Malignant mesothelioma is the most serious of all asbestos-related diseases. Although uncommon, mesothelioma is no longer considered rare. Making a correct mesothelioma diagnosis is particularly difficult for doctors because the disease does not respond well to therapy. There is no known cure for mesothelioma, but treatments such as mesothelioma radiation and chemotherapy have helped to improve the typical mesothelioma prognosis.
The chest cavity, abdominal cavity, and the cavity around the heart are surrounded by a layer of specialized mesothelial cells. Most other internal organs are also covered by these cells. The tissue formed by these cells is called mesothelium.
A special protective lubricating fluid that allows organs to move around is produced by the mesothelium. This protective fluid helps the lungs to move without resistance inside the chest cavity while breathing. The medical name for the mesothelium of the chest is the pleura and the medical name for the mesothelium of the abdomen is the peritoneum. The mesothelium of the "sac-like" space around the heart is called the pericardium.
A malignant (cancerous) tumor of the mesothelium is called a malignant mesothelioma. As most mesothelial tumors are cancerous, malignant mesothelioma is often simply called mesothelioma. Mesothelioma tumors can also be benign (noncancerous) but benign mesotheliomas are much more rare.
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 including Navy Shipyards.
Although the disease is much more commonly seen in 60-year old men, mesothelioma in women and children has been described as well. Mesothelioma causes are 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 mesotheliomas are divided into three main types. About 50% to 70% of mesotheliomas 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%). Mesothelioma treatment options for all three types are the same.
About three-fourths of mesotheliomas start in the chest cavity. They are known as pleural mesothelioma. Another 10% to 20% begin in the abdomen. These are called peritoneal mesothelioma. Pericardial mesothelioma, starts in the cavity around the heart, and is very rare. The covering layer of the testicles is actually an outpouching of peritoneum into the scrotum. Mesotheliomas that affect this covering of the testicles are quite rare.
How is Mesothelioma Treated?
Mesothelioma, while certainly an aggressive disease, is a treatable malignancy. While there is no cure for mesothelioma, treatment options including surgery, chemotherapy, and radiation therapy are available for many patients. While a combination of Alimta® and Cisplatin is currently the only FDA approved chemotherapy regimen, several clinical trials are currently in progress utilizing other drugs including Gemcitabine and Onconase, with many showing dramatically improved results in certain patients.
Radiation therapy is also utilized, but typically in conjunction with other treatment methods like surgery and chemotherapy. Surgical resection of mesothelioma is possible in early-stage-diagnosed patients. Aggressive surgeries such as extrapleural pneumonectomy can extend survival rates far beyond previously-thought timeframes. Diagnostic and palliative surgeries such as pleurocentesis and pleurodesis are also common in patients of malignant mesothelioma.
Alternative therapies have also been used effectively by many mesothelioma patients to assist in managing symptoms of the disease and conventional treatments. These treatments are mainly preferential but can be extremely valuable to many patients.
How is Mesothelioma Diagnosed?
Mesothelioma can be a difficult malignancy to diagnose because the symptoms and pathology of the disease closely resemble other respiratory conditions. For this reason, misdiagnosis is not uncommon in mesothelioma patients. Symptoms of mesothelioma include chest pain, chronic cough, effusions of the chest and abdomen, and the presence of blood in lung fluid.
Diagnostic surgeries, including a biopsy, will typically be required to determine the type of malignant cells that are present in the body. Typically a body imaging scan, including a magnetic resonance image (MRI) or computer topography (CT scan) will be required to determine the extent and location of the disease.
Typically, mesothelioma patients will be referred by their personal physicians to one of the many renowned mesothelioma doctors in the United States. These oncologists are well versed in the disease behavior and pathology and are the most familiar with cutting-edge mesothelioma treatment options. Dr. David Sugarbaker of the Brigham and Women's Hospital, an extension of Harvard University and the Dana Farber Cancer Institute in Boston, MA, is at the forefront of mesothelioma treatment through the International Mesothelioma Program.
What Causes Mesothelioma
Mesothelioma is known only to be caused by exposure to asbestos, though cases have been documented in children or other individuals with no asbestos history. Asbestos is a microscopic and naturally-occuring mineral that lodges in the pleural lining of the lungs and the peritoneal lining of the abdominal cavity. In most cases, several years will pass (up to 60) before mesothelioma develops in those who had been exposed to asbestos.
In many cases, those diagnosed with mesothelioma who are known to have been exposed to asbestos may be eligible for financial compensation from asbestos manufacturers for their illness. Those who have been diagnosed with mesothelioma and were exposed to asbestos should fill out the brief form on this page. We'll rush you a complimentary mesothelioma and asbestos exposure information kit detailing new mesothelioma treatments, active clinical trials, top doctors, as well as how to obtain compensation for asbestos-related health conditions like mesothelioma.
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