Malignant mesothelioma is a rare, asbestos-related cancer that usually forms on the protective lining of the lungs and abdomen. The disease has no definitive cure, but advancements in conventional treatments along with emerging therapies are helping patients improve their survival.
Perceptions about malignant mesothelioma are changing.
Incidence rates still hover around 3,000 new cases each year in the U.S., according to a 2017 report from the Centers for Disease Control and Prevention.
Exposure to asbestos, a naturally occurring mineral once highly regarded in construction and manufacturing, is still the overwhelming cause of the disease.
However, scientific research and increased awareness are leading to earlier diagnoses, while improved and developing mesothelioma treatments are allowing patients to live longer than ever.
As more thoracic surgeons and oncologists become familiar with mesothelioma, patients will have more experienced doctors who can extend their life expectancy and increase their chances of surviving this disease.
In order to understand mesothelioma and choose the best path to extend survival, you must first grasp the intricacies of the cancer. Prognosis and life expectancy depend on the type and stage of mesothelioma, along with the age, gender and overall health of the patient.
“I remain optimistic that we can, in the next decade, put together the right combination of patients and treatments to effect a cure, which is our holy grail.”
Director of Lung Institute at Baylor College of Medicine
Each type of mesothelioma is classified by the location in the body where it develops. Prognosis, symptoms and treatment options vary by type. The pleural and peritoneal types of mesothelioma are the most common, while pericardial accounts for just 1 percent of cases.
Another rare type known as testicular mesothelioma represents less than 1 percent of all mesotheliomas.
Mesothelioma can take anywhere from 20 to 50 years after asbestos exposure before symptoms appear. It's the main reason the majority of patients are diagnosed later in life. Approximately 75 percent of cases are men who were exposed to asbestos while serving in the military or working certain blue-collar jobs.
High-risk occupations for asbestos exposure include:
Asbestos use has dropped significantly in recent decades, but the toxic mineral is still prevalent in older buildings. Jobs that may disturb asbestos-containing construction materials continue to put workers at risk.
Non-occupational mesothelioma risk factors include renovating a home or building constructed before 1980, washing the clothes of someone in a high-risk occupation, and living near abandoned asbestos mines or areas where asbestos occurs naturally in the environment.
Court documents provide irrefutable proof the asbestos industry leveraged its power and influence to keep workers and the public in the dark about the hazards of asbestos. Workers were not warned about the carcinogen, and their families paid for the industry's negligence.Read the Full Story
Doctors use several methods to test for malignant mesothelioma, but only a biopsy can truly confirm a diagnosis. This usually comes after a series of other tests and scans once symptoms arise.
Most people initially undergo a basic chest X-ray. If an abnormal growth is detected, doctors will recommend a more detailed imaging scan such as a PET scan, CT scan or MRI.
Blood tests are also available, but they do not confirm the presence of mesothelioma. Research is underway to determine if blood tests can aid in early diagnosis for at-risk former asbestos workers.
If cancer is suspected, doctors will recommend taking a tissue sample, also known as a biopsy. Doctors use biopsies to definitively confirm the presence of mesothelioma cells.
It is essential to consult a doctor at the first sign of symptoms. Because mesothelioma is rare, the cancer is often misdiagnosed as less serious conditions such as the flu or pneumonia.
Anyone who thinks or knows they were exposed to asbestos at some point in time should immediately notify their primary care doctor about their exposure history. This will ensure mesothelioma and other asbestos-related diseases are not ruled out as the cause of the symptoms.
The stage of mesothelioma cancer describes how far the tumor has spread (metastasized) from its point of origin, and doctors label the extent of pleural mesothelioma as stage 1, 2, 3 or 4.
During the early mesothelioma stages, tumors are localized. By the late stages, the cancer has spread to nearby locations or throughout the body.
Typically, patients diagnosed in the early stages can be treated effectively with surgery, chemotherapy and other treatments, while late-stage patients are often treated palliatively to manage their pain and relieve symptoms.
