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Mesothelioma Cancer | Prognosis, Treatment and Survival

Mesothelioma is a rare, aggressive form of cancer that develops in the lining of the lungs, abdomen, or heart. Caused by asbestos, mesothelioma has no known cure and has a very poor prognosis.

According to a 2017 report by the Centers for Disease Control, 2,400 2,800 people are diagnosed with mesothelioma in the United States each year. People who have worked with or been exposed to asbestos have the highest risk of developing mesothelioma. After being exposed to asbestos, mesothelioma symptoms can take 20 50 years to appear.

The life expectancy for mesothelioma patients is poor, as there is no cure for the disease. The stage of the disease, cell type, and location of the tumor(s) are the most important factors for a patients survival. Factors such as the patients overall health, age, and whether the cancer has spread also impact prognosis.

After receiving a mesothelioma diagnosis, there are a number of vital decisions that must be made. The Mesothelioma Cancer Alliance is dedicated to providing patients with the best resources available on current treatment, stories of survival and hope, and financial assistance.

Heather Von St. James is a 12-year pleural mesothelioma survivor who has become a spokeswoman for mesothelioma awareness and a proponent of banning asbestos.

She also works with newly diagnosed mesothelioma patients as a mentor and advocate, helping them understand their treatment and legal options.

Heather offers valuable insights into her successful treatment approach with Dr. David Sugarbaker. She has a unique perspective on life after surviving a mesothelioma diagnosis and enjoys sharing her story. Click here to connect with Heather.

Mesothelioma is most commonly classified by the location in the body where it develops. Specifically, the cancer forms in the lining of certain organs or spaces within the body, known as the mesothelium. Mesothelioma typically develops in one of three specific areas.

The most common type, pleural mesothelioma is caused by the inhalation of asbestos fibers.

Inhaled or swallowed asbestos fibers can become trapped in the lining of the abdomen (the peritoneum).

In rare cases, asbestos fibers can get lodged in the pericardium, the lining around the heart cavity.

Mesothelioma symptoms can take 20 50 years to appear after the first exposure to asbestos. The signs of mesothelioma often look like those of other diseases, which can lead to misdiagnosis. When someone exhibits mesothelioma symptoms, doctors perform a variety of tests to rule out other diseases. It normally takes weeks or months for doctors to arrive at an accurate mesothelioma diagnosis.

Upon diagnosis, the doctor will categorize the disease into one of four stages. While there are several staging systems, the TNM System which stands for tumor, lymph nodes, and metastasis is the most commonly used.

The mesothelioma tumor is located in only one area and has not spread to other parts of the body.

A large tumor may have progressed to nearby areas and/or the lymph nodes, but has not gone on any further.

Tumors have typically spread beyond the local area to several nearby locations and the lymph nodes.

The tumors have spread into multiple areas and throughout the lymphatic system, invading other organs throughout the body.

Typically, Stage 1 and Stage 2 mesothelioma can be treated effectively with surgery and other forms of therapy. However, Stage 3 and Stage 4 mesothelioma are often treated palliatively.

Treatment for mesothelioma is similar to other types of cancer. The most common treatments are surgery, chemotherapy, and radiation. Newer treatments are being studied as part of clinical trials and may be available for some patients who do not respond to conventional therapies.

In some cases, treatment can improve a patient’s prognosis, extending his/her life significantly. Treatment can also be used palliatively to reduce pain and discomfort caused by the symptoms of mesothelioma.

Finding a mesothelioma doctor and creating a custom treatment plan based on your diagnosis is the most important decision you can make to improve prognosis. Browse our catalog of top mesothelioma doctors around the country.

Mesothelioma clinics and cancer centers offer patients a way to get the most comprehensive care, using the latest technology and techniques available. Locate the best mesothelioma clinics near you.

The costs of treating mesothelioma are significant. If you were exposed to asbestos on the job, in your home, or elsewhere, you have the right to recover these expenses from those responsible for the exposure.

Financial assistance is available to help offset the high cost of mesothelioma treatment. The primary ways mesothelioma patients and their families can receive compensation are:

Those who have been diagnosed with mesothelioma or other types of terminal cancer can find tremendous comfort in the support they get from family, friends and caregivers.

FREE Mesothelioma Awareness Wristbands and Treatment Guide.

JM Mazurek; G Syamlal; JM Wood; SA Hendricks, A Weston. U.S. Centers for Disease Control. Malignant Mesothelioma Mortality United States, 19992015. March 3, 2017:66(8);214218. DOI: 10.15585/mmwr.mm6608a3

National Cancer Institute Malignant Mesothelioma (Source)

Wagner, J.C., Sleggs, C.A., and Marchand, Paul. Diffuse Pleural Mesothelioma and Asbestos Exposure in the North Western Cape Province. Department of Thoracic Surgery: University of The Witswatersrand. Johannesburg, South Africa. 1960.

Grondin, Sean C., Sugarbaker, David J. Pleuropneumonectomy in the Treatment of Malignant Pleural Mesothelioma Chest December 1999 116:suppl 3 450S-454S;

Rusch, Valerie W. Indications for pneumoctomy. Extrapleural pneumonectomy

Roggli VL, Sharma A, Butnor KJ, Sporn T, Vollmer RT (2002). “Malignant mesothelioma and occupational exposure to asbestos: a clinicopathological correlation of 1445 cases”. Ultrastruct Pathol 26(2): 5565.

Brigham and Womens Hospital International Mesothelioma Program (Source)

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Mesothelioma Cancer | Prognosis, Treatment and Survival

Mesothelioma – What is Malignant Mesothelioma Cancer

Malignant mesothelioma is a rare, asbestos-related cancer. It forms on the protective tissues covering the lungs, abdomen and heart. Symptoms include coughing, chest pain and shortness of breath. Treatments combining surgery, radiation and chemotherapy improve survival and life expectancy.

Mesothelioma is a rare cancer caused by exposure to asbestos.

The disease forms on the mesothelium a protective lining that covers the lungs, abdomen, heart and testes.

Tumors can be benign (noncancerous). But when tumors are cancerous, doctors call the disease malignant mesothelioma. It is often shortened to mesothelioma.

The American Cancer Society records about 3,000 new cases of mesothelioma each year in the U.S.

Asbestos remains the primary cause of mesothelioma.

The cancer develops when a person ingests asbestos, and it causes changes to a persons DNA. Our genes are made of DNA. Some of the genes in our body control how cells grow, multiply and die. Changes in our genes may cause cells to divide out of control and may lead to cancer.

A person inhales or swallows airborne asbestos fibers.

The asbestos fibers become lodged in the lining of the lungs, abdomen or heart.

The embedded fibers damage the mesothelial cells and cause inflammation.

Over time, tumors begin to form on the damaged mesothelium.

These mesothelioma symptoms usually do not show until tumors have grown and spread. Mesothelioma latency is 20-50 years. Thats how long it takes from initial exposure to accurate diagnosis. For that reason, many people with mesothelioma are in their 60s or 70s.

You should talk to a mesothelioma specialist soon if you have a history of asbestos exposure and experience these symptoms. An early diagnosis may improve your prognosis and life expectancy.

Select the diagnosis you or your loved one is facing and receive a free guide with the right information for you:

Asbestos use in the military was widespread from 1940 to 1980. Veterans from all branches of the U.S. armed forces were at risk of exposure. Navy veterans are most at risk. This branch used the largest quantity of asbestos products.

LEARN ABOUT VETERANS

More than 75 occupations have exposed workers to asbestos. Auto mechanics, textile workers, steel mill workers, construction workers and firefighters are among the most at risk.

LEARN ABOUT OCCUPATIONS

Asbestos workers unknowingly carried asbestos fibers on their body and clothing. This resulted in secondary asbestos exposure among residents such as women and children.

LEARN ABOUT SECONDARY EXPOSURE

Oncologists name each type of mesothelioma by the location in the body where it develops.

The pleural and peritoneal types of mesothelioma are the most common. Pericardial accounts for 1 percent of cases. Another rare type is testicular mesothelioma. It represents less than 1 percent of all mesotheliomas.

Prognosis, symptoms and treatment options vary by type.

Younger patients and women have a better mesothelioma prognosis than older men. People diagnosed with peritoneal mesothelioma also have a higher chance of survival.

Patients eligible to undergo multimodal therapy, which is a combination of two or more standard-of-care treatments, have a better life expectancy and improved prognosis.

A patients mesothelioma cell type also plays a significant role in prognosis and life expectancy. The three types of cells include:

Epithelioid: These cells are the most responsive to treatment, which improves prognosis and life expectancy. They comprise 50 percent of mesothelioma diagnoses.

Sarcomatoid: These cells are the least responsive to treatment. Patients with this cell type have a poorer prognosis and shorter life expectancy. These cells comprise 10 percent of diagnoses.

Biphasic: A combination of epithelioid and sarcomatoid cells. This type is less responsive to treatment. But prognosis and life expectancy depends on the ratio of both types of cells. This type accounts for 30-40 percent of diagnoses.

The life expectancy for most patients is about 12 months after diagnosis.

Stage and cell type of the cancer are the factors that most affect prognosis. Age, gender and patients asbestos exposure history also affect survival outlook.

Eating a nutrient-rich diet, undergoing cancer treatments, including multimodal therapy, and staying healthy can improve prognosis.

The cancer is localized. Surgery is most effective at this stage. Survival rate is higher. Median life expectancy at stage 1 is 22.2 months.

LEARN ABOUT STAGE 1

Tumors have started to spread from the original location into adjacent structures. Surgery is still an option. Median life expectancy at stage 2 is 20 months.

LEARN ABOUT STAGE 2

Cancer has progressed to a more advanced stage with spread into the regional lymph nodes. Surgery may still be an option. Median life expectancy at stage 3 is 17.9 months.

LEARN ABOUT STAGE 3

Cancer has spread extensively in the area where it developed. Chemotherapy and immunotherapy control symptoms and prolong survival. Median life expectancy at stage 4 is 14.9 months or less.

LEARN ABOUT STAGE 4

Mesothelioma is a rare cancer. It represents only 0.3 percent of all cancer diagnoses. Most doctors and oncologists have never encountered it.

A 2009 study published in the Journal of General Internal Medicine states that cancer care requires the technical knowledge and skills of specialty physicians such as medical oncologists, surgeons and radiation oncologists.

