Mesothelioma Information and Articles
Mesothelioma
is an uncommon form of cancer, usually associated with previous exposure
to asbestos, which affects the pleura, a sac which surrounds the lungs,
the peritoneum, the lining of the abdominal cavity, or the pericardium,
a sac that surrounds the heart.
In this disease, 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, or have been exposed
to asbestos dust and fibre in other ways, such as by washing the clothes
of a family member who worked with asbestos, or by home renovation
using asbestos cement products.
Mesothelioma Symptoms
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.
Diagnosis of Mesothelioma
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.
Mesothelioma Pathophysiology
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.
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.
Mesothelioma Epidemiology
Incidence
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.
Risk Factors
Working with asbestos is the major risk factor for
mesothelioma. A history of asbestos exposure exists in almost 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.
The combination of smoking and asbestos exposure significantly
increases a person's risk of developing cancer of the air passageways
in the lung. The Kent brand of cigarettes used asbestos in its filters
for the first few years of production in the 1950s and some cases
of mesothelioma have resulted. Smoking current cigarettes does not
appear to increase the risk of mesothelioma.
Asbestos Exposure
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.
By contrast, the British Government's Health and
Safety executive (HSE) states formally that any threshold for mesothelioma
must be at a very low level and it is widely agreed that if any such
threshold does exists at all, then it cannot currently be quantified.
For practical purposes, therefore, HSE does not assume that any such
threshold exists. 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.
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.
Much controversy still continues regarding Asbestosis
(and asbestos-related diseases) compensation and liability disputes.
Mesothelioma Treatments
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.
Mesothelioma Research
Because mesothelioma is very hard to control, the
U.S. 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.
Mesothelioma Legal Issues
In the United States, the average mesothelioma-related
settlement was $1 million; for cases that go to trial awards averaged
$6 million, according to a study by the RAND Corporation.
Only a small fraction of the thousands of asbestos-related
lawsuits in the United States every year are related to mesothelioma.
In 2004, a bill in the United States Senate aimed a asbestos litigation
reform failed to reach a floor vote.
In January of 2005, Senate Judiciary Committee Chairman
Arlen Spector annouced he would again try to pass an asbestos litigation
reform bill.
For people at la
fitness maintenance is a serious issue. Whether they have to use
pilates or abdicate smoking,
they take their health seriously. In addition to pilates,
they use other equipment as well. Many are regular consumers of vitamin
shoppe as well.
Source: Wikipedia
Articles on Mesothelioma
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