contralateral Mediastinal Shift
An unusual clinical feature of mesothelioma is the presentation of contralateral mediastinal shift due to pleural mesothelioma tissue, rather than a pleural effusion. - 5/1/08
Heated Intraoperative Intraperitoneal Chemotherapy Developed by Renowned Surgeon
Dr. Paul Sugarbaker, renowned oncologic surgeon specializing in mesothelioma at the Washington Cancer Institute, developed a leading-edge surgical procedure to treat mesothelioma called heated intraoperative intraperitoneal chemotherapy. - 4/29/08.
Monday, December 8, 2008
Recent reports
reports show that an estimated 2,500 to 3,000 new cases per year of mesothelioma are diagnosed in the United States each year. Although mesothlioma is relatively uncommon, projections show that its incidence is expected to rise over the next decade.
The first diagnosis of mesothelioma on average occurs between 50 - 70 years of age. Mesothlioma affects men more often than women mostly dues to increased occupational exposure. The disease is also less common in African Americans than it is in white Americans.
As mesothelioma is disease that is difficult to detect in its early stages, often the disease is advanced at its first diagnosis. Accordingly, the average survival period using current treament protocols is a little over one year. When fortunate enough to find the cancer early and treat it aggressively, chances increase significantly of reaching the two year survival point. Approximately 20% or patients diagnosed with mesothelioma are able to achieve a five year survival rate.
Those who live at least five years after their cancer is diagnosed have a good chance to continue living a productive life for many additional years. As treatment therapies continue to advance for mesothelioma, we can expect survival rates to continue to improve as well for those recently diagnosed.
If you have any questions regarding your legal rights, please contact us.
Malignant mesothelioma is an uncommon form of cancer and of all asbestos related diseases, the most serious. The symptoms associated with the disease make it difficult for doctors to diagnose. Often, by the time that a proper diagnosis is made, the disease has progressed to a point where patients do not respond well to treatment therapy. Malignant mesothelioma is caused almost exclusively by the inhalation of airborne asbestos particles. Another unique factor associated with the disease is that there can be a long latency period between the time an individual is exposed to asbestos and the actual manifestation of the disease in the form of malignant mesothelioma.
Pleural Mesothelioma – affects the chest and lungs
Malignant pleural mesothelioma often originates within the chest cavity and can, at times, involve the lung. This particular form of mesothelioma can metastasize to numerous organs in the body – even the brain - and tends to do so more frequently than not.
Pleural mesothelioma is not always easily detectable. Frequently, in the early stages of the disease, symptoms may be mild. Patients usually report pain in one area of the chest that never seems to go away, weight loss and fever. Occasionally, other symptoms are more severe and include problems with breathing due to fluid build up in the chest. A CT Scan of the chest area has proven to be the best test for identifying how far along the disease has progressed.
Frequently serum markers are used to diagnose of various forms of cancer. Mesothelioma cannot be diagnosed using this method as no serum markers currently exist. If high levels of hyaluronic acid are present it may be possible to distinguish mesothelioma from other types of cancer or to determine the effectiveness of a treatment protocol.
The survival rate for patients diagnosed with pleural mesothelioma typically is not high. Patients typically do not live beyond seventeen months from the onset of symptoms. Only 8% of those diagnosed with mesothelioma will live three to five years from the onset of symptoms.
Peritoneal Mesothelioma – affects the abdomen
Peritoneal mesothelioma originates in the abdomen and will frequently spread to other organs in area including the liver, spleen or bowel. Severe abdominal pain is the most common complaint that patients present to their doctor. There may also be a discomfort level with fluid build up in the abdomen as well. Other symptoms of peritoneal mesothelioma may include difficult bowel movements, nausea and vomiting, fever and swollen feet.
The survival rate is even worse for those diagnosed with peritoneal mesothelioma will patients typically surviving only ten months from time that they first started experiencing the symptoms noted above.
Pericardial Mesothelioma – affects the heart
Pericardial mesothelioma is the least common form of mesothelioma. Pericardial mesothelioma, as the name suggests, involves the heart. This rare type of mesothelioma invades the pericardium, the sac that surrounds the heart. As the cancer progresses, the heart is not able to deliver oxygen as efficiently to the body causing further decline in health at an increasingly rapid rate. The symptoms most commonly associated with pericardial mesothelioma mimic those of a heart attack: nausea, pain in the chest and shortness of breath.
Benign Mesothelioma – affects the peritoneum
Cystic mesothelioma primarily affects women of younger age and affects the peritoneum. This type of mesothelioma is not frequently diagnosed and is also not a malignant form of the disease. It is, however, extremely difficult to identify and requires specialized microscopes and immunologic techniques to aid in diagnosis.
Mesothelioma in Uncommon Sites
A form of cardiac cancer that is rarely seen involves the pericardium. Tumors associated with this type of mesothelioma are not easily detectable and patients presented with this diagnosis tend to have a very low survival rate. There have also been reports of mesothelioma involving ovaries in women and the scrotum in men. Treatment for all of these rare forms of mesothelioma will vary depending on what stage a patient has progressed to but in most all cases the projected outcome is not favorable.
If you have any questions regarding your legal rights, please contact us.
The first diagnosis of mesothelioma on average occurs between 50 - 70 years of age. Mesothlioma affects men more often than women mostly dues to increased occupational exposure. The disease is also less common in African Americans than it is in white Americans.
As mesothelioma is disease that is difficult to detect in its early stages, often the disease is advanced at its first diagnosis. Accordingly, the average survival period using current treament protocols is a little over one year. When fortunate enough to find the cancer early and treat it aggressively, chances increase significantly of reaching the two year survival point. Approximately 20% or patients diagnosed with mesothelioma are able to achieve a five year survival rate.
Those who live at least five years after their cancer is diagnosed have a good chance to continue living a productive life for many additional years. As treatment therapies continue to advance for mesothelioma, we can expect survival rates to continue to improve as well for those recently diagnosed.
If you have any questions regarding your legal rights, please contact us.
Malignant mesothelioma is an uncommon form of cancer and of all asbestos related diseases, the most serious. The symptoms associated with the disease make it difficult for doctors to diagnose. Often, by the time that a proper diagnosis is made, the disease has progressed to a point where patients do not respond well to treatment therapy. Malignant mesothelioma is caused almost exclusively by the inhalation of airborne asbestos particles. Another unique factor associated with the disease is that there can be a long latency period between the time an individual is exposed to asbestos and the actual manifestation of the disease in the form of malignant mesothelioma.
