Mesothelioma: Introduction

Background: Mesothelial cells normally line the body cavities, including the pleura, peritoneum, pericardium, and testis. Malignancies involving mesothelial cells in these body cavities are known as malignant mesothelioma, which may be localized or diffuse. Diagnosis is difficult because the results from fluid analysis of the effusion from the tumor are not usually diagnostic. Most, but not all, pleural malignant mesothelioma is associated with asbestos exposure. Of patients with pleural malignant mesothelioma, 77% have been exposed to asbestos in the past. Mesothelioma is more common in males than in females and it occurs in the fifth and seventh decade of life. Most of malignant mesothelioma occur in the pleura (90% of the time).

Pathophysiology: The 3 major histological types of mesothelioma are sarcomatous, epithelial, and mixed. Pleural mesothelioma usually begins as discrete plaques and nodules that coalesce to produce a sheetlike neoplasm. Tumor growth usually begins at the lower part of the chest. The tumor may invade the diaphragm and encase the surface of the lung and interlobar fissures.

The tumor may also grow along drainage and thoracotomy tracts. As the disease progresses, it often extends into the pulmonary parenchyma, chest wall, and mediastinum. Pleural mesothelioma may extend into the esophagus, ribs, vertebra, brachial plexus, and superior vena cava.

Asbestos is the principal carcinogen implicated in the pathogenesis. The industries associated with asbestos exposure include ship building, construction, ceramics, paper mill, auto parts, railroad and insulation.

Most malignant mesotheliomas have complex karyotypes, with extensive aneuploidy and rearrangement of many chromosomes. A loss of a single copy on chromosome 22 is the most common abnormality.

Frequency:

• In the US: Approximately 2500-3000 cases are diagnosed per year.

• Internationally: Frequency is 0.9 cases per 100,000 persons.

Mortality/Morbidity:

• Median survival for patients with malignant mesothelioma is 11 months. It is almost always fatal. Median survival based on histologic type is 9.4 months for sarcomatous, 12.5 months for epithelial, and 11 months for mixed. Approximately 15% of patients have an indolent course.

• Asbestos exposure is linked to at least 50% of patients developing malignant mesothelioma. Approximately 8 million people in the United States have been exposed to asbestos in the workplace. Family members are also exposed to asbestos embedded in the worker's clothing. The combination of tobacco and asbestos exposure greatly increases the risk of developing pleural mesothelioma.

Race:

• Mesothelioma has no racial predilection. Asbestos exposure is the most important factor. Race is not a factor.

Sex:

• Malignant mesothelioma is more common in men, with a male-to-female ratio of 3:1. It can also occur in children; however, these cases are not thought to be associated with asbestos exposure.

• With regard to women with mesothelioma, a 1996 case series by Ascoli et al showed 86% of tumors arising from the pleura, of which most were the epithelial type. Of the patients in this series, 75% had a history of exposure to asbestos and more than half developed the malignancy secondary to household contact with a worker exposed to asbestos.

• With regard to men with mesothelioma, the same case series demonstrated 45.5% with a history of exposure to asbestos and 53% with occupational exposure to asbestos. Most who were involved were construction workers, railroad workers, naval mechanics, bakers, explosive workers, and automobile mechanics.

Age:

• Malignant mesothelioma has a peak incidence 35-45 years after asbestos exposure. It commonly develops in the fifth to seventh decade of life.

Mesothelioma: Are there clinical trials available?

Treating mesothelioma depends upon the disease stage, the location of tumors, the patient's age, history and health at time of diagnosis, and many other factors.

One option to explore is participating in clinical trials. These are scientific studies of medications for different types of cancer. Your doctor may be aware of current clinical trials to gain new mesothelioma information for asbestos cancer. If you are interested in considering a clinical trial, you may wish to review the National Cancer Institute booklet, Taking Part in Clinical Trials: What Cancer Patients Need to Know. This booklet explains the potential benefits and risks of clinical trials. It is available at the National Cancer Institute's Locator Web Site at http://cancer.gov/publications. You should always discuss the advantages and disadvantages of a clinical trial with your doctor.

