HEALTH: MESOTHELIOMA (ASBESTOS

HEALTH - MESOTHELIOMA (ASBESTOS) MESOTHELIOMA (CANCER)

What is Mesothelioma Cancer?

Mesothelioma is a rare form of cancer (malignancy) that begins in the lining of the internal organs of the body. Approximately three-fourths of cases of mesothelioma begin in the lining surrounding the lungs (called pleural mesothelioma). While pleural mesothelioma does begin in the chest cavity, it does not start in the lungs, and it is often incorrectly grouped with lung cancer. Mesothelioma that begins in the tissue surrounding the abdominal area (called peritoneal mesothelioma) accounts for about 10% to 20% of cases.

Peritoneal mesothelioma is much less common. This can effect the organs in the abdomen, and its symptoms are related to this area of the body, that is, abdominal swelling, nausea, vomiting, and bowel obstruction. The rarest form of mesothelioma is pericardial mesothelioma, which involves the sac surrounding the heart.

Between 2,000 and 3,000 people are diagnosed with mesothelioma in the United States each year, according to the American Cancer Society.

There are three main types of mesothelioma:

Epithelial type. The epithelial type accounts for 50% to 70% of people diagnosed with mesothelioma. It has the best prognosis (chance of recovery) due to its slower growth, and this type is more likely to respond to treatment.

Sarcoma type. The sarcoma type accounts for 7% to 20% of people diagnosed with mesothelioma and has a worse prognosis.

Mixed type. The mixed type accounts for 20% to 35% of people diagnosed with mesothelioma and contains both epithelial and sarcomatous types. This type of mesothelioma has an intermediate prognosis.

Cancer begins when cells become abnormal, grow uncontrollably, and eventually form a tumor. Tumors can be benign (non-cancerous) or malignant (cancerous, meaning it can spread to other parts of the body). This section covers malignant mesothelioma.

Benign pleural mesothelioma
A form of noncancerous (benign) tumor that can occur in the chest is sometimes called benign mesothelioma. However, this name is misleading. Benign mesothelioma doesn't begin in the same cells where the cancerous forms of mesothelioma begin. And, in a minority of cases, benign mesothelioma can be very aggressive, despite the term "benign." For this reason, some doctors now refer this tumor as solitary fibrous tumor.

Solitary fibrous tumor usually doesn't cause symptoms. Most cases are inadvertently discovered during tests and procedures for other health conditions. It isn't clear what causes solitary fibrous tumors, but they aren't linked to asbestos exposure. Treatment for solitary fibrous tumor typically includes surgery.

Health: Risk Factors of Mesothelioma (Asbestos - Cancer)

The following factors can increase a person’s risk of developing mesothelioma:

Asbestos exposure. 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.

Between 70% to 80% of people diagnosed with mesothelioma have a history of occupational asbestos exposure. Asbestos is a group of natural minerals found in the earth. Because of its strong, flexible fibers, asbestos was once commonly added to cement, insulation, roof shingles, and other products. People involved in the manufacturing of products containing asbestos or their installation and maintenance can breathe in or swallow the asbestos fibers.

These fibers can also be carried in asbestos dust on clothing or personal items, exposing family members of the workers to potentially high levels of the minerals. Current safety regulations require people who work with asbestos to wear protective equipment and to shower and change clothes before leaving the workplace. If you've been directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.

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

Smoking. Smoking by itself does not increase the risk of mesothelioma, but the combination of smoking and asbestos exposure greatly increases the risk of certain types of cancer in the lung.

Radiation exposure. Some research links mesothelioma to the radioactive substance thorium dioxide, which was used along with X-rays to diagnose various health conditions from the 1920s to the 1950s. Thorium dioxide was later found to cause cancer and is no longer used.

Zeolite exposure. Exposure to a type of mineral called zeolite may cause mesothelioma.

Infection. Infection with certain viruses, such as the simian virus 40 (SV40), may be associated with mesothelioma, although this link has not been proven.

Even though some cases of mesothelioma occur with no known risk factors, many cases of mesothelioma can be traced to asbestos or chemical exposure. Therefore, it is important to always wear protective gear when working with asbestos.

Family history. A family history of mesothelioma may increase your risk of mesothelioma, but more research is needed to understand this theory.

Additional Asbestos Facts:

Asbestos is a mineral that's found naturally in the environment. Asbestos fibers are strong and resistant to heat, making them useful in a wide variety of applications, such as in insulation, cement, brakes, shingles, flooring and many other products. People who work around asbestos fibers are thought to have the greatest risk of mesothelioma.

