Tuesday, October 12, 2010

Mesothelioma FAQS

Mesothelioma: Questions and Answers
Mesothelioma is a rare form of cancer in which malignant (cancerous) cells are found in the mesothelium, a protective sac that covers most of the body's internal organs. Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles.

What is the mesothelium?

The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.

The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart. The mesothelial tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women.

What is mesothelioma?

Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.

How common is mesothelioma?

Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age.

What are the risk factors for mesothelioma?

Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in about 70 percent to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos.

Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung.

Who is at increased risk for developing mesothelioma?

Asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

The risk of asbestos-related disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma. On the other hand, not all workers who are heavily exposed develop asbestos-related diseases.

There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.

What are the symptoms of mesothelioma?

Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.

These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis.

How is mesothelioma diagnosed?

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.

A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

How is mesothelioma treated?

Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

Surgery is a common treatment for mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.

Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).

Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).

To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.

Are new treatments for mesothelioma being studied?

Yes. Because mesothelioma is very hard to control, the National Cancer Institute (NCI) is sponsoring clinical trials (research studies with people) that are designed to find new treatments and better ways to use current treatments. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease. Participation in clinical trials is an important treatment option for many patients with mesothelioma.

People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from the Cancer Information Service (CIS) (see below) at 1–800–4–CANCER. Information specialists at the CIS use PDQ®, NCI's cancer information database, to identify and provide detailed information about specific ongoing clinical trials. Patients also have the option of searching for clinical trials on their own. The clinical trials page on the NCI's Cancer.gov Web site, located at http://www.cancer.gov/clinicaltrials on the Internet, provides general information about clinical trials and links to PDQ.

People considering clinical trials may be interested in the NCI booklet Taking Part in Cancer Treatment Research Studies. This booklet describes how research studies are carried out and explains their possible benefits and risks. The booklet is available by calling the CIS, or from the NCI Publications Locator Web site at http://www.cancer.gov/publications on the Internet.
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How can a doctor or lawyer help you

Asbestos Methelioma Attorneys by Peter Kingston
in Health / Cancer (submitted 2008-12-11)

When someone is diagnosed with mesothelioma, they may find that they need an attorney to help them with their case. This is a disease that is rare, and there is little to be said about the condition. The rate of this disease is on the increase and there are new mesothelioma attorneys that are trying to settle many cases for different people. They have stepped in for the rights of the people to help them with their case.
These lung cancer patients deserve to have the respect and the care that they deserve for all their duties while in the work force. It is important that these patients and their families have the necessary information that they deserve to be well informed about the entire process. Malignant mesothelima is a rare form of lung cancer that is brought on by asbestos.
Handling asbestos causes mesothelioma. This comes from working in an environment that is affected by this deadly material or by someone that is contracted to remove it. Most of the time, the workers are made clear of the dangers that can be caused by working with this type of material. However, some employers will allow little or no protection from the material when the employees are handling it. These workers are entitled to compensation for their work.
For most people, they will not get any better and will have to live with this type of problem for the rest of their life. When someone has to go through that much pain and suffering in their life because their company did not tell them that they were in danger, they will deserve a settlement for their time and their pain. Mesothelioma attorneys will fight for their patients to have all of their medical bills paid and to have a little extra money to help them with the rest of their life. This is an important procedure that will determine how well you settle out.
You need to be confident in your attorney so that the facts can be presented and the client will have a fair and good case. In some cases the patients will die before the case is settled. In these cases, the families of them will be entitled to the remaining settlement. They will have to live without their family member for the rest of their life due to this terrible form of cancer and they will deserve to be compensated well for that reason. Mesothelioma attorneys will help them fight for what their loved one wanted so much. In the end, the money and the settlement cannot make what is wrong turn right. It is not going to bring back the loved one. However, it will be telling these companies that they did something wrong and that they did not get away with it. You will be fighting for rights of the workers and the responsibilities of the employers.

