Mesothelioma (or, more precisely, malignant mesothelioma) is a rare form of cancer that develops from transformed cells originating in themesothelium, the protective lining that covers many of the internal organs of the body. It is usually caused by exposure to asbestos.
The
most common anatomy site for the development of mesothelioma is
the pleura (the outer lining of the lungs and internal chest wall), but
it can also arise in the peritoneum (the lining of the abdominal
cavity), and the pericardium (the sac that surrounds the heart), or
the tunica vaginalis (a sac that surrounds the testis).
Most
people who develop mesothelioma have worked in jobs where they inhaled
asbestos, or were exposed to asbestos dust and fibers in other ways. It
has also been suggested that washing clothes of a family member who
worked with asbestos increases their risk for developing
mesothelioma. Unlike lung cancer, there seems to be no association
between mesothelioma and tobacco smoking, but smoking greatly increases
the risk of other asbestos-induced cancers. Some people who were exposed
to asbestos have collected damages for asbestos-related disease,
including mesothelioma. Compensation via asbestos funds or class action
lawsuits is an important issue in law practices regarding mesothelioma
(see asbestos and the law).
Signs
and symptoms of mesothelioma include shortness of breath due to pleural
effusion (fluid between the lung and the chest wall) or chest
wall pain, and constitutional signs such as unexplained weight loss. The
diagnosis may be suspected with chest X-ray and CT scan, but must be
confirmedpathologically with a biopsy (removing a sample of the
suspicious tissue) and microscopic examination.
A thoracoscopy (inserting a tube with a camera into the chest) can be
used to acquire biopsy material, and allows the introduction of
substances such as talc to obliterate the pleural space (a procedure
called pleurodesis), preventing more fluid from accumulating and
pressing on the lung. Despite treatment with chemotherapy, radiation
therapy or sometimes surgery, the disease carries a poor prognosis.
Research about screening tests for the early detection of mesothelioma
is ongoing.
Signs and symptoms
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.
Symptoms
of peritoneal mesothelioma include weight loss and cachexia, abdominal
swelling and pain due to ascites (a buildup of fluid in the abdominal
cavity). Other symptoms of Peritoneal Mesothelioma may include bowel
obstruction, blood clotting abnormalities, anemia, and fever. If the
cancer has spread beyond the mesothelium to other parts of the body,
symptoms may include pain, trouble swallowing, or swelling of the neck
or face.
These symptoms may be caused by mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
Pleural effusion, or fluid surrounding the lung
Shortness of breath
Fatigue or anemia
Wheezing, hoarseness, or cough
Blood in the sputum (fluid) coughed up (hemoptysis)
Abdominal pain
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.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
Ascites, or an abnormal buildup of fluid in the abdomen
A mass in the abdomen
Problems with bowel function
Weight loss
Blood clots in the veins, which may cause thrombophlebitis
Disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
Jaundice, or yellowing of the eyes and skin
Low blood sugar level
Pleural effusion
Pulmonary emboli, or blood clots in the arteries of the lungs
Severe ascites
A mass in the abdomen
Problems with bowel function
Weight loss
In severe cases of the disease, the following signs and symptoms may be present:
Disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
Jaundice, or yellowing of the eyes and skin
Low blood sugar level
Pleural effusion
Pulmonary emboli, or blood clots in the arteries of the lungs
Severe ascites
A
mesothelioma does not usually spread to the bone, brain, or adrenal
glands. Pleural tumors are usually found only on one side of the lungs.
Cause
Working with asbestos is the major risk factor for mesothelioma. In the United States, asbestos
is the major cause of malignant mesothelioma and has been considered
"indisputably" 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.A history of
asbestos exposure exists in most cases. However, mesothelioma has been
reported in some individuals without any known exposure to asbestos. In
rare cases, mesothelioma has also been associated with irradiation,
intrapleural thorium dioxide (Thorotrast), and inhalation of other
fibrous silicates, such as erionite. Some studies suggest that
simian virus 40 (SV40) may act as a cofactor in the development of
mesothelioma.
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 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, they are not adequate to prevent or
protect against asbestos-related cancers such as mesothelioma Likewise,
the British Government's Health and Safety Executive (HSE) states
formally that any threshold for mesothelioma must be at a very low level
and it is widely agreed that if any such threshold does 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.There appears to be a linear,
dose-response relationship, with increasing dose producing increasing
disease. Nevertheless, mesothelioma may be related to brief, low level
or indirect exposures to asbestos. The dose necessary for effect appears
to be lower for asbestos-induced mesothelioma than for pulmonary
asbestosis or lung cancer. Again, there is no known safe level of
exposure to asbestos as it relates to increased risk of mesothelioma.
The
duration of exposure to asbestos causing mesothelioma can be short. For
example, cases of mesothelioma have been documented with only 1–3
months of exposure. People who work with asbestos wear personal
protective equipment to lower their risk of exposure.