Pleural Mesothelioma – affects the chest and lungs
Malignant pleural mesothelioma often originates within the chest cavity and can, at times, involve the lung. This particular form of mesothelioma can metastasize to numerous organs in the body – even the brain - and tends to do so more frequently than not.
Pleural mesothelioma is not always easily detectable. Frequently, in the early stages of the disease, symptoms may be mild. Patients usually report pain in one area of the chest that never seems to go away, weight loss and fever. Occasionally, other symptoms are more severe and include problems with breathing due to fluid build up in the chest. A CT Scan of the chest area has proven to be the best test for identifying how far along the disease has progressed.
Frequently serum markers are used to diagnose of various forms of cancer. Mesothelioma cannot be diagnosed using this method as no serum markers currently exist. If high levels of hyaluronic acid are present it may be possible to distinguish mesothelioma from other types of cancer or to determine the effectiveness of a treatment protocol.
The survival rate for patients diagnosed with pleural mesothelioma typically is not high. Patients typically do not live beyond seventeen months from the onset of symptoms. Only 8% of those diagnosed with mesothelioma will live three to five years from the onset of symptoms.
Peritoneal Mesothelioma – affects the abdomen
Peritoneal mesothelioma originates in the abdomen and will frequently spread to other organs in area including the liver, spleen or bowel. Severe abdominal pain is the most common complaint that patients present to their doctor. There may also be a discomfort level with fluid build up in the abdomen as well. Other symptoms of peritoneal mesothelioma may include difficult bowel movements, nausea and vomiting, fever and swollen feet.
The survival rate is even worse for those diagnosed with peritoneal mesothelioma will patients typically surviving only ten months from time that they first started experiencing the symptoms noted above.
Pericardial Mesothelioma – affects the heart
Pericardial mesothelioma is the least common form of mesothelioma. Pericardial mesothelioma, as the name suggests, involves the heart. This rare type of mesothelioma invades the pericardium, the sac that surrounds the heart. As the cancer progresses, the heart is not able to deliver oxygen as efficiently to the body causing further decline in health at an increasingly rapid rate. The symptoms most commonly associated with pericardial mesothelioma mimic those of a heart attack: nausea, pain in the chest and shortness of breath.
Benign Mesothelioma – affects the peritoneum
Cystic mesothelioma primarily affects women of younger age and affects the peritoneum. This type of mesothelioma is not frequently diagnosed and is also not a malignant form of the disease. It is, however, extremely difficult to identify and requires specialized microscopes and immunologic techniques to aid in diagnosis.
Mesothelioma in Uncommon Sites
A form of cardiac cancer that is rarely seen involves the pericardium. Tumors associated with this type of mesothelioma are not easily detectable and patients presented with this diagnosis tend to have a very low survival rate. There have also been reports of mesothelioma involving ovaries in women and the scrotum in men. Treatment for all of these rare forms of mesothelioma will vary depending on what stage a patient has progressed to but in most all cases the projected outcome is not favorable.
If you have any questions regarding your legal rights, please contact us.
different types of mesothelioma?
Malignant mesothelioma is an uncommon form of cancer and of all asbestos related diseases, the most serious. The symptoms associated with the disease make it difficult for doctors to diagnose. Often, by the time that a proper diagnosis is made, the disease has progressed to a point where patients do not respond well to treatment therapy. Malignant mesothelioma is caused almost exclusively by the inhalation of airborne asbestos particles. Another unique factor associated with the disease is that there can be a long latency period between the time an individual is exposed to asbestos and the actual manifestation of the disease in the form of malignant mesothelioma.
Pleural Mesothelioma – affects the chest and lungs
Malignant pleural mesothelioma often originates within the chest cavity and can, at times, involve the lung. This particular form of mesothelioma can metastasize to numerous organs in the body – even the brain - and tends to do so more frequently than not.
Pleural mesothelioma is not always easily detectable. Frequently, in the early stages of the disease, symptoms may be mild. Patients usually report pain in one area of the chest that never seems to go away, weight loss and fever. Occasionally, other symptoms are more severe and include problems with breathing due to fluid build up in the chest. A CT Scan of the chest area has proven to be the best test for identifying how far along the disease has progressed.
Frequently serum markers are used to diagnose of various forms of cancer. Mesothelioma cannot be diagnosed using this method as no serum markers currently exist. If high levels of hyaluronic acid are present it may be possible to distinguish mesothelioma from other types of cancer or to determine the effectiveness of a treatment protocol.
The survival rate for patients diagnosed with pleural mesothelioma typically is not high. Patients typically do not live beyond seventeen months from the onset of symptoms. Only 8% of those diagnosed with mesothelioma will live three to five years from the onset of symptoms.
Peritoneal Mesothelioma – affects the abdomen
Peritoneal mesothelioma originates in the abdomen and will frequently spread to other organs in area including the liver, spleen or bowel. Severe abdominal pain is the most common complaint that patients present to their doctor. There may also be a discomfort level with fluid build up in the abdomen as well. Other symptoms of peritoneal mesothelioma may include difficult bowel movements, nausea and vomiting, fever and swollen feet.
The survival rate is even worse for those diagnosed with peritoneal mesothelioma will patients typically surviving only ten months from time that they first started experiencing the symptoms noted above.
Pericardial Mesothelioma – affects the heart
Pericardial mesothelioma is the least common form of mesothelioma. Pericardial mesothelioma, as the name suggests, involves the heart. This rare type of mesothelioma invades the pericardium, the sac that surrounds the heart. As the cancer progresses, the heart is not able to deliver oxygen as efficiently to the body causing further decline in health at an increasingly rapid rate. The symptoms most commonly associated with pericardial mesothelioma mimic those of a heart attack: nausea, pain in the chest and shortness of breath.
Benign Mesothelioma – affects the peritoneum
Cystic mesothelioma primarily affects women of younger age and affects the peritoneum. This type of mesothelioma is not frequently diagnosed and is also not a malignant form of the disease. It is, however, extremely difficult to identify and requires specialized microscopes and immunologic techniques to aid in diagnosis.
Mesothelioma in Uncommon Sites
A form of cardiac cancer that is rarely seen involves the pericardium. Tumors associated with this type of mesothelioma are not easily detectable and patients presented with this diagnosis tend to have a very low survival rate. There have also been reports of mesothelioma involving ovaries in women and the scrotum in men. Treatment for all of these rare forms of mesothelioma will vary depending on what stage a patient has progressed to but in most all cases the projected outcome is not favorable.
If you have any questions regarding your legal rights, please contact us.