Myths and facts about mesothelioma

Mesothelioma is a severe disease that is thinning out its roots everywhere in the world especially in United States of America. It is a lethal form of cancer that is dreaded across the globe. For though there is medication to handle the disease's symptoms, a cure to mesothelioma is still missing.

Excess confrontation of asbestos is posited as the primary cause of mesothelioma.

Asbestos is a naturally occurring mineral that is used in insulation, clothing and fire-resistant materials. But its usage is often less significant than the disasters caused by it. For those who work with asbestos, breathe or inhale the infesting tiny asbestos particles that result in development of mesothelioma and other Asbestos Related Diseases (ARDs). Initially people were unaware of the damaging nature of these particles. It was discovered only lately through various tests such as X-Rays, MRI tests i.e. Magnetic Resonance Imagery and CAT scans or Computed Axial Tomography scans.

Mesothelioma's very cause has become its bone of contention. This is because numerous asbestos workers and consumers who have been inflicted by this deadly disease claim that they were not intentionally forewarned of the perils of this material. Consequently lawsuits were and are till date filed on these companies. However, it is a myth to think that these court cases have driven many asbestos-manufacturing companies to bankruptcy. The facts reveal that many such companies have survived under the protection of Chapter 11 and that they have in turn used their insolvency to pay off their former debts and have reorganized themselves by it. But this is not the only myth associated with mesothelioma, there are countless others.

1. One universally known myth is that nothing can be done after a person is in the grip of mesothelioma. Though there is no cure for this unsympathetic form of cancer, some medicines can help with lifestyle quality and symptoms.

2. People commonly believe that working in mines and playing in piles where you are surrounded by asbestos and staying close to a person suffering from mesothelioma are the only factors responsible for its outbreak. But in reality, mesothelioma and any other ARD is not a communicable one and individuals who have never taken up any such tasks are even inflicted with it.

3. The next important thing hovering on people's mind related to mesothelioma is smoking. Some believe that smoking invokes this disease. But the truth is that those who smoke and are exposed to asbestos perhaps involve the highest risk of being infected by mesothelioma. But there are innumerable patients of this ARD who have never smoked even a single cigarette throughout their lives.

4. Those who think that an exposure to asbestos will result in an instant exhibition of its symptoms are even wrong. According to medical science, the effects remain latent and unknown for 10-40 years.

5. Generally it is deemed that even a slight exposure to asbestos particles leads to mesothelioma. So if these fibres are detected in your house or office, they should be removed as soon as possible and all the materials that came in contact with it should be thoroughly cleansed. But this is not what is actually required. An improper hurried removal can be extremely hazardous since these particles easily get mixed in the surrounding air and cause damage. The best technique to ward off the threat of asbestos particles is to properly cover the affected area. Moreover, this task should not be taken up by any naïve individual. Only the skilled certified asbestos abatement professionals should be called to do this job.

6. A number of people are of the opinion that Chrysotile is a safe form of asbestos. But researches have shown that all forms of asbestos including the largely used Chrysotile are effective in causing Mesothelioma and other ARDs like lung cancer, asbestosis etc.

Robert Linebaugh writes about a variety of health topics, but focuses on mesothelioma. Learn more at http://www.justmeso.com.

How to find a Lawyer

Mesothelioma Lawyers and other Asbestos Disease Laywers & Attorneys
When you have been diagnosed with a life-threatening disease like malignant mesothelioma, legal matters are probably not the first issue on your mind.

It is completely natural to be fearful, angry and concerned over how you will pay for your mesothelioma treatment and what will happen to your family when you are no longer able to work. It is for these last two reasons however that you should be considering legal action from the moment you are diagnosed with mesothelioma. The main reason for this is because of the statute of limitations on legal action. This is a period of time within which you must file a claim, or forfeit your right to do so. The statute of limitations varies from one state to another. Any delay could impact your right to make a claim, but do not assume it is too late. A mesothelioma lawyer may still be able to recover damages on your behalf even if the common statute of limitations has passed. The other reason you need to find a mesothelioma lawyer as soon as possible is because it may be the only recourse you have in order to get compensation for medical expense and lost income. Because of the system currently in place, –retaining a lawyer and filing a lawsuit may be your best choice to hold corporations accountable and force them to cover your pain, suffering, expenses and losses - all for which they may be found liable.