When asbestos is broken up, such as during the mining process or when removing asbestos insulation, dust may be created. If the dust is inhaled or swallowed, the asbestos fibers may settle in the lungs or in the stomach, where they can cause irritation that may lead to mesothelioma, though how exactly this happens isn't understood.

Mesothelioma risk is believed to be increased in people who are exposed to high levels of asbestos, in people who are exposed to asbestos over a long period of time and in people exposed to asbestos at a young age. It can take 30 to 40 years or more for mesothelioma to develop as a result of asbestos exposure.

Some people with years of asbestos exposure never develop mesothelioma. And yet, others with very brief exposure develop the disease. This indicates that other factors may be involved in determining whether someone gets mesothelioma or doesn't. For instance, you could inherit a predisposition to cancer or some other health condition could increase your health risk of mesothelioma.

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NATURAL CANCER TREATMENT

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Health: Symptoms of Mesothelioma (Asbestos - Cancer)

People with mesothelioma may experience the following symptoms. Sometimes, people with mesothelioma do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. Often, symptoms of mesothelioma may not appear until years or even decades after asbestos exposure. If you are concerned about the symptoms on this list, please talk to your doctor.

General symptoms of mesothelioma may include:

Weight loss
Fatigue
Problems with blood clotting
Anemia (low level of red blood cells)
Fever
Night sweats

If mesothelioma is in the lung area, symptoms may include:

Shortness of breath, caused by fluid from the cancer or the increasing size of the tumor limiting the amount of chest space for the lungs to expand
Pain in the chest area - Chest pain under the rib cage

Painful breathing (pleurisy)

Painful coughing

Unusual lumps of tissue under the skin on your chest

Unexplained weight loss

Dry (nonproductive) cough

If mesothelioma is in the abdominal area, symptoms may include:

Abdominal pain
Abdominal swelling
Bowel obstruction - A change in your bowel habits, such as more frequent diarrhea or constipation

Lumps of tissue in the abdomen

Unexplained weight loss

Other forms of mesothelioma
Symptoms of pericardial mesothelioma and mesothelioma of the tunica vaginalis are unclear. These forms are so rare that not much information is available. Pericardial mesothelioma symptoms may include difficulty breathing or chest pains. Mesothelioma of the tunica vaginalis may be first detected as a mass on a testicle.

See your doctor or health care provider if you have symptoms that may indicate mesothelioma. Symptoms of mesothelioma aren't specific to this disease and, due to the rarity of mesothelioma, are more likely to be related to other health conditions. If any persistent symptoms seem unusual or bothersome to you, ask your doctor to evaluate them.

Health: Diagnosis of Mesothelioma (Asbestos - Cancer)

If there are symptoms that might indicate mesothelioma, your doctor or health care provider will conduct a physical exam to check for any lumps or other unusual symptoms.

It's not uncommon for mesothelioma to be misdiagnosed initially because mesothelioma is rare, and its symptoms aren't specific. Your doctor will likely rule out other more common health conditions before considering mesothelioma.

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.

Your doctor may order imaging scans, such as a chest X-ray or a computerized tomography (CT) scan of your chest or abdomen, to look for abnormalities. If further examination is warranted, the following tests may be done:

Thoracoscopy

For pleural mesothelioma, thoracoscopy allows the surgeon to see inside your chest. In this procedure, the surgeon makes one or more small incisions between your ribs. A tube with a tiny video camera is then inserted into your chest cavity — a procedure sometimes called video-assisted thoracoscopic surgery (VATS). Special surgical tools allow your surgeon to cut away tissue for testing.

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.
Fine-needle aspiration. The doctor removes fluid or a piece of tissue with a small needle inserted into your chest or abdomen.
Laparoscopy. Laparoscopy allows the surgeon to see inside your abdomen. Using one or more small incisions into your abdomen, the surgeon inserts a tiny camera and special surgical tools to obtain a small piece of tissue for examination.
Thoracotomy. Thoracotomy is surgery to open your chest between the ribs to allow a surgeon to check for signs of disease. He or she removes a sample of tissue for testing.
Laparotomy. Laparotomy is surgery to open your abdomen to allow a surgeon to check for signs of disease. He or she removes a sample of tissue for testing.

The tissue sample is analyzed under a microscope to see whether the abnormal tissue is mesothelioma and what types of cells are involved. The type of mesothelioma you have determines your treatment plan.

Like most cancers, the prognosis for this disease often depends on how early it is diagnosed and how aggressively it is treated. Unfortunately, mesothelioma is often found at a stage in which a cure is unobtainable. Many will succumb to the disease within one year of diagnosis.