If mesothelioma is diagnosed, it is important to begin treatment as soon as possible, before you even consider looking at asbestos mesothelioma lawsuit case studies. The material presented here is for information purposes only, and should not be construed as advising or endorsing one form of treatment over another.

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Mesothelioma: Are there other mesothelioma treatments?

Surgery

In some cases, surgery for a patient with mesothelioma may extend and improve the quality of life. However, such surgery is serious and complicated. Consultation with a specialist is always best if considering this treatment option. One type of surgery, called a pleurectomy or decortication, involves opening the chest and removing the tumor from the lung. This procedure relieves chest pain and prevents the recurrence of effusions (the escape of fluid) in the pleura. Another type of surgery, extra pleural pneumonectomy, involves the removal of the lung, the diaphragm, or the lining of the heart. Gortex, a synthetic fabric, replaces the heart lining or diaphragm. After surgery, the patient undergoes chemotherapy and radiation to destroy any remaining cancer cells. A pneumonectomy involves the removal of a lung. This procedure generally occurs during a late stage of mesothelioma.

Thoracentesis or Paracentesis

Thoracentesis removes fluid from the lung lining, or pleura. The fluid that accumulates as part of mesothelioma can cause discomfort or shortness of breath. Once fluid is drained from the pleura, a form of talcum powder or other material may be applied that causes the lung to adhere to the chest wall. Paracentesis is a similar procedure to remove fluid from the abdominal cavity. If there is a chronic problem with fluid buildup, a catheter can be inserted to drain fluid on an as needed basis. Fluid removal can alleviate difficulty with breathing and chest pain. Consultation with a specialist is always best before pursuing thoracentesis or paracentesis.

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Mesothelioma: How is mesothelioma treated?

For those who are diagnosed with mesothelioma, getting treatment is much more important than filing a mesothelioma claim. Please make sure that your or your loved one is getting proper treatment before you worry about mesothelioma lawsuits.

Chemotherapy and Radiation Therapy

The most common treatment option for mesothelioma, chemotherapy can be administered through a pill, injection or intravenously. Chemotherapy uses a drug or a combination of drugs to kill cancer cells. The drug can be administered systemically (through the blood stream) or directly into an area such as the pleural cavity. There are new chemotherapy advances as researchers continue to attempt to find successful treatment protocols and uncover new cancer information for mesothelioma. In a recent clinical trial study, researchers reported that mesothelioma patients on a new chemotherapy drug regimen lived longer and had less pain. The results show that tumors shrank in 41% of patients on pemetrexed (brand name Alimta ™) in combination with cisplatin, another form of chemotherapy. According to the study, only 17% of patients receiving cisplatin alone experienced tumor shrinkage and those on the pemetrexed combination, on average, lived almost 3 months longer. Radiation therapy kills cancer cells or shrinks tumors with high-energy x-rays. Radiation therapy can damage healthy tissue in the process of treating cancer. Research is now examining ways of delivering radiation directly to the tumor. In radiation therapy, a machine may be used to emit radiation, or radioisotopes (materials that produce radiation) may be administered through plastic tubes in the part of the body where the cancer cells are found.

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Mesothelioma: How is mesothelioma diagnosed?

Although it is relatively easy to find mesothelioma information online, mesothelioma itself is not easy to diagnose. A chest x-ray may show a buildup of fluid in the lining around the lung. The doctor may order a CT scan for further evaluation. A CT scan can also determine if fluid has built up inside the lungs.

After the CT scan, the doctor may perform a biopsy to make a definitive diagnosis. A tissue sample taken from the lung will be reviewed under a microscope to determine if the tumor is benign (non-cancerous) or malignant (cancerous).

Once diagnosed, "stages" describe the extent of malignant pleural mesothelioma and determine the best course of treatment. One system of "stages" is the TNM system. This system describes the size of the tumor (T), if the lymph nodes are involved (N), and if cancer has metastasized, or spread to other areas of the body (M).

