Mesothelioma Information

What is Malignant mesothelioma?

It is a cancer that is found in the layer of tissue that covers the majority of the internal organs called the mesothelium. It is comprised of two layers of cells. One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricatory fluid that is released between these layers that allows organs such as the heart and lungs to move easily against the adjacent structures.

Mesothelioma is divided into various categories depending on where the mesothelium is affected by the cancer. The lung tissue is called pleural mesothelioma and is the most common. If it occurs in the stomach, it is called peritoneal mesothelioma. This accounts for 10-20% of all cases.

Malignant mesothelioma has been increasing over the past 20 years with about 2000-3000 new cases each year in the U.S. The American Cancer Society estimates that up to 8 million Americans may have already been exposed to asbestos, the main cause of malignant mesothelioma. Men are more likely to develop mesothelioma than women. It is more common in older adults although it can be diagnosed at any age.

What are the risk factors for mesothelioma?

Exposure to asbestos is the major risk factor for mesothelioma. It is estimated that 70%-80% of all cases involve exposure to asbestos.

Asbestos is the name of a group of minerals that occur naturally in the environment. They are strong, flexible fibers that can be separated into thin threads and woven. Asbestos fibers are resistant to heat, making them useful in a wide variety of industrial products. They are used in cement, brake linings, roof shingles, flooring products, textiles and insulation. When tiny asbestos particles are dislodged they float in the air and can be inhaled or swallowed. If the asbestos particles are inhaled or swallowed, they may settle in the lungs or stomach, where they can cause irritation that may lead to mesothelioma.

Mesothelioma risk is believed to be increased for those exposed to high levels of asbestos, those who are exposed over a long period of time and to people exposed at a young age. It can take 30-50 years for mesothelioma to develop as a result of asbestos exposure.

Since the early 1940’s, millions of American workers have been exposed to asbestos dust. The risk associated with asbestos exposure was not known then. However, as time went by, it was found that an increased risk of developing mesothelioma was prevalent among shipyard workers, people working in asbestos mines or mills, producers of asbestos products, workers in the heating and construction industries. Now OSHA sets limits for acceptable levels of asbestos exposure in the workplace.

Even though exposure to high levels of asbestos and/or long periods of time increase the risk of mesothelioma, some people with only brief exposure have developed the disease.

People who live with workers exposed to asbestos may also be at risk. Asbestos is thought to be carried home on the worker’s clothes. Today workers are required to shower and change clothes after working with asbestos largely to protect their families.

While smoking does not increase the risk of mesothelioma, those who smoke and are exposed to asbestos have a much greater chance of developing mesothelioma.

Other factors that may increase the risk of mesothelioma include the Simian Virus (SV40). Millions were exposed to SV40 when receiving polio vaccinations between 1955 & 1963.

Symptoms of mesothelioma

Symptoms may not appear until 30-50 years after exposure to asbestos. Even then it is difficult to detect since the early signs are frequently ignored or confused with every day ailments. Symptoms of mesothelioma vary depending on where the cancer occurs.

Pleural mesothelioma

The majority of people diagnosed with pleural mesothelioma experience lower back pain or side chest pain as well as shortness of breath. Lower numbers of people experience difficulty in swallowing or have a persistent cough, fever, weight loss or fatigue. Symptoms also include muscle weakness, loss of sensory capability, coughing up blood, facial and arm swelling and hoarseness.

Peritoneal Mesothelioma

This originates in the abdomen with resulting symptoms of stomach pain, weight loss, nausea and vomiting. Other symptoms include swelling due to fluid build up in abdomen, bowel obstruction, blood clotting, anemia and fever. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis.

How is mesothelioma diagnosed?

Diagnosis begins with a review of the patients medical history including any history of asbestos exposure. A physical exam which includes x-rays of chest or abdomen and lung function tests. A CT (Cat) Scan or an MRI may also be useful.