There is no official staging system for pericardial or testicular mesothelioma.
Learn about exposure, symptoms and treatment with our free mesothelioma guide.Get Your Free Guide Now
Mesothelioma symptoms can be so mild that few people notice or recognize them, and many don't experience any until later stages of the cancer. Fatigue and slight pain around the tumor may surface in early stages, while late-stage symptoms are more noticeable and commonly motivate people to visit the doctor.
These late symptoms depend on the type of mesothelioma and can include shortness of breath, chronic pain near the tumor, weight loss, fluid buildup or bowel obstruction. Effective therapies can relieve symptoms. Palliative care focuses on managing symptoms and improving quality of life.
Because this disease represents only 0.3 percent of all diagnosed cancers, most primary care doctors and many oncologists rarely treat or even see mesothelioma. Finding a mesothelioma specialty center with a staff that truly understands the intricacies of the cancer and the best ways to treat it is crucial to extending survival.
A mesothelioma diagnosis is the first step in determining a survival outlook, which is also known as a prognosis period. While life expectancy is based on the average time a person is expected to live, a prognosis is individualized to the patient based on how the disease is expected to affect their body and life span.
The two biggest factors of a mesothelioma prognosis are the stage and cell type of the cancer.
Patients with early stages typically have a better prognosis than those with stage 3 or stage 4 because more treatment options are available the earlier the cancer is detected.
Mesothelioma cancer cells come in three types: Epithelioid, sarcomatoid and biphasic. Epithelioid is the most common and easier to treat than the other types.
Other factors affecting prognosis include age, gender, overall health of the patient and their history of asbestos exposure.
Prognosis varies greatly from person to person, but younger patients, women and people diagnosed with peritoneal mesothelioma typically have a better prognosis than older men diagnosed with the pleural type.
The leading treatment options for mesothelioma include surgery, chemotherapy and radiation therapy. Many specialists prefer to combine two or more of these treatments, which is an approach known as multimodal therapy. Numerous studies show this approach improves survival rates.
Palliative treatments that ease symptoms are quite common for patients of all stages. Emerging therapies, such as immunotherapy, show promise. Additionally, many survivors credit less traditional alternative treatments for helping them live longer.
The type of surgery and most effective delivery method of chemotherapy varies with the type of mesothelioma.
Radiation therapy is used alone or in combination with chemotherapy or surgery to kill cancer cells, manage tumors and prevent cancer from spreading along the path of a biopsy incision.
Aggressive surgeries for pleural mesothelioma include the lung-removing extrapleural pneumonectomy (EPP) and the lung-sparing pleurectomy and decortication (P/D). Palliative surgeries, such as thoracentesis and pleurodesis, aim to control fluid buildup and manage symptoms. Systemic chemotherapy is often delivered before surgery to reduce the tumor size or post-surgery to reduce the risk of recurrence.
The most promising treatment for peritoneal mesothelioma patients is cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). In the procedure, doctors remove as much cancerous growth from the abdominal cavity as possible before delivering heated chemotherapy drugs directly to the abdomen. Paracentesis is a palliative option which removes excess fluid from the abdomen to relieve pain and reduce symptoms.
Historically, mesothelioma is a cancer that mostly affects older men who were exposed to asbestos while serving in the military or working certain blue-collar jobs. But the gender gap is closing as mesothelioma incidence rates among women are on the rise. Women now comprise nearly one-fourth of all cases.Read the Full Story
Aside from conventional treatments, many mesothelioma patients turn to clinical trials to extend survival. These experimental studies are small and controlled opportunities for scientists to test new drugs, therapies and different combinations of treatments.
Clinical trials often become an option for patients whose traditional treatments were unsuccessful or for those not eligible for surgery.
“The therapy has given me a new window. It’s like getting my life back.”
Mesothelioma survivor Walter Merth on participating in a Keytruda clinical trial.
