What is Mesothelioma?

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Mesothelioma is a type of cancer that develops in the layers of tissue that surround the
internal organs (the mesothelium). The lining of the lungs (the pleura) is the most commonly
affected area, but cancer can also develop in the tissue in the abdomen that surrounds
the digestive organs (the peritoneum), the lining of the heart, and the tissue that surrounds
the testicles.^[1]

Mesothelioma typically develops slowly, manifesting itself in symptoms such as extreme
tiredness, fever, shortness of breath, chest pain, a persistent cough, nausea, abdominal
pain, swelling or weight loss.^[2]

The majority of mesothelioma cases are a result of exposure to asbestos, a once common
building material that is now known to be highly toxic. The more exposure to asbestos, the
greater the risk of cancer. Roughly five times more men than women are diagnosed with
mesothelioma and around half of all cases occur in individuals 75 years of age or older. It
is a fairly rare type of cancer, with around 3,000 reported cases in the USA each year.^[3]

There is no known cure for mesothelioma and treatment can be challenging. Life expectancy,
therefore, is often limited to between several months and several years after the initial
diagnosis.

Symptoms of Mesothelioma

The symptoms of mesothelioma can be difficult to detect due to their similarity to the symptoms
of other, more common, conditions. Symptoms can also be very slow to develop, making them
potentially unnoticeable in the condition’s early stages. In some cases, they can take
decades to fully develop.

Symptoms can also differ according to the cancer’s location.

Pleural mesothelioma in the tissue lining of the lungs has symptoms that include:

• Shortness of breath
• Lower back or chest pain
• Fatigue
• A persistent cough (especially if coughing up blood)
• Difficulty swallowing
• Fever or sweating (particularly at night)
• Sudden weight loss or lack of appetite

Peritoneal mesothelioma in the abdomen tissue that surrounds the digestive organs has symptoms that include:

• Abdominal swelling and pain
• Breathing difficulties
• Nausea
• Sudden weight loss or lack of appetite
• Constipation or improper bowel function
• Fever or sweating (particularly at night)

Pericardial mesothelioma, a rare form of the condition that develops in the lining of the
heart has symptoms that include:

• Heart palpitations, heart murmurs or an irregular heartbeat
• Difficulty breathing
• Chest pain
• Coughing
• Fever and night sweats

Causes of Mesothelioma

Although there are rare instances where no link can be found, the vast majority of all cases
of mesothelioma — some 80 percent — are directly related to exposure to asbestos. The link
between asbestos and mesothelioma, therefore, is considered indisputable by healthcare
professionals.

Asbestos is a naturally occurring mineral that has been known of since antiquity and mined
since the early 19th century, though it was only in the latter half of the 20th century that
it became common building material. Although researchers discovered a link between asbestos
and cancer as early as the late 1940s, the extent of its dangers did not become common
knowledge until much later and it was only banned in the USA in 1989.^[4]

Those with a history of long-term exposure to asbestos are most at risk of being diagnosed
with mesothelioma. However, cases have also been reported of mesothelioma in individuals
who were only exposed to the material for a relatively short period of time (1-3 months).

Environmental Exposure

Statistically, populations living close to naturally occurring asbestos deposits are at a far
higher risk of developing mesothelioma than those who do not. Naturally occurring asbestos
is found across the globe, including in the United States, Canada, and South Africa. Forty
percent of the world’s asbestos is mined in Russia, with large amounts also mined in China
and Kazakhstan.

When the earth is mined or construction work is undertaken, the asbestos is disturbed, releasing
particles into the air and exposing large areas to the risk of inadvertent inhalation.

Occupational Exposure

Working with asbestos, particularly in the construction and mining industries, has been
proven to vastly increase one’s risk of developing a number of diseases, including malignant
mesothelioma. Despite asbestos now being banned, the risk of exposure still exists when
dealing with buildings built before the banning order took effect. The use of masks and
artificial respiratory systems has been shown to greatly reduce the risks posed.

Diagnosing Mesothelioma

Due to the symptoms of mesothelioma also being common to less serious conditions, as well
as to other pleural and peritoneal malignancies, the cancer can often be difficult to diagnose.
Those with a history of exposure to asbestos who display the symptoms should therefore make
this clear to their care providers and seek out a doctor specializing in mesothelioma.

A full diagnosis of the cancer can take months, from first identification through initial
imaging tests to confirmation through biopsies. Due to the rarity of the disease, patients
displaying the symptoms will first be asked to recall their full work history and any
exposure to asbestos. Prolonged exposure is grounds for clinical suspicion of mesothelioma
and will significantly hasten the diagnostic process.

Imaging

If an initial chest X-ray shows signs of pleural thickening — a tell-tale sign of mesothelioma
— a PET scan, CT scan, MRI, or a combination of the three will follow. These scans give doctors a detailed look inside the body, allowing them to identify the presence of any
malignant cancer. If a large amount of fluid is found in the pleural cavity, it is common
for doctors to drain the fluid using a syringe and test it for cancerous cells. Though it
does not completely exclude the presence of mesothelioma, if no cancerous cells are found,
the chances of the disease are greatly reduced.