Pleural Mesothelioma – affects the chest and lungs
Malignant pleural mesothelioma often originates within the chest cavity and can, at times, involve the lung. This particular form of mesothelioma can metastasize to numerous organs in the body – even the brain - and tends to do so more frequently than not.
Pleural mesothelioma is not always easily detectable. Frequently, in the early stages of the disease, symptoms may be mild. Patients usually report pain in one area of the chest that never seems to go away, weight loss and fever. Occasionally, other symptoms are more severe and include problems with breathing due to fluid build up in the chest. A CT Scan of the chest area has proven to be the best test for identifying how far along the disease has progressed.
Frequently serum markers are used to diagnose of various forms of cancer. Mesothelioma cannot be diagnosed using this method as no serum markers currently exist. If high levels of hyaluronic acid are present it may be possible to distinguish mesothelioma from other types of cancer or to determine the effectiveness of a treatment protocol.
The survival rate for patients diagnosed with pleural mesothelioma typically is not high. Patients typically do not live beyond seventeen months from the onset of symptoms. Only 8% of those diagnosed with mesothelioma will live three to five years from the onset of symptoms.
Peritoneal Mesothelioma – affects the abdomen
Peritoneal mesothelioma originates in the abdomen and will frequently spread to other organs in area including the liver, spleen or bowel. Severe abdominal pain is the most common complaint that patients present to their doctor. There may also be a discomfort level with fluid build up in the abdomen as well. Other symptoms of peritoneal mesothelioma may include difficult bowel movements, nausea and vomiting, fever and swollen feet.
The survival rate is even worse for those diagnosed with peritoneal mesothelioma will patients typically surviving only ten months from time that they first started experiencing the symptoms noted above.
Pericardial Mesothelioma – affects the heart
Pericardial mesothelioma is the least common form of mesothelioma. Pericardial mesothelioma, as the name suggests, involves the heart. This rare type of mesothelioma invades the pericardium, the sac that surrounds the heart. As the cancer progresses, the heart is not able to deliver oxygen as efficiently to the body causing further decline in health at an increasingly rapid rate. The symptoms most commonly associated with pericardial mesothelioma mimic those of a heart attack: nausea, pain in the chest and shortness of breath.
Benign Mesothelioma – affects the peritoneum
Cystic mesothelioma primarily affects women of younger age and affects the peritoneum. This type of mesothelioma is not frequently diagnosed and is also not a malignant form of the disease. It is, however, extremely difficult to identify and requires specialized microscopes and immunologic techniques to aid in diagnosis.
Mesothelioma in Uncommon Sites
A form of cardiac cancer that is rarely seen involves the pericardium. Tumors associated with this type of mesothelioma are not easily detectable and patients presented with this diagnosis tend to have a very low survival rate. There have also been reports of mesothelioma involving ovaries in women and the scrotum in men. Treatment for all of these rare forms of mesothelioma will vary depending on what stage a patient has progressed to but in most all cases the projected outcome is not favorable.
If you have any questions regarding your legal rights, please contact us.
Mesothelioma risk Factors
What are the idents.
The chance of developing mesothelioma is in direct proportion to the duration and amount of asbestos exposure that an individual sustains. Those who are exposed to high levels of asbestos at a young age, for long periods of time have a greater risk of being diagnosed with mesothelioma than those who have short, low level exposure. Another important consideration is that Mesothelioma can take a long time to manifest. Often, twenty to forty years can elapse from the time of exposure to diagnosis. Genetic factors can also play a role which explains why not everyone exposed to asbestos develops and asbestos related disease.
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.
Tobacco
Smoking alone is not linked to mesothelioma, but smokers who are exposed to asbestos have a much higher chance of developing lung cancer (as much as fifty to ninety percent higher). Research indicates that lung cancer is the leading cause of death among asbestos workers.
If you have any questions regarding your legal rights, please contact us.
The chance of developing mesothelioma is in direct proportion to the duration and amount of asbestos exposure that an individual sustains. Those who are exposed to high levels of asbestos at a young age, for long periods of time have a greater risk of being diagnosed with mesothelioma than those who have short, low level exposure. Another important consideration is that Mesothelioma can take a long time to manifest. Often, twenty to forty years can elapse from the time of exposure to diagnosis. Genetic factors can also play a role which explains why not everyone exposed to asbestos develops and asbestos related disease.
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.
Tobacco
Smoking alone is not linked to mesothelioma, but smokers who are exposed to asbestos have a much higher chance of developing lung cancer (as much as fifty to ninety percent higher). Research indicates that lung cancer is the leading cause of death among asbestos workers.
If you have any questions regarding your legal rights, please contact us.
risk factors for malignant mesothelioma? There are several risk factors that increase the likelihood that a person will develop mesothelioma. The pri
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. Other secondary factors include exposure to radiation, zeolite, simian virus 40 (SV40) and tobacco. We discuss each of these risk factors in more detail below.
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.
Over 700,000 schools and buildings in the United States today contain asbestos insulation as reported by the US Environmental Protection Agency. Asbestos exposure doesn’t stop there, however. Asbestos is often found in ship yards, manufacturing facilities, railway facilities and construction sites. Blue collar workers are at the highest risk for developing mesothelioma due to occupational exposure and include those who work in mines, factories, shipyards, construction sites, railroads and for insulation manufacturers and gas mask manufacturers. The occupations most widely affected are miners, factory workers, railroad workers, ship builders and construction workers - especially those who install asbestos containing insulation. Sometimes family members related to the workers receive second hand exposure to asbestos from the dust and fibers that were brought home on the workers clothes and also become at risk for contracting mesothelioma.
Serpentine fibers and amphiboles are the 2 primary types of asbestos used. Chrysotile is a form of serpentine fiber and the most frequently used. These fibers tend to be curly and flexible. Amphibole fibers, however, are generally straight and thin and usually comprise one of five types: crocidolite, amosite, anthrophylite, tremolite, and actinolyte. The crocidolite type of Amphiboles is thought to be the leading contributor to cancer caused by asbestos. Serpentine fibers are dangerous as well, however, and have also been linked to mesothelioma.
Some research points to the fact that inhaled asbestos fibers cause a physical irritation resulting in cancer rather than the cancer being caused by a reaction that is more chemical in nature. As fibers are inhaled through the mouth and nose they are cleared from the body by adhering to mucus in the nose, throat and airways and then get expelled by coughing or swallowing. The Amphibole fibers (long and thin) do not clear as easily and it is therefore thought that they can embed into the lining of the lungs and chest and result in mesothelioma.
