Mesothelioma Cancer - Overview

Mesothelioma is a rare type of cancer that develops in the mesothelial cells that lines many organs and body cavities. The mesothelium (composed of mesothelial cells) is the membrane that lines three of the body's cavities, and depending on what cavity it lines it is given a specific name: the thoracic cavity (pleura), abdominal cavity (peritoneum), and the heart sac (pericardium).

Mesothelioma is a rare cancer that can develop in the mesothelium of the thoracic cavity in the lungs.

The mesothelium that covers the internal organs is called the visceral mesothelium, while the layer that covers the body wall is called parietal mesothelium.

Mesothelium tissue also surrounds the male internal reproductive organs and covers the internal reprductive organs in women.

Mesothelioma is an aggressive cancer of this mesothelium, in which cells of the mesothelium become abnormal and divide uncontrollably and without order. They can invade and damage nearby tissues and organs. Most cases of mesothelioma begin in the thoracic cavity (pleura) or the abdominal cavity (peritoneum).

Approximately 2,000 to 3,000 cases of mesothelioma are diagnosed each year in the United States, comprising around 3 percent of all cancer diagnoses. This cancer occurs more frequently in men than in women, about four times more frequent. All forms of mesothelioma, except for benign mesothelioma, are invariably fatal. The prognosis for mesothelioma is almost always poor and most studies report a median survival of less than one year, but the prognosis really depends on how early it is diagnosed and aggressively it is treated.

Causes of Mesothelioma

Mesothelioma is caused by asbestos exposure. Asbestos is a naturally-occurring fibrous substance that was widely used in the twentieth century in a number of different industries. Popular because of its durability, fire resistance, and insulating properties, it was regularly used in the manufacture of several thousand different products, up until the time that asbestos warnings were issued in the mid-1970s. It is estimated that more than 90 percent of mesothelioma cases are linked to asbestos exposure.

The exact way in which asbestos causes mesothelioma is not well understood though doctors and researchers have put forth many hypotheses. What is apparent, however, is that any length of exposure to asbestos can be hazardous and may result in the development of asbestos-related diseases later in life.

Types of Mesothelioma

There are five known types of mesothelioma. Four of these are malignant cancers, and one is a benign condition.

Once asbestos is inhaled it can effect many of the bodys different organs including the throat, lungs, stomach, heart and testicles.

Pleural Mesothelioma: This type of mesothelioma develops in the lining of the lungs, known as the pleura. It is the most common form of malignant mesothelioma, with around 70 percent of cases being pleural in origin.

Peritoneal Mesothelioma: This form of mesothelioma develops in the lining of the abdominal cavity, known as the peritoneal membrane. Approximately 25 percent of mesotheliomas are of this type.

Pericardial Mesothelioma: This form of mesothelioma develops in the lining of the heart, known as the pericardium. About 5 percent of all mesothelioma cases are pericardial.

Testicular Mesothelioma: This is the rarest type of malignant mesothelioma; to date, there have been less than 100 recorded cases. Testicular mesothelioma develops in the tunica vaginalis of the testicles.

Benign Mesothelioma: The benign form of mesothelioma most commonly develops in the pleura. This is the only form of mesothelioma for which full cure and recovery is a probable outcome, though it may be a precursor of future asbestos-related problems.

Mesothelioma Symptoms and Diagnosis

Mesothelioma is difficult to diagnose, largely due to the fact that it remains latent in the body for up to five decades and is usually not diagnosed until its late stages.

A medical exam is the first step in diagnosing an asbestos-related illness.

The most common symptoms of pleural mesothelioma are shortness of breath, chest pain, and persistent cough. However, some patients may not show any symptoms at all. A frequent sign is pleural effusion (water in the lungs).

Some symptons of peritoneal mesothelioma include weight loss, abdominal pain and swelling, and bowel obstruction. If the cancer has spread to other parts of the body, some other common symptoms may include trouble swallowing, swelling of the neck or face, blood clotting problems, anemia, and fever.