These are factors that impact a mesothelioma patients survival. Thats why finding a mesothelioma specialist is so important.

Finding a mesothelioma specialty center with experienced mesothelioma doctors is crucial to survival.

More than 70 percent of mesothelioma patients undergo chemotherapy

Mesothelioma treatment helps patients live longer lives. But not every patient is eligible for each type of mesothelioma treatment.

The most common treatments for mesothelioma include:

Surgery: Offers greatest chance of survival. Usually used for diagnosis, tumor removal or palliative care to reduce pain. Patients with strong health and limited cancer spread are good candidates.

Chemotherapy: More than 70 percent of patients undergo chemotherapy. It uses powerful drugs to shrink tumors and kill cancer cells.

Radiation Therapy: Used to reduce pain from growing tumors. When combined with surgery and chemotherapy, it reduces risk of local recurrence. It can be used at any cancer stage.

Immunotherapy: This experimental treatment boosts the immune system to fight the cancer. Primarily used in clinical trials.

Multimodal Therapy: A combination of two or more treatments. Clinical studies show this approach improves survival rates.

HIPEC: A multimodal treatment for peritoneal mesothelioma patients. Surgery is first used to remove as many tumors as possible. Heated chemotherapy is then applied to the abdominal cavity to destroy remaining cancer cells.

Palliative Treatments: May include surgery, radiation, chemotherapy or HIPEC. The purpose is not curative care. Instead, the goal is to reduce pain and improve quality of life. Good for any mesothelioma patient.

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Thank you for the doctor referral info. We met with the doctor and came away with what seemed like a weight lifted.

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Clinical trials offer mesothelioma patients access to experimental therapies. They also provide scientific and medical information for researches to develop new treatments. Patients in clinical trials also receive excellent medical care.

Herbal medicines, mind-body therapies, holistic healing and other complementary therapies may benefit patients.

The median value for mesothelioma claims, according to a 2010 report from the RAND Corporation, a nonprofit institution that conducts research and analysis on asbestos bankruptcy trusts.

Many companies that produced, distributed or used asbestos products knew it was deadly. But they neglected to warn their employees. Filing a lawsuit can help mesothelioma patients cover lost wages, medical expenses and other costs.

A person with mesothelioma can file a personal injury lawsuit. Mesothelioma lawyers file these against companies responsible for their clients asbestos exposure. Families can file wrongful death claims when a loved one dies of mesothelioma.

Qualified mesothelioma attorneys can help you decide when to file a lawsuit. They can also guide you through the process. Time is of the essence because statute of limitations may expire. A mesothelioma lawyer will review your case so you receive the highest compensation.

Support is available for mesothelioma patients, survivors and loved ones in many forms.

The Mesothelioma Centers monthly online support group meets every second Wednesday. Licensed mental health counselor Dana Nolan runs the support group. Patients and survivors can share their experiences with others on a similar cancer journey.

See the article here:

Mesothelioma – What is Malignant Mesothelioma Cancer

Mesothelioma – Wikipedia

Cancer associated with asbestos

Mesothelioma is a type of cancer that develops from the thin layer of tissue that covers many of the internal organs (known as the mesothelium).[9] The most common area affected is the lining of the lungs and chest wall.[1][3] Less commonly the lining of the abdomen and rarely the sac surrounding the heart,[10] or the sac surrounding the testis may be affected.[1][11] Signs and symptoms of mesothelioma may include shortness of breath due to fluid around the lung, a swollen abdomen, chest wall pain, cough, feeling tired, and weight loss.[1] These symptoms typically come on slowly.[2]

More than 80% of mesothelioma cases are caused by exposure to asbestos.[3] The greater the exposure the greater the risk.[3] As of 2013 about 125 million people have been exposed to asbestos at work.[12] High rates of disease occur in people who mine asbestos, produce products from asbestos, work with asbestos products, live with asbestos workers, or work in buildings containing asbestos.[3] Asbestos exposure and the onset of cancer are generally separated by about 40 years.[3] Washing the clothing of someone who worked with asbestos also increases the risk.[12] Other risk factors include genetics and infection with the simian virus 40.[3] The diagnosis may be suspected based on chest X-ray and CT scan findings, and is confirmed by either examining fluid produced by the cancer or by a tissue biopsy of the cancer.[2]

Prevention centers around reducing exposure to asbestos.[4] Treatment often includes surgery, radiation therapy, and chemotherapy.[5] A procedure known as pleurodesis, which involves using substances such as talc to scar together the pleura, may be used to prevent more fluid from building up around the lungs.[5] Chemotherapy often includes the medications cisplatin and pemetrexed.[2] The percentage of people that survive five years following diagnosis is on average 8% in the United States.[6]

In 2015 about 60,800 people had mesothelioma and 32,000 died from the disease.[7][8] Rates of mesothelioma vary in different areas of the world.[3] Rates are higher in Australia, the United Kingdom, and lower in Japan.[3] It occurs in about 3,000 people per year in the United States.[13] It occurs more often in males than females.[3] Rates of disease have increased since the 1950s.[3] Diagnosis typically occurs after the age of 65 and most deaths occur around 70 years old.[3] The disease was rare before the commercial use of asbestos.[3]

Symptoms or signs of mesothelioma may not appear until 20 to 50 years (or more) after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space (pleural effusion) are often symptoms of pleural mesothelioma.[14]

Mesothelioma that affects the pleura can cause these signs and symptoms:[14]

In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung. The disease may metastasize, or spread to other parts of the body.

The most common symptoms of peritoneal mesothelioma are abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other features may include weight loss, fever, night sweats, poor appetite, vomiting, constipation, and umbilical hernia.[15] 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.[citation needed]These symptoms may be caused by mesothelioma or by other, less serious conditions.

Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:[citation needed]

Pericardial mesothelioma is not well characterized, but observed cases have included cardiac symptoms, specifically constrictive pericarditis, heart failure, pulmonary embolism, and cardiac tamponade. They have also included nonspecific symptoms, including substernal chest pain, orthopnea (shortness of breath when lying flat), and cough. These symptoms are caused by the tumor encasing or infiltrating the heart.[10]

In severe cases of the disease, the following signs and symptoms may be present:[citation needed]

If a mesothelioma forms metastases, these most commonly involve the liver, adrenal gland, kidney, or other lung.[16]

Working with asbestos is the most common risk factor for mesothelioma.[17] However, mesothelioma has been reported in some individuals without any known exposure to asbestos. Tentative evidence also raises concern about carbon-fibre nanotubes.[18][19]

The incidence of mesothelioma has been found to be higher in populations living near naturally occurring asbestos. People can be exposed to naturally occurring asbestos in areas where mining or road construction is occurring, or when the asbestos-containing rock is naturally weathered. Another common route of exposure is through asbestos-containing soil, which is used to whitewash, plaster, and roof houses in Greece.[12] In central Cappadocia, Turkey, mesothelioma was causing 50% of all deaths in three small villagesTuzky, Karain, and Sarhdr. Initially, this was attributed to erionite. Environmental exposure to asbestos has caused mesothelioma in places other than Turkey, including Corsica, Greece, Cyprus, China, and California.[12][20][21] In the northern Greek mountain town of Metsovo, this exposure had resulted in mesothelioma incidence around 300 times more than expected in asbestos-free populations, and was associated with very frequent pleural calcification known as “Metsovo Lung”.[22][23]

The documented presence of asbestos fibers in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibers.[citation needed]

Exposure to talc is also a risk factor for mesothelioma; exposure can affect those who live near talc mines, work in talc mines, or work in talc mills.[24]

In the United States, asbestos is considered the major cause of malignant mesothelioma[25] and has been considered “indisputably”[26] associated with the development of mesothelioma. Indeed, the relationship between asbestos and mesothelioma is so strong that many consider mesothelioma a signal or sentinel tumor.[27][28][29][30] A history of asbestos exposure exists in most cases.

Pericardial mesothelioma may not be associated with asbestos exposure.[10]

Asbestos was known in antiquity, but it was not mined and widely used commercially until the late 19th century. 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 publicly known. However, an increased risk of developing mesothelioma was later found among naval personnel (e.g., Navy, Marine Corps, and Coast Guard), 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 official position of the U.S. Occupational Safety and Health Administration (OSHA) and the U.S. EPA is that protections and “permissible exposure limits” required by U.S. regulations, while adequate to prevent most asbestos-related non-malignant disease, are not adequate to prevent or protect against asbestos-related cancers such as mesothelioma.[31] Likewise, the British Government’s Health and Safety Executive (HSE) states formally that any threshold for exposure to asbestos must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE assumes that no such “safe” threshold exists. Others have noted as well that there is no evidence of a threshold level below which there is no risk of mesothelioma.[32] There appears to be a linear, dose-response relationship, with increasing dose producing increasing risk of disease.[33] Nevertheless, mesothelioma may be related to brief, low level or indirect exposures to asbestos.[26] The dose necessary for effect appears to be lower for asbestos-induced mesothelioma than for pulmonary asbestosis or lung cancer.[26] Again, there is no known safe level of exposure to asbestos as it relates to increased risk of mesothelioma.