Asbestosis (scar tissue in the lungs) or lung cancer can also be caused by the inhalation of asbestos fibers. In fact, people exposed to asbestos are seven times more likely to develop lung cancer over the general public. Workers who sustain high levels of asbestos exposure are more likely to die from asbestosis, lung cancer or mesothelioma than any other disease. It is also believed that the action of coughing up and swallowing asbestos could contribute to a form of mesothelioma originating in the abdomen called peritoneal mesothelioma. Mesothelioma has been found to exist in other organs of the body as well such as the larynx, pancreas and colon, but those instances are extremely limited compared to lung cancer inc
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. Other secondary factors include exposure to radiation, zeolite, simian virus 40 (SV40) and tobacco. We discuss each of these risk factors in more detail below.
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.
Over 700,000 schools and buildings in the United States today contain asbestos insulation as reported by the US Environmental Protection Agency. Asbestos exposure doesn’t stop there, however. Asbestos is often found in ship yards, manufacturing facilities, railway facilities and construction sites. Blue collar workers are at the highest risk for developing mesothelioma due to occupational exposure and include those who work in mines, factories, shipyards, construction sites, railroads and for insulation manufacturers and gas mask manufacturers. The occupations most widely affected are miners, factory workers, railroad workers, ship builders and construction workers - especially those who install asbestos containing insulation. Sometimes family members related to the workers receive second hand exposure to asbestos from the dust and fibers that were brought home on the workers clothes and also become at risk for contracting mesothelioma.
Serpentine fibers and amphiboles are the 2 primary types of asbestos used. Chrysotile is a form of serpentine fiber and the most frequently used. These fibers tend to be curly and flexible. Amphibole fibers, however, are generally straight and thin and usually comprise one of five types: crocidolite, amosite, anthrophylite, tremolite, and actinolyte. The crocidolite type of Amphiboles is thought to be the leading contributor to cancer caused by asbestos. Serpentine fibers are dangerous as well, however, and have also been linked to mesothelioma.
Some research points to the fact that inhaled asbestos fibers cause a physical irritation resulting in cancer rather than the cancer being caused by a reaction that is more chemical in nature. As fibers are inhaled through the mouth and nose they are cleared from the body by adhering to mucus in the nose, throat and airways and then get expelled by coughing or swallowing. The Amphibole fibers (long and thin) do not clear as easily and it is therefore thought that they can embed into the lining of the lungs and chest and result in mesothelioma.
Asbestosis (scar tissue in the lungs) or lung cancer can also be caused by the inhalation of asbestos fibers. In fact, people exposed to asbestos are seven times more likely to develop lung cancer over the general public. Workers who sustain high levels of asbestos exposure are more likely to die from asbestosis, lung cancer or mesothelioma than any other disease. It is also believed that the action of coughing up and swallowing asbestos could contribute to a form of mesothelioma originating in the abdomen called peritoneal mesothelioma. Mesothelioma has been found to exist in other organs of the body as well such as the larynx, pancreas and colon, but those instances are extremely limited compared to lung cancer inc
Mesothelioma Causes
What are the main causes of mesothelioma?
Mesothelioma is most predominantly caused by asbestos exposure. Asbestos fibers that are inhaled through the mouth and nose may eventually become embedded in the lining of the lungs, causing damage and resulting in lung cancer or asbestosis (scar tissue formation in the lungs). It has also been found that swallowing asbestos fibers could contribute to a form of mesothelioma originating in the abdomen called peritoneal mesothelioma.
Mesothelioma generally results from occupational exposure but there are instances of environmental exposure to asbestos that can cause the disease. Oftentimes second hand exposure of a family member to an asbestos workers dirty work clothes can result in that family member developing mesothelioma.
Asbestos insulation workers appear to have the highest death rate. One study reports that almost six percent of asbestos workers fall victim to mesothelioma and asbestos insulation workers are over 300 times more likely to die from mesothelioma than the general public.
Find out more about Nanotechnology.
If you have any questions regarding your legal rights, please contact us.
Mesothelioma is most predominantly caused by asbestos exposure. Asbestos fibers that are inhaled through the mouth and nose may eventually become embedded in the lining of the lungs, causing damage and resulting in lung cancer or asbestosis (scar tissue formation in the lungs). It has also been found that swallowing asbestos fibers could contribute to a form of mesothelioma originating in the abdomen called peritoneal mesothelioma.
Mesothelioma generally results from occupational exposure but there are instances of environmental exposure to asbestos that can cause the disease. Oftentimes second hand exposure of a family member to an asbestos workers dirty work clothes can result in that family member developing mesothelioma.
Asbestos insulation workers appear to have the highest death rate. One study reports that almost six percent of asbestos workers fall victim to mesothelioma and asbestos insulation workers are over 300 times more likely to die from mesothelioma than the general public.
Find out more about Nanotechnology.
If you have any questions regarding your legal rights, please contact us.
warning signs of mesothelioma
Mesothelioma is difficult to diagnose because the early signs and symptoms of the disease can be subtle at best. 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 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. Symptoms to also consider 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. In the event that there is a hernia present, fluid build up may occur in the abdomen as well.
Anyone previously exposed to asbestos displaying any of these symptoms should seek medical attention right away.
If you have any questions regarding your legal rights, please contact us.
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. Symptoms to also consider 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. In the event that there is a hernia present, fluid build up may occur in the abdomen as well.
Anyone previously exposed to asbestos displaying any of these symptoms should seek medical attention right away.
If you have any questions regarding your legal rights, please contact us.
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.
Medical history review and exam
The first step that your health professional will take in evaluating you for an asbestos related disease is to obtain a full medical history to determine the level and severity of risk factors and presenting symptoms. This interview will look consider among other things, where you were exposed to asbestos, 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 forms 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 imaging tests
Chest x-rays are used to identify abnormalities in the lungs including unusual thickening, mineral deposits and fluid in the chest area. If these conditions are present then it may be evidence that mesothelioma has developed.
Diagnostic image tests like x-rays, CT scans and MRI's are useful in determining more information about the cancer including how far it is progressed. Each method provides another piece of information to your doctor to assist in making an accurate diagnosis. 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.
Testing fluid and tissue samples
If fluid build-up in the chest, abdomen or heart area is present, your doctor may want to obtain a sample. To accomplish this he/she will use a long needle to obtain fluid from the target area. The fluid will then be sent to the lab for analysis.
If fluid build-up in the chest, abdomen or heart area is present, your doctor may want to obtain a sample. To accomplish this he/she will use a long needle to obtain fluid from the target area. The fluid will then be sent to the lab for analysis.