Also, diagnosis may be difficult due to the non-specific nature of most mesothelioma symptoms, which often resemble symptoms of less serious diseases.

The process of diagnosis usually begins with a compilation of the patient's full medical and work history, including any exposure to asbestos. A medical examination is performed and if a problem is suspected, one or more diagnostic tests are ordered. These typically include medical imaging tests such as x-rays, CT, and MRI scans, as well as biopsy procedures that test samples of fluid and tissue for the presence of cancer cells. Diagnostic tests are also used to determine how far the cancer has advanced, and whether it has spread to other locations in the body.

Mesothelioma Treatment

There are a variety of treatment options for mesothelioma patients including radiation, chemotherapy, and surgery.

Mesothelioma treatments can be divided into two main categories: curative treatments and palliative treatments. Curative treatments are those carried out in an attempt to remove all cancer cells and cure the disease. Palliative treatments are designed to ease pain and make a patient more comfortable.

Treatments for mesothelioma include conventional treatments such as surgery, chemotherapy, and radiation therapy, as well as experimental procedures, including immunotherapy and gene therapy.

Generally, a patient with mesothelioma will receive more than one type of conventional treatment. For example, they may undergo surgery to remove the bulk of cancerous tissue, and then receive chemotherapy or radiation therapy to kill any remaining cancer cells.

Experimental treatments are typically available only to patients who agree to enter clinical trials. In these cases, patients must fit certain criteria to be eligible.

Legal Issues

The dangers of asbestos exposure were known long before any efforts were made to protect workers. Thousands of American workers were exposed to asbestos during the twentieth century, with no indication as to the risks that they were facing.

Companies that produced asbestos-containing products or used these products on a daily basis are liable for their negligence in failing to protect their workers. If you or a loved one has developed mesothelioma or another asbestos-related disease as a result of asbestos exposure, it's important to know you can talk to an attorney about seeking compensation for pain and suffering as well as reimbursement for medical expenses and lost income. For more information, please fill out the form on the right to receive a comprehensive packet.

Mesothelioma Cancer & Fire Fighters

Because so many buildings contain asbestos, firefighters hold a higher risk than the average person of being exposed to asbestos. Many of the buildings and structures that firefighters enter contain asbestos-containing materials or products that can release microscopic asbestos fibers into the surrounding air. Even materials found in wall insulation, ceiling & floor tiles, or pipe coverings can eventually become frayed or damaged, causing these fibers to be released. Once these asbestos fibers are released they can easily lodge themselves within a number of the body's organs including the lungs, stomach, and testicles.

Once a firefighter has inhaled asbestos he or she is at risk for developing mesothelioma cancer. A firefighter may go 20-25 years without developing mesothelioma symptoms and then suddenly become very ill without notice. Depending on the type of mesothelioma cancer the firefighter develops the symptoms can be different, however most of them include persistent dry or raspy cough, coughing up blood, difficulty swallowing, and shortness of breath. If a firefighter thinks they may have been exposed to asbestos or is experiencing these symptoms.it is very important for them to see their physician and have them perform a regular CT Scan or X-ray to make sure they haven't inhaled any asbestos fibers.

Sources:

1. Castleman, B. Asbestos: Medical and Legal Aspects. Aspen Publishers: New York. 2005.
2. Dodson, R. and Hammar, S. Asbestos: Risk Assessment, Epidemiology, and Health Effects. Taylor & Francis: Boca Raton. 2006.
3. http://www.mayoclinic.com/print/mesothelioma/DS00779/DSECTION=all&METHOD=print
4. http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_malignant _mesothelioma_diagnosed_29.asp?sitearea
5. http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_malignant _mesothelioma_29.asp?sitearea
6. http://www.cancer.org/downloads/PUB/DOCS/SECTION28/89.pdf
7. http://www.marf.org/Resources/UnderstandingMeso/MesoDetails.html
8. http://sup.ultrakohl.com/Uscap/uscap05/meso3.htm
9. http://medind.nic.in/ibq/t04/i3/ibqt04i3p142.pdf
10. http://www.cancerbackup.org.uk/Aboutcancer/Whatiscancer/Whatiscancer/related_faqs/QAs/502
11. http://www.nlm.nih.gov/medlineplus/ency/article/000116.htm

Gene Therapy

Gene therapy involves using genetic material to specifically target cancer cells and make them more vulnerable to chemotherapy treatment.