The time from first exposure to onset of the disease, is between 25 and 70 years.[34] It is virtually never less than fifteen years and peaks at 3040 years.[26][35] The duration of exposure to asbestos causing mesothelioma can be short. For example, cases of mesothelioma have been documented with only 13 months of exposure.[36][37]

Exposure to asbestos fibers has been recognized as an occupational health hazard since the early 20th century. Numerous epidemiological studies have associated occupational exposure to asbestos with the development of pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumors, and diffuse malignant mesothelioma of the pleura and peritoneum. Asbestos has been widely used in many industrial products, including cement, brake linings, gaskets, roof shingles, flooring products, textiles, and insulation.[38]

Commercial asbestos mining at Wittenoom, Western Australia, took place from 1937 to 1966. The first case of mesothelioma in the town occurred in 1960. The second case was in 1969, and new cases began to appear more frequently thereafter. The lag time between initial exposure to asbestos and the development of mesothelioma varied from 12 years 9 months up to 58 years.[39] A cohort study of miners employed at the mine reported that 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.[citation needed]

Occupational exposure to asbestos in the United States mainly occurs when people are maintaining buildings that already have asbestos. Approximately 1.3 million US workers are exposed to asbestos annually; in 2002, an estimated 44,000 miners were potentially exposed to asbestos.[24]

Family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases.[11][40][41] This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers via washing a worker’s clothes or coming into contact with asbestos-contaminated work clothing.[12][24] To reduce the chance of exposing family members to asbestos fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace.[citation needed]

Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos. Those performing renovation works or DIY activities may expose themselves to asbestos dust. In the UK, use of chrysotile asbestos was banned at the end of 1999. Brown and blue asbestos were banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials.[citation needed]

In a recent research carried on white American population in 2012, it was found that people with a germline mutation in their BAP1 gene are at higher risk of developing mesothelioma and uveal melanoma.[42]

Erionite is a zeolite mineral with similar properties to asbestos and is known to cause mesothelioma.[11] Detailed epidemiological investigation has shown that erionite causes mesothelioma mostly in families with a genetic predisposition.[12][20][21] Erionite is found in deposits in the Western United States, where it is used in gravel for road surfacing, and in Turkey, where it is used to construct homes. In Turkey, the United States, and Mexico, erionite has been associated with mesothelioma and has thus been designated a “known human carcinogen” by the US National Toxicology Program.[21]

In rare cases, mesothelioma has also been associated with irradiation of the chest or abdomen, intrapleural thorium dioxide (thorotrast) as a contrast medium, and inhalation of other fibrous silicates, such as erionite or talc.[11][24] Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma.[24] This has been confirmed in animal studies,[43][44] but studies in humans are inconclusive.[43][45][46]

The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibers in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fiber can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibers from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibers may be deposited in the gut after ingestion of sputum contaminated with asbestos fibers.[citation needed]

Pleural contamination with asbestos or other mineral fibers has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than “feathery fibers” (chrysotile or white asbestos fibers).[26] However, there is now evidence that smaller particles may be more dangerous than the larger fibers. They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. “We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately,” said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System.[47]

Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibers. It has been suggested that in humans, transport of fibers to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localized lesions of accumulated asbestos fibers in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumor.[citation needed]

Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibers remain unclear despite the demonstration of its oncogenic capabilities (see next-but-one paragraph). However, complete in vitro transformation of normal human mesothelial cells to a malignant phenotype following exposure to asbestos fibers has not yet been achieved. In general, asbestos fibers are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.[citation needed]

Analysis of the interactions between asbestos fibers and DNA has shown that phagocytosed fibers are able to make contact with chromosomes, often adhering to the chromatin fibers or becoming entangled within the chromosome. This contact between the asbestos fiber and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.[citation needed]

Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:[citation needed]

Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms:

Several genes are commonly mutated in mesothelioma, and may be prognostic factors. These include epidermal growth factor receptor (EGFR) and C-Met, receptor tyrosine kinases which are overexpressed in many mesotheliomas. Some association has been found with EGFR and epithelioid histology but no clear association has been found between EGFR overexpression and overall survival. Expression of AXL receptor tyrosine kinase is a negative prognostic factor. Expression of PDGFRB is a positive prognostic factor.[49] In general, mesothelioma is characterized by loss of function in tumor suppressor genes, rather than by an overexpression or gain of function in oncogenes.[50]

As an environmentally triggered malignancy, mesothelioma tumors have been found to be polyclonal in origin, by performing a X-inactivation based assay on epitheloid and biphasic tumors obtained from female patients.[51] These results suggest that an environmental factor, most likely asbestos exposure, may damage and transform a group of cells in the tissue, resulting in a population of tumor cells that are, albeit only slightly, genetically different.[citation needed]

Asbestos fibers have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic (chromosome-breaking) and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.[citation needed]

Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor- (TGF-) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres.[citation needed]

Diagnosis of mesothelioma can be suspected with imaging but is confirmed with biopsy. It must be clinically and histologically differentiated from other pleural and pulmonary malignancies, including reactive pleural disease, primary lung carcinoma, pleural metastases of other cancers, and other primary pleural cancers.[11]Primary pericardial mesothelioma is often diagnosed after it has metastasized to lymph nodes or the lungs.[10]

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. A history of exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma.[14] A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytopathology if this fluid is aspirated with a syringe.[10] For pleural fluid, this is done by thoracentesis or tube thoracostomy (chest tube); for ascites, with paracentesis or ascitic drain; and for pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).[citation needed] However, with primary pericardial mesothelioma, pericardial fluid may not contain malignant cells and a tissue biopsy is more useful in diagnosis.[10] Using conventional cytology diagnosis of malignant mesothelioma is difficult, but immunohistochemistry has greatly enhanced the accuracy of cytology.[citation needed]

Generally, a biopsy is needed to confirm a diagnosis of malignant mesothelioma. A doctor 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. Alternatively, the chest surgeon might directly open the chest (thoracotomy). If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, an open surgical procedure may be necessary.[citation needed]

Immunohistochemical studies play an important role for the pathologist in differentiating malignant mesothelioma from neoplastic mimics, such as breast or lung cancer that has metastasized to the pleura. There are numerous tests and panels available, but no single test is perfect for distinguishing mesothelioma from carcinoma or even benign versus malignant. The positive markers indicate that mesothelioma is present; if other markers are positive it may indicate another type of cancer, such as breast or lung adenocarcinoma. Calretinin is a particularly important marker in distinguishing mesothelioma from metastatic breast or lung cancer.[11]

There are three main histological subtypes of malignant mesothelioma: epithelioid, sarcomatous, and biphasic. Epithelioid and biphasic mesothelioma make up approximately 75-95% of mesotheliomas and have been well characterized histologically, whereas sarcomatous mesothelioma has not been studied extensively. Most mesotheliomas express high levels of cytokeratin 5 regardless of subtype.[11]

Epithelioid mesothelioma is characterized by high levels of calretinin.[11]

Sarcomatous mesothelioma does not express high levels of calretinin.[11]

Other morphological subtypes have been described:

Staging of mesothelioma is based on the recommendation by the International Mesothelioma Interest Group.[52] TNM classification of the primary tumor, lymph node involvement, and distant metastasis is performed. Mesothelioma is staged IaIV (one-A to four) based on the TNM status.[52][53]

Mesothelioma can be prevented in most cases by preventing exposure to asbestos. The US National Institute for Occupational Safety and Health maintains a recommended exposure limit of 0.1 asbestos fiber per cubic centimeter.[24]

There is no universally agreed protocol for screening people who have been exposed to asbestos. Screening tests might diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients. The serum osteopontin level might be useful in screening asbestos-exposed people for mesothelioma. The level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.[54] Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by mesothelioma cells.[55]

Mesothelioma is generally resistant to radiation and chemotherapy treatment. Long-term survival and cures are exceedingly rare.[11] Treatment of malignant mesothelioma at earlier stages has a better prognosis. Clinical behavior of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favors local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease. The histological subtype and the patient’s age and health status also help predict prognosis. The epithelioid histology responds better to treatment and has a survival advantage over sarcomatoid histology.[56]

Surgery, by itself, has proved disappointing. In one large series, the median survival with surgery (including extrapleural pneumonectomy) was only 11.7 months.[57] However, research indicates varied success when used in combination with radiation and chemotherapy (Duke, 2008), or with one of the latter. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed.[citation needed] In localized pericardial mesothelioma, pericardectomy can be curative; when the tumor has metastasized, pericardectomy is a palliative care option. The entire tumor is not often able to be removed.[10]

For patients with localized disease, and who can tolerate a radical surgery, radiation can be given post-operatively as a consolidative treatment. The entire hemithorax is treated with radiation therapy, often given simultaneously with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations. It can also induce severe side-effects, including fatal pneumonitis.[58] As part of a curative approach to mesothelioma, radiotherapy is commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.[citation needed]

Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy, when given alone with curative intent, has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be beyond human tolerance.[citation needed] Radiotherapy is of some use in pericardial mesothelioma.[10]

Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive “curative” surgery.[59] This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma, showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the group of patients treated with cisplatin in the combination with pemetrexed and who also received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give.[citation needed] Cisplatin and pemetrexed together give patients a median survival of 12.1 months.[11]

Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, or vinorelbine on its own, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin.[60]

In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.[citation needed]

In pericardial mesothelioma, chemotherapy – typically adriamycin and/or cisplatin – is primarily used to shrink the tumor and is not curative.[10]

Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Gurin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.[citation needed]

This technique is used in conjunction with surgery,[61] including in patients with malignant pleural mesothelioma.[62] The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained. High concentrations of selected drugs are then administered into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.[citation needed]

All of the standard approaches to treating solid tumorsradiation, chemotherapy, and surgeryhave been investigated in patients with malignant pleural mesothelioma. Although surgery, by itself, is not very effective, surgery combined with adjuvant chemotherapy and radiation (trimodality therapy) has produced significant survival extension (314 years) among patients with favorable prognostic factors.[63] However, other large series of examining multimodality treatment have only demonstrated modest improvement in survival (median survival 14.5 months and only 29.6% surviving 2 years).[57] Reducing the bulk of the tumor with cytoreductive surgery is key to extending survival. Two surgeries have been developed: extrapleural pneumonectomy and pleurectomy/decortication. The indications for performing these operations are unique. The choice of operation namely depends on the size of the patient’s tumor. This is an important consideration because tumor volume has been identified as a prognostic factor in mesothelioma.[64] Pleurectomy/decortication spares the underlying lung and is performed in patients with early stage disease when the intention is to remove all gross visible tumor (macroscopic complete resection), not simply palliation.[65] Extrapleural pneumonectomy is a more extensive operation that involves resection of the parietal and visceral pleurae, underlying lung, ipsilateral (same side) diaphragm, and ipsilateral pericardium. This operation is indicated for a subset of patients with more advanced tumors, who can tolerate a pneumonectomy.[66]

Mesothelioma often has a poor prognosis. Typical survival despite surgery is between 12 and 21 months depending on the stage of disease at diagnosis with about 7.5% of people surviving for 5 years.[67]

Women, young people, people with low-stage cancers, and people with epithelioid cancers have better prognoses.[11] Negative prognostic factors include sarcomatoid or biphasic histology, high platelet counts (above 400,000), age over 50 years, white blood cell counts above 15.5, low glucose levels in the pleural fluid, low albumin levels, and high fibrinogen levels. Several markers are under investigation as prognostic factors, including nuclear grade, and serum c-reactive protein. Long-term survival is rare.[49]

