Easy Steps to Prevent Mesothelioma

Mesothelioma is a rare cancer that attacks the body's mesothelial cells around the organs. The mesothelium provides a protective membranous lining for the internal organs and allows moving organs (i.e. the heart and the lungs) to glide easily against adjacent structures. The names of the three regions of mesothelial cells that provide protective coating are 1) pleura, the sac which surrounds the lungs; 2) peritoneum, the lining which protects the abdominal cavity; and 3) pericardium, the sac which surrounds the heart. Three different types of mesothelioma cancer attack these three different regions.
Pleural mesothelioma: A type of lung cancer which attacks the pleura surrounding the lungs, this is the most common type of mesothelioma, affecting approximately two-thirds of all mesothelioma patients. Symptoms include horseness, fever, blood in sputum, swollen arms and face, coughing, loss of weight, difficulty breathing, chest pain, weak muscles, and reduced tactile sensitivity.

Peritoneal mesothelioma: A cancer of the abdomen which attacks the peritoneum lining the abdominal cavity. This affects approximately one-third of all mesothelioma patients. Symptoms include abdominal bloating, impaired bowl function, fever, swollen feet, and nausea.

Pericardial mesothelioma: This form of mesothelioma which attacks the pericardium surrounding the heart is extremely rare. Symptoms include chest pain, dyspnea, cough, and palpitations. Mesothelioma has been linked to asbestos exposure. Asbestos is a type of building material used in thermal insulation products and ceiling tiles. In the United States, asbestos usage peaked during the 1950s - 1970s. During the late 1960s, concerns over the health consequences of asbestos exposure began to arise, thereby decreasing the amount of asbestos manufactured in next two decades. By the 1980s, a new industry of asbestos abatement began to flourish. But according to the United States Environmental Protection Agency (EPA), as many as 733,000 schools and public buildings still contain asbestos.
Small asbestos fibers that enter the air do not evaporate and can remain suspended in the air for a long time. These fibers, when breathed into the body, are toxic. There are three types of asbestos exposure.

Occupational asbestos exposure: People working in factories that manufacure asbestos are likely to have a high exposure to asbestos and are most at risk of developing asbestosis or mesothelioma.

Paraoccupational asbestos exposure: Family members of workers exposed to asbestos in the workplace are susceptible to exposure from asbestos dust brought home by the worker on his clothes or skin.

Neighborhood asbestos exposure: Those who live in the vicinity of an asbestos manufacturing plant are also at risk.
Mesothelioma is still a relatively rare form of cancer. There are an estimated 2,000 - 3,000 new cases per year in the United States. Approximately 7-13 per one million male patients with a history of asbestos exposure contract mesothelioma. Diagnosis usually occurs 20-40 years after initial exposure to asbestos.

About the author:
Amie Perlowski writes about mesothelioma and other asbestos-related diseases. Learn more at http://www.lsasbestoslaw.com/results.html.

Asbestos Cancers

About Asbestos Cancers

Asbestos cancer is a general term for a variety of cancers caused by exposure to asbestos. Malignant mesothelioma, a rare cancer of the membranes that line the chest (pleural mesothelioma) and abdomen (peritoneal mesothelioma), is nearly always attributable asbestos exposure. Lung cancer may also be asbestos related.

Mesothelioma is sometimes mistakenly referred to as a lung cancer because almost two-thirds of the diagnosed cases affect the pleural lining, which predomenantly surrounds the lungs. In actuality, this cancer resides outside the lungs, but may affect their functioning, as it is the job of the pleural lining to permit movement between the lungs, diaphragm and other organs as they function (think of the expansion and contraction of the lungs as the breath in and expel air).

What is asbestos?

Asbestos is a fibrous mineral that has been used widely in everyday products because it won't conduct electricity and is heat- and chemical- resistant. These asbestos fibers, when loose, can easily be inhaled or swallowed, and remain in the body for years, eventually resulting in an asbestos-related cancer.

