Mesothelioma is a rare but aggressive form of cancer which most commonly arises in the pleura, or lining, of the lung (pleura mesothelioma). Malignant mesothelioma can occur in the lining of the stomach (peritoneal mesothelioma) as well as the lining of the heart pericardial mesothelioma).
Exposure to asbestos is the overwhelmingly accepted cause of malignant mesothelioma. Asbestos is a natural but deadly mineral which was widely used as a construction material during the mid to late 20th century.
A long period of time, called “latency period,”elapses from the time of an individual’s exposure to asbestos to the development and diagnosis of malignant mesothelioma. Latency periods of 30, 40, and even 50 years are very common. Tragically, even minimal or short-term exposures to asbestos can cause malignant mesothelioma.
Because of this long latency period, many of the 2,000 – 3,000 mesothelioma victims diagnosed each year in the United States are people who were exposed to asbestos decades ago while working in oilfields, refineries, steel mills, power houses, residential homes, commercial buildings, hospitals, schools, and US Navy vessels. Women and children may also develop mesothelioma from asbestos brought into the home on the work clothes of fathers, husbands, and other family members that were exposed to asbestos in the work place.
There are three different cell types or strains of mesothelioma all of which are very aggressive. The long-term prognosis for each type of mesothelioma is poor:
Epithelioid accounts for 50% to 70% of all cases.
Sarcomatoid accounts for 10% to 15% of all cases. This is the most aggressive form of mesothelioma.
Biphasic or Mixed accounts for 10% to 15% of all cases.
- Shortness of breath
- Chest or abdominal pain
- Significant weight loss
- Blood in sputum coughed up from the lungs
- Persistent cough
- Difficulty swallowing
- Prolonged hoarseness
How is Mesothelioma Diagnosed?
Doctors may use a combination of procedures to render a diagnosis. However, the diagnosis of mesothelioma is typically confirmed by a pathologists who examines a tissue biopsy or fluid. Pathology tests are performed on samples of body fluid or tissue to determine the cell type. Certain types of dyes or coloring are added to the patient’s biopsy samples. Depending on how the tissue responds to the dye, the doctor can make a diagnosis. The type of staining performed to render a mesothelioma diagnosis is known as immunohistochemical staining.
Other medical procedures that may occur prior to and lead to a pathologic diagnosis of malignant mesothelioma include:
- Bronchoscopy involves an examination of the lungs, The doctor inserts a lighted tube down the patients throat and trachea into the lungs.
- Thoracoscopy a procedure which allows the doctor to look inside your chest cavity by making an incision through the chest wall and inserting an instrument called a thoracoscope which permits them to examine the chest cavity.
- Thorascentisis it is common for some patients to develop fluid on their lungs (pleural effusions). This procedure drains the pleural effusions by injecting a needle into the chest. The thorascentisis may be performed to collect fluid for diagnostic testing or to relieve pain or improve breathing.
- Needle Biopsy a procedure involving a thin needle to take samples of cells for review under a microscope.
- Talc Pleurodesis a treatment that involves inserting talc between the pleural linings. It causes inflammation so that pleural effusion (liquid build up) is less likely to occur.
The most common chemotherapy regimen for mesothelioma involves a combination of the chemotherapy drugs Alimta (Pemetrexed) and Cisplatin.
One surgery treatment option for some mesothelioma patients is known as an extrapleural pneumonectomy or EPP. An EPP involves removing the lung where the tumor is found as well as the lung lining or pleura, the diaphragm and the pericardium. Even with this surgery, the overall treatment plan still includes chemotherapy or radiation.
Other treatment options involve clinical trials. Clinical trials are a type of research study to test how well new medical approaches work in people. Clinical trials for mesothelioma involve new drugs or chemotherapy treatments.
Treatment options are evolving and research on new treatment options and experimental therapies are ongoing. There are many dedicated doctors and scientists devoting their professional lives to prolong life expectancies and to ultimately find a cure for mesothelioma.
Treating mesothelioma involves a multidisciplinary approach requiring the collaboration of expert surgeons, oncologists, pathologists and others. If you are concerned about whether you are suffering from mesothelioma, the first step is to immediately contact your family doctor, a pulmonologist or a treatment center near you.
Major treatment centers in the United States with Mesothelioma treatment programs include:
- M.D. Anderson – Houston, Texas
- Lung Institute at Baylor College of Medicine – Houston, Texas
- Scott & White – Temple, Texas
- Brigham and Women’s University – Boston, Massachusetts
- University of Chicago – Chicago, Illinois
- Johns Hopkins Hospital – Baltimore, Maryland
- Barbara Ann Karmanos Cancer Institute – Detroit, Michigan
List of Physicians, Cancer Treatment and Research Centers by State
Where Can I Get More Mesothelioma Medical Information?
The first and best source for medical information is your doctor. There are also several good general sources of information on the Internet. Some of the links to other Web sites that may help you find more medical information ar
How Do I Find Support Groups?
Mesothelioma is a rare disease, so it can be difficult to locate support groups in your area. However, it’s important to find other people that are experiencing many of the same challenges you may be facing. Very worthwhile support group: www.cancer.org