Mesothelioma cancer most commonly develops in the lungs of people exposed to asbestos.
Effective treatments are available to ease symptoms and improve your prognosis.
Mesothelioma is a rare cancer caused almost exclusively by exposure to asbestos. It usually affects the thin, protective membrane surrounding the lungs, heart or abdominal cavity. Doctors diagnose an estimated 3,000 cases of mesothelioma a year in the United States, and the majority of those are traced to job-related exposure.
Although asbestos use declined dramatically in recent decades in this country, the incidence of mesothelioma remains steady. That difference can be traced to the distinct latency period linked to mesothelioma. The disease can take anywhere from 20 to 50 years after exposure to asbestos before it shows obvious symptoms and an oncologist can make a definitive diagnosis. While no cure for the disease exists and the prognosis is typically poor, researchers made significant progress in recent years in understanding mesothelioma and developing new treatment options and alternative therapies.
How Asbestos Causes Mesothelioma
Mesothelioma cancer develops after exposure to asbestos, which most often occurs in the workplace – in industrial settings, shipyards, auto repair shops, old houses, schools and public buildings. It usually takes long-term exposure to put someone at risk, asbestos is highly toxic. Even short-term and one-time exposures are known to cause mesothelioma cancer.
Microscopic asbestos fibers are breathed in or swallowed. The human body has difficulty destroying or getting rid of these fibers. Over decades, the fibers cause biological changes that result in inflammation, scarring and genetic damage. The most susceptible area to these fibers is the lining of the lungs, called the pleura, although fibers also can become trapped in the lining of the abdominal cavity (peritoneum). Once fibers cause biological damage, the stage is set for the decades-long latency period for the development of malignant mesothelioma.
Types and Symptoms
Pleural mesothelioma is the most common type of mesothelioma, representing about 75 percent of cases. Peritoneal mesothelioma is the second most common type, consisting of about 10 to 20 percent of cases. Approximately 1 percent of cases are of the pericardial variety. Another rare type known as testicular mesothelioma represents less than 1 percent of cases.
This type forms in the lining of the lungs. An increased incidence rate led to more studies to improve treatment methods and survival rates.
Developing in the lining of the abdominal cavity, peritoneal mesothelioma responds best to a combination of surgery and heated chemotherapy.
Emerging from the lining of the heart, pericardial mesothelioma is the most challenging to treat because of tumor location.
Because early symptoms of mesothelioma are so mild, few people notice or recognize them, and many don't experience any symptoms until later stages of the cancer. Fatigue and slight pain around the tumor may surface in early stages. Late-stage malignant mesothelioma symptoms are more noticeable and commonly provoke someone to visit the doctor. These late-onset symptoms can include shortness of breath, chronic pain near the tumor, weight loss, fluid buildup or bowel obstruction. Effective therapies are available to relieve symptoms, and some treatments, like talc pleurodesis, can even prevent symptom recurrence.
How Mesothelioma is Diagnosed
All patients have a unique path to a diagnosis, but the most important factors to an accurate diagnosis are imaging scans and biopsies. Doctors use several tests to diagnose mesothelioma. Most people initially undergo a basic chest X-ray to check for any abnormalities. If abnormal growth is detected, a doctor will recommend a more detailed imaging scan like a PET scan, CT scan or MRI. If mesothelioma is suspected, a biopsy will be recommended. In a biopsy, a tissue sample is collected to confirm the presence of mesothelioma cells.
Blood tests for mesothelioma are also available, but they do not confirm the presence of mesothelioma. Research and development is underway to determine if mesothelioma blood tests can aid in early diagnosis for at-risk former asbestos workers.
There are at least five systems that doctors use for the staging of pleural mesothelioma. Older systems like those created by Drs. Butchart and Sugarbaker did not classify tumors with tumor-node-metastasis (TNM) descriptors, so the International Mesothelioma Interest Group (IMIG) developed the detailed IMIG staging system in 1995. This system is the most widely used staging system for mesothelioma.
Treatment options for mesothelioma include surgery, chemotherapy and/or radiation therapy. Many mesothelioma doctors prefer to combine two or more of these treatments, an approach known as multimodal therapy. Clinical trials show this approach has improved survival rates.
Curative surgery is available for early stage patients, while palliative surgery is best for late-stage patients and helps to ease symptoms.