A bronchoscopy procedure may be recommended for patients who are suspected of having pleural mesothelioma. For this medical test, a soft tube illuminates the trachea and bronchi to determine if any masses are present in the airways. If deemed necessary, the technician my take sample of tissue that appears to be abnormal for further testing.
If lymph node involvement is suspected which is common with lung cancer, patients may also undergo a mediastinoscopy. This procedure is similar to a bronchoscopy in that a soft tube enters the body under the chest bone and illuminates the chest area. In this way, the surgeon can examine lymph nodes for abnormalities, check to see how far disease may have progressed and when necessary help diagnose lung cancer vs. mesothelioma.
Diagnosing mesothelioma is never easy. Fluid build up alone in the chest, belly or heart regions is not enough to confirm a diagnosis. Tissue samples obtained from biopsy procedures are also difficult to discern because mesothelioma cancer cells often resemble other types of cancer. For this reason, specialized laboratory procedures are often employed to identify certain chemicals that are known to exist with mesothelioma and high powered laboratory equipment is used to examine the smallest details of cancer cells to confirm that mesothelioma is present.
If you have any questions regarding your legal rights, please contact us.
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.
Medical history review and exam
The first step that your health professional will take in evaluating you for an asbestos related disease is to obtain a full medical history to determine the level and severity of risk factors and presenting symptoms. This interview will look consider among other things, where you were exposed to asbestos, 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 forms 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 imaging tests
Chest x-rays are used to identify abnormalities in the lungs including unusual thickening, mineral deposits and fluid in the chest area. If these conditions are present then it may be evidence that mesothelioma has developed.
Diagnostic image tests like x-rays, CT scans and MRI's are useful in determining more information about the cancer including how far it is progressed. Each method provides another piece of information to your doctor to assist in making an accurate diagnosis. 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.
Testing fluid and tissue samples
If fluid build-up in the chest, abdomen or heart area is present, your doctor may want to obtain a sample. To accomplish this he/she will use a long needle to obtain fluid from the target area. The fluid will then be sent to the lab for analysis.
If fluid build-up in the chest, abdomen or heart area is present, your doctor may want to obtain a sample. To accomplish this he/she will use a long needle to obtain fluid from the target area. The fluid will then be sent to the lab for analysis.
A bronchoscopy procedure may be recommended for patients who are suspected of having pleural mesothelioma. For this medical test, a soft tube illuminates the trachea and bronchi to determine if any masses are present in the airways. If deemed necessary, the technician my take sample of tissue that appears to be abnormal for further testing.
If lymph node involvement is suspected which is common with lung cancer, patients may also undergo a mediastinoscopy. This procedure is similar to a bronchoscopy in that a soft tube enters the body under the chest bone and illuminates the chest area. In this way, the surgeon can examine lymph nodes for abnormalities, check to see how far disease may have progressed and when necessary help diagnose lung cancer vs. mesothelioma.
Diagnosing mesothelioma is never easy. Fluid build up alone in the chest, belly or heart regions is not enough to confirm a diagnosis. Tissue samples obtained from biopsy procedures are also difficult to discern because mesothelioma cancer cells often resemble other types of cancer. For this reason, specialized laboratory procedures are often employed to identify certain chemicals that are known to exist with mesothelioma and high powered laboratory equipment is used to examine the smallest details of cancer cells to confirm that mesothelioma is present.
If you have any questions regarding your legal rights, please contact us.
Mesothelioma Stages
Malignant mesothelioma is the most serious of all asbestos-related diseases. Although uncommon, mesothelioma is no longer considered rare. Mesothelioma is a cancer that is particulary difficult for doctors to diagnose and one that does not respond well to therapy.
The chest cavity, abdominal cavity, and the cavity around the heart are surrounded by a a layer of specialized mesothelial cells. Most other internal organs are also covered by these cells. The tissue formed by these cells is called mesothelium.
A special protective lubricating fluid that allows organs to move around is produced by the mesothelium. This protective fluid helps the lungs to move without resistance inside the chest cavity while breathing. The medical name for the mesothelium of the chest is the pleura and the medical name for the mesothelium of the abdomen is the peritoneum. The mesothelium of the "sac-like" space around the heart is called the pericardium.
A malignant (cancerous) tumor of the mesothelium is called a malignant mesothelioma. As most mesothelial tumors are cancerous, malignant mesothelioma is often simply called mesothelioma. Tumors of the mesothelium can also be benign (noncancerous) but benign mesotheliomas are much more rare.
Mesothelioma was recognized as a tumor of the pleura, peritoneum and pericardium in the late 1700's. However it was not until much later, in 1960, that this particular type of tumor was described in more detail and even more importantly, its association with asbestos exposure was recognized. The first report linking mesothelioma to asbestos exposure was written by J.C.Wagner, and described 32 cases of workers in the "Asbestos Hills" in South Africa. Since than the relationship between mesothelioma and asbestos exposure has been confirmed in studies around the world.
The incidence of mesothelioma in the United States remains very low, with 14 cases occurring per million people per year. Despite these numbers the noticed threefold increase in mesothelioma in males between 1970 and 1984, is directly associated with environmental and occupational exposure to asbestos, mostly in areas of asbestos product plants and shipbuilding facilities.
Although the disease is much more commonly seen in 60-year old men, it has been described in women and early childhood as well. The cause of the disease is not so well understood in these latter two groups, but there is some evidence of possible asbestos exposure for some of these cases as well.
Malignant mesotheliomas are divided into three main types. About 50% to 70% of mesotheliomas are the epithelioid type. This type has the best prognosis (outlook for survival). The other two types are the sarcomatoid type (7%-20%), and the mixed/biphasic type (20%-35%). Treatment options for all three types are the same.
About three-fourths of mesotheliomas start in the chest cavity. They are known as pleural mesothelioma. Another 10% to 20% begin in the abdomen. These are called peritoneal mesothelioma. Pericardial mesothelioma, starts in the cavity around the heart, and is very rare. The covering layer of the testicles is actually an outpouching of peritoneum into the scrotum. Mesotheliomas that affect this covering of the testicles are quite rare.
Questions
- What are the key statistics about mesothelioma?
- What are the different types of mesothelioma?
- What are the risk factors for mesothelioma?
- What causes mesothelioma?
- What are the signs and symptoms of mesothelioma?
- How is mesothelioma diagnosed?
- How is mesothelioma staged?
- What treatments are available for mesothelioma?