"Suicide Gene Therapy" is the most popular form of gene thearpy being used.

The main type of gene therapy being developed for use in mesothelioma patients is called "suicide gene therapy," because it forces cancer cells to produce substances that cause their death.

When undergoing this type of gene therapy, the patient is treated with a non-infectious virus that has been altered with genetic material that makes them produce a particular protein.

Following this procedure, the patient is then treated with a chemotherapeutic medication that is specially formulated to be toxic only to cancer cells. This type of therapy has produced some promising results for mesothelioma patients, but it is still only available through clinical trials.

Immunotherapy is a type of treatment in which the patient's own immune system is 'tricked' into killing cancer cells. A healthy, normally-functioning immune system does not kill cancer cells, because even though these are diseased cells, the immune system is unable to recognize them as being harmful.

There are two main types of immunotherapy: active and passive. In active immunotherapy, mesothelioma cancer cells are removed from a patient and then treated in a laboratory to turn them into a vaccine. Following this laboratory treatment, the patient is injected with the vaccine and if the treatment is successful, the patient's immune system recognizes the vaccine as a harmful substance, thus recognizing the cancer as being harmful as well.

Passive immunotherapy is somewhat different in that it does not attempt to activate the patient's immune system. Instead, it uses substances such as cytokines (molecules that direct and regulate the immune system) and other agents to help boost the patient's immune response to their cancer.

Sources:

1. Dodson, R. and Hammar, S. Asbestos: Risk Assessment, Epidemiology, and Health Effects. Taylor & Francis: Boca Raton. 2006.
2. Galateau-Salle, Francoise. Pathology of Malignant Mesothelioma. Springer-Verlag London Limited: London. 2006.
3. Pass, I., Vogelzang, N., Carbone, M. Malignant Mesothelioma: Advances in Pathogenesis, Diagnosis, and Transitional Therapies. Springer: New York. 2005.
4. http://www.cancer.org/downloads/PUB/DOCS/SECTION28/89.pdf
5. http://www.ornl.gov/sci/techresources/Human_Genome/medicine/genetherapy.shtml
6. http://marf.org/Documents/SymSlides/Steven%20Albelda,%20MD%20WM.pdf
7. http://www.cancer.gov/cancertopics/factsheet/Therapy/photodynamic
8. http://www.drugs.com/mtm/gemcitabine.html
9. http://www.drugs.com/mtm/navelbine.html

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Photodynamic Therapy

Photodynamic therapy is a highly specialized and specific form of treatment that is most often used to treat skin cancers, some types of lung cancer, and pleural mesothelioma.

Photodynamic therapy uses light energy to kill cancer cells.

However, this treatment is usually unsuitable for patients with metastasized cancer; it is most effective in patients who have localized disease.

This type of therapy involves the use of light energy to kill cancer cells. In photodynamic therapy treatment, the patient is given an intravenous solution of a medication that makes cancer cells highly sensitive to a particular kind of light.

One to three days after this treatment, the patient is exposed to the light, and cancer cells that have absorbed the medication are killed.

Radiation

Radiation therapy, or "ionizing radiation", is used to kill cancer cells and to limit the spread of cancer. For patients with mesothelioma, radiation therapy is most often used in conjunction with surgery.

Radiation is often used in conjunction with surgery.

However, in some cases radiation may be used as a stand-alone treatment to relieve pain and other symptoms associated with mesothelioma. In either case, it is rare for radiation therapy to provide more than short-term symptomatic relief.