Blood tests

Like all types of cancer, mesothelioma releases abnormal substances into the bloodstream.
While there is no test that can definitively identify these substances and diagnose
mesothelioma, various biomarker tests, or assays, are available and can be useful to the
diagnostic process.

Biopsy

The presence of malignant mesothelioma can only be fully confirmed with a full biopsy. To
do this, a pathologist will examine a tissue sample, or in the case of suspected chest cancer
or abdomen cancer, this may involve a thoracoscopy or laparoscopy, respectively. These
procedures are types of minimally invasive surgery, wherein surgeons are able to remove a
tissue sample through a small incision in the abdomen or chest.

Mesothelioma Treatment

There currently exists no cure for mesothelioma, however, there are treatments available
that can help prolong life expectancy and improve quality of life. These typically involve
a combination of surgery, chemotherapy and radiation therapy. In some cases, emerging or
experimental treatments may also be prescribed.^[5] The direction that treatment will take
is largely determined by the maturity of cancer, the age and general health of the
patient, as well as how far cancer has spread (this will depend on what stage cancer
has entered – see the prognosis section for more details on the stages of mesothelioma).

Surgery

If cancer has been detected early, surgery will involve fully removing the tumor(s) —
or, depending on where the cancer is located — the mesothelial lining, lymph nodes or sections
of the lungs or heart. However, if the cancer is more developed, this may be impossible and
surgery will typically be paired with chemotherapy or radiation therapy — a treatment route
that has proven effective in combatting malignant mesothelioma.

Chemotherapy

Courses of chemotherapy have proven the most effective treatment method in combatting
mesothelioma in controlled testing. Chemotherapy drugs work by halting the multiplication
of cancerous cells in the body and thereby stopping the spread of the disease and the
development of tumors.^[6] There are more than 100 types of chemotherapy drugs currently
available on the market, with each differentially effective in treating patients in different
stages of the disease.

Chemotherapy can result in significant side effects, most commonly vomiting, stomatitis, exhaustion, and diarrhea. Typically, the chemotherapy drugs are administered intravenously in cycles of several weeks followed by a short recuperation break. To lessen the side effects and more directly target specific tumors, doctors have pioneered a method of localized chemotherapy whereby the drug is injected straight into the tumor itself. While this method has proven effective in combatting early-stage mesothelioma, it is not suitable for tackling the disease once it has spread from its original location.

Radiation Therapy

If cancer remains localized and the patient is in otherwise good health, radiation
therapy, in conjunction with surgery and sometimes chemotherapy as well, can be an effective
treatment method. It has been shown to significantly improve a patient’s prognosis, however,
it is considered a radical option that can result in serious side effects. These can include
pneumonitis; a condition that involves the inflammation of the alveoli (air sacs) in the
lungs that can sometimes be fatal in itself.

Emerging Treatments

If surgery, chemotherapy, and radiation therapy prove ineffective, some patients may be
eligible for emerging treatments in their clinical trial stage. These treatment options are
those that have not yet been approved by the U.S. Food and Drug Administration and are
therefore considered experimental.

One such promising treatment method is immunotherapy. This type of treatment harnesses the
power of the body’s own immune system, training it to specifically attack the cancerous
cells and leave the healthy cells alone. This is done by introducing antigens (substances
the body recognizes as toxic) into the body, stimulating and improving the immune system’s
response to their presence. When used in addition to conventional methods, immunotherapy
has seen some success in improving life expectancies.

Across the world, numerous clinical trials are taking place on new drugs for the treatment of
mesothelioma. These new, cutting-edge drugs promise to advance the treatment of cancer
and improve the prognosis of patients. New drugs take years to be tested and become
available on the market, though patients with particularly severe cases may be eligible
for inclusion on these clinical trials.

Mesothelioma Prognosis

Mesothelioma spreads quickly and is difficult to treat, meaning the prognosis is generally
poor. Roughly 50 percent of people with mesothelioma in one location are expected to survive
until the first anniversary of their initial diagnosis. Life expectancy after diagnosis,
however, depends on a multitude of factors, most significantly the stage at which the cancer
is detected and the age of the patient.

People diagnosed with mesothelioma before the age of 50, and women in particular, can expect
a better prognosis. Whether the cancer is pleural or peritoneal is also a factor. The prognosis
can be improved by maintaining a healthy lifestyle, seeing a mesothelioma specialist and
receiving a second opinion.^[7]

Long-term survival, however, is rare, with around one in every 10 people surviving for over 5 years after diagnosis.^[8]

Doctors generally describe the growth and spread of mesothelioma using the idea of four stages:

• Stage 1: The earliest stage of the cancer when it is still localized to one area of
  the body, with no spread to the lymph nodes or metastasis. If mesothelioma is detected
  during this stage the patient has the most treatment options and can expect a higher life
  expectancy.
• Stage 2: The cancer is still largely localized to one side of the body, but may have
  spread to the lymph nodes or other organs. Aggressive treatment options may still be an
  option.
• Stage 3: The cancer is still localized to one side of the body, but has spread further,
  including to the lymph nodes. Surgical treatment methods become less viable.
• Stage 4: The cancer has conclusively spread to areas far beyond its origin (distant
  metastases). Treatment at this stage is generally limited to easing the uncomfortable
  symptoms.