Pericardial mesothelioma has a 10-month median survival time.[10]

In peritoneal mesothelioma, high expression of WT-1 protein indicates a worse prognosis.[11]

Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate varies from one country to another, from a low rate of less than 1 per 1,000,000 in Tunisia and Morocco, to the highest rate in Britain, Australia and Belgium: 30 per 1,000,000 per year.[68] For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades.[69] Worldwide incidence is estimated at 1-6 per 1,000,000.[11] Incidence of mesothelioma lags behind that of asbestosis due to the longer time it takes to develop; due to the cessation of asbestos use in developed countries, mesothelioma incidence is expected to decrease.[24] Incidence is expected to continue increasing in developing countries due to continuing use of asbestos.[11] 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. Approximately one fifth to one third of all mesotheliomas are peritoneal.[citation needed] Less than 5% of mesotheliomas are pericardial. The prevalence of pericardial mesothelioma is less than 0.002%; it is more common in men than women. It typically occurs in a person’s 50s-70s.[10][70]

Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[71] Between 1973 and 1984, the incidence of pleural mesothelioma among Caucasian males increased 300%. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women.[citation needed] More than 80% of mesotheliomas are caused by asbestos exposure.[11]

The incidence of peritoneal mesothelioma is 0.53.0 per million per year in men, and 0.22.0 per million per year in women.[72]

Mesothelioma accounts for less than 1% of all cancers diagnosed in the UK, (around 2,600 people were diagnosed with the disease in 2011), and it is the seventeenth most common cause of cancer death (around 2,400 people died in 2012).[73]

The connection between asbestos exposure and mesothelioma was discovered in the 1970s. In the United States, asbestos manufacture stopped in 2002. Asbestos exposure thus shifted from workers in asbestos textile mills, friction product manufacturing, cement pipe fabrication, and insulation manufacture and installation to maintenance workers in asbestos-containing buildings.[24]

Mesothelioma, though rare, has had a number of notable patients:

Although life expectancy with this disease is typically limited, there are notable survivors. In July 1982, Stephen Jay Gould, a well-regarded paleontologist, was diagnosed with peritoneal mesothelioma. After his diagnosis, Gould wrote “The Median Isn’t the Message”,[80] in which he argued that statistics such as median survival are useful abstractions, not destiny. Gould lived for another 20 years, eventually succumbing to cancer not linked to his mesothelioma.

Some people who were exposed to asbestos have collected damages for an asbestos-related disease, including mesothelioma. Compensation via asbestos funds or class action lawsuits is an important issue in law practices regarding mesothelioma.[citation needed]

The first lawsuits against asbestos manufacturers were in 1929. Since then, many lawsuits have been filed against asbestos manufacturers and employers, for neglecting to implement safety measures after the links between asbestos, asbestosis, and mesothelioma became known (some reports seem to place this as early as 1898). The liability resulting from the sheer number of lawsuits and people affected has reached billions of dollars.[81] The amounts and method of allocating compensation have been the source of many court cases, reaching up to the United States Supreme Court, and government attempts at resolution of existing and future cases. However, to date, the US Congress has not stepped in and there are no federal laws governing asbestos compensation.[82]In 2013, the “Furthering Asbestos Claim Transparency (FACT) Act of 2013” passed the US House of representatives and was sent to the US Senate, where it was referred to the Senate Judiciary Committee.[83] As the Senate did not vote on it before the end of the 113th Congress, it died in committee. It was revived in the 114th Congress, where it has not yet been brought before the House for a vote.[84]

The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. In 1960, an article published by Wagner et al. was seminal in establishing mesothelioma as a disease arising from exposure to asbestos.[85] The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. Prior to the use of advanced microscopy techniques, malignant mesothelioma was often diagnosed as a variant form of lung cancer.[86] In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker.[87] The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.[citation needed]

In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.[citation needed]

Despite proof that the dust associated with asbestos mining and milling causes asbestos-related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called “Is this Killer in Your Home?” in Australia’s Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, “The Health Hazard at Wittenoom”, containing the results of air sampling and an appraisal of worldwide medical information.[citation needed]

By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.[citation needed]

In Leeds, England the Armley asbestos disaster involved several court cases against Turner & Newall where local residents who contracted mesothelioma claimed compensation because of the asbestos pollution from the company’s factory. One notable case was that of June Hancock, who contracted the disease in 1993 and died in 1997.[88]

The WT-1 protein is overexpressed in mesothelioma and is being researched as a potential target for drugs.[11]

There are two high-confidence miRNAs that can potentially serve as biomarkers of asbestos exposure and malignant mesothelioma. Validation studies are needed to assess their relevance.[89]

Mesothelioma at Curlie (based on DMOZ)

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Mesothelioma – Wikipedia

Mesothelioma.net | Resources for Mesothelioma Victims & Families

While this thank you is long overdue, it is still deeply, deeply heartfelt. My family will be forever grateful to you for your care, compassion, encouragement and for making it possible for us to gather with family and seek help without any worry about work responsibilities. You have such an exemplary and kind heart and we cannot thank you enough for all you did (and continue to do so) to help us get through this difficult time.

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Mesothelioma Causes, Symptoms, Treatment & Prognosis

Mesothelioma facts

What is mesothelioma?

Mesothelioma is a rare form of cancer (malignancy) that most frequently arises from the cells lining the sacs of the chest (the pleura) or the abdomen (the peritoneum). Pleural mesothelioma is the most common form, often becoming apparent with symptoms in the chest area such as chest pain, cough, and/or shortness of breath. Shortness of breath often occurs due to a large pleural effusion (fluid in the thoracic cavity). Peritoneal mesothelioma is much less common. This can affect 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.

There are two major cell types of mesothelioma, epithelial and sarcomatoid. Sometimes both of these cell types can be present, also referred to as biphasic. The sarcomatoid type is rarer and occurs in only about 15% of cases; it portends a poorer prognosis. In very rare cases, mesothelioma can originate from benign, non-malignant cells. Surgery cures this so-called benign mesothelioma.

There are many causes of chest pain. A serious form of chest pain is angina, which is a symptom of heart disease and results from inadequate oxygen supply to the heart muscle. Angina can be caused by coronary artery disease or spasm of the coronary arteries. Chest pain can also be due to a heart attack (coronary occlusion), aortic aneurysm dissection, myocarditis, esophageal spasm, esophagitis, rib injury or disease, anxiety, and other important diseases. Do not try to ignore chest pain and “work (or play) through it.” Chest pain is a warning to seek medical attention.

What are mesothelioma symptoms?

Most people present with complaints of shortness of breath. They also can have complaints of chest pain and cough. 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. The number of new cases of mesothelioma has been relatively stable since 1983, the same time that the U.S. Occupational Safety and Health Administration (OSHA) instituted restrictions on asbestos. 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 do health care professionals diagnose mesothelioma?

Pathological examination from a biopsy diagnoses mesothelioma. A health care professional removes tissue. Then a pathologist places it under a microscope and 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:

What is the prognosis for mesothelioma?

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

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, based mainly on the extent of primary tumor mass and divides mesotheliomas into four stages.

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)

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

What is the treatment for mesothelioma?

There are three traditional kinds of treatment for patients with malignant mesothelioma. Often physicians combine two or more of these in the course of treatment:

Surgery: There are several types of surgery used in treating mesothelioma.

Radiation therapy uses high-energy X-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are (internal radiation therapy).

If fluid has collected in the chest or abdomen, your doctor may drain the fluid out of your body by putting in a needle into the chest or abdomen and using gentle suction to remove the fluid. If a doctor removes fluid from the chest, this is called thoracentesis. If a physician removes fluid from the abdomen, this is called paracentesis. Your doctor may also put drugs through a tube into the chest to prevent more fluid from accumulating.

Health care professionals administer adjuvant radiation in a manner to avoid exposure of the opposite lung to radiation and its potential side effects.

Chemotherapy is the use of drugs to kill cancer cells. Health care professionals administer chemotherapy by pill, or it may be put into the body by a needle in the vein or muscle. Often, a platinum-based chemotherapy (cisplatin or carboplatin) drug is given along with a second agent, pemetrexed. The side effects can be quite toxic, therefore they are used in people who are physically well enough to tolerate these side effects.

Chemotherapeutic agents can be administered either systemically (through the bloodstream) or intrapleurally (in the pleural cavity). When it is administered intrapleurally, the treatment is localized at the site of the tumor. These drugs are generally very toxic and you should discuss their use very carefully with your physician.

Is there any promising research or are there promising drugs for mesothelioma?

Medical researchers are testing new approaches to treat malignant mesothelioma. They often combine traditional treatments or include something entirely new. They include:

Research is being conducted at various cancer centers all over the United States.

A recent study involving L-NDDP produced two cases of remission in mesothelioma patients. Another study found that a drug known as lovastatin might hold promise for mesothelioma patients.

To learn more about mesothelioma clinical studies and journal medical journal articles, visit the Mesothelioma Web (http://www.mesotheliomaweb.org).

What other kinds of information is available for people with mesothelioma?

There are numerous cancer web sites, some specific to mesothelioma. Because they are often difficult to locate, we have listed some relevant medical web sites that have information about mesothelioma.

American Institute for Cancer Research(http://www.aicr.org)

American Thoracic Society(http://www.thoracic.org/)

Canadian Cancer Society(http://www.bc.cancer.ca)

Mesothelioma Web(http://www.mesotheliomaweb.org)

Medically Reviewed on 7/5/2018

References

Mujoomdar, A.A., and D.J. Sugarbaker. “Hyperthermic Chemoperfusion for the Treatment of Malignant Pleural Mesothelioma.” Semin Thorac Cardiovasc Surg 20.4 Winter 2008: 298-304.

Ried, Michael, et al. “Cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion for malignant pleural tumours: perioperative management and clinical experience.” Eur J Cardio-thoracic Surgery 43.4 April 2013: 801-807.

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Mesothelioma Causes, Symptoms, Treatment & Prognosis

Mesothelioma | Overview, Top Treatments & Survival Tips

Selecting a Top Doctor is Critical

Selecting a mesothelioma specialist is one of the most important decisions a patient can make. Specialists are doctors who are experienced and knowledgeable about treating a specific disease. General oncologists do not have much experience in treating mesothelioma because only 2,000 to 3,000 cases are diagnosed in the U.S. each year.