Immunotherapy is a promising cancer treatment only available to mesothelioma patients through clinical trials. Checkpoint inhibitors, such as pembrolizumab (Keytruda) and avelumab (Bavencio), have shown encouraging results in multicenter trials testing the drugs in combination with surgery and chemotherapy regimens. In May 2017, the U.S. Food and Drug Administration approved pembrolizumab as a first-line treatment of metastatic non-small cell lung cancer, making approval for mesothelioma a possibility in the near future.
Photodynamic therapy uses light energy to kill cancer cells. A 2016 clinical trial at the Penn Medicine Abramson Cancer Center nearly doubled survival for pleural mesothelioma patients who received intraoperative photodynamic therapy (PDT) and chemotherapy following a P/D procedure.
The process of killing tumor cells by exposing them to extreme cold — known as cryotherapy — is a viable treatment option for mesothelioma patients in the few places that offer the procedure. Unlike many treatments, cryotherapy causes few side effects. In May 2015, the Mayo Clinic in Rochester, Minnesota, opened the only ongoing cryotherapy clinical trial for mesothelioma in the U.S.
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Treatment is expensive, and insurance companies may not cover the cost of diagnostic tests or experimental therapies. People without medical insurance will face an even harder battle. If you or a loved one is diagnosed, consider taking steps to protect your finances.
Mesothelioma and other asbestos-related diseases are entirely preventable, but the companies that mined, manufactured and sold asbestos products put profits before the health of customers and their own employees. Our legal system ensures these companies are held accountable for their negligence.
Mesothelioma lawsuits include personal injury claims and wrongful death claims. Most lawsuits are settled out of court before a trial takes place.
Asbestos trust funds are established by now defunct companies that filed for bankruptcy protection. To date, these funds contain more than $30 billion to compensate workers and their families.
Veterans exposed to asbestos during military service can file for asbestos-related claims through the U.S. Department of Veterans Affairs (VA).
Government programs, such as Medicare or Medicaid, can help older patients or those with limited finances, while workers’ compensation may be available to people exposed to asbestos on the job.
Don’t let the notion of high costs of mesothelioma treatments deter you from pursuing the best treatment options possible. In addition to legal options, travel and housing grants may be available as well as access to social security disability benefits.
Veterans Department Director Aaron Munz uses his experience to help fellow veterans understand VA benefits claims.
Because asbestos use in the military was rampant from 1940 to 1980, veterans from all branches of the U.S. Armed Forces who served during those years are now at high risk of developing mesothelioma and other asbestos-related conditions. Job duties known for high rates of harmful exposures include pipefitting, mechanical work, equipment maintenance and shipyard work.
Veterans diagnosed with mesothelioma or other asbestos-related diseases have the option to pursue VA benefits, including VA health care and VA Disability Compensation.
While this is often the only way for veterans to receive compensation from the government, veterans exposed to asbestos before or after military service may be eligible to file a lawsuit or pursue an asbestos bankruptcy trust.
The U.S. government never warned servicemen who fought for America about the deadly long-term effects of asbestos exposure in the military. Now, a broken VA health care system fails them a second time by abandoning veterans dying of mesothelioma.Read the Full Story
Despite the often poor prognosis associated with malignant mesothelioma, there are a number of encouraging stories of success: Accounts of people who live to celebrate special days with spouses, children and grandkids. Each mesothelioma survivor has a unique story to tell.Read More Stories on Our Wall of Hope
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Every year, peritoneal mesothelioma survivor Trina West-Clark takes a trip to the casino to have a few cocktails with [...]Read Trina's Story
Every cancer diagnosis comes with a wide range of physical and emotional challenges. Know that you are not in this alone.
Although there is no definitive cure for mesothelioma, promising advancements are made every day in clinical trials and at specialty centers in the U.S. and around the world. Because of these groundbreaking treatments and improved standard-of-care, mesothelioma patients become survivors.