Health: Complications of Mesothelioma (Asbestos - Cancer)

Complications from spreading cancer
As pleural mesothelioma spreads in the chest, it puts pressure on the structures in that area. This can cause complications, such as:

Difficulty breathing

Chest pain

Difficulty swallowing

Swelling caused by pressure on the large vein that leads from your upper body to your heart (superior vena cava syndrome)

Pain caused by pressure on the nerves and spinal cord

Accumulation of fluid in the chest (pleural effusion), which can compress the lung nearby and make breathing difficult

Death
Mesothelioma that progresses can lead to death. People who die of mesothelioma usually die from related complications, such as lung failure, heart problems, stroke and other health causes.

Health: Staging of Mesothelioma (Asbestos - Cancer)

Treatment options are determined by the stage of mesothelioma (the extent to which the tumor has spread in the body). There are three staging systems currently in use, and each one measures somewhat different variables.

The oldest staging system and the one most often used is the Butchart system, which is based mainly on the extent of primary tumor mass and divides mesotheliomas into four stages.

Butchart system extent of primary tumor mass

Stage I: Mesothelioma is present in the right or left pleura and may also involve the diaphragm on the same side.

Stage II: Mesothelioma invades the chest wall or involves the esophagus, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.

Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may also be involved.

Stage IV: There is evidence of metastasis or spread through the bloodstream to other organs.

The more recent TNM system considers variables of tumor in mass and spread, lymph node involvement, and metastasis.

TNM system: variables of T (tumor), N (lymph nodes), and M (metastasis)

Stage I: Mesothelioma involves right or left pleura and may also have spread to the lung, pericardium, or diaphragm on the same side. Lymph nodes are not involved.

Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It may also have spread into the lung, pericardium, or diaphragm on the same side.

Stage III: Mesothelioma is now in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side with or without spread to lymph nodes on the same side as the primary tumor.

Stage IV: Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, extended to the pleura or lung on the opposite side, or directly extended into organs in the abdominal cavity or neck. Any distant metastases is included in this stage.

The Brigham system is the latest system and stages mesothelioma according to resectability (the ability to surgically remove the tumor) and lymph node involvement.

Brigham system: variables of tumor resectability and nodal status

Stage I: resectable mesothelioma and no lymph node involvement

Stage II: resectable mesothelioma but with lymph node involvement

Stage III: unresectable mesothelioma extending into chest wall, heart, or through diaphragm, peritoneum; with or without extrathoracic lymph-node involvement

Stage IV: distant metastatic disease

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Natural Alternative Treatment: CANCER FREE
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Health: Conventional Treatment for Mesothelioma (Asbestos - Cancer)

The treatment of mesothelioma depends on the size and location of the tumor, whether the cancer has spread, and the person’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan. For mesothelioma, there are three main types of treatment: surgery, radiation therapy, and chemotherapy.

Surgery

The type of surgery for mesothelioma depends on the stage and location of the cancer. A surgeon may remove the affected lining. In the case of pleural mesothelioma, this is called a pleurectomy, and in peritoneal mesothelioma, it is called a peritonectomy. Generally, the tumor cannot be completely removed with these procedures. A more aggressive surgery for pleural mesothelioma is called an extrapleural pneumonectomy.

This involves removing not just of the lining of the lung, but also the entire lung itself, a portion of the diaphragm, and often a portion of the lining around the heart. This is a difficult surgery and is recommended only after the doctor has reviewed a number of factors, including the patient’s overall health and the stage of the disease. If the entire tumor cannot be removed, other treatments such as radiation therapy or chemotherapy may be recommended.

Surgical options may include:

Surgery to decrease fluid buildup. Pleural mesothelioma may cause fluid to build up in your chest, causing difficulty breathing. Surgeons insert a tube or catheter into your chest to drain the fluid. Surgeons may also inject medicine into your chest to prevent fluid from returning (pleurodesis).

Surgery to remove the tissue around the lung or abdomen. Surgeons may remove the tissue lining the ribs and the lungs (pleurectomy) or the tissue lining the abdominal cavity (peritonectomy) in order to relieve symptoms of mesothelioma.

Surgery to remove as much of the cancer as possible (debulking). If all of the cancer can't be removed, surgeons may attempt to remove as much as possible.

Surgery to remove a lung and the surrounding tissue. Removing the affected lung and the tissue that surrounds it may relieve signs and symptoms of pleural mesothelioma. This procedure also allows doctors to use higher doses of radiation against any remaining mesothelioma, since they won't need to worry about protecting your lung from damaging radiation.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy.