Glossary of Terms
asbestos: combination of several minerals that separate into long, threadlike fibers. Because they do not burn, do not conduct heat or electricity, and are very resistant to chemicals, these minerals are often used for making fireproof materials, electrical insulation, roofing, filters, etc. benign: doing no harm, good incidence: the frequency with which an event occurs (usually in a group at risk) pericardium: a thin membrane surrounding the heart and the roots of the great blood vessels.
peritoneum: a thin membrane that covers the abdominal cavity and partially covers some of the abdominal organs.
pleura: a thin membrane that covers the lungs (visceral pleura) and lines the chest cavity (parietal pleura) malignant: harmful, dangerous (a malignant tumor is a cancer).
median: middle number in a series of numbers (for example: median survival of 10 months means that for that specific group of patients the survival varied from probably 2 months to 30 months).
mesoderm: the middle layer of cells in an embryo, from which the muscular, skeletal, vascular, connective etc. tissues develop.
mesothelioma: a tumor of the mesothelium, that can be benign (localized) or malignant (diffusely spread), and that is most commonly caused by the ingestion of asbestos particles.
mesothelium: the thin layer of mesodermal epithelial cells that forms the pleura, peritoneum, pericardium.
metastases: the spread of tumor cells from one part of the body to another unrelated part of the body by the way of the bloodstream or lymphatics.
prognosis: prediction of the probable course of the disease in an individual. Prognostic factors are factors associated with prognosis.
TNM staging: assigning a stage to the tumor based on size, local versus disseminated growth, lymph node involvement and presence or absence of distant metastases.
tumor: a mass of tissue, a growth independent of its surrounding structures and having no physiological function/ a neoplasm. A tumor can be benign or malignant.
Mesothelioma Treatment
For your convenience, we have consolidated mesothelioma treatment information for your review. This section is updated on a weekly basis.
Mesothelioma Alerts
Researchers have reported that combination resection, intraperitoneal chemotherapy, and whole abdominal radiation therapy is effective for treating malignant peritoneal mesothelioma. - 4/9/08
Stage 3 pure epithelial mesothelioma patients undergoing radical decortication/pleurectomy appear to have significantly better results than patients who have less extensive operations - 2/06/08
Some malignant mesothelioma patients may have a prognosis that's not as grim as once widely believed, said a Nordic collaborative group - 9/21/07
Pemetrexed combined with either cisplatin or carboplatin demonstrated activity in previously untreated malignant pleural mesothelioma - 6/6/2007
Chemo Combination Improves Survival in Asbestos Cancer - 2/8/2007
Conventional Therapies
Conventional mesothelioma therapies include surgery, radiation and chemotherapy. You should keep in mind that if you choose one course of action for mesothelioma treatment, you may preclude other courses. All of your options should be considered as soon as possible.
Experimental Therapies
Several forms of mesothelioma treatment such as the drug Alimta, gene therapy, immunotherapy, photodynamic therapy and multimodality therapy are still in their experimental stages. We invite you to read the following articles on experimental therapies for Malignant Mesothelioma.
Mesothelioma Clinical Trials
Information about current studies of promising new or experimental mesothelioma treatments.
Mesothelioma Treatment by Stage
This section lists typical treatment strategies based on the stage (using the Butchart staging system) of a pleural mesothelioma.
Questions to Ask your Doctor
As you deal with your cancer and the process of treatment, you need to have honest, open discussions with your cancer care team. We have listed some questions that you might want to ask in this section.
Cancer Centers
Top Cancer Centers for mesothelioma treatment have been listed alphabetically by state for your convenience. Listings include contact information and Web site links where available.
Leading Mesothelioma Physicians
We have become familiar with medical doctors who specialize in aggressively treating malignant mesothelioma. Some of these doctors will review your medical records for free to see if you are a candidate for their mesothelioma treatment protocol.
Mesothelioma Articles & Abstracts
Selected abstracts relating to malignant mesothelioma from PubMed, the National Library of Medicine's search service.
Mesothelioma Resources
Links to helpful resources on the World Wide Web for victims of mesothelioma and their families.
If you have any questions regarding treatment options or your legal rights, please contact us.
Mesothelioma Alerts
Researchers have reported that combination resection, intraperitoneal chemotherapy, and whole abdominal radiation therapy is effective for treating malignant peritoneal mesothelioma. - 4/9/08
Stage 3 pure epithelial mesothelioma patients undergoing radical decortication/pleurectomy appear to have significantly better results than patients who have less extensive operations - 2/06/08
Some malignant mesothelioma patients may have a prognosis that's not as grim as once widely believed, said a Nordic collaborative group - 9/21/07
Pemetrexed combined with either cisplatin or carboplatin demonstrated activity in previously untreated malignant pleural mesothelioma - 6/6/2007
Chemo Combination Improves Survival in Asbestos Cancer - 2/8/2007
Conventional Therapies
Conventional mesothelioma therapies include surgery, radiation and chemotherapy. You should keep in mind that if you choose one course of action for mesothelioma treatment, you may preclude other courses. All of your options should be considered as soon as possible.
Experimental Therapies
Several forms of mesothelioma treatment such as the drug Alimta, gene therapy, immunotherapy, photodynamic therapy and multimodality therapy are still in their experimental stages. We invite you to read the following articles on experimental therapies for Malignant Mesothelioma.
Mesothelioma Clinical Trials
Information about current studies of promising new or experimental mesothelioma treatments.
Mesothelioma Treatment by Stage
This section lists typical treatment strategies based on the stage (using the Butchart staging system) of a pleural mesothelioma.
Questions to Ask your Doctor
As you deal with your cancer and the process of treatment, you need to have honest, open discussions with your cancer care team. We have listed some questions that you might want to ask in this section.
Cancer Centers
Top Cancer Centers for mesothelioma treatment have been listed alphabetically by state for your convenience. Listings include contact information and Web site links where available.
Leading Mesothelioma Physicians
We have become familiar with medical doctors who specialize in aggressively treating malignant mesothelioma. Some of these doctors will review your medical records for free to see if you are a candidate for their mesothelioma treatment protocol.
Mesothelioma Articles & Abstracts
Selected abstracts relating to malignant mesothelioma from PubMed, the National Library of Medicine's search service.
Mesothelioma Resources
Links to helpful resources on the World Wide Web for victims of mesothelioma and their families.
If you have any questions regarding treatment options or your legal rights, please contact us.
Were you exposed to asbestos?
Early, Ludwick, Sweeney & Strauss has consistently been at the top of the list in terms of per case settlement dollars obtained for its asbestos clients. We represent in excess of one thousand five hundred victims of asbestos disease in their cases against the asbestos industry. Hundreds of these victims suffer from mesothelioma and other asbestos cancers.