Mesothelioma patients may receive one of two types of radiation therapies, depending on whether or not they are suitable candidates for either procedure.

External beam radiation therapy is the traditional type of radiation therapy, where tumors are bombarded with beams of radiation to kill cancer cells. Brachytherapy is a newer type of radiation treatment. It involves tiny radioactive rods which are implanted within a tumor to provide a strong, concentrated dose of radiation to tumors while doing very little damage to surrounding healthy tissue.

Chemotherapy

Most forms of chemotherapy involve the intravenous administration of drugs such as Alimta and Cisplatin. Chemotherapeutic drugs are targeted to kill cells that are rapidly dividing by interfering with processes that occur during cell division.

Chemotherapy is an effective treatment option but comes with unpleasant side effects.

However, while cancer cells themselves divide rapidly, so do some types of healthy cells, causing some of the unpleasant side effects that are often associated with this form of treatment. Though older chemotherapy medications seemed to do little to fight mesothelioma, newer chemotherapy drugs are showing much promise.

A relatively new form of chemotherapy called heated chemotherapy is an option for patients with peritoneal mesothelioma.

This treatment is carried out following surgery, and involves the perfusion of heated chemotherapeutic medications into the peritoneum.

Surgery

Surgical treatments for mesothelioma include three main types - diagnostic surgery, curative surgery, and palliative surgery. Some types of surgery fall into more than one category.

Surgery can only be performed during mesothelioma stages I and II.

For example, thoracentesis may be used as a diagnostic procedure, and as a palliative treatment to provide symptomatic relief. Only curative surgery can potentially remove all cancer from a patient with mesothelioma.

However, for curative surgery to be effective, it is particularly important that mesothelioma be diagnosed as early as possible. Unfortunately, mesothelioma is not usually diagnosed until it reaches Stage III or IV, when surgery is not an option.

Mesothelioma Treatment - Overview

There are several mesothelioma treatment options including chemotherapy, radiation, and surgery.

There are several types of treatment available for patients with mesothelioma, some recommended more frequently than others. The most commonly used treatments are surgery, chemotherapy, and radiation therapy. In addition, some experimental treatments are becoming more widely used, or are showing some encouraging results in clinical trials. These treatments include photodynamic therapy, gene therapy, and immunotherapy, among others.

5-Year Survival Rates for Mesothelioma.

Most of these treatments are not used in isolation. In many cases, treatment may consist of a combination of therapies. For example, surgery to remove as much of the cancer as possible may be followed by radiotherapy or chemotherapy to remove residual cancer cells. This is one of the most common treatment options for mesothelioma among those who are candidates for surgery.

A number of alternative therapies can also be combined with traditional treatment options. Many patients choose to add alternative therapies such as massage, acupuncture, or TENS therapy to their conventional treatment approach in an effort to enhance or compliment the treatment process. A numer of alternative therapies, including aromatherapy, meditation, or yoga, are often added to a treatment regimen to provide pain relief and foster relaxation.

All About Malignant Mesothelioma

Malignant mesothelioma is a rare form of cancer that affects the mesothelial cells of the serous membranes in the body. The most common form of mesothelioma, affecting the lining of the lung, is pleural mesothelioma. Two to three thousand new cases of malignant mesothelioma are diagnosed each year.

The mission of All About Malignant Mesothelioma is to provide a one-stop resource for comprehensive, up-to-date mesothelioma information. We cover the full scope of malignant mesothelioma issues including background, history, risk factors, diagnosis, and treatment. Please recommend the site to someone who may benefit from mesothelioma information.

Introduction to Malignant Mesothelioma

Malignant mesothelioma affects the lining or membranes of certain large cavities in the body. These cavities, called the serous cavities, house certain major organs in the body including the heart, lungs, abdomen and others. The membranes that surround these cavities are called the serous membranes. They serve to protect these major organs from the friction and abrasion that occur as the organs move against each other during typical daily functioning, such as breathing and heart beating. The serous membranes derive from specialized cells called mesothelial cells. These cells form to create the mesothelium, which is the major tissue layer of the serous membranes. Cancer that occurs in the mesothelium tissue is called mesothelioma.