Latency,
the time from first exposure to manifestation of disease, is prolonged
in the case of mesothelioma. It is virtually never less than fifteen
years and peaks at 30–40 years. In a review of occupationally related
mesothelioma cases, the median latency was 32 years. Based upon the data
from Peto et al., the risk of mesothelioma appears to increase to the third or fourth power from first exposure.
Environmental exposures
Incidence
of mesothelioma had been found to be higher in populations living near
naturally occurring asbestos. For example, in central Cappadocia,
Turkey, mesothelioma was causing 50% of all deaths in three small
villages — Tuzköy, Karain and Sarıhıdır. Initially, this was attributed
to erionite, a zeolite mineral with similar properties to asbestos.
Recently, however, detailed epidemiological investigation showed that
erionite causes mesothelioma mostly in families with a genetic
predisposition. 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.
Occupational
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.
Commercial
asbestos mining at Wittenoom, Western Australia, occurred between 1945
and 1966. A cohort study of miners employed at the mine reported that
while no deaths occurred within the first 10 years after crocidolite exposure,
85 deaths attributable to mesothelioma had occurred by 1985. By 1994,
539 reported deaths due to mesothelioma had been reported in Western
Australia.
Paraoccupational secondary exposure
Family
members and others living with asbestos workers have an increased risk
of developing mesothelioma, and possibly other asbestos related
diseases. This risk may be the result of exposure to asbestos dust
brought home on the clothing and hair of asbestos workers. To reduce the
chance of exposing family members to asbestos fibres, asbestos workers
are usually required to shower and change their clothing before leaving
the workplace.
Asbestos in buildings
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 was banned in the UK around 1985.
Buildings built or renovated prior to these dates may contain asbestos
materials.
Diagnosis
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. 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. For pleural fluid, this is done
by thoracentesis or tube thoracostomy (chest tube); for ascites,
with paracentesis or ascitic drain; and for pericardi] 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). Unfortunately, the diagnosis of
malignant mesothelioma by cytology alone is difficult, even with expert
pathologists.
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, more
extensive diagnostic surgery may be necessary.
Immunohistochemical
studies play an important role for the pathologist in differentiating
malignant mesothelioma from neoplastic mimics. There are numerous tests
and panels available. No single test is perfect for distinguishing
mesothelioma from carcinoma or even benign versus malignant.
Screening
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. Doctors have begun testing the Mesomark assay which
measures levels of soluble mesothelin-related proteins (SMRPs) released
by diseased mesothelioma cells.
Pathophysiology
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.
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). 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. Dr. Fein has treated several patients for "World Trade
Center syndrome" or respiratory ailments from brief exposures of only a
day or two near the collapsed buildings.
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.
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 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.
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.
Treatment
The
prognosis for malignant mesothelioma remains disappointing, although
there have been some modest improvements in prognosis from newer
chemotherapies and multimodality treatments.Treatment of malignant
mesothelioma at earlier stages has a better prognosis, but cures are
exceedingly rare. 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.
Surgery
Surgery,
by itself, has proved disappointing. In one large series, the median
survival with surgery (including extrapleural pneumonectomy) was only
11.7 months. However, research indicates varied success when used in
combination with radiation and chemotherapy (Duke, 2008). (For more
information on multimodality therapy with surgery, see below). 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 thepericardium are removed.
Radiation
For
patients with localized disease, and who can tolerate a radical
surgery, radiation is often given post-operatively as a consolidative
treatment. The entire hemi-thorax 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 with some patients surviving more than 5
years. As part of a curative approach to mesothelioma, radiotherapy is
also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
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 very toxic.
Chemotherapy
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. 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.
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.
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.
Immunotherapy
Treatment
regimens involving immunotherapy have yielded variable results. For
example, intrapleural inoculation of Bacillus Calmette-Guérin (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.
Heated Intraoperative Intraperitoneal Chemotherapy
A
procedure known as heated intraoperative intraperitoneal chemotherapy
was developed by Paul Sugarbaker at the Washington Cancer Institute. The
surgeon removes as much of the tumor as possible followed by the direct
administration of a chemotherapy agent, heated to between 40 and 48°C,
in the abdomen. The fluid is perfused for 60 to 120 minutes and then
drained.
This
technique permits the administration of high concentrations of selected
drugs 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.
This technique is also used in patients with malignant pleural mesothelioma.
Multimodality Therapy
All
of the standard approaches to treating solid tumors—radiation,
chemotherapy, and surgery—have 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 (3–14
years) among patients with favorable prognostic factors.] 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).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 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. 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. Extrapleural pneumonectomy is a more extensive
operation that involves resection of the parietal and visceral pleurae,
underlying lung, ipsilateral diaphragm, and ipsilateral pericardium.
This operation is indicated for a subset of patients with more advanced
tumors, who can tolerate a pneumonectomy.
Epidemiology
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. 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. It has been estimated that
incidence may have peaked at 15 per 1,000,000 in the United States in
2004. Incidence is expected to continue increasing in other parts of the
world. 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.