We are currently licensed to practice in: California, Connecticut, Illinois, Massachusetts, Missouri, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Washington D.C. Almost two decades of asbestos law experience has resulted in close working relationships with attorneys throughout the United States for the representation of individuals with mesothelioma.
We have dedicated extensive resources to gathering information and evidence against the asbestos industry. We will carefully explain your legal rights to you.
We will explain the multiple paths to follow to maximize your recovery against asbestos manufacturers and suppliers. We will discuss with you the options of law suits, out of court settlements, claims in the bankruptcy courts, and class action filings. We will seek to determine and advise you as to the best course of action in your case. In many cases we can obtain settlement offers from certain asbestos manufacturers within a few months of retention.
We urge you to consider our extensive database of medical information and product identification that dates back to the 1930's when choosing your legal representation.
Our Web site contains the most up-to-date information from the best sources; it is a source of pride, and we hope that it shows. Maintaining the site and adding new material is a daily process because our clients indicate they want it that way. In fact, Early, Ludwick, Sweeney & Strauss is often approached by doctors and world medical conferences, asking if they can place information on our Web site. Of course, we answer yes. Moreover, we are a nationally recognized law firm, which runs at the forefront of asbestos litigation, as we are intimately involved with current legal and political events regarding asbestos. We urge you to contact Early, Ludwick, Sweeney & Strauss first. If we are unable to help you, we will find the best person who can!
If you have any questions regarding your legal rights, please contact us
Asbestos
The research we do for our client's cases results in a large amount of pertinent and up to date information on asbestos, the asbestos industry, asbestos cancers and treatment options. We have compiled that information here in an on-line information library. We hope that by providing this information, we create a valuable resource, which will benefit people who have access to it. This section will be updated regularly as we uncover new and important information.
Asbestos Industry
We are continuously updating our computer database which contains information about the specific manufacturers, suppliers, and installers of asbestos products at major shipyards, power generating stations, oil refineries, skyscrapers, railroads, merchant marine lines, steel mills, paper mills, schools, hospitals and other commercial locations. This database is crucial in the effort to convince these companies that they have certain responsibilities and obligations to specific individuals.
Asbestos Diseases
Since we represent families throughout the country, we have become familiar with medical doctors who specialize in aggressively treating malignant mesothelioma, lung cancer, asbestosis, and pleural mesothelioma.
We keep up to date on the newest research, diagnosis information and treatment options for these asbestos exposure related diseases.
Tuesday, November 4, 2008
Mesothelioma
Mesothelioma is a form of cancer which is caused by previous exposure to asbestos. In this disease, cancer (malignant) cells develop 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).
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking.
Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking.
Symptoms
Usually, Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. The symptoms of pleural mesothelioma are shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space.
Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity), bowel obstruction, blood clotting abnormalities, anemia, and fever. Symptoms may include pain, trouble swallowing, or swelling of the neck or face if the cancer has spread beyond the mesothelium to other parts of the body.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
- chest wall pain
- pleural effusion, or fluid surrounding the lung
- shortness of breath
- fatigue or anemia
- wheezing, hoarseness, or cough
- blood in the sputum (fluid) coughed up
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
- abdominal pain
- ascites, or an abnormal buildup of fluid in the abdomen
- a mass in the abdomen
- problems with bowel function
- weight loss
In severe cases of the disease, the following signs and symptoms may be present:
- blood clots in the veins, which may cause thrombophlebitis
- disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
- jaundice, or yellowing of the eyes and skin
- low blood sugar level
- pleural effusion
- pulmonary emboli, or blood clots in the arteries of the lungs
- severe ascites
A mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs.
Diagnosis
To diagnose mesothelioma is 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 fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done 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 completely 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 done 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 small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells. The procedure could diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients.
| Positive | Negative |
| EMA (epithelial membrane antigen) in a membranous distribution | CEA (carcinoembryonic antigen) |
| WT1 (Wilms' tumour 1) | B72.3 |
| Calretinin | MOC-3 1 |
| Mesothelin-1 | CD15 |
| Cytokeratin 5/6 | Ber-EP4 |
| HBME-1 (human mesothelial cell 1) | TTF-1 (thyroid transcription factor-1) |
Screening
There is no universally agreed protocol for screening people who have been exposed to asbestos. However some research indicates that the serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.
Staging
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
Pathophysiology
The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibres in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fibre can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibres may be deposited in the gut after ingestion of sputum contaminated with asbestos fibres.
Pleural contamination with asbestos or other mineral fibres has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers).However, there is now evidence that smaller particles may be more dangerous than the larger fibers They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.
Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibres. It has been suggested that in humans, transport of fibres to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localised lesions of accumulated asbestos fibres in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumour.
Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibres remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibres has not yet been achieved. In general, asbestos fibres are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.
Analysis of the interactions between asbestos fibres and DNA has shown that phagocytosed fibres are able to make contact with chromosomes, often adhering to the chromatin fibres or becoming entangled within the chromosome. This contact between the asbestos fibre and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.
Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:
- Neurofibromatosis type 2 at 22q12
- P16INK4A
- P14ARF
Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:
- Inactivation of tumor suppressor genes
- Activation of oncogenes
- Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region
- Activation of DNA repair enzymes, which may be prone to error
- Activation of telomerase
- Prevention of apoptosis
Asbestos fibres have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.
Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.
Epidemiology
Incidence
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence is approximately one per 1,000,000. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades. It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States . Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
Risk factors
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.
Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
The combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer, bronchial carcinoma). The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma.
Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma.
Exposure
Asbestos was known in antiquity, but it wasn't mined and widely used commercially until the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
Occupational
Exposure to asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum.
The documented presence of asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure.
Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.
Paraoccupational Secondary Exposure
Family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
Asbestos in buildings
Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos. Those performing renovation works or diy activities may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos was banned at the end of 1999. Brown and blue asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials.
Environmental Exposure
Incidence of mesothelioma had been found to be higher in populations living near Naturally Occurring Asbestos (NOA).
Treatment
Treatment of MM using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.
Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies, has proved disappointing. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. It is not possible to remove the entire mesothelium without killing the patient.
Radiation
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Chemotherapy
In February 2004, the United States Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.
Immunotherapy
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
Heated Intraoperative Intraperitoneal Chemotherapy
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute. The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.
Prevention & Expectations
What can be done to prevent the disease? Since the 1970s, the Environmental Protection Agency and the Occupational Safety and Health Administration have regulated the asbestos industry in the U.S. In the past, asbestos was used as a fire retardant and an insulator. Other products are now used in its place. The controversy involving exposure to different forms of asbestos continues.