A specialist can give patients a more accurate diagnosis which can expand treatment options and improve their prognosis. Treatment prescribed by a specialist can significantly extend a patient’s life. Not every specialist treats every type of mesothelioma. Depending on the stage, type, location, severity and more, certain specialists are a better fit than others.

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Mesothelioma | Overview, Top Treatments & Survival Tips

Mesothelioma | 2018 Statistics, Symptoms, Treatment Options

Most often, mesothelioma is treated with a multimodal plan, or combination, of conventional cancer treatment methods including surgery and chemotherapy. Treatment will either focus on extending life expectancy or, at a late stage, focus on palliative care to relieve side effects. Research and clinical trials have found new hope for a potential cure with emerging treatments, like immunotherapy, to combat the disease and improve life expectancy.

After receiving a mesothelioma diagnosis, the most important step is finding a mesothelioma doctor who specializes in asbestos-related diseases. They will be the best person to determine the most effective treatment options for your individual case, and will also be aware of the latest treatment advancements or clinical trials available. Creating a custom treatment plan with a mesothelioma doctor is the most effective way to improve prognosis.

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What is Mesothelioma Cancer? | Mesothelioma Book

Mesothelioma is a cancer found in the lining surrounding the lungs, the stomach, the heart or the testicles. This cancer takes its name from the name that is given to this lining – the mesothelium. The pleura is the name for the mesothelial tissue surrounding the lungs and lining the chest cavity. If the cancer is in this lining, it is called “pleural mesothelioma.” Pleural mesothelioma is the most common type of mesothelioma.

The peritoneum is the lining that covers most of the organs in the abdominal cavity, while the pericardium is the lining that covers and protects the heart. If the cancer is in either of these areas, it is called “peritoneal mesothelioma” or “pericardial mesothelioma.”

Like other forms of cancer, mesothelioma occurs when cells become abnormal and divide or grow out of control. When someone has mesothelioma, the lubricating fluid in the lining may be over-produced. This excess fluid encases the organs with a thick layer of tumor tissue, described as a rind type of layer, that puts pressure on the organs. People with pleural mesothelioma often complain of shortness of breath and a buildup of fluid in the chest area. In advanced cases of mesothelioma, cells metastasize, or grow and invade other organs and spread to other areas of the body.

The only agreed upon cause of mesothelioma is exposure to asbestos.

It often takes 10 to 60 years after exposure to asbestos before the symptoms of mesothelioma develop.

This period of time is referred to as a latency period. Because of the latency period, the disease commonly affects men and women that are at least 50 years of age and that worked with asbestos between 10 and 60 years ago.

However, there are many known cases of people developing mesothelioma at an earlier age. Often these are the sons and daughters whose parents were exposed to asbestos and who unwittingly brought the invisible dust home on their clothes or who did home remodeling projects and used products, such as joint compound, that contained asbestos. In some cases the child was around the parent as the parent changed the brakes – lined with asbestos – in the family car. This is called secondary exposure to asbestos.

Many people working 10 to 60 years ago were not required to use any type of protection in the workplace while they were exposed to asbestos even though the companies that manufactured the products containing asbestos had full knowledge that it was dangerous and that exposure to it would harm the health of many of the workers.

As with other cancers, a speedy diagnosis is important to effective treatment of mesothelioma. If you believe that you may have mesothelioma and that you worked with asbestos in the past, you should inform your doctor of this fact.

If you wish to learn more about mesothelioma, CLICK HERE to receive a free book written by medical professionals who have treated mesothelioma.

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Malignant Mesothelioma Cancer | Prognosis, Treatment & Legal Help

Many families find themselves overwhelmed by the cost of mesothelioma treatment and the challenges of caring for a loved one full time. You should not have to worry about how you can afford legal help, too.

A good malignant mesothelioma attorney will provide a free initial consultation on your case. You should also not be charged anything to get started on your claim. Instead, the mesothelioma attorney should be willing to handle your case on a contingency-fee basis. That means you dont pay anything until the attorney recovers compensation for you.

Contact us to discuss your legal options for pursuing compensation after a mesothelioma diagnosis. As an added service to veterans, our attorneys also take care of VA claims for those diagnosed with mesothelioma.

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Malignant Mesothelioma Cancer | Prognosis, Treatment & Legal Help

Mesothelioma Guide | Your Guide to Malignant Mesothelioma

Side Effects

Side effects are a main concern for patients considering chemotherapy. Doctors can adjust chemotherapy treatments if patients are experiencing severe side effects.

Chemotherapy is often given to patients through an IV, a port, or a pill. Doctors will give chemotherapy before, during, or after surgery to maximize its effectiveness.

Alimta and cisplatin are the standard chemotherapy drugs for mesothelioma. There are several other chemotherapy drugs available for patients who need different options.

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Mesothelioma Guide | Your Guide to Malignant Mesothelioma

What is Mesothelioma? Learn About Causes, Survival Rates …

What is Mesothelioma?

Mesothelioma is a rare and aggressive disease that is known to develop over a period of 20 to 40 years. In many cases, the disease is not diagnosed until the end stage, when it is more difficult to treat. There is no cure for mesothelioma, but advanced medical treatments have allowed patients to live longer with the disease. Up to 3,000 people a year are diagnosed with mesothelioma.

Malignant mesothelioma is cancer that forms in the mesothelium, or the thin layer of cells that surround major organs. Mesothelioma is almost always caused by exposure to asbestos. There are three common locations for mesothelioma to form:

In general, the average life expectancy for mesothelioma patients is between 12 to 21 months. Some 40 percent of patients survive about a year after a diagnosis and about 20 percent live more than two years following a diagnosis. While rare, there are some patients who live longer than five years with the disease.

The patients age at diagnosis, general health and access to treatment specialists are among the many factors that go into determining a mesothelioma patients life expectancy. Other factors that play a key role are the location of the disease (pleural mesothelioma patients have better survival rates than other disease locations), cell types involved (epithelial cells respond better to treatment than other types) and stage (earlier stage disease is more responsive to treatment). Experts warn that life expectation estimations vary greatly by patient and individual circumstances.

The primary cause of any form of mesothelioma is exposure to the thin, fibrous mineral called asbestos. When asbestos fibers are inhaled, they travel through the lungs to reach the pleura, where they cause inflammation and scarring to form pleural mesothelioma. In cases of peritoneal and pericardial mesothelioma, researchers suspect asbestos fibers are ingested, travel through the lymph system or are absorbed through the skin to irritate surrounding cells. In all cases, the irritations damage cell DNA, causing cells to grow rapidly and abnormally and forming tumors.

Small studies have indicated some people are genetically predisposed to developing mesothelioma because they are more susceptible to the dangers of asbestos. Researchers are also reviewing a link between mesothelioma and Simian virus 40 (SV40), a DNA virus that contaminated early polio vaccines. There has been no definitive link between the virus and mesothelioma.

Physicians determine the stage of disease by performing numerous tests including X-rays, CT (CAT) scans, MRIs, PET scans and biopsies. It is important to determine where the cancer started and if it has spread from the point of origin for a correct disease staging. An accurate assessment of disease stage is crucial to successful treatment options.

Most physicians use a universally accepted tumor grading system to stage the disease. This allows physicians to communicate about a single patient to devise the best treatment plan. The TNM system looks at the size and growth of tumors (T), the involvement of lymph nodes (N) and the metastasis, or spread, of the disease (M). From there, the cancer is staged, with stages I and II as the early disease process and stages III and IV as the more advanced disease. Most cases of mesothelioma are diagnosed in the later stages, making treatment difficult.

About 55 percent of mid- to late-stage mesothelioma patients live six months after a diagnosis, some 40 percent survive the first year after a diagnosis and about 9 percent survive five years or longer. An overall survival rate is dependent on a number of factors including state and location of the disease, the patients age and general health and the access to treatment specialists. Long-term survivors credit lifestyle changes, alternative medicine and treatment from mesothelioma specialists as contributing factors to their success.

A recent study that looked at 20 years of survivor information, from 1992 to 2012, found pleural and peritoneal survivorship was on the rise. The study found recent advances in treatment, including hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery, appear to have increased survival rates in peritoneal mesothelioma patients. The studys author suggested genetics, various treatment modalities and gene environment interactions might also play a part in patient longevity.

The optimal treatment approach for most mesothelioma patients is multimodal therapy which is surgery, chemotherapy and radiation. This approach, if successful, eliminates diseased tissue and allows for palliative care. Your treatment plan will depend on your diagnosis, disease stage and overall health.

For decades, all branches of the military required asbestos be used to protect service members from heat, fire and chemical threats. It was widely used in barracks, offices, vehicles and vessels. Over a period of 50 years, some 5 million veterans were exposed to asbestos in shipbuilding operations alone. About 30 percent of mesothelioma patients are U.S. military veterans. Occupations that include carpentry, construction, roofing, auto mechanics and milling are at risk for exposure to dangerous levels of asbestos.

It is estimated that more than 300 asbestos products were used on military installations and in military applications between the early 1930s and the late 1970s. More recently, soldiers serving in Iraq, Afghanistan and the Middle East may be been exposed from airborne asbestos. Companies that produced these products concealed the dangers of mesothelioma to put profits ahead of the safety and well being of our troops.

Gender, age, severity of symptoms, level of asbestos exposure, stage of disease and disease cell type play a significant role in the overall prognosis for mesothelioma patients. In addition, external factors including diet, age, stress level and general health play a role. The average pleural mesothelioma patient with late-stage disease survives about 12 months after a diagnosis, but those treated with surgery and radiation may extend their prognoses by some 28 months. Peritoneal mesothelioma patients who are treated with heated intraperitoneal chemotherapy (HIPEC) outlive their prognoses by 24 months to 7 years.

Many patients are able to improve their prognosis by seeking treatment options from a qualified mesothelioma specialist. Doctors who are practiced and trained in mesothelioma disease treatment approaches have specialized skills, education and access to crucial information that can make positive changes on long-term health.