Symptoms and Diagnosis

Symptoms

Because asbestos fibers remain in the body so long, symptoms of asbestos-related diseases may only appear decades after the asbestos has been inhaled. Common symptoms of an asbestos-related cancer include:

• Shortness of breath
• A cough or a change in cough pattern
• Blood in the sputum (fluid) coughed up from the lungs
• Pain in the chest or abdomen
• Difficulty in swallowing or prolonged hoarseness
• Significant weight loss

If any of these symptoms develop and you believe you may have worked with--or been around someone who has worked with--asbestos, make an appointment to see your doctor immediately.

Diagnosis

Once you have contacted your physician and explained your symptoms, the doctor may perform a complete physical examination. This may include a chest x-ray and lung function tests. While a chest x-ray cannot determine whether there are asbestos fibers in the lungs, it can help determine whether your lungs may have changed due to asbestos exposure. A x-ray specialist in asbestos-related diseases may be required to examine and interpret your x-rays.

If an abnormal area is found through the x-ray, you may need to have a biopsy to learn if that area is cancerous. In a biopsy, a surgeon or a medical oncogolgist (a doctor who specializes in diagnosing and treating cancer) removes a tissue sample. Then this sample is examined under a microscope by a pathologist.

Because asbestos fibers can be found in urine, feces, mucus, or material from the lungs, you may have to undergo additional testing to determine the scope of your condition.

Treatment of Mesothelioma

Treatment of MM using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.

Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing with a 5 year survival rate of less than 10%. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. It is not possible to remove the entire mesothelium without killing the patient.

Radiation

For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy with radiation often times being given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.

Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.

Chemotherapy

In February 2004, the Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.

Immunotherapy

Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.

Heated Intraoperative Intraperitoneal Chemotherapy

A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute.The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.

This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.

What Is Mesothelioma

Malignant mesothelioma is an uncommon, but no longer rare, cancer that is difficult to diagnose and poorly responsive to therapy. Malignant mesothelioma is the most serious of all asbestos-related diseases.

A layer of specialized cells called mesothelial cells lines the chest cavity, abdominal cavity, and the cavity around the heart. These cells also cover the outer surface of most internal organs. The tissue formed by these cells is called mesothelium.

The mesothelium helps protect the organs by producing a special lubricating fluid that allows organs to move around. For example, this fluid makes it easier for the lungs to move inside the chest during breathing. The mesothelium of the chest is called the pleura and the mesothelium of the abdomen is known as the peritoneum. The mesothelium of the pericardial cavity (the "sac-like" space around the heart) is called the pericardium.

Tumors of the mesothelium can be benign (noncancerous) or malignant (cancerous). A malignant tumor of the mesothelium is called a malignant mesothelioma. Because most mesothelial tumors are cancerous, malignant mesothelioma is often simply called mesothelioma.

Mesothelioma was recognized as a tumor of the pleura, peritoneum and pericardium in the late 1700's. However it was not until much later, in 1960, that this particular type of tumor was described in more detail and even more importantly, its association with asbestos exposure was recognized. The first report linking mesothelioma to asbestos exposure was written by J.C.Wagner, and described 32 cases of workers in the "Asbestos Hills" in South Africa. Since then, the relationship between mesothelioma and asbestos exposure has been confirmed in studies around the world.

The incidence of mesothelioma in the United States remains very low, with 14 cases occurring per million people per year. Despite these numbers, the noticed threefold increase in mesothelioma in males between 1970 and 1984, is directly associated with environmental and occupational exposure to asbestos, mostly in areas of asbestos product plants and shipbuilding facilities.

Although the disease is much more commonly seen in 60-year-old men, it has been described in women and early childhood as well. The cause of the disease is not so well understood in these latter two groups, but there is some evidence of possible asbestos exposure for some of these cases as well.

Malignant mesothelioma is divided into three main types. About 50% to 70% of mesothelioma occurrences are the epithelioid type. This type has the best prognosis (outlook for survival). The other two types are the sarcomatoid type (7%-20%), and the mixed/biphasic type (20%-35%). Treatment options for all three types are the same.

About three-fourths of mesothelioma occurrences start in the chest cavity and is known as pleural mesothelioma. Another 10% to 20% begin in the abdomen and is called peritoneal mesothelioma. Pericardial mesothelioma, starting in the cavity around the heart, is very rare. The covering layer of the testicles is actually an outpouching of peritoneum into the scrotum. Mesothelioma that affects this covering of the testicles is quite rare.