Chemotherapy is often combined with surgery or radiation therapy to kill malignant cells, shrink tumors, prevent recurrence and relieve symptoms.
Radiation therapy is used alone or in combination with chemotherapy or surgery to kill cancer cells, manage tumors and prevent tumor seeding.
Palliative treatments that ease symptoms are quite common for patients of all stages. Experimental therapies like immunotherapy are showing progress for the future of mesothelioma treatment. Additionally, less traditional alternative treatments are available and widely touted by mesothelioma survivors.
Mesothelioma Doctors & Treatment Centers
Mesothelioma doctors encompass a number of specialties, including surgeons, medical and radiation oncologists, radiologists, pathologists and palliative care specialists. All can be part of a mesothelioma treatment team. Working with a mesothelioma specialist can make all the difference in your treatment.
The most regarded mesothelioma treatment centers attract patients from across the country. Renowned for their cutting-edge technology and groundbreaking research, these centers connect patients with a multidisciplinary team of physicians with years of experience in treating mesothelioma.
Funding for mesothelioma research falls far short of that for other cancers, but new drugs and treatment options are facilitated through important clinical trials. These experimental studies are small and controlled opportunities for scientists to develop effective drugs like Cisplatin and Carboplatin. New cutting-edge clinical trials are being introduced all the time at cancer centers around the world.
Support Group for Mesothelioma Patients & Families
If you or a loved one has been diagnosed with a form of mesothelioma, join our support group to hear from others who find themselves in the same situation as you. Call (800) 615-2270 to sign up.
The prognosis for mesothelioma is most affected by the stage of the cancer. Both early and late-stage patients have treatment options to improve their prognosis. Many mesothelioma patients live longer than their estimated life expectancy and such outcomes are dependent on a number of prognostic factors, including:
- Stage of cancer
- Type of mesothelioma
- Tumor cell type
- Overall health
- Size and location of tumor
- Blood characteristics
Despite the often poor prognosis of someone who has malignant mesothelioma, there are a number of encouraging stories of success – bios of people who are beating the disease and living to celebrate special days with wives, husbands, kids and grandkids. Each mesothelioma survivor has a tale to tell, and there is something to take away from every story.
Legal Help for Mesothelioma
People with malignant mesothelioma often have legal options because of the cause of the disease - exposure to asbestos. Those options include filing a claim with an established asbestos trust fund or filing a lawsuit against a company or companies believed to be responsible for the exposure. A winning claim, a winning lawsuit or a case settlement can help patients recoup medical expenses and can help secure the financial future for their families.
Fast Fact: A 2011 report from the Government Accountability Office reported that $36.8 billion remained in asbestos trusts. This money was set aside to help compensate people with mesothelioma and their families.
One reason legal options exist is because of liability. Asbestos-related diseases are considered 100 percent preventable. Asbestos mining companies, manufacturers of asbestos-containing products, and employers who did not inform workers about potential exposure all could have some liability issue if they fail to prevent exposure to asbestos. Communicating with an experienced mesothelioma lawyer helps patients and families understand how legal options can help cover other damages.
Most mesothelioma lawsuits are settled out of court - before they to go trial. A paper trail of occupational asbestos exposure can lead defendants to get out from under lawsuit costs as soon as possible. Settlements can range from moderate to large sums, it all depends on the case.
The outcome of an asbestos-related lawsuit can vary because each case is unique and comes with its own set of facts, but juries have returned with verdicts of $337.million (for Alfred Todak), $30.3 million (for Susan Buttitta) and $22 million (for Eugene McCarthy and Walter Koczur).
Recent Mesothelioma News
Researchers at the National Cancer Institute recently uncovered a better way to use immunotoxin drugs like SS1P to kill mesothelioma cancer cells without harming the healthy ones. The key was finding the right drug combination to work as immune suppressors, which allowed the immunotoxin to work more effectively. The results were impressive, as a large percentage of patients with advanced mesothelioma found their tumors shrink during a recent trial with SS1P.
University of Pennsylvania researchers also came up with a recent advancement in the staging of mesothelioma, which should allow doctors to diagnose the disease earlier and treat it more effectively. Their study involved previously overlooked posterior intercostal lymph nodes, which were examined for the first time in patients who had undergone radical pleurectomies.