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What is Mesothelioma? Learn About Causes, Survival Rates …

Mesothelioma Veterans Center – Asbestos Benefits & VA Claims

Since asbestos was used so frequently, in so many trades, its projected that millions of working men and women were exposed to asbestos. From construction to plumbing to mining and manufacturing, asbestos was ever-present. Learn how and where you may have been exposed and what compensation may be available for you.

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Mesothelioma Veterans Center – Asbestos Benefits & VA Claims

Malignant Pleural Mesothelioma Cancer Information

Pleural mesothelioma is the most common type of asbestos-related cancer. Though its an aggressive illness, ongoing advancements in chemotherapy, surgery and clinical trials are extending patients’ lives years beyond their life expectancy.

Free Mesothelioma Guide

Malignant pleural mesothelioma is a rare, aggressive cancer that develops in the pleura, a thin layer of tissue surrounding the lungs.

Inhaling microscopic asbestos fibers is the primary cause of mesothelioma. Once these fibers enter the lungs, they can become lodged in the pleura, accumulating and causing cellular damage that can lead to cancer. This process often takes decades. Mesothelioma may not develop until 20-50 years after asbestos exposure.

Pleural mesothelioma (PM) is the most common of the four types of mesothelioma. It accounts for nearly 75 percent of all cases diagnosed annually in the U.S., and the majority of cases are traced to occupational exposure to asbestos. Factory workers, shipyard workers, mechanics and construction workers have the highest risk of developing the disease.

We know receiving a pleural mesothelioma diagnosis can be frightening and confusing, and our Patient Advocates are here to ease your burden. Take advantage of our resources to learn about the latest research and top doctors who can help you cope with this rare cancer.

The initial symptoms of pleural mesothelioma include chest pain, shortness of breath, slight fatigue and weight loss. Because these symptoms mirror those of less serious illnesses, such as pneumonia or the flu, doctors often misdiagnose the cancer in its early stages.

Unfortunately, many of the more serious symptoms, such as painful breathing, coughing blood and difficulty swallowing, arent noticeable until the cancer has reached its later stages, when treatment options are usually more limited.

Pleural mesothelioma symptoms can include:

Other signs of mesothelioma can include certain benign asbestos-related diseases.

For example, studies show people with pleural plaques (areas of fibrous thickening on the lung’s lining that can become calcified) are at an increased risk of developing pleural mesothelioma. Pleural thickening is another benign condition that sometimes develops before PM.

Asbestosis is a chronic respiratory disease characterized by scarring and inflammation in the lungs. Approximately 15 percent of people with asbestosis develop pleural mesothelioma.

It’s important to discuss any exposure to asbestos with a physician as early as possible and seek out a specialist if your risk level is high. It can take months, and sometimes up to a year, to diagnose this rare cancer.

To ensure a definitive diagnosis, your doctor will first conduct a full medical and occupational history review. Then you will typically undergo multiple imaging tests such as X-rays, CT scans or PET scans.

The most important step of the diagnostic process is the biopsy, in which a surgeon collects samples of the tumor through a minor outpatient surgical procedure known as a thoracoscopy or video-assisted thoracoscopic surgery (VATS). A pathologist then analyzes the samples to determine what kind of disease or cancer is present.

Most doctors use the following staging system to describe the severity of pleural mesothelioma:

This stage is divided into two categories. During stage 1a, the cancer is localized to the outer layer of the pleura, which is closer to the chest wall. At stage 1b, the cancer is also located on the inner layer of the pleura, which is closer to the lung.

The cancer has spread to the lung tissue, diaphragm and linings of the chest cavity.

The cancer has advanced beyond the lining of the lungs and impacted other internal organs, lymph nodes near the main tumor, esophagus, trachea, fatty tissues and possibly other nearby areas.

The cancer is possibly on both sides of the chest cavity, inside distant lymph nodes and in other organs such as the brain, spine and prostate. At stage IV, pleural mesothelioma cancer cannot be treated with surgery because metastasis (the spread of the cancer) is too extensive.

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Conventional pleural mesothelioma treatment can involve surgery, chemotherapy, radiation or a combination of two or more of these, which is known as multimodal therapy. These treatment methods can be curative, reducing the cancer and extending life expectancy, or they can be palliative, which means they are performed to alleviate cancer-related pain.

In addition to these traditional methods of cancer treatment, researchers are developing emerging techniques to fight the cancer. Cancer centers specializing in PM host clinical trials to test new drugs, treatment methods and other medical advancements.

Extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D) are two surgeries that can potentially eliminate the cancer. The EPP removes the affected lung, parts of the chest lining, heart lining, nearby lymph nodes and part of the diaphragm. The P/D spares the affected lung but takes out the lining around it and tumors inside the chest cavity.

Younger, healthier patients fare best with surgery, but it’s not effective for people with late-stage cancer or multiple tumors.

Chemotherapy involves treatment with a drug designed to kill cancer cells. It is usually administered by IV. Your physician will determine dosage and frequency based on your health, weight and cancer stage.

While the effects of chemotherapy are immediate, it has a poor success rate and causes discomfort during infusions.

Radiation therapy is commonly administered alongside chemotherapy and following surgery to kill any cancer cells the surgeon accidentally left behind. Radiation is most effective when used with other types of treatment, though it can provide some pain relief on its own.

Although emerging and experimental treatments can be risky because they have not yet proven effective, they can lead to improvements of traditional cancer therapies.

For example, in recent immunotherapy clinical trials, researchers boosted the immune systems of some pleural mesothelioma patients to significantly minimize cancer symptoms and tumor progression.

Many patients with PM also use integrative oncology or complementary and alternative treatments, such as massage and yoga, to relieve pain and other side effects of treatment. While these therapies cannot cure cancer, they can improve your quality of life and relieve stress.

Alternative therapies include:

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Danielle DiPietro Patient Advocate

Your choice of doctor and treatment center can have a tremendous impact on your experience with pleural mesothelioma.

There is no one-size-fits-all treatment plan for this disease. You need a personalized approach from a specialist who understands the intricacies of PM and is up to date on the most modern and effective treatment options. This kind of doctor can only be found at a specialty center.

Most of the top pleural mesothelioma specialists practice at cancer centers in major metropolitan areas. If you do not live near a cancer center, traveling to one is worth the time and expense because these are the doctors who can give you years beyond your initial prognosis.

A few notable mesothelioma doctors:

Dr. Hedy Kindler is the director of the mesothelioma program at the University of Chicago Medical Center.

Dr. Abraham Lebenthal is a nationally renowned surgeon who specializes in treating mesothelioma at Bostons Brigham and Women’s Hospital, which is a world leader in mesothelioma treatment.

Dr. Anne Tsao, director of the mesothelioma program at the University of Texas MD Anderson Cancer Center, is a national leader in the diagnosis and treatment of lung cancers and pleural mesothelioma.

Dr. Robert Cameron, a renowned thoracic surgeon and pioneer in mesothelioma treatment, practices at the VA Greater Los Angeles Healthcare System and the UCLA Medical Center.

Dr. J.F. Pingpank Jr. specializes in peritoneal mesothelioma at the University of Pittsburgh Medical Center, which is ranked as one of the top 25 best hospitals for cancer care in the U.S.

Dr. Jacques Fontaine is a thoracic surgeon at the Mesothelioma Research and Treatment Center at the Moffitt Cancer Center in Tampa, Florida.

Our Doctor Match program will guide you to the right specialist based on your diagnosis and location. Our experienced Patient Advocates can provide a closer look at some of the nation’s best pleural mesothelioma doctors and help match you with the right provider for your needs.

There are specialty cancer centers across the nation, and there may be one or two near where you live. When choosing a center, consider its doctors and location, your ability to travel and your preferred treatment method, as well as what you expect from your health care team.

Top cancer centers include:

Nearly 30 percent of PM patients are military veterans. As in the construction industry, the U.S. armed forces made extensive use of asbestos for much of the twentieth century. Members of the military, especially Navy sailors, have often been at risk of hazardous occupational exposure.

The Veterans Department at the Pleural Mesothelioma Center will provide you with a curated list of mesothelioma specialists and centers that cater to veterans and their families.

Get information about your legal options and find out if you qualify for financial assistance.

A prognosis is your doctors best estimate of how your cancer will affect your health and life expectancy. Prognosis is usually measured in terms such as “good,” “favorable” or “poor.”

Life expectancy is measured in months or years. The average life expectancy of patients with pleural mesothelioma is 1221 months after diagnosis, but that’s not the case for everyone. Depending on certain factors, some patients may improve their initial prognosis and live years beyond their life expectancy.

While a patient cannot change factors such as age, cancer stage and cell type, they do have some control over their overall health, smoking habits, nutrition and level of exercise. Most important, a patient or caretaker can take the initiative in educating themselves about treatment options and seeking out the best health care professionals available.

Even an experienced oncologist can misdiagnose and incorrectly treat pleural mesothelioma. Finding an oncologist who specializes in malignant mesothelioma and has years of experience with this rare cancer will greatly improve your prognosis. Let our Patient Advocates find the best doctor for you.

Research shows the most favorable treatment results arise from a multimodal approach a combination of one or more traditional treatments such as surgery, chemotherapy and radiation therapy. Tell your doctor you are interested in exploring multimodal treatment.

When standard treatment isnt enough, you may want to consider clinical trials. Because of an increase in pleural mesothelioma diagnoses, more and more clinical trials are seeking patients. While clinical trials test experimental therapies and new drug combinations, all participants still receive the best standard-of-care treatment.

Moderate exercise and good nutrition are the foundation of physical fitness. The healthier your immune system is, the better your body will respond to pleural mesothelioma treatment. Healthy choices about diet and exercise may improve your prognosis and your state of mind.

Snehal Smart is the Pleural Mesothelioma Centers in-house medical doctor, serving as both an experienced Patient Advocate and an expert medical writer for the website. When she is not providing one-on-one assistance to patients, Dr. Snehal stays current on the latest medical research, reading peer-reviewed studies and interviewing oncologists to learn about advancements in diagnostic tools and cancer treatments.

Last Modified August 4, 2017

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Malignant Pleural Mesothelioma Cancer Information

Mesothelioma: How Has Paul Kraus Survived For Over 20 Years?

