Malignant Pleural Mesothelioma: Summary
The following is a summary of key points about malignant pleural mesothelioma:


* Malignant pleural mesothelioma is a disease in which malignant (cancer) cells form in the lining of the chest
* Being exposed to asbestos can affect the risk of developing malignant pleural mesothelioma
* Possible signs of malignant pleural mesothelioma include shortness of breath and pain under the rib cage
* Tests that examine the inside of the chest are used to find and diagnose malignant pleural mesothelioma
* Certain factors affect prognosis (chance of recovery) and treatment options for malignant pleural mesothelioma (see Mesothelioma Survival Rate).

Labels: Malignant Pleural Mesothelioma

o Thoracoscopy. An incision (cut) is made between two ribs and a thoracoscope (a thin, lighted tube) is inserted into the chest.

o Peritoneoscopy. An incision is made in the abdominal wall and a peritoneoscope (a thin, lighted tube) is inserted into the abdomen.

o Laparotomy. An incision is made in the wall of the abdomen to check the inside of the abdomen for signs of disease.

o Thoracotomy. An incision is made between two ribs to check inside the chest for signs of disease.

* Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope (a thin, lighted tube) is inserted through the nose or mouth into the trachea and lungs. Tissue samples may be taken for biopsy.

* Cytologic exam: An exam of cells under a microscope (by a pathologist) to check for anything abnormal. For malignant pleural mesothelioma, fluid is taken from around the lungs. A pathologist checks the cells in the fluid.


After is malignant pleural mesothelioma diagnosis is confirmed, additional tests will be performed in order to determine the stage of the cancer.

Treatment Options for Malignant Pleural Mesothelioma
Malignant pleural mesothelioma treatment options may include:


* Surgery (see Mesothelioma Surgery)
* Radiation therapy (see Mesothelioma Radiation)
* Chemotherapy (see Mesothelioma Chemotherapy).

Labels: Malignant Pleural Mesothelioma

Diagnosing Malignant Pleural Mesothelioma
Sometimes it is hard to tell the difference between malignant pleural mesothelioma and lung cancer, so tests are performed to examine the inside of the chest to accurately diagnose the condition.


The following tests and procedures may be used to diagnose malignant pleural mesothelioma:


* Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits, exposure to asbestos, past illnesses, and treatments will also be taken.

* Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

* Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:

o The number of red blood cells, white blood cells, and platelets.
o The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
o The portion of the blood sample made up of red blood cells.

* Sedimentation rate: A procedure in which a sample of blood is drawn and checked for the rate at which the red blood cells settle to the bottom of the test tube.

* Biopsy: The removal of cells or tissues from the pleura so they can be viewed under a microscope by a pathologist to check for signs of malignant pleural mesothelioma. Procedures used to collect the cells or tissues include the following:

o Fine-needle aspiration biopsy. The removal of part of a lump, suspicious tissue, or fluid, using a thin needle. This procedure is also called a needle biopsy.

Labels: Malignant Pleural Mesothelioma

Malignant pleural mesothelioma is a rare disease in which cancer cells develop in the pleura (the protective sac covering the lungs). The main risk factor for malignant pleural mesothelioma is exposure to asbestos. Most people with the disease were exposed to asbestos in the workplace. Possible signs of malignant pleural mesothelioma include shortness of breath and pain under the rib cage. It can be difficult to distinguish between malignant pleural mesothelioma and lung cancer, so it may be necessary to examine the inside of the chest to confirm the diagnosis.

Malignant Pleural Mesothelioma: An Overview
Mesothelioma is a benign (noncancerous) or malignant (cancerous) tumor affecting the mesothelium, which is a type of protective sac that covers internal organs. Most cases of mesothelioma begin in the pleura (lining around the lungs) or peritoneum (the lining around the abdomen).

Malignant pleural mesothelioma is a type of mesothelioma in which cancer cells begin to grow in the pleura.

Most people who develop malignant pleural mesothelioma have worked on jobs where they inhaled asbestos particles.

