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WHAT IS MESOTHELIOMA?

Mesothelioma is a cancer that affects the thin membrane protecting several of the body’s most important organs, including the lungs, abdomen and heart. Treatment for this disease includes surgery, chemotherapy and radiation therapy.

There are roughly 3,000 new cases of mesothelioma in the United States every year. It’s caused by asbestos, a natural, fire-resistant mineral. Many industries, such as construction, manufacturing, and the military, have used asbestos in a variety of materials. It takes decades from the time of asbestos exposure for mesothelioma to develop.

What is Mesothelioma

Types of Mesothelioma

  • Pleural mesothelioma affects the protective lining of the lungs, the pleura. It’s the most common location where the disease occurs — about 75 percent of all diagnosed cases are pleural. If you’ve been diagnosed with pleural mesothelioma, you’ve got the most treatment options available, and the highest life expectancy.
  • Peritoneal mesothelioma affects the protective lining of the abdominal cavity, the area of your body containing several organs, including the stomach, intestines, kidneys, and liver. It’s the second most common location where mesothelioma grows—about 20 to 24 percent of all mesotheliomas occur here.
  • Pericardial mesothelioma affects the protective lining of the heart. It’s the rarest location where mesothelioma occurs, and accounts for about 1 percent of all cases. Because it’s rare, doctors don’t get to treat many patients with mesothelioma in this location, and haven’t had many chances to create effective treatments. As more cases appear, however, they’ll be able to do so. 
 

Symptoms of Mesothelioma

The symptoms of mesothelioma make diagnosing the disease difficult. Symptoms take 10 to 50 years to appear after a person has been exposed to asbestos. The symptoms of mesothelioma are common in several other illnesses.

Doctors may mistake breathing difficulty and persistent coughing — both symptoms of early–stage pleural mesothelioma — for pneumonia or another respiratory illness.

Doctors diagnose most patients when the disease has reached an advanced stage because the symptoms are nonspecific. If you have a history of exposure to asbestos, and have felt any of the following symptoms, get in touch with a member of our Patient Help Team. We’ll connect you to an experienced doctor and get you treatment that can help improve your prognosis.

Pleural Mesothelioma Symptoms

  • Fatigue
  • Shortness of breath
  • Difficulty breathing
  • Persistent coughing
  • Persistent chest pain
  • Weight loss
  • Fever

Peritoneal Mesothelioma Symptoms

  • Buildup of fluid in the abdominal cavity
  • Weight loss
  • Nausea
  • Vomiting
  • Irregular bowel movements
  • Abdominal pain
  • Hernias

Pericardial Mesothelioma Symptoms

  • Chest pain
  • Heart murmurs
  • Excessive palpitations
  • Labored breathing
  • Fatigue
  • Night sweats

Causes of Mesothelioma

The only known cause of mesothelioma is exposure to asbestos, a naturally-occurring mineral used by many industries in materials ranging from wall insulation to brake pad lining. Experts estimate that the carcinogenic mineral has caused 80 percent of all cases in the U.S.

How Asbestos Causes Mesothelioma

Mesothelioma occurs when asbestos fibers get stuck in the mesothelium, a general name for the protective lining of a person’s lungs, abdomen, or heart.

Asbestos is made of tiny fibers that break apart and become airborne very easily.

If you’re exposed to damaged or disturbed asbestos-containing materials for a long period of time, you may inhale large amounts of microscopic asbestos fibers. Overtime, they’ll collect in the mesothelium, where they cause irritation, inflammation, and cellular damage that leads to mesothelioma.

Who is at Risk

70 to 80 percent of all patients report workplace exposure to asbestos.

Most exposure to asbestos occurs during work; 70 to 80 percent of patients diagnosed with mesothelioma had a history of occupational exposure to the materials containing the mineral. Though the EPA considers any level or length of time unsafe, experts link the development of mesothelioma to heavy, long-term exposure.

Workplace Asbestos Exposure

Occupations where workers may experience this kind of exposure to asbestos include:

  • Drywall installers
  • Demolition specialists
  • Firefighters
  • Mill workers
  • Power and chemical plant operators
  • Automobile and airplane mechanics
  • Shipbuilders

Veterans who served in the armed forces from the 1930s to the 1970s are most at-risk for developing mesothelioma. The military used asbestos-containing materials to safeguard servicemen and women from fire. In doing so, it unknowingly exposed veterans to large amounts of asbestos, and increased their risk of developing mesothelioma. Veterans now account for 30 percent of all diagnoses in the U.S.

Diagnosing Mesothelioma

Being diagnosed correctly is the first and most important step you’ll take towards getting treatment. If you’ve been exposed to asbestos in the past, and are feeling ongoing symptoms, see an experienced doctor. He or she will order an imaging test — like an x-ray, CT scan, or PET scan — to find visual signs of cancer. If the imaging scan shows anything that looks like a tumor or buildup of fluid, a doctor may order a blood test to make sure the next step in the diagnostic process, a biopsy, is necessary.