Looking for mesothelioma information? The following section provides extensive information about mesothelioma, including symptoms, treatment, and more. Click on an item in the menu below to jump to that topic:

Mesothelioma is a rare form of cancer that develops from cells of the mesothelium, the lining that covers many internal organs. There are approximately 2,000 cases of mesothelioma diagnosed in the United States each year. Mesothelioma is caused by exposure to asbestos, a naturally-occurring carcinogen that was put into thousands of industrial and consumer products even after many companies knew that it was dangerous.

Although rare, mesothelioma cancer is not a death sentence. The worlds longest-living mesothelioma survivor wrote a free book to provide helpful insight, resources, and share his survival experiences.

Mesothelioma is a rare form of cancer, known as the asbestos caused cancer, that develops from cells of the mesothelium, the lining that covers many of the internal organs of the body.

The main purpose of the mesothelium is to produce a lubricating fluid between tissues and organs. This fluid provides a slippery and protective surface to allow movement.

For example, it allows the lungs to expand and contract smoothly inside the body each time you take a breath. When the cells of the mesothelium turn cancerous they become mesothelioma thats where the name comes from.

Mesothelioma is a rare disease and there are only approximately 2,000 cases diagnosed in the United States every year. There are many more cases diagnosed throughout the world, especially in Australia and the U.K. where large amounts of asbestos was used.

Number of cases per year in other countries:

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There are four types of malignant mesothelioma: Pleural, peritoneal, pericardial and testicular. Pleural mesothelioma affects the outer lining of the lungs and chest wall and represents about 75% of all cases. Peritoneal mesothelioma affects the abdomen and represents about 23%. Incidences of cases in the lining of the testis and the heart represent about 1% each.

Pleural mesothelioma affects the lining of the lungs

When then pleural lining around the lungs and chest wall are involved in this cancer it is called pleural mesothelioma. There are actually two layers of tissue that comprise the pleural lining. The outer layer, the parietal pleura, lines the entire inside of the chest cavity. The inner layer is called the visceral pleura and it covers the lungs.

Mesothelioma usually affects both layers of the pleura. Often it forms in one layer of the pleura and invades the other layer. The cancer may form many small tumors throughout this tissue.

Learn More About Pleural Mesothelioma

The Peritoneal Cavity surrounds the liver, stomach, intestines and reproductive organs.

When the peritoneum, the protective membrane that surrounds the abdomen is involved in this cancer it is called peritoneal mesothelioma. Just like pleural mesothelioma, there are two layers of tissues involved with the peritoneum, the parietal layer covers the abdominal cavity, while the visceral layer surrounds the stomach, liver and other organs.

The cancer often forms many small tumors throughout the tissue. One doctor has described it as if someone took a pepper shaker and scattered the pepper over the tissue.

Learn More About Peritoneal Mesothelioma

In addition to the different types of locations within the body, there are also different cell types. These types are all considered mesothelioma, but they can affect the patients prognosis.

The three mesothelioma cell types are: epithelioid, sarcomatoid and biphasic.

Epithelioid mesothelioma cells are the most common type of mesothelioma cell and has the best prognosis of the three cell types. Notice the dark purple, elongated egg shaped cells amongst the healthy pink colored tissue.

Sarcomatoid mesothelioma cells are the rarest of the three cell types and tends to be more aggressive than epitheloid cells. Notice the dark purple nodules amongst the healthy light purple colored tissue.

Biphasic mesothelioma cells are mixtures of both cell types (epithelioid and sacromatoid) and usually has a prognosis that reflects the dominant cell type.

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Mesothelioma is caused by exposure to asbestos and it is therefore considered the asbestos caused cancer.

Asbestos has been in use since ancient times, but after the Industrial Revolution its use became widespread and was used all over the world in thousands of industrial and consumer products even after many companies knew that it was dangerous. Construction materials, automotive parts and household products such as hair dryers and oven mitts contained asbestos in the past.

Today, asbestos has been outlawed in most places around the world, however, asbestos has not been outlawed in the United States and is still found in millions of homes and public buildings, such as schools, offices and parking garages.

Learn More About Causes

Asbestos under the microscope looks like hundreds of tiny swords

Asbestos is actually a naturally occurring mineral found throughout the world. It was called the magic mineral because it is resistant to heat and corrosion. Also, it is a fiber so it can be woven into other materials.

Asbestos is composed of millions of sharp microscopic fibers. These fibers are so small that the body has difficulty filtering them out. This means that if you around airborne asbestos you may inhale it or ingest it. This is known as asbestos exposure.

The actual process as to how asbestos causes mesothelioma is still being investigated. Most scientists believe that when the small sharp fibers are ingested or inhaled they cause cell damage which can cause chronic inflammation.

This inflammation can then set the stage for disease after many years or even decades. Some scientists believe that a persons immune system may actually help prevent the cancer, even if that person is exposed to asbestos.

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Since asbestos causes this rare disease, how to people get exposed to asbestos? While asbestos was in thousands of products, workers in some professions had more exposure to this carcinogen than others.

Examples of occupations that exposed workers to asbestos includes: Navy veterans, construction trades such as electricians, mechanics, and plumbers, people working in power houses and power plants, firefighters, and refinery workers. Individuals in these professions often had a multitude of asbestos containing products on their various job sites.

Most asbestos containing products were removed voluntarily by the late 1970s. However, because there is no comprehensive ban on asbestos in the U.S. and because of the long latency period, people are still being diagnosed with mesothelioma today.

Learn More About Occupational Asbestos Exposure

Old Advertisement for Asbestos Sheets

The history of asbestos in the United States and other industrialized countries is a sad story of corporate greed. Companies that produced asbestos containing products saw their workers becoming sick with lung scarring, asbestosis, and cancer nearly 100 years ago.

Some companies even brought in researchers and scientists to better understand the health impact of asbestos. Once it was shown that their magic mineral was toxic to human beings, the industry faced a dilemma.

Should they protect workers, warn consumers, notify public health officials, and most importantly, phase out this dangerous mineral? Their answer was no.

Instead industry did just the opposite. They warned no one, kept their knowledge about asbestos secret and continued to use it for decades! Only by the 1960s did independent researchers like Dr. Irving Selikoff of Mt. Sinai School of Medicinebegin to connect asbestos exposure to disease.

By then hundreds of thousands of men, women, and children were already exposed to this deadly mineral. The EPA would ban asbestos in 1989. However, the asbestos industry would sue the EPA and win.

In 1991 the ban was lifted. Even today, there is no comprehensive asbestos ban in the United States. Sad but true.

(Asbestos Medical and Legal Aspects by Barry Castleman)

Asbestos fibers cling to the clothing of workers and can be transferred to others, such as children or spouses.

People exposed directly to asbestos are called primary exposed. Sometimes the person who is primary exposed will transfer asbestos fibers from their clothes to the clothes of another person. The person who gets this transfer of asbestos exposure is said to have secondary exposure.

One example of secondary exposure is called the deadly hug. Sadly, the deadly hug happens when an adult comes home from work with asbestos on their clothes and hugs their son or daughter, unknowingly transferring the dangerous fibers to their child. There have been many cases of adults being diagnosed with mesothelioma whose only exposure to asbestos came from their time as a child.

Read About Secondary Exposure

There is a long latency period for mesothelioma which is the time from asbestos exposure to diagnosis of the cancer. This period can range anywhere from 20 to 50 years. There are different theories as to why there is such a long latency period and why most people exposed to asbestos do not get mesothelioma.

One theory suggests that there may be other variables that play a role. For example, some doctors believe that the condition or competency of a persons immune system could determine whether asbestos in their body leads to cancer.

Other possibilities include a persons genes and diet.

When doctors suspect a patient has mesothelioma they will initiate a work-upin order to make a diagnosis. This work-up may include imaging scans, biopsies, pathology exams, blood tests and staging.

Diagnosing Mesothelioma

Various types of scans may be used to determine if there are signs of tumors or other abnormalities. These scans may include X-rays, CT scans, MRIs, or PET scans.

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If scans reveal what doctors believe may be a cancer then a biopsy may be suggested. A biopsy is a procedure where doctors remove a small piece of the suspected tumor tissue from the patients body.

More on Biopsies

Blood tests and biomarkers may sometimes be used to determine if mesothelioma is present in the body. While these tests are helpful they are not considered as important as the biopsy which is considered the gold standard.

More on Biomarkers

The biopsy material will then be given to a pathologist. A pathologist will use special stains and other tests to determine if there is cancer and identify exactly what type of cancer was removed from the patient.

More on Pathology Exams

If mesothelioma is diagnosed, doctors may stage the disease. Over the years a variety of staging systems have been used. The one used most frequently today groups the disease into localized (only in the mesothelium) or advanced (spread outside the mesothelium).

More on Staging

The prognosis of mesothelioma or any other cancer depends on a number of variables. Those variables include:

More on Prognosis

A doctor specializing in mesothelioma can properly diagnose you and determine the best course of treatment. Find a mesothelioma specialist or doctor near you.

The treatments for mesothelioma can be divided into three paths: Conventional Therapies, Clinical Trials, and Alternative Modalities.

Conventional therapies include chemotherapy, radiation therapy and surgery. The standard chemo drugs used are Alimta (pemetrexed) and cisplatin (or carboplatin). They are often prescribed for the various types of mesothelioma, regardless of location. Both chemo and radiation therapy are known as cytotoxic or cell killing therapies. They work indiscriminately, killing both healthy and cancer cells. This is the reason that they can have severe side effects.

Learn About Treatment

The standard of care in many hospitals is to treat peritoneal mesothelioma with surgery and HIPEC. HIPEC stands for hyperthermic intraperitoneal perioperative chemotherapy which basically means flushing the surgical area with heated chemotherapy during the surgical procedure. The obvious advantage of this approach is that it enables doctors to put the chemo in exactly the place it needs to be.

Of all the conventional treatments available, surgery is generally considered the most effective. For pleural mesothelioma, there are various types of surgical procedures, including lung sparring surgery (also called pleurectomy/decorticiaton or PD) and extrapleural pneumonectomy (also called EPP).

Pleurectomy/decortication surgery is a two-part surgery that removes the lining surrounding one lung (pleurectomy), then removes any visible cancer seen growing inside the chest cavity (decortication). The advantage of P/D or lung sparring surgery is exactly what the name implies a lung is not removed.

An extrapleural pneumonectomy (EPP) is a much more invasive surgery than PD. An EPP involves removing a lung, the diaphragm, portions of the chest lining and heart lining, and nearby lymph nodes.