Legal Issues Related to Mesothelioma

Many people have sought to claim compensation for the development of mesothelioma as a result
of exposure to asbestos. Since the first in 1929, large amounts of lawsuits and class action
cases have been launched, normally against asbestos manufacturers and employers.^[9] In the
The USA, total claims have reached billions of dollars. Despite these precedents in the courts,
as yet, the US Congress has passed no federal law on the issue.

Mesothelioma FAQs

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1. Cancer Research UK. “Mesothelioma.” November 10, 2015. Accessed June 21, 2017. ↩

2. NHS Choices. “Mesothelioma” March 02, 2016. Accessed June 21, 2017. ↩

3. American Cancer Society. “Malignant Mesothelioma.” February 17, 2016. Accessed June 21, 2017. ↩

4. Asbestos. [“Why Isn’t Asbestos Banned in the United States.”] (https://www.asbestos.com/blog/2012/09/17/why-isnt-asbestos-banned-in-the-united-states/) September 17, 2012. Accessed June 21, 2017. ↩

5. Mesothelioma. “Mesothelioma Treatment” Accessed June 22, 2017. ↩

6. Pleural Mesothelioma Center. “Chemotherapy for Mesothelioma.” November 29, 2016. Accessed June 22, 2017. ↩

7. The Mesothelioma Group. [“Mesothelioma Prognosis.”] (https://www.mesotheliomagroup.com/mesothelioma/prognosis/) Accessed June 22, 2017. ↩

8. American Cancer Society. [“Survival statistics for mesothelioma.”] (https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html) February 17, 2016. Accessed June 22, 2017. ↩

9. Asbestos. “Compensation & Financial Assistance.” June 16, 2016. Accessed June 22, 2017. ↩

10. Mesothelioma Web. “Benign Mesothelioma.” Accessed June 22, 2017. ↩

11. Asbestos Network. “Asbestos and Cigarette Usage Increases Risk of Asbestos lung Cancer.” Accessed June 22, 2017. ↩

12. Surviving Mesothelioma. “Is Mesothelioma Hereditary?” February 27, 2012. Accessed June 22, 2017. ↩

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**What ‍is Mesothelioma?**



Mesothelioma is a rare and aggressive cancer‌ that ‍originates from ​the thin ‍lining that surrounds the lungs, chest, ⁢or abdomen ⁤(known as the pleura or peritoneum). This⁤ lining, known as the mesothelium,⁤ protects​ these organs and produces fluid to aid in their smooth function.



**Causes of​ Mesothelioma**



The primary cause of mesothelioma is exposure to asbestos, a fibrous​ mineral. When asbestos fibers are inhaled⁢ or swallowed, they can lodge ​in the ‌lungs or abdomen and over time, damage the‌ DNA of‍ mesothelial cells. ⁣This damage can lead to uncontrolled cell growth⁤ and the formation of tumors.



**Types of Mesothelioma**



Based on the location of the tumor, mesothelioma is classified into ⁤the following types:



* **Pleural Mesothelioma:** The most common type,​ affecting the lining⁣ of the⁣ lungs (pleura).

* **Peritoneal Mesothelioma:** Occurs in the ⁣lining of the abdomen (peritoneum).

* **Testicular Mesothelioma:** A rare form that ⁤affects the testicles.



**Risk ⁣Factors**



The‌ primary risk factor‌ for mesothelioma⁤ is exposure to asbestos. Other potential risk factors include:



* Occupation: ​Occupations⁣ like mining, construction, and shipbuilding have a⁣ higher ‌risk due to ⁣asbestos exposure.

* Environmental exposure: Living⁢ in areas with high ‍levels of asbestos in soil or water can increase risk.

* Military service: Asbestos was used extensively in military equipment and‍ buildings, posing risks to veterans.

* ⁢Genetics: In rare cases, genetic mutations may make individuals more susceptible ⁢to mesothelioma.



**Symptoms**



Symptoms of ⁢mesothelioma vary depending on the ⁢type and location of the tumor. Pleural mesothelioma commonly causes:



* Shortness of ‌breath

* Chest pain

* Dry cough

* Fatigue



Peritoneal mesothelioma may lead to:



* Abdominal pain

* Bloating

* Weight loss

* Nausea



**Diagnosis**



Diagnosing mesothelioma typically involves a combination of:



* Medical history and physical exam

* Chest or⁤ abdominal X-ray

*‌ CT or MRI scans

* Biopsy to confirm the ‍diagnosis



**Treatment**



Treatment options for mesothelioma are tailored to the individual patient and may include:



* Surgery to remove the tumor

*‍ Radiation therapy to kill⁣ cancer cells

* Chemotherapy to ‌shrink tumors

* Palliative care to⁤ manage symptoms



**Prognosis**



The prognosis for ⁤mesothelioma depends​ on various factors, including the stage of the disease,​ overall ⁣health, and type of treatment. While it is a rare ⁣and aggressive form of cancer, advances in treatment ⁤and research offer hope for patients.