Getting a biopsy is the only way to confirm that you have mesothelioma.

A biopsy helps your doctor determines the cell type cell type of the disease — information he or she will use to create an effective treatment plan that can improve your prognosis.

Stages of Mesothelioma

Your cancer stage is an important part of your diagnosis. Along with its cell type, the stage of mesothelioma determines how effective treatment will be. Doctors haven’t created a staging system that’s specific to mesothelioma just yet, because the disease is rare. Instead, they use a number of systems—TNM, Butchart, and Brigham—specific to other cancers. Using different criteria, each system divides the spread of cancer into 4 stages. Generally speaking, the earlier the stage, the less mesothelioma has spread, and the easier it is for surgeons to remove.

  • Stage 1. At stage one, the tumor only affects the area in the mesothelium where it originated; it hasn’t yet spread to other organs. If you’re diagnosed with stage–one mesothelioma, you’ll respond well to treatment, and will enjoy a better prognosis than patients with advanced–stage mesothelioma.
  • Stage 2. At stage two, the tumor has grown larger and may have spread to organs outside the area of where it first appeared in the mesothelium. Depending on your overall health, curative surgery is still an option for you–there’s not a substantial difference in prognosis between stage–one and stage–two patients.
  • Stage 3. At stage three, the tumor has spread throughout one side of your body, and may have spread to other areas, including nearby lymph nodes, the esophagus, the chest wall, ribs, or heart. Tumors at this stage do not respond well to curative treatments, but surgery may still be an option. Your doctors will likely use palliative treatment to improve your quality of life.
  • Stage 4. At stage four, the tumor has spread to both sides of the body. It may have invaded the brain, bone cells, far away lymph nodes, and other organ tissues. Most curative treatments, such as surgery and chemotherapy, are not effective in removing stage–four mesothelioma because it has spread so far. Doctors will instead use palliative treatment to relieve discomfort caused by symptoms.They may also enroll you in a clinical trial, where they’ll use new treatments to try and improve your prognosis.

Treatment Options

If you’ve been diagnosed with mesothelioma, you have a number of treatment options, including surgery, chemotherapy, and radiation therapy. Broadly speaking, your treatment will fall into 2 categories: curative or palliative.

With curative treatment, doctors extend your survival time by removing as much of the mesothelioma as possible. They often combine multiple curative treatments to achieve amazing results.

With palliative treatment, doctors treat the symptoms of mesothelioma rather than the cancer itself. Its purpose is to improve your quality of life by easing symptoms like chest or abdominal pain.

Doctors don’t treat mesothelioma with a one-size-fits-all approach, because the disease affects each patient differently. How your doctor uses surgery, chemotherapy, or radiation therapy depends on your diagnosis—the cancer stage, cell type, and location of the mesothelioma all play an important role in your treatment.

  • Surgery. The most effective is surgery if you’re diagnosed with stage 1 or 2 mesothelioma. This is because the disease hasn’t spread far beyond the lining of the lungs, abdomen, or heart. If you’re diagnosed with stage 3 or 4 mesothelioma, doctors use surgery to improve your quality of life by removing obstructive tumors.
  • Chemotherapy. Doctors use chemotherapy to shrink tumors, making their removal via surgery easier and more efficient. They also use it as a palliative measure to shrink tumors that restrict breathing, or cause excessive abdominal pain.
  • Radiation Therapy. Like chemotherapy, radiation therapy helps doctors remove tumors, and relieve discomfort caused by their obstructive growth.
  • Multimodal Therapy. This is a combination of two or more treatments. Doctors have greatly increased the life expectancy of patients with pleural and peritoneal mesothelioma with multimodal therapy.
  • New Treatments in Clinical Trials. Researchers are also developing new treatments, like immunotherapy and gene therapy, in clinical trials. Emerging treatments can benefit patients diagnosed with any stage of mesothelioma; if you’ve been diagnosed with advanced–stage mesothelioma, you may find an option to improve your prognosis.

Your Prognosis

A prognosis is an estimate your doctor makes on how your diagnosis will affect you in the future; they base it on how diagnoses similar to yours affected other people in the past. The location, cell type, and cancer stage of the mesothelioma play a role your doctor’s estimate, and helps them decide which treatment options will work best for you.

Improving your prognosis

A prognosis is not set in stone—you can take action to change it by:

You can also contact our Patient Help Team for more free information about mesothelioma, treatment, and how to improve your prognosis. A member of our team will have a conversation with you about your diagnosis, and can even help you find treatment to improve your prognosis.

Sources:

  • American Cancer Society. Malignant Mesothelioma. Accessed on 1/11/16. Retrieved from: http://www.cancer.org/acs/groups/cid/documents/webcontent/003119-pdf.pdf
  • National Institute of Health. Malignant Mesothelioma Treatment. Accessed on 1/11/16. Retrieved from: http://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq
  • Environmental Protection Agency. Asbestos. Accessed on 1/11/16. Retrieved from: http://www.epa.gov/asbestos