Malignant mesothelioma takes on three forms:

• Peritoneal mesothelioma, in the peritoneum or membrane surrounding the abdomen. A rare form of peritoneal mesothelioma can also affect the male testicles, because the lining around the scrotum is an extension of the peritoneum.
• Pericardial mesothelioma, in the perdicardium or lining surrounding the heart.
• Pleural mesothelioma, which is the most common form of malignant mesothelioma and affects the lining of the lung cavity.

All mesotheliomas are now considered to be malignant, or cancerous. They start as a localized tumor and spread rapidly to include most of the surrounding tissues and organs. Originally, fibrous cists and other non-cancerous growths that appeared in the serous membranes were thought to be mesotheliomas and were termed "benign fibrous mesothelioma" and "multicystic mesothelioma." These conditions are now known not to originate in the mesothelial cells, but other cells within the serous membranes. These conditions are typically localized, non-cancerous and do not spread rapidly.

Etiology of Malignant Mesothelioma

Most cases of malignant mesothelioma are associated with a previous exposure to fibrous minerals, of which asbestos is the most important. There is now indisputable evidence of the role of these fibers in the development of this disease. This has been demonstrated in animal experiments and many other experiments. Not everyone who is exposed to asbestos fibers has developed malignant mesothelioma, suggesting that other factors may also be involved.

Although malignant mesothelioma is rare, it is a serious, deadly disease. It is often in the advanced stages when it is detected, so the outlook for the patients is not as good as it is for the cancers that are detected earlier. The average survival time after detection is 1 to 2 years. This survival time also depends on the type of mesothelioma.

Further Malignant Mesothelioma Information

Please continue reading the articles on this website for more mesothelioma information and asbestos information. In addition, we recommend the following malignant mesothelioma resources:

• American Cancer Society
• MedlinePlus, National Library of Medicine (NIH)
• National Cancer Institute, National Institutes of Health
• Yahoo! Health

What is Mesothelioma?

Throughout the past decade, the term "mesothelioma" has become more and more recognizable. Once an obscure disease that meant little to the general public, mention of this disease now conjures up thoughts and pictures of factories and mines strewn with asbestos and the unfortunate workers who were employed in those dangerous places.

Thanks to concerned medical professionals, researchers, and watchdog organizations, we're learning more and more about mesothelioma and how it affects the lives of those who are afflicted. However, there's still far to go as both better treatments and a cure for the disease are sought.

About the Disease

Simply put, mesothelioma is an aggressive form of cancer caused primarily by the inhalation of dangerous asbestos fibers. The disease attacks the mesothelium, a protective, two-layered membrane that covers the internal organs of the body including the lungs, heart and abdominal organs. Between these layers, the cells produce fluid, which allows easy movement of the heart and lungs within the chest cavity. The layer that covers the lungs is called the pleura, and the layer that covers the heart is called the pericardium. The peritoneum lines the abdominal cavity. Mesothelium also lines the male and female reproductive organs. Mesothelioma can affect any of these cells, but is usually seen in the pleural or peritoneal mesothelium. The most commonly diagnosed form of this cancer is pleural mesothelioma.

Mesothelioma takes anywhere from 20 to 50 years to develop, which is why older individuals are usually the victims. However, recent cases involving September 11th World Trade Center first responders and clean-up crews show that high concentrations of asbestos can cause the disease to develop much more rapidly. A few WTC workers have already died of the disease.

Effects of the Disease

The invasion of the mesothelium by cancer cells makes it very difficult for the patient to breathe, resulting in the need for oxygen, especially as the disease progresses. Those with the pleural form of mesothelioma may also suffer from pleural effusions. These effusions prevent the smooth movement of the lungs and other organs in the chest. Peritoneal mesothelioma also affects the stomach area and abdominal cavity, causing nausea, vomiting, or loss of appetite, which can result in dangerous weight loss. In addition to breathing difficulties and loss of appetite, mesothelioma victims also complain of excessive coughing, sleeping difficulties, persistent chest pain, fever, and pain in the lower back.