Numerous studies have been performed comparing the prognosis with a pleurectomy/decortications surgery versus an extrapleural pneumonectomy. While there is no consensus on the subject, the latest reports suggest that PD may be a better choice for many patients because survival is generally equivalent to EPP and PD is less invasive and therefore easier to tolerate.

There are also other surgical procedures used to treat pleural effusion. Pleural effusion is the buildup of excess fluid in the pleural space between the visceral and parietal linings of the lungs. Examples of these procedures include pleurodesis and thoracentesis.

More on Surgery

Clinical trials are treatments that are still being tested. These treatments may include chemotherapy or other more innovative approaches based on immune therapy, gene therapy or other biological approaches. One example of new treatments being tried in mesothelioma involve the use of monoclonal antibodies. Monoclonal antibodies are essentially an immune system therapy that tries to use antibodies to target cancer cells. The National Cancer Institute indexes clinical trials offered throughout the country.

Discover Clinical Trials

Alternative modalities include a large number of approaches such as intravenous vitamin therapy, herbs and Traditional Chinese Medicine, cannabis oil, dietary approaches, and mind-body medicine. It is important to note that while none of these modalities are FDA approved, there are a number of long-term mesothelioma survivors who have used them, including Paul Kraus.

Read About Alternative Treatments

Mesothelioma is not the only disease caused by asbestos. Asbestosis which is essentially scarred lung tissue, pleural plaques and some lung cancers can also be caused by asbestos. There may also be compensation available to victims of these diseases as well. Treatments vary by condition.

Learn About Other Asbestos Diseases

Factors such as multi-drug resistance, therapy related side effects, and disease recurrence after therapy have all been implicated as problems that prevent successful treatment of malignant mesothelioma. However, recent scientific evidence suggests that some common dietary phytochemicals, such as curcumin and quercetin, may have the ability to regulate microRNAs associated with malignant mesothelioma and possibly inhibit the cancer by regulating the expression of various genes which are known to be aberrant in malignant mesothelioma.

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Mesothelioma: How Has Paul Kraus Survived For Over 20 Years?

Mesothelioma Cancer | We Get You the Fast Help You Need

Approximately 3,000 people are diagnosed with malignant mesothelioma in the United States every year. In most cases, these victims exposure took place on the job and the cause of the illness can be traced to an unsafe workplace.

For example, in the past, an overwhelming amount of job sites across the nation used asbestos-containing materials (ACMs) in buildings, equipment, products, machinery, insulation, electrical wiring, and more.

Workers were exposed to ACMs each time they went to work, inhaling tiny, odorless asbestos fibers. Once the fibers become lodged in the body, its literally impossible to expel all of. Over time, the workers began developing asbestos-related illnesses, such as mesothelioma, asbestosis, and asbestos-related lung cancer.

With changing regulations and mitigation, exposure to asbestos is on the decline, but people continue to be diagnosed. This is because the disease has what is known as a long latency period. This means that the amount of time that can pass between the time of exposure to asbestos and the time that symptoms begin to appear can be as long as fifty years.

It is an unfortunate reality, but medical science has made great strides in understanding how this deadly disease progresses and various ways to prolong and improve the lives of those who have been diagnosed with the condition. Currently, however, there is still no cure for asbestos illnesses.

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Mesothelioma Cancer | We Get You the Fast Help You Need

Mesothelioma Help Now – Providing Health Options for Mesothelioma

Mesothelioma is a rare and complex cancer for which there is no cure. With the only known cause being asbestos, mesothelioma is more than a diagnosisits a life-altering event affecting entire families and communities. With over 3,000 new diagnoses each year, you are not alone in your fight against mesothelioma. As a community,we stand together in this battle. Vast support networks and resources are here to help you understand this disease and get Mesothelioma Help Now.

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Mesothelioma Help Now – Providing Health Options for Mesothelioma

Mesothelioma Lawyer Center | Leading Asbestos Attorneys

For over 15 years weve been helping families like yours connect with leading mesothelioma lawyers. There are many law firms that handle mesothelioma and asbestos cases. Choosing from among them can be overwhelming. We clear through the confusion and help you connect withonly the top lawyers near you.

There arent enough words to describe how much our family appreciates everything you have done for us since we met 4 years ago. I feel a very special bond between us that will continue for a very long time.~ Marilyn & Family

Finding the best legal representation is a crucial part of any asbestos-related case. Mesothelioma and asbestos cases can be complicated. Finding a legal team that specializes in and has experience with these cases is crucial for the best outcomes. A general practice lawyer does not have the knowledge needed to take your case.

You also need to choose a lawyer that who makes you feel comfortable and who you feel has your best interests in mind. Choose the professional who will fight for you, educate you about the laws and how they affect the choices you make, and who will keep you up to date as your case proceeds.

Perhaps most importantly, a good asbestos or mesothelioma lawyer will have the experience you need to help you determine which path to take to seek justice and compensation. Whether you should file a claim with an asbestos trust fund, start a lawsuit, go to trial with your case, or seek compensation through the Veterans Administration is a tough decision to make without good legal advice. Learn more about finding an asbestos lawyer.

Mesothelioma trust funds have been set up by companies who have experienced an overwhelming amount of asbestos-related lawsuits These trusts were set up to compensate victims of asbestos exposure now and in the future.

Today, there are over a hundred asbestos and mesothelioma trust funds set up in the United States alone, and that number may grow as more and more companies face liability. According to the United States Government Accountability Office (GAO), close to $17.5 billion has already been awarded to victims of diseases caused by exposure to asbestos. An estimated $30 billion is still available for future cases.

In the past, victims of mesothelioma and other asbestos-related diseases had to rely on lawsuits for compensation. But since many companies were ordered to set up mesothelioma trust funds, compensation to mesothelioma victims is now more readily available. Get more information about asbestos trust funds.

Mesothelioma lawsuits give victims of asbestos-related diseases a way to get compensation for medical expenses, pain and suffering, lost wages, and in some instances, punitive damages. Although there has already been a myriad of mesothelioma lawsuits in the United States alone, these numbers are expected to increase worldwide over the next decade as more people develop illnesses from exposure to asbestos.

If you or a loved one has been diagnosed with an asbestos-related disease, such as malignant mesothelioma or asbestosis, the first step in getting the substantial compensation you may qualify for is to learn more about how the lawsuit process works and what you may be entitled to.Learn more about filing a mesothelioma lawsuit.

The majority of lawsuits for mesothelioma end in settlements rather than in a trial. In a settlement, the plaintiffs representation negotiates a compensation amount with the defendants. Although its difficult to determine how long a settlement will take, on average they are generally a lot faster as compared to a full mesothelioma trial with a jury verdict.

Mesothelioma settlement amounts vary according to how long the defendant has lived with an asbestos-related illness, what stage the illness is in, and the circumstances surrounding how asbestos exposure took place. Many mesothelioma cases have resulted in million-dollar settlements, and some settlements have even reached $10 million and more for both the defendants and their loved ones. Its important to understand how mesothelioma settlements work beforehand so that there are no surprises during your case. Get more information about settlements.

If you served in the U.S. military and you believe your asbestos exposure occurred during service, you may be able to file for and receive compensation through the Veterans Administration (VA). There are certain requirements you need to meet, and you may also qualify for other types of compensation. To sort through the complicated process, and to determine what you qualify for, let an experienced mesothelioma lawyer guide you. Learn more about what the VA offers asbestos victims.

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Mesothelioma Lawyer Center | Leading Asbestos Attorneys

Mesothelioma: Physical & Mental Effects of Asbestos Cancer

Once inside the body, asbestos has the potential to slowly damage DNA in ways that cause a cell to become cancerous. Once a cell turns cancerous, it replicates uncontrollably, resulting in a buildup of cells that slowly forms into a tumor.

Mesothelioma is unique in the way it grows. Most tumors form as a singular mass. But mesothelioma tumors more commonly develop as numerous small nodules on the lining of the lungs or abdomen.

The nodules eventually grow and merge, forming a sheath-like tumor often compared to a fruit rind. As the cancer progresses, the tumor envelopes vital organs and causes physical effects such as pain or difficulty breathing.

Tumors originating in the lung lining will first affect pulmonary health, while those developing in the abdominal lining will first affect the digestive system.

Physical signs of mesothelioma usually arise in later stages of development. It is rare for stage I or II mesothelioma to cause noticeable symptoms.

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Mesothelioma: Physical & Mental Effects of Asbestos Cancer

Mesothelioma: Medical and legal information on asbestos …

The MesotheliomaCenter is dedicated to providing those who suffer from the asbestos-related cancer malignant mesotheliomaalso known as asbestos canceror from asbestos-related lung cancer, or who know someone who does, with the most up to date information and support.

A rare and aggressive malignancy, mesothelioma is cancer affecting the lining that surrounds various organs and cavities within the body. Mesothelioma gets its name from this lining, which is called the mesothelium.

This lining exists in several places in the body, but tumors are most commonly found in the pleura (the mesothelial lining of the lungs and chest) and the abdomen. Pleural mesothelioma accounts for most cases of mesothelioma, about two thirds of all diagnosed cases. Abdominal or peritoneal mesothelioma makes up most of the remaining third (pericardial mesothelioma, affecting the lining of the heart, is an exceedingly rare variation).

Perhaps the most striking about mesothelioma, which kills more than 3000 people each year, is that is considered almost wholly preventable. Mesothelioma is almost always directly linked to asbestos exposure. Because of this, mesothelioma is often referred to as “asbestos cancer,” however, mesothelioma is not the only cancer caused by asbestos. Lung cancer is also caused by asbestos exposure.

Malignant Mesothelioma is a rare form of cancer in which malignant cells are found in the sac lining of the chest (pleura) or abdomen (peritoneum). Virtually all cases of malignant mesothelioma are attributable to asbestos exposure.

While “meso” (as it is sometimes called) is one of the most aggressive cancers, strides are constantly being made in combating this deadly disease. We encourage you to bookmark this site and return for the latest news and resources important to those suffering from mesothelioma and their families.

Our staff diligently seeks new information and we are available 24 hours a day to help you find answers for your individual situation.

You may e-mail us right now or call us at (412)-471-3980. (Please read our disclaimer before proceeding.)

Last update: January 19, 2018. 04:52:16 pm.

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