A thorough medical history may reveal exposure to asbestos in the past or the presence of suspicious symptoms. Physical examination is followed by x-rays of the affected area of the body (lungs, heart, or abdomen). Positive x-rays signal the need for a CT scan (computerized tomography) or MRI (magnetic resonance imaging) for a detailed analysis of body structures. When the location of the abnormal cells is known, biopsies are taken. Biopsy of lung tissues is done by thoracotomy since the tumor affects the outer lung surface. Abdominal biopsies are obtained via laparoscopy. In both cases, small incisions allow the surgeon to visualize the internal organs and to take tissue for pathological examination.
Surgery is often needed to determine the staging of the disease. This reveals whether the tumor is self-contained or has spread to adjacent structures or other more remote areas of the body. This information can then guide treatment.
Exposure to asbestos is the greatest risk factor for the development of mesothelioma, causing 80% of all cases, but it can also occur in the absence of exposure. Heavy concentrations and longer duration of exposure results in a greater risk for the disease, but shorter exposure times have also caused the disease. Men and women seem to be affected equally, but since more men work with asbestos, they have a higher incidence. Smoking AND asbestos exposure greatly multiplies the risk.
The U.S. Occupational Safety and Health Administration (OSHA) is responsible for setting the limits of asbestos exposure. Those who work with asbestos must wear equipment that reduces the risk of exposure. Workers should shower and change clothes at work to avoid bringing asbestos home with them, since family members have been known to contract the disease in this way.
Early symptoms of mesothelioma may mimic those of pneumonia:
• dyspnea
• cough,
• shortness of breath
• chest pain
• hypoxia
Symptoms worsen if fluid builds up in the pleural space causing a pleural effusion. Invasion of adjacent structures or metastasis to other parts of the body can occur, with symptoms depending on the structures or organs affected. Sometimes there are no symptoms and diagnosis occurs as a result of routine physical exams.
Treatment can consist of radiation, surgery, or chemotherapy but results have been disappointing. Clinical trials are underway to study other ways to fight this cancer and interested patients should consult with their doctor about participation in such trials. For now, palliative care with narcotic pain relief and supplemental oxygen for shortness of breath is frequently all that can be done. Fluid build-up is drained via thoracentesis or paracentesis.
Mesothelioma is a rare type of cancer. It begins in the cells of the outer lining of organs, called the mesothelium. It most commonly affects the lung, but may also affect the heart and abdominal organs. Pleural mesothelioma enlarges until it limits lung movement and can then spread to the mediastinum. Death commonly occurs in 4 months to 1 year with less than 10% living more than 3 years after diagnosis is confirmed.
Mesothelioma is most often occurs after asbestos exposure. This exposure can be 20 to 40 years prior to tumor formation. Smoking and asbestos exposure together greatly increases the risk. The families of workers who are exposed to asbestos can also be at risk due to inhalation of fibers that are on a worker’s clothes. Most asbestos exposures happened in the past so the surge of mesothelioma cases is expected to decline in the years to come.
Mesothelioma is often difficult to diagnose because the symptoms are so similar to other conditions such as lung cancer and other types of cancers. The first step in diagnosis is to conduct a thorough physical examination. The physician also will gather a lengthy medical history, including questions related to possible asbestos exposure. An X-ray will provide an image of the lungs or abdomen showing any abnormal changes. Furthermore, a CT scan (computed tomography) will produce more detailed pictures of areas inside the body using a computer rather than film. An MRI (magnetic resonance imaging) provides a three-dimensional, detailed view of the areas where mesothelioma is suspected. The MRI can differentiate mesothelioma from other lung tumors and determine its location and size. However, the most definitive test is a biopsy (tissue sample) of the affected tissues to provide information regarding the strength and rate of growth of the tumor.
Mesothelioma is a rare cancer, representing less than 1% of all cancers. In the United States in 2000, there were only 2300 cases of mesothelioma diagnosed. The single, greatest risk for developing mesothelioma is exposure to asbestos, either in the workplace or at home. Typically patients who have had a long-term exposure to asbestos are at the highest risk of developing mesothelioma. However, some cases have been documented when patients have only been exposed to asbestos for a short time, such as one to two months. Other risk factors involve living with a person who was exposed to asbestos in their work environment, due to the fact that asbestos could be embedded in a worker’s clothing or hair. The combination of tobacco use and asbestos also greatly increases the risk of developing mesothelioma in the lung lining. Often, it takes 20-50 years after the asbestos exposure before mesothelioma is detected.
There are a variety of symptoms for mesothelioma, dependent on where the mesothelioma is located. The most common symptoms for pleural mesotheliomas (cancer of the lining of the lung) are difficulty in breathing/shortness of breath, pain under the rib cage, and a dry, hacking cough. These symptoms are caused by the excess fluid and build-up of tumor tissue in the pleural space surrounding the lungs. Less common symptoms may include weight loss for no reason, fever, night sweats and feeling easily fatigued.
The symptoms of peritoneal mesothelioma (cancer of lining of the abdomen) may include abdominal swelling and pain, weight loss, and a mass in the abdomen, all due to the accumulation of excess fluid and tissue building in the abdominal cavity. Additional symptoms include bowel obstruction, anemia (a lowered red blood cell count), fever, and blood clotting abnormalities.
Mesothelioma is a very rare cancer which originates in the membranes lining the chest, abdominal cavities or the heart. These membranes are called mesothelium, which is a protective sac of thin tissues covering vital organs. The mesothelium is comprised of two layers, the visceral membrane which covers the organ and the parietal membrane which forms a sac around it. A fluid is produced by the mesothelium to allow organs to move easily in the body.
Mesothelioma occurs when the cells in the tissue continually produce this fluid. Excess fluid and tissue builds up around these vital organs making it difficult for them to function effectively. The cells can then multiply and spread to other organs or areas in the body which is called metastasis.
The majority of malignant mesotheliomas (around 90%) occur in the lining of the lungs. The remaining cases of mesotheliomas develop in the abdomen and the heart.
There are a variety of different treatment options for Mesothelioma. However, the type of treatment depends on several factors such as the location of the tumor, the stage of the disease, and the patient’s age and current health.
One treatment option is to perform surgery to remove the tumor and the surrounding mesothelial tissue. However, this treatment option should be used only for younger, healthy patients. Another treatment option is to perform radiation therapy, which uses high energy x-rays to destroy the cancer cells in the location of the tumor. Chemotherapy is an option frequently used, which involves using drugs to fight the cancer by injecting them intravenously into a patient’s vein or putting it directly into a patient’s chest or abdomen. Lastly, thoracentesis (draining excess fluid in the lungs) or paracentesis (draining excess fluid in the abdomen) can be used to relieve a patient’s symptoms and control his pain.
Stage I mesothelioma is used to describe disease progression characterized by the presence of mesothelioma within the right or left pleura, which is the membrane that covers the lungs. The cancer may also be present, on the same side only, in the lung, pericardium, or diaphragm.
Stage 2 mesothelioma describes the state in which the cancer spreads to the extent of invading one or more additional areas, including the pleura on both sides, the chest wall, esophagus, heart, and/or lymph nodes in the chest.
Stage 3 mesothelioma indicates further spread of the cancer, involving penetration through the diagram into the peritoneum, which is the lining of the abdomen. This state my also involve additional lymph nodes beyond the chest area.
Stage 4 mesothelioma is the final state of mesothelioma, in which the cancer cells have gained entry to the bloodstream, enabling the disease to spread to other organs throughout the body. The process of spreading via the bloodstream is referred to as distant metastes.