Finding the right mesothelioma attorney will help maximize your chances of winning a settlement in a court of law.

What an Asbestos Attorney Does

A mesothelioma lawyer is one who practices in the field of torts - that is, personal injury law and has experience representing victims of asbestos. Torts cover everything from minor sports injuries caused by a Little League coach's oversight to wrongful death due to gross negligence on the part of a large corporation.

Because asbestos litigation is now entering its fifth decade, has become so frequent and involves such large sums of money, it has become a sub-specialty of the law; in legal terms, asbestos liability is said to be a mature tort. This means that there have been enough cases over a sufficient amount of time to establish case law and precedent.

Because mesothelioma can take years and even decades to appear after initial asbestos exposure, these cases pose unique challenges. Over such periods of time, companies go out of business, change their names and/or go into the production of different materials; they move to other states or even other countries; often, they have been acquired by other corporations and are operated as subsidiaries.

This can cause difficulty in identifying the party who bears ultimate liability. Typically, preparing for an asbestos case requires large amounts of painstaking research which involves close examination of old records, previous cases, legal documents and even photographs. Often, witnesses must be found and asked for testimony regarding events and issues dating back twenty to forty years and more.

In addition, because the onset of the disease is often years after exposure to the cause, establishing this causation ("cause and effect," which is at the heart of all personal injury litigation) often requires the testimony of medical experts.

How to Find the Right Mesothelioma Lawyer

It is tempting to go straight to the Internet and type "mesothelioma lawyer" into your favorite search engine. However, this may not be the best strategy. First of all, such a query will result in well over two million hits. Even if you limit your search to a specific state, you may wind up with a million hits or more. You should be satisfied with your communication with a lawyer and mesothelioma law firms before making your decision.

Consider what is at stake, and then proceed accordingly. You may want ot ask a potential mesothelioma lawyer the following questions:

How many mesothelioma (not just asbestos) cases have they handled?

What were the usual outcomes (out-of-court settlement, win, loss, appeal)?

Will the attorney be handling your case personally? (At times attorneys may refer your case to another firm that may be better suited to help in your situation - often providing you with the services of both their firms and another at no extra cost to you- this may be a benefit to you)

Will you be able to speak with him/her as needed? Will your calls be returned in a timely manner and your questions answered clearly?

Will s/he and/or the firm accept the case on a contingency basis? (Because of high costs of this type of case, this is often the only option for many individuals; the lawyer takes his/her fee and expenses as a percentage of the final award)

Will your case be handled on an individual basis, or "bundled" with several other similar cases? (This may hurt you if your case is a strong one, but can be helpful to weaker cases)

Does the attorney or firm have a network of lawyers nationwide who will share their research and expertise in order to build a solid case on your behalf?

Mesothelioma Lawyers

Mesothelioma Lawyer - Your Legal Options
Each year, thousands of people pass away or become ill due to the negligence of asbestos manufacturers and the development of asbestos-related disease. If you or a loved one has been diagnosed with an illness related to asbestos such as mesothelioma, speaking with a mesothelioma lawyer can help you understand if you have legal options for compensation. In recent years, mesothelioma litigation has helped thousands receive financial assistance to cover medical expenses and lost income.

Mesothelioma, which is almost exclusively caused by asbestos exposure, and other asbestos-related illnesses are attributed to negligence because companies that manufactured asbestos-containing products knew about the health risks of asbestos exposure, but decided not to tell employees or leak this information to the general public. There is evidence suggesting that companies which manufactured asbestos-containing materials knew about these hazards as early as the 1920s. A mesothelioma lawyer has focused their legal practice to knowledgeably and effectively bring justice to the corporations that knowingly exposed employees and the public to asbestos products.

