Mesothelioma Causes, Symptoms and Diagnosis

Mesothelioma

Mesothelioma is a rare type of cancer that typically affects the lining of the lungs, heart and abdomen.

Mesothelioma is a rare cancer that can develop in the membrane that lines the lungs, called the mesothelium.

Approximately 2,000 to 3,000 cases of mesothelioma are diagnosed each year in the United States, comprising around 3 percent of all cancer diagnoses. This cancer occurs about four times more frequently in men than in women and all forms of mesothelioma, except for benign mesothelioma, are invariably fatal.

The life expectancy for mesothelioma patients is generally reported as less than one year following diagnosis, however a patient’s prognosis is affected by numerous factors including how early the cancer is diagnosed and how aggressively it is treated.

Mesothelioma is an aggressive cancer that affects the mesothelium causing cells in the membrane to become cancerous and divide rapidly. This causes the thickening of the membrane, fluid buildup and the formation of tumors. This can result in difficulty breathing, nausea, fatigue and a myriad of other concerns.

Mesothelioma Causes

Mesothelioma is caused by asbestos exposure which occurs when fibers are inhaled or ingested into the body and become lodged in body cavities, causing inflammation or infection. Asbestos is a naturally-occurring fibrous substance that was widely used in the 20th century in a number of different industries. When the public became aware of the hazards associated with the mineral, warnings were issued in the mid-1970s and use of the product began to decline.

More than 30 percent of those diagnosed with mesothelioma are veterans. Please visit the page on asbestos for additional information about the mineral.

Mesothelioma Types

There are five known types of mesothelioma. The four listed below are malignant cancers, and benign mesothelioma is a non-cancerous condition.

Once asbestos is inhaled it can effect many of the bodys different organs including the throat, lungs, stomach, heart and testicles.

Pleural Mesothelioma: This type of mesothelioma develops in the lining of the lungs, known as the pleura. It is the most common form of malignant mesothelioma, with around 70 percent of cases being pleural in origin.

Peritoneal Mesothelioma: Comprising approximately 25 percent of mesothelioma cases, this form of mesothelioma develops in the lining of the abdominal cavity, known as the peritoneal membrane.

Pericardial Mesothelioma: This form of mesothelioma develops in the lining of the heart, known as the pericardium. Approximately 5 percent of all mesothelioma cases are pericardial.

Testicular Mesothelioma: Testicular mesothelioma develops in the tunica vaginalis of the testicles and is the rarest form of the cancer.

Mesothelioma Symptoms

Symptoms of mesothelioma often do not appear for 20 to 50 years after initial exposure to asbestos occurred. Mesothelioma symptoms often resemble less-serious conditions, which can make a diagnosis of mesothelioma difficult. Below is a list of several common symptoms mesothelioma patients may experience.

Pleural Symptoms: Shortness of breath, chest pain, persistent cough, fatigue, lumps under the skin on the chest

Peritoneal Symptoms: Weight loss, abdominal pain and swelling, bowel obstruction, nausea

Pericardial Symptoms: Heart palpitations, irregular heartbeat, chest pain, difficulty breathing, night sweats

Testicular Symptoms: Painful or painless testicular lumps

Mesothelioma Diagnosis

A medical exam is the first step in diagnosing an asbestos-related illness.

The process of mesothelioma diagnosis usually begins with a review of a patient’s medical history followed by a physical examination.

If a problem is suspected, a doctor may request several diagnostic tests. These typically include medical imaging scans such as:

• X-rays
• CT scans
• PET scans
• MRI scans

A combination of these tests is often used to determine the location, size and type of the cancer. Biopsy procedures are often requested following an imaging scan to test samples of fluid and tissue for the presence of cancerous cells.

Mesothelioma Treatments

After a patient begins to demonstrate mesothelioma symptoms and a diagnosis occurs, the next step is often exploring applicable treatment options to create the best treatment plan possible. Treatment options range from surgery to chemotherapy and Asbestos.com offers mesothelioma patients and their loved ones comprehensive information about current treatment options and new developments in a complimentary informational packet available here.

There are a variety of treatment options for mesothelioma patients including radiation, chemotherapy, and surgery.

The most common mesothelioma treatments recommended by doctors for patients include surgery, chemotherapy and radiation therapy. Experimental procedures, including immunotherapy and gene therapy are also utilized by mesothelioma patients. Patients often undergo multiple treatments to combat the disease.

Experimental treatments are also available to patients who participate in a clinical trial, conducted to test up-and-coming procedures and medications.

What is mesothelioma?

Malignant mesothelioma is the most serious of all asbestos-related diseases. Although uncommon, mesothelioma is no longer considered rare. Mesothelioma is a cancer that is particulary difficult for doctors to diagnose and one that does not respond well to therapy.

The chest cavity, abdominal cavity, and the cavity around the heart are surrounded by a 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. Tumors of the mesothelium 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 than 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.

Although the disease is much more commonly seen in 60-year old men, it has been described in women and early childhood as well. The cause of the disease is 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%). 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.

What are the symptoms of mesothelioma?

Most people present with complaints of shortness of breath. They also can have complaints of chest pain. Surprisingly, this pain is often not pleuritic; that is, it does not get worse with deep breathing. This is surprising in that the pleura (outer surface of the lung) is often involved in this disease, and most other diseases involving the pleura are often associated with pleuritic pain (pain that worsens with deep breathing). Patients may also be asymptomatic, with the disease discovered by physical exam or an abnormal chest X-ray.

As the disease progresses, shortness of breath increases, and weight loss, decreased appetite, and night sweats can develop. Local invasion by the tumor can result in changing of voice, loss of function of the diaphragm, and symptoms specific to the area and involvement of adjacent structures.

What causes mesothelioma?

Most people with malignant mesothelioma have worked on jobs where they breathed asbestos. Usually, this involves men over 40 years of age. Others have been exposed to asbestos in a household environment, often without knowing it. Interestingly, the number of new cases of mesothelioma has been relatively stable since 1983, the same time that the restrictions on asbestos were instituted by the U.S. Occupational Safety and Health Administration (OSHA). In Europe, the number of new cases of mesothelioma continues to rise.

How much asbestos exposure does it take to get mesothelioma?

An exposure of as little as one or two months can result in mesothelioma 30 or 40 years later and in some cases, as much as 70 years later.

How long does it take after asbestos exposure for mesothelioma to show up?

People exposed in the 1940s, '50s, '60s, and '70s are now being diagnosed with mesothelioma because of the long latency period of asbestos disease.

How is mesothelioma diagnosed?

Mesothelioma is diagnosed by pathological examination from a biopsy. Tissue is removed, placed under the microscope, and a pathologist makes a definitive diagnosis and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid buildup around the lungs (pleural effusions), shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an X-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:

• Thoracoscopy
  
  For pleural mesothelioma, the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital using a local anesthetic or painkiller.
  
  If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and using gentle suction to remove the fluid. This is called thoracentesis.



• Peritoneoscopy
  
  For peritoneal mesothelioma, the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.
  
  If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.



• Biopsy
  
  If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.
  
  Unfortunately, in some cases, tumor cells can grow along the tract where the biopsy is taken. This can be minimized with the use of radiation to the area.

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