Between
1940 and 1979, approximately 27.5 million people were occupationally
exposed to asbestos in the United States. 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.
Legal issues
Main article: Asbestos and the law
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. 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.
- History
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. 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. In 1962 McNulty
reported the first diagnosed case of malignant mesothelioma in
an Australian asbestos worker. The worker had worked in the mill at the
asbestos mine in Wittenoom from 1948 to 1950.
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.
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.
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.
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.
Mesothelioma cancer treatment depends largely on the extent (stage) of the cancer and the location of the malignancy (type). Several methods of mesothelioma treatment are
available and researchers are hard at work developing new and improved
ways to manage symptoms and promote longevity and quality of life in
patients with this deadly cancer. The following is a brief overview of
the treatment options. A detailed consultation with a healthcare
provider is the best way to determine what treatments are appropriate.
Mezothelioma Surgery
Unfortunately, surgical treatment of mesothelioma cancer has
proved somewhat disappointing. In some cases; however, it is used with
success. Treatment for pleural mesothelioma may include a pleurectomy
(or decortication), during which the lining of the chest is removed. The
less common extrapleural pneumonectomy procedure (EPP), during which
the lung, inside lining of the chest, the hemi-diaphragm and pericardium
are removed, may also be an option.
Mezothelioma Radiation
For
patients whose malignant mesothelioma is localized, radiation may be
given in conjunction with radical surgery. Chemotherapy may also be
combined in this approach. The technique of using surgery followed by
radiation with chemotherapy was pioneered by the thoracic oncology team
at Boston’s Brigham & Women's Hospital.
Mezothelioma Chemotherapy
In 2004, the US Food and Drug Administration (FDA) approved pemetrexed (brand nameAlimta) for the treatment of malignant pleural mesothelioma. This drug is often given in conjunction with another drug called cisplatin. While these drugs do carry the risk of some side effects, they have proven effective for many patients with mesothelioma cancer.
Other Mezothelioma Treatments
Immunotherapy,
Heated Intraoperative Intraperitoneal Chemotherapy, and palliative
treatments have also been developed to help treat mesothelioma cancer.
Medical research and clinical trials are ongoing in an aggressive
attempt to find better ways to treat this devastating condition.
If you wish to learn more about mesothelioma treatment and your legal rights, pleasecontact mesothelioma treatment centers to speak with a qualified and caring asbestos attorneys
Mezothelioma
Mezothelioma
is a misspelled variation of the malignancy "mesothelioma." Associated
with the inhalation of asbestos, mesothelioma cancer develops
principally among those who are exposed to asbestos on-the-job.
However, malignant mesothelioma can also affect those who have suffered
secondary exposure to this toxic mineral. Asbestos was widely used throughout much of the twentieth century due to its durability and heat-resistant qualities.
An
aggressive asbestos cancer that carries a poor prognosis, mesothelioma
can affect the lining of the lungs (pleural mesothelioma), heart
(pericardial mesothelioma), or abdomen (peritoneal mesothelioma).
The mesothelioma latency period can be up to five decades, and is
usually diagnosed when symptoms begin to surface.
Mesothelioma
doctors generally recommend treatment with chemotherapy, including the
drug Alimta®, the only FDA-approved drug specifically recommended for
treatment of this disease. Other treatment might
include surgery (generally in cases of early diagnosis) or mesothelioma
radiation.
Other common misspellings:
- Mesolthilioma
- Mesothaleoma
- Mesotheoma
- Mefothelioma
- Mesiothelioma
- Mesophilianoma
- Mesotheliom
- Mesothemeola
- Mesotheliomea
- Mestafelioma
Mesothelioma Symptoms
Mesothelioma Resource Online has created and developed this site to provide answers and support for people diagnosed with mesothelioma cancer, as well as their families and loved ones. Mesothelioma is a rare form of cancer that is caused by exposure to asbestosand
has long been considered a mystery and incurable. However, over the
past two decades, physicians, scientists and researchers have begun to
unravel this mystery and help people diagnose mesothelioma in its earlier stages, while providing more extensive forms of treatment, vast resources, and general information to make coping and survivalmore about optimism rather than uncertainty..
Mesothelioma
Detailed chart of asbestos exposure and the body. View Here
Mesothelioma is a rare type of cancer that
primarily affects the lining of the lungs, but can also affect the
heart, abdomen and other organs. Approximately 2,000 to 3,000 cases of
mesothelioma cancer are diagnosed each year in the United States,
comprising around .3 percent of all cancer diagnoses. The average age at
diagnosis is 62 years of age, occurs about four times more frequently
in men than in women and is almost always caused by exposure to
asbestos.
The life
expectancy for mesothelioma patients is generally reported as less than
one year following diagnosis, however, a patient's prognosis can be
positively affected by numerous factors including how early the cancer
is diagnosed and how aggressively it is treated.