By the 1930s and '40s, medical evidence had clearly linked asbestos exposure to lung disease and deadly asbestos cancers. Although asbestos companies were warned of these dangers, many chose not to use alternative substances in order to keep their profits high. Mesothelioma litigation exists because of these unethical actions and asbestos manufacturers are held liable for the undue suffering of those coping with asbestos-related disease. To read more about this corporate scandal, please see The Asbestos Cover-Up.

Those diagnosed with mesothelioma have legal options and may seek compensation through the help of a mesothelioma lawyer. Filing a claim against the entity responsible for your asbestos exposure may result in compensation for the costs, as well as pain and suffering, associated with asbestos-induced illnesses. The following include some of the expenses for which compensation may be pursued:

Lost wages
Medical bills
Group support for you and your loved ones
Funeral expenses
Travel expenses relating to medical treatments
Other expenses not covered by health insurance
A mesothelioma lawyer can review additional expenses that could be covered under each claim, as each case varies. It is important to save all medical and financial records relating to asbestos-induced illness for this purpose. Aside from providing these types of documents and answering questions about how you may have been exposed to asbestos, you will not have to be involved with other stages of the case. Mesothelioma lawyers understand their clients may be too tired to deal with the details of filing a lawsuit or attending trial. For this reason, mesothelioma lawyers handle every aspect of the case.

Mesothelioma Litigation - Types of Lawsuits

There are two types of lawsuits that can be filed in asbestos injury cases. If a family member has passed away from an asbestos-related disease, a wrongful death suit can be filed. In a personal injury claim, the individual suffering with an asbestos-related illness must be the one to file suit. Specific rights in these lawsuits depend on the county and state where the case is filed.

Employees of companies that used asbestos are not the only individuals who have rights against asbestos manufacturers. Although the vast majority of mesothelioma litigation cases are between primary asbestos exposure victims and the manufacturers of asbestos containing products, other groups have rights as well. For example, if you experienced secondary exposure and have developed an asbestos-related disease because a spouse or family member worked with asbestos, you may also have a claim.

Additional Resources

Resources available at Asbestos.com can only offer basic assistance in understanding the generalities of the mesothelioma litigation process. If you seek legal information, it is always a good idea to speak with a qualified lawyer of your choosing to ensure that you get accurate information regarding any potential claim that you might have.

Need an Answer Fast?

If you have a quick question about mesothelioma, lawsuits, or anything related to these topics, fill out our quick question form and get a response in minutes.

Asbestos

Asbestos

There are different kinds of asbestos. The most common forms are:

"White" asbestos or Chrysotile which is obtained from serpentine rocks. Chrysotile is the type most often used in industry. It is more flexible than other types of asbestos and can be spun and woven into fabric. This is the kind of asbestos used in theatre curtains and firefighters' suits.

"Brown" asbestos or Amosite is a trade name for the amphiboles belonging to the Cummingtonite - Grunerite solid solution series, commonly from Africa.

"Blue" asbestos or Riebeckite is also known under the name of Crocidolite. Blue asbestos is commonly thought of as the most dangerous type of asbestos.
In the United States, chrysotile has been the most commonly used type of asbestos. Chrysotile was often present in a wide variety of materials, including but not limited to:

sheetrock taping
mud and texture coats
vinyl floor tiles, sheeting, adhesives and ceiling tiles
plasters and stuccos
roofing tars, felts, siding, and shingles
"transite" panels, siding, countertops, and pipes
acoustical ceilings
fireproofing
putty
caulk
gaskets
brake pads and shoes
clutch plates
stage curtains
fire blankets
interior fire doors
fireproof clothing for firefighters
refractory cements and papers
Asbestos has been classified as a known human carcinogen (a substance that causes cancer) by the U.S. Department of Health and Human Services, the EPA, and the International Agency for Research on Cancer. In 1989 the EPA passed the Asbestos Ban and Phase Out Rule which was subsequently overturned in the case of Corrosion Proof Fittings v. U.S. Environmental Protection Agency, 1991. This ruling leaves many consumer products that can still legally contain trace amounts of asbestos.