A biopsy is necessary to confirm a diagnosis of mesothelioma. The procedure performed by an oncologist or surgeon removes a sample of tissue for examination under a microscope by a pathologist. If the cancer is in the chest, the doctor makes a small cut in the chest wall and a thin lighted tube is inserted. This is called a thoracoscopy. If the cancer is in the abdomen, a small opening is made in the abdomen to obtain a tissue sample. This is called a peritoneoscopy. If the diagnosis is mesothelioma, the doctor will want to know what stage the disease is at. Staging involves more tests to see if the disease has metastasized or spread to other parts of the body.

Stage I mesothelioma is localized cancer limited to one area of the chest or abdomen.

Stage II mesothelioma is considered advanced and involves the mesothelium and has spread to other adjacent areas such as the lungs and/or diaphragm.

Stage III is the same as II but it has spread to the lymph nodes.

Stage IV is the most advanced. The cancer has spread to distant areas commonly the brain and areas of the lung away from the tumor.

How is mesothelioma treated?

Treatment for mesothelioma depends on the location of the cancer, the state of the disease, the patients age, and general health. The following treatment options are available:

Surgery is used to decrease fluid build up particularly with pleural mesothelioma. A tube is inserted into the chest to drain the fluid. Medicine may be injected to prevent fluid from returning.

Surgery is used to remove tissue lining the ribs and the lungs (pleurectomy) to relieve signs and symptoms. If all the cancer can’t be removed, they will remove as much as possible (debulking)

Surgery is used to remove a lung surrounding tissue to relieve signs and symptoms of pleural mesothelioma. This allows for higher dosage of radiation for treating any remaining mesothelioma.

Chemotherapy uses chemicals to kill cancer cells. Chemotherapy drugs travel throughout your body designed to kill rapidly growing cells. This not only kills cancer cells, but healthy rapidly growing cells like hair follicles and those in your gastrointestinal system. Chemotherapy may be utilized before or after surgery to reduce the signs and symptoms of mesothelioma.

Those with peritoneal mesothelioma may receive chemotherapy drugs that have been heated (hyperthermic). These drugs are administered directly into the abdominal cavity rather than throughout the body. This does not injure the healthy cells in other parts of the body and thus, higher doses of chemotherapy can be used.

Radiation therapy directs high energy radiation to a specific spot or spots on the body. In cases of pleural mesothelioma, doctors use low doses of radiation aimed at the entire chest. High doses are not used since they may damage the heart, lungs and spinal cord all within the chest area. Radiation may reduce the signs and symptoms of mesothelioma.

Combination therapy of surgery, chemotherapy and radiation may be used, but it is an aggressive method reserved for younger, healthier people in the earlier stages.

Clinical trials are studies of new mesothelioma treatment methods. These research studies with people are sponsored by the National Cancer Institute. Before any new treatment can be recommended for general use, doctors conduct clinical trials to see if the treatment is safe and effective against the disease. People interested in clinical trials should speak to their doctor.

LEGAL ISSUES

All lawsuits, including those arising from asbestos exposure, have time limits in which to start a lawsuit. If you don’t start your lawsuit timely, you are forever barred from suing. Some states only have a “Statue of limitations” of 1 year after being diagnosed with mesothelioma. An experienced attorney can help determine where the case is to be filed and whether you have a case.

A lawsuit can be brought by the person with mesothelioma or by the spouse or family member of the person who died of mesothelioma. Since some states’ laws do not allow the same types of compensation for the family of the deceased as would be available to the mesothelioma victim while alive, it is best for the person with a mesothelioma diagnosis to pursue his/her claim as soon as it is diagnosed. A claim should be pursued even during the period that the mesothelioma patient is being treated.

Attorneys who handle mesothelioma cases do not charge legal fees on an hourly basis. They work for a “contingency fee”. The legal fee is based on a percentage of the recovery of money damages in the case. If there is no recovery, no legal fee is owed. Expenses are paid by the attorney to obtain medical records, court filing fees, etc. and be reimbursed only when the case is settled.

Since every case is different, the amount of time it takes to resolve will vary from state to state. Some jurisdictions have expedited trials which can speed up the case but most cases take years. Similarly, the amount of compensation for a mesothelioma case will depend on many factors and cannot be accurately predicted.