At Stage 1, the cancerous growth is in the lining of the lungs, heart or abdomen. Stage 2 is when the mesothelioma has moved from the lining into the lymph nodes. In Stage 3 the cancer has spread into the chest wall, heart, diaphragm, or stomach. Stage 4 is the most serious stage, when the cancer has spread to organs such as the liver, pancreas or colon.

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If you are a loved one and interested in pursuing an asbestos mesothelioma lawsuit, please contact us for more information.

We often get results in seven months or less. We can help you protect your family and get the compensation you deserve.

Mesothelioma: How do I prevent mesothelioma?

If you are doing mesothelioma research even though neither you nor anyone you know has been diagnosed, you are probably wondering what the best way to avoid ever having the disease is. The only way to prevent mesothelioma and avoid ever having to file a mesothelioma lawsuit is to completely eliminate all exposure to asbestos. Even a small exposure to asbestos is not safe. However, because asbestos was once used to make so many different products, it is difficult to eliminate exposure.

Workers exposed to asbestos on the job should wear protective clothing and masks. It is also good practice to change clothing before leaving work to avoid bringing particles into the home. Family members exposed to asbestos particles may have an increased risk of disease. Hopefully, you will be able to avoid ever needing to file an asbestos claim, and legal mesothelioma assistance won't be something that you'll need in the future.

If you are a loved one and interested in pursuing an asbestos mesothelioma lawsuit, please contact us for more information.

We often get results in seven months or less. We can help you protect your family and get the compensation you deserve.

Mesothelioma: How did I get it?

The only known cause of mesothelioma is exposure to asbestos. Mesothelioma results from breathing microscopic asbestos fibers into the lungs. When breathed into the lungs, asbestos tears the lung tissue. The fibers cause the lungs to form scar tissue again and again (asbestosis) or can cause lung cancer. If asbestos fibers damage mesothelial tissue, it may lead to mesothelioma.

Smoking appears to be unrelated to mesothelioma injury. However, the combination of smoking and asbestos exposure may increase the risk of other forms of cancer.

Asbestos was used to make many different materials, including cement, brake linings, roof shingles, flooring products, textiles and insulation. Particles released from any of these materials can be inhaled or carried home on clothing-- where they expose family members to the risk of mesothelioma.

Generally, it takes 20 to 40 years from the time of asbestos exposure until symptoms appear or pleural mesothelioma is diagnosed. This time is called the "latency" period.

Mesothelioma is a serious disease. Half of the patients diagnosed at an early stage and treated aggressively live two years from the date of the diagnosis. One in five are still alive five years after diagnosis. Many patients live more than five years after diagnosis.

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Mesothelioma: What is mesothelioma?

Mesothelioma is a cancer of the mesothelium, the protective sac that covers and protects most internal organs of the body. The mesothelium has two layers, one, which covers the organ, and a second, which forms a sac around it. The mesothelium has different names depending on the location in the body. The pleura is the mesothelial tissue surrounding the lungs and lining the chest cavity.The peritoneum covers most of the organs in the abdominal cavity (where abdominal mesothelioma occurs), while the pericardium covers and protects the heart.

The mesothelium produces a lubricating fluid that allows organs within it to move and glide easily. For example, the fluid allows the lungs to breathe and the heart to expand and contract.

Like other forms of cancer, mesothelioma occurs when cells become abnormal and divide or grow out of control. Inmesothelioma, the helpful lubricating fluid is over-produced.This excess fluid encases the organs with a thick layer of tumor tissue, described as similar to a rind type of layer. In advanced cases ofmesothelioma, cells metastasize, or grow and invade other organs and spread to other areas of the body.

The majority of individuals suffering from mesothelioma have cancer in the lining of the lung. Sometimes, mesothelioma occurs in the lining of the abdominal cavity peritoneal mesothelioma) or in the lining of the heart (pericardial mesothelioma).

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We often get results in seven months or less. We can help you protect your family and get the compensation you deserve