There are two major types of asbestos: chrysotile and amphibole. It is thought that exposure to the amphibole form is more likely to cause mesothelioma. However, chrysotile has been used more frequently, hence many mesotheliomas are caused by chrysotile.
Removal is taking place in schools and other public buildings throughout the U.S. The hope is that these measures will greatly reduce the occurrence of this cancer.
What are the long-term effects of the disease? A mesothelioma is a highly aggressive tumor that is generally deadly. Current treatment of malignant mesothelioma is designed to make the person with cancer comfortable. Although long-term survival cannot usually be expected, the case of famed paleontologist Stephen Jay Gould is a noted exception.
What are the risks to others? Mesothelioma is not contagious and cannot be passed from one person to another. The exposure to the asbestos that caused the cancer occurred many years to several decades before the disease appeared. People who live with asbestos workers have a higher risk of getting this cancer.
What happens once treatment is over? Although mesothelioma is very unpleasant it's still important for person after treatment is over to keep up all follow-up appointments and that's vital because further testing is always needed to check whether cancer is coming back or to examine possible side effects that could be rather unpleasant and what's even worse permanent.
Notable people that died from mesothelioma
Mesothelioma, though rare, has had a number of notable patients. Australian anti-racism activist Bob Bellear died in 2005. British science fiction writer Michael G. Coney, responsible for nearly 100 works also died in 2005. American film and television actor Paul Gleason, perhaps best known for his portrayal of Principal Richard Vernon in the 1985 film The Breakfast Club, died in 2006. Mickie Most, an English record producer, died of mesothelioma in 2003. Paul Rudolph, an American architect known for his cubist building designs, died in 1997.
Bernie Banton was an Australian workers' rights activist, who fought a long battle for compensation from James Hardie after he contracted mesothelioma after working for that company. He claimed James Hardie knew of the dangers of asbestos before he began work with the substance making insulation for power stations. Mesothelioma eventually took his life along with his brothers and hundreds of James Hardie workers. James Hardie made an undisclosed settlement with Mr Banton only when his mesothelioma had reached its final stages and he was expected to have no more than 48hrs to live. Australian Prime Minister-elect Kevin Rudd mentioned Mr Banton's extended struggle in his acceptance speech after winning the 2007 Australian Federal Election.
Steve McQueen was diagnosed with peritoneal mesothelioma on December 22, 1979. He was not offered surgery or chemotherapy because doctors felt the cancer was too advanced. McQueen sought alternative treatments from clinics in Mexico. He died of a heart attack on November 7, 1980, in Juárez, Mexico, following cancer surgery. He may have been exposed to asbestos while serving with the US Marines as a young adult—asbestos was then commonly used to insulate ships' piping—or because of its use as an insulating material in car racing suits. (It is also reported that he worked in a shipyard during World War II, where he might have been exposed to asbestos.
United States Congressman Bruce Vento died of mesothelioma in 2000. The Bruce Vento Hopebuilder is awarded yearly by his wife at the MARF Symposium to persons or organizations who have done the most to support mesothelioma research and advocacy.
After a long period of untreated illness and pain, rock and roll musician and songwriter Warren Zevon was diagnosed with inoperable mesothelioma in the fall of 2002. Refusing treatments he believed might incapacitate him, Zevon focused his energies on recording his final album The Wind including the song "Keep Me in Your Heart," which speaks of his failing breath. Zevon died at his home in Los Angeles, California, on September 7, 2003.
Christie Hennessy, the influential Irish singer-songwriter, died of mesothelioma in 2007, and had stridently refused to accept the prognosis in the weeks before his death. His mesothelioma has been attributed to his younger years spent working on building sites in London.
Bob Miner, one of the founders of Software Development Labs, the forerunner of Oracle Corporation died of mesothelioma in 1994.
History
The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. It was not until 1960 that an article published by Wagner et al first officially established mesothelioma as a disease arising from exposure to crocidolite asbestos. The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker. The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.
In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.
Despite proof that the dust associated with asbestos mining and milling causes asbestos related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information.
By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.
References
- ^ United States Department of Health and Human Services.
- ^ "Cigarette smoking, asbestos exposure, and malignant mesothelioma" by Muscat JE, Wynder EL in Cancer Research (1991) volume 51 pages 2263-7 Entrez PubMed 2015590
- ^ Beyer, HL; Geschwindt RD, Glover CL et al. (April 2007). "MESOMARK: a potential test for malignant pleural mesothelioma". Clinical Chemistry 53 (4): 666–672. PMID 17289801.
- ^ "Soluble mesothelin-related protein--a blood test for mesothelioma" by B. W. Robinson, J. Creaney, R. Lake, A. Nowak, A. W. Musk, N. de Klerk, P. Winzell, K. E. Hellstrom and I. Hellstrom in Lung Cancer (2005) volume 49, pages S109-S111 Entrez PubMed 15950789.
- ^ "Malignant mesothelioma and occupational exposure to asbestos: a clinicopathological correlation of 1445 cases" by V. L. Roggli, A. Sharma, K. J. Butnor, T. Sporn and R. T. Vollmer in Ultrastruct Pathol (2002) volume 26 pages 55-65 Entrez PubMed 12036093.
- ^ "Advances in Malignant Mesothelioma" by Bruce W. S. Robinson and Richard A. Lake in The New England Journal of Medicine (2005) volume 353 pages 1591-1603 Entrez PubMed 16221782.
- ^ "SV40 in human tumors: new documents shed light on the apparent controversy" by D. S. MacLachlan in Anticancer Res (2002) volume 22, pages 3495-3499 Entrez PubMed 12552945.
- ^ a b "Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients." by D. Sugarbaker in J Thorac Cardiovasc Surg (1999) volume 117, pages 54-63 Entrez PubMed 9869758.
- ^ McQueen's Legacy of Laetrile. New York Times (2005-11-15).
- ^ RTE radio 1, Playback, 8 December
- ^ u.tv
- ^ Irish singer Hennessy dies at 62 - BBC News - 11 December 2007
- ^ Gould, Stephen Jay. The Median Isn't the Message.
- ^ "Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province" by J. C. Wagner, C. A. Sleggs and P. Marchand in Br J Ind Med. (1960) volume 17, pages 260-271 Entrez PubMed 13782506.
- ^ "Malignant pleural mesothelioma in an asbestos worker" by J. C. McNulty in Med J Aust (1962) volume 49, pages 953-954 Entrez PubMed 13932248.
- Wikipedia.org
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