Although it is clear that health risks from asbestos exposure increase with heavier exposure and longer exposure time, investigators have found asbestos-related diseases in individuals with only brief exposures. Generally, those who develop asbestos-related diseases show no signs of illness for a long time after their first exposure. It can take from 10 to 40 years or more for symptoms of an asbestos-related condition to appear.

Mesothelioma Basics

Mesothelioma Basics

Mesothelioma is a rare form of cancer in which malignant (cancerous) cells are found in the mesothelium, a protective sac that covers most of the body's internal organs.


What is the mesothelium? The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.

The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart.

What is mesothelioma? Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.

How common is mesothelioma? Over 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. See statistics for more details.

What are the risk factors for mesothelioma? Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in the majority of cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. Click here to learn more about asbestos

Who is at increased risk for developing mesothelioma? Since the early 1940s, millions of American workers have been exposed to asbestos dust. An increased risk of developing mesothelioma was originally found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other trades people. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

There is evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers.

What are the symptoms of mesothelioma? Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.

How is mesothelioma diagnosed? Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful.

A biopsy confirms a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist removes a sample of tissue for examination under a microscope by a pathologist. (See Pathology Diagnosis to learn why some patients request a second opinion.)

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

What is the conventional approach to treating mesothelioma? Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Standard treatment for all but localized mesothelioma is generally not curative. 1 (See survival rates for median survival rates with different treatments.)

Surgery - Extrapleural pneumonectomy in selected patients with early stage disease may improve recurrence-free survival, but its impact on overall survival is unknown. Pleurectomy and decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and pain caused by invasive tumor. Operative mortality from pleurectomy/decortication is <2%, while mortality from extrapleural pneumonectomy has ranged from 6% to 30%. 2

Radiation/Chemotherapy - The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients treated; however, the duration of symptom control is short-lived. Single-agent and combination chemotherapy have been evaluated in single and combined modality studies. The most studied agent is doxorubicin, which has produced partial responses in approximately 15% to 20% of patients studied. Some combination chemotherapy regimens have been reported to have higher response rates in small phase II trials; however, the toxic effects reported are also higher, and there is no evidence that combination regimens result in longer survival or longer control of symptoms. 3

Alimta - The only FDA approved chemotherapy for malignant pleural mesothelioma (in combination with cisplatin) is pemetrexed (Alimta). In the key clinical trial that led to its approval, Alimta was combined with another chemotherapy drug (cisplatin) and compared with cisplatin alone. The patients who received the two drugs (Alimta and cisplatin) had their cancers progress (grow/spread) in 5.7 months (median). The patients who only received cisplatin had their tumors progress in 3.9 months (median). The median survival for the patients who received both drugs was 12.1 months versus 9.3 months for cisplatin only. 4

For some physicians, these therapeutic gains are not impressive. For example, some have written, "For the treatment of mesothelioma, there is little evidence that current therapies (chemotherapy, radiation, surgery) provide significant benefit for survival or quality of life.[R]adical treatments, occupying the 3 months after diagnosis, can take up the best 3 months that the patient might have had.Malignant mesothelioma has largely defeated treatment..."5



Sources:
Unless otherwise indicated by an endnote, the above material was adapted from National Cancer Institute Cancer Facts - Mesothelioma: Questions and Answers 5/13/2002.
1 National Cancer Institute Malignant Mesothelioma (PDQ®): Treatment; Health Professional Version - Treatment Option Overview available here on September 30 , 2005.
2 Id.

3 Id.

4 Vogelzang NJ, et al., Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma . J Clin Oncol. 2003 Jul 15;21(14):2636-44.

5 Treasure T, Sedrakyan A., Pleural mesothelioma: little evidence, still time to do trials . Lancet. 2004 Sep 25-Oct 1;364(9440):1183-5.