What is mesothelioma?

Mesothelioma is a form of cancer affecting the abdominal cavity, chest cavity, and the region surrounding the heart. Due to its uncommon nature, mesothelioma is typically difficult to diagnose and treat. It has been connected with exposure to asbestos, a material formerly present in many work environments. Only about 3,000 individuals are diagnosed annually.

Individuals with a history of extended asbestos exposure are at the highest risk for developing malignant mesothelioma. Even a small exposure to this cancer-causing material can result in malignant mesothelioma. However, mesothelioma has a latency of up to thirty-forty years, and many individuals previously exposed to asbestos are now displaying symptoms. This means the average age of mesothelioma patients is between 50 and 70 years. Men are typically affected more, due to the common presence of asbestos in industrial settings. There are three major types of malignant mesothelioma . epithelial, sarcomatoid, and mixed. Epithelial mesothelioma is most common. Symptoms may include, but are not limited to respiratory distress, a lasting cough, and pneumonia. In addition, symptoms are often mistaken for less serious ailments, and many patients do not show any signs at all.

Individuals with pleural mesothelioma may accumulate some fluid between the lung lining and chest cavity. This can be detected through a chest x-ray, as well as CT scans.

Diagnosis of Mesothelioma is based on a pathological exam, more commonly referred to as a biopsy. This exam will test a tissue sample for the presence of malignant and/or pleural mesothelioma.

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Asbestos as the Primary Cause of Mesothelioma

Asbestos is a type of insulation material, which was used widely in the past in the following industries:

• Construction industry
• Ship building industry
• Automotive industry
• Other manufacturing industries

Mesothelioma occurred most often in persons who worked in the above industries and were exposed to asbestos in their workplace. The use of asbestos was very widespread after 1945. However, first symptoms of mesothelioma may not become apparent 10-40 years after the initial exposure, which makes it very hard to diagnose. The peak in mesothelioma cases is expected to be reached around 2010 according to some studies. There are three most commonly used types of asbestos: white, brown, and blue. Brown and blue asbestos are most commonly associated with mesothelioma. These types of asbestos have been banned by most countries in the 1990s.

Asbestos is a very dangerous substance and can cause a lot of damage to your health. It is made up of very small fibers, which can find their way to pleura (outside lining of the lung) and damage the cells pleura is made of. These fibers can also be carried on clothing, which makes them dangerous not only to the person exposed to asbestos, but to their family members as well.

How Do Doctor's Diagnose Mesothelioma?

The first step to diagnosing mesothelioma is a complete evaluation of a patient's medical history to determine symptoms and any past asbestos exposure, as well as a complete physical. In addition, physicians may request an MRI (magnetic resonance imaging) scan or an X-ray of the abdomen or chest region to help determine the location and size of the tumor.

In cases of pleural and peritoneal mesothelioma, fluid (effusion) may collect in the chest or abdominal region. Physicians may use a procedure known as fine needle aspiration to obtain a sample of this fluid for further testing. In addition, this procedure can be used to drain the effusion to temporarily relieve chest pain or other symptoms.

Usually, a biopsy of the tumor is required to make a diagnosis, however, sometimes only a fluid sample is needed. Below are a number of procedures commonly used.

Peritoneoscopy

In a case of peritoneal mesothelioma the doctor will use a tool called a peritoneoscope, which will be placed inside an opening made in the patient's abdomen. If fluid is found in the abdomen it will be drained through a process called paracentesis, which requires a needle to be placed inside the abdomen in order to extract the fluid.

Thoracoscopy

In diagnosing pleural mesothelioma a doctor may use a special instrument called a thoracoscope in order to examine the patient's chest cavity. This test requires an incision to be made in the chest wall, which will be used to place the thoracoscope between the patient's ribs. If the doctor finds fluid collected in a patient's chest, it will be drained out of the chest cavity through a needle. This test commonly requires anesthetic or another form of pain suppression.

Biopsy

If cancerous tissue is found in the patient's lungs or abdomen it will be extracted and examined by the doctor. This process helps the doctor determine potential ways of treatment and is usually done during the above two processes or may require additional surgery.

Mesothelioma Symptoms

In early stages of the disease, mesothelioma may not have any visible symptoms and is very hard to detect. In later stages of development, certain symptoms begin to develop and are usually caused by the growth of cancer and its pressure on certain nerves.

The symptoms of the two main types of mesothelioma (Pleural and Peritoneal) are described below:

Peritoneal Mesothelioma:

• Abdominal pain (stomach)
• Abdomen swelling
• Feeling sick
• Loss of appetite
• Losing over 10% of your body weight while not dieting
• Constipation and diarrhea

Pleural Mesothelioma:

• Lower back of chest pain
• Continual Cough
• Breath shortness
• Husky voice
• Losing over 10% of your body weight while not dieting
• Fever or sweating
• Trouble swallowing

The above symptoms may be caused by other illnesses not related to mesothelioma, however, if you have been exposed to asbestos in the past or if the symptoms persist, it is very important that you consult with your physician or health care provider immediately.

Pleural Mesothelioma - Cancer of the Lung Lining

Pleural Mesothelioma affects the chest cavity, sometimes including the lungs. Metastates, or the spreading of the cancer, can occur in any other organs, and is much more common than originally thought. This form of mesothelioma usually has a slow onset, with the most common symptoms is localized chest pain. This can be accompanied by trouble breathing, caused by pleural effusion, or a buildup of liquid in the pleural space (chest cavity). Additional symptoms include cough, weight loss, and fever. The best test for determining the extent of Pleural Mesothelioma is a computed chest tomograph (CT-scan). Median survival time for this form of Mesothelioma is approximately 17 months from the onset of symptoms. This is the most common form of mesothelioma, accounting for 80-90% of cases.

The pleura are the tissues lining or covering surrounding the actual lungs. There are 2 pleural membranes, separated by the pleural space. These membranes are fibrous sheets, protecting the lungs by producing a lubricating fluid to assist in lung operation.

Peritoneal Mesothelioma

Peritoneal Mesothelioma affects the abdomincal cavity and organs, including the liver, spleen and bowels. Pain is the most common symptom in cases of Peritoneal Mesothelioma. However, the accumulation of fluid can often cause the abdominal region to appear enlarged. Other common symptoms include vomiting, nausea, foot swelling, increased body temperature or fever, and difficulty in moving bowels. The survival time is poorer than pleural mesothelioma, with most patients averaging 10 months from the first display of symptoms. Peritoneal Mesothelioma accounts for approx. 10 percent of mesothelioma cases

Pericardial Mesothelioma and Desmoplastic Malignant Mesothelioma

Pericardial Mesothelioma is affects the thin lining of tissue that surrounds the heart, or the pericardium. This cancer can occur at any age, although the mean age of presentation is 46. Symptoms include chest pain, cough, dyspnea, and palpitations. As with the other forms of Mesothelioma, a strong link to asbestos exposure seems evident. Surgery and radiation therapy can provide some palliation, however the prognosis is extremely poor.

A common sign of pericardial mesothelioma is pericardial effusion, or a collection of fluid in the sac that surrounds the heart. If caused by cancer, this symptom can be caused by the direct spread of cancer, or the result of cancer metastasized from other parts of the body.

Desmoplastic Malignant Mesothelioma

Desmoplastic malignant mesothelioma is the growth of fibrous or connective tissues around the tumor of the lining of the lung or chest cavity. The term .desmoplastic. refers to the growth of fibrous or connective tissue. "Desmo-" comes from the Greek "desmos" meaning "a fetter or band" and "-plastic" is also borrowed from the Greek, from "plassein" meaning "to form" = to form a band or fetter.