Mesothelioma, in general, is a very painful disease and because it is usually not diagnosed until it's in an advanced stage. For this reason, the symptoms are typically quite serious. Late diagnosis also means that the cancer is more likely to have metastasized, or spread, making successful mesothelioma treatment even more difficult.

Who Gets Mesothelioma?

Statistics show that, because of their work history, the disease most often affects men between the ages of 50 and 70 who were employed in an asbestos-laden environment before asbestos warnings and bans were in place in the 1970s. Though women still have a much lower frequency of the disease, cases of second-hand exposure to asbestos has prompted more diagnoses among women, especially those whose male family members worked with asbestos. The occupations most associated with mesothelioma are shipyard workers, electricians, plumbers, construction industry workers, pipefitters, boilermakers, and anyone subject to heavy exposure to dangerous asbestos and airborne asbestos fibers.

An abundance of cases have also demonstrated that mesothelioma can develop among people who lived in communities where asbestos factories or mines were located. In some instances, entire towns have been adversely affected by the presence of asbestos fibers in the air. For example, in Libby, Montana - site of a former vermiculite asbestos mine - hundreds have already died of mesothelioma.

Though still significantly rarer than other cancers, an estimated 2,000 to 3,000 new cases of mesothelioma are diagnosed each year in the United States. Other countries, notably the United Kingdom and Australia, report a much higher incidence of the disease. Nevertheless, the United States - like many other countries - has seen an increase in asbestos-caused cancer as men who worked in U.S. shipyards in the 1940s and 1950s, at the height of production, are now being diagnosed with mesothelioma.

Dealing with Mesothelioma

Mesothelioma is most often diagnosed in its late stages, and such a diagnosis is devastating to the individual and his/her family. Though research into the disease has been ongoing, there is currently no cure for mesothelioma. Some patients may be candidates for surgery to remove tumors or even an entire lung, but most are better treated with radiation or chemotherapy. More often than not, these treatments are palliative, serving to lessen the severity of the symptoms of the disease rather than offering a cure.

Medical professionals and research scientists, however, are constantly exploring new ways to combat the disease. For example, doctors know that some combinations of chemotherapy drugs work better than others and tests developed to ascertain earlier diagnosis of the disease or to monitor those most at risk have arrived on the scene.

Who's to Blame?

The reason someone develops mesothelioma is usually the lack of proper protection offered to those who worked with asbestos. Though the dangerous properties of asbestos and asbestos products have been evident for decades, many employers neglected to protect their workers from inhaling asbestos while on the job. It wasn't until public awareness of the dangers of the material were revealed in the 1970s that many employers began offering protective clothing such as respirators, gloves, aprons, and other such items to those working with asbestos on a daily basis.

Due to the negligence of employers, many companies who manufacture asbestos or products that contain asbestos have been subject to literally thousands of lawsuits filed by those who've been harmed by the material. Many of those lawsuits have come from individuals suffering from mesothelioma.

References:

• Dodson, R. and Hammar, S. Asbestos: Risk Assessment, Epidemiology, and Health Effects. Taylor & Francis: Boca Raton. 2006.
• Stahel RA,Weder W, Felip E; ESMO Guidelines Working Group. Malignant pleural mesothelioma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Clinic and Policlinic of Oncology, University Hospital of Zurich, Switzerland. 2008.
• Pass, I., Vogelzang, N., Carbone, M. Malignant Mesothelioma: Advances in Pathogenesis, Diagnosis, and Transitional Therapies. Springer: New York. 2005.
• http://www.cancer.gov/cancertopics/types/malignantmesothelioma
• http://www.nlm.nih.gov/medlineplus/mesothelioma.html

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