Radiation therapy focuses high-energy beams to a specific spot or spots on your body. Radiation may reduce symptoms in people with pleural mesothelioma. Doctors aim radiation at the entire chest to obtain the best result. However, many sensitive organs are in the chest, such as the heart, lungs, esophagus and spinal cord, so doctors must use low doses of radiation to spare these organs. Radiation therapy is sometimes used after biopsy or surgery to prevent mesothelioma from spreading to the surgical incision.

Side effects from radiation therapy include tiredness, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

The chemotherapy treatment best studied in mesothelioma is the combination of pemetrexed (Alimta) and cisplatin (Platinol). These medications are given intravenously (by vein) every three weeks. The most common side effects include, but are not limited to, nausea, vomiting, damage to the kidneys, numbness and tingling in the fingers or toes, decreased hearing, rash, fatigue, lowering of the white blood count making one susceptible to infection, or lowering of the red blood count (anemia). Patients on this treatment may be given vitamins (B12 and folic acid) to decrease the risk of these side effects. Other medications, such as antinausea medications, are also available to relieve many of these side effects.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications.

Intraperitoneal chemotherapy may also be used to reduce the symptoms of peritoneal mesothelioma that can't be removed through surgery.

Palliative therapy

The goal of palliative therapy is to relieve the symptoms that result from the cancer and cancer treatment, to improve the patient’s quality of life. Examples of palliative care for mesothelioma include draining fluid that has built up in the patient’s chest or abdomen, or using radiation therapy or chemotherapy to relieve symptoms.

Combination therapy

Surgery, chemotherapy and radiation therapy may be combined. This aggressive therapy can be grueling and may not be appropriate for everyone. Younger, healthier people and those with earlier stage mesothelioma may be more able to endure this treatment. Combination therapy has shown the most promise in treating mesothelioma. However, most people will eventually experience a recurrence of this cancer despite aggressive treatment. Combination therapy has been used in both pleural mesothelioma and peritoneal mesothelioma.

Clinical trials
Clinical trials are studies of new mesothelioma treatment methods. People with mesothelioma may opt for a clinical trial for a chance to try new types of treatment. However, a cure isn't guaranteed. Carefully consider your treatment options and talk to your doctor about what clinical trials are open to you. Your participation in a clinical trial may help doctors better understand how to treat mesothelioma in the future.

Clinical trials are currently investigating a number of targeted drugs. Targeted drug therapy uses drugs to attack specific abnormalities within cancer cells. Targets being studied in mesothelioma include a substance that cancer cells make to attract new blood vessels to bring the cancer oxygen and nutrients. Another target is an enzyme that helps cancer cells develop resistance to chemotherapy drugs. Researchers hope drugs that target these areas can help kill mesothelioma cells.

Treatment for other types of mesothelioma
Pericardial mesothelioma and mesothelioma of the tunica vaginalis are very rare and can be very aggressive. Early-stage cancer may be removed through surgery. Doctors have yet to determine the best way to treat later stage cancers, though. Your doctor may recommend other treatments to improve your quality of life.

New types of treatment and medications are being tested in clinical trials.

More information about treatment studies can be found at cancer.gov/clinicaltrials .

Health: Prevention of Mesothelioma (Asbestos - Cancer)

Reducing your exposure to asbestos may lower your risk of mesothelioma.

Find out whether you work with asbestos
Most people with mesothelioma were exposed to the asbestos fibers at work. Workers who may encounter asbestos fibers include:

Miners
Factory workers
Insulation manufacturers
Railroad workers
Ship builders
Gas mask manufacturers
Construction workers
Auto mechanics

Ask your employer whether you have a risk of asbestos exposure on the job.

Follow your employer's safety regulations
Follow all safety precautions in your workplace, such as wearing protective equipment. You may also be required to shower and change out of your work clothes before taking a lunch break or going home. Talk to your doctor about other precautions you can take to protect yourself from asbestos exposure.

Be safe around asbestos in your home
Older homes and buildings may contain asbestos. In many cases, it's more dangerous to remove the asbestos than it is to leave it intact. Breaking up asbestos may cause fibers to become airborne, where they can be inhaled. Consult experts trained to detect asbestos in your home. These experts may test the air in your home to determine whether the asbestos is a risk to your health. Don't attempt to remove asbestos from your home — hire a qualified expert. The Environmental Protection Agency offers advice on its Web site for dealing with asbestos in the home.

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Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.

Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services

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HEALTH: MESOTHELIOMA (ASBESTOS) MESOTHELIOMA (CANCER)