Risk Factors for Malignant Pleural Mesothelioma
Being exposed to asbestos can affect the risk of developing malignant pleural mesothelioma. Many people with malignant pleural mesothelioma have worked or lived in places where they inhaled or swallowed asbestos. After being exposed to asbestos, it usually takes a long time for malignant pleural mesothelioma to occur.

Other risk factors for malignant pleural mesothelioma include the following:


* Living with a person who works near asbestos
* Being exposed to a certain virus.


Symptoms of Malignant Pleural Mesothelioma
Malignant pleural mesothelioma symptoms usually result from an accumulation of fluid in the pleura. These pleura mesothelioma symptoms often consist of:


* Shortness of breath
* Pain in the chest or under the ribcage.


Keep in mind that other more common, less serious conditions can cause similar symptoms. If you are experiencing any possible malignant pleural mesothelioma symptoms, visit your healthcare provider so that the problem can be diagnosed and treated.

Labels: Malignant Pleural Mesothelioma

Symptoms and Diagnosis of Mesothelioma
For more about mesothelioma symptoms, click on the full eMedTV article about Mesothelioma Symptoms.

To find out more about making a mesothelioma diagnosis, click on the full eMedTV article about Mesothelioma Diagnosis.

Treatment Options for Mesothelioma
Treatment for mesothelioma depends on:


* The location of the cancer
* The stage of the disease
* The patient's age and general health.


Standard mesothelioma treatment options include:


* Surgery
* Radiation therapy
* Chemotherapy.


Sometimes, all three treatment methods are combined.

Mesothelioma Statistics
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but mesothelioma can appear in either men or women at any age.

Labels: What is Mesothelioma

Risk Factors for Mesothelioma
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in about 70 to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos.

There is some evidence that 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 fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.

Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing lung cancer (see Causes of Lung Cancer).

Mesothelioma and Asbestos
Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been mined and used commercially since the late 1800s; its use greatly increased during World War II. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. Since the early 1940s, millions of American workers have been exposed to asbestos dust.

If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

Initially, the risks associated with asbestos exposure were unknown. 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
* Other tradespeople.


Today, the US Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

The risk of asbestos-related disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma. On the other hand, not all workers who are heavily exposed develop asbestos-related diseases.

Labels: What is Mesothelioma

Mesothelioma is a rare form of cancer affecting the mesothelium, which is a membrane that covers and protects most of the internal organs of the body. Most cases of mesothelioma begin in the pleura (the lining around the lungs) or peritoneum (the lining around the abdomen). Mesothelioma is typically caused by asbestos exposure. A history of asbestos exposure at work is reported in about 70 to 80 percent of all cases of the disease. Standard treatment options for mesothelioma include surgery, chemotherapy, and radiation therapy.

Mesothelioma: An Introduction
Mesothelioma is a benign (noncancerous) or malignant (cancerous) tumor affecting the mesothelium, which is a membrane that covers most of the body's internal organs. Most cases of mesothelioma begin in the pleura (lining around the lungs) or peritoneum (the lining around the abdomen).

Benign mesothelioma can also be called a fibroma, and cancerous mesothelioma is also known as malignant mesothelioma. A mesothelioma can further be named based on where it occurs. For example, malignant pleural mesothelioma is cancer that begins in the lining around the lungs.

Most people who develop malignant mesothelioma have worked on jobs where they inhaled asbestos particles. A benign mesothelioma does not appear to have any relationship to asbestos exposure.

Understanding the Mesothelium
The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: one layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.

The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity, while the pericardium covers and protects the heart. The mesothelial tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis, and the tunica serosa uteri covers the internal reproductive organs in women.

Labels: What is Mesothelioma

Research Studies on Malignant Mesothelioma
Because mesothelioma is very hard to control, clinical trials are being conducted that are designed to find new treatments and better ways to use current malignant mesothelioma treatments. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease. Participation in clinical trials is an important treatment option for many patients with malignant mesothelioma.

People interested in taking part in a clinical trial should talk with their doctor.

Labels: Malignant Mesothelioma

Malignant Mesothelioma Staging
After a malignant mesothelioma diagnosis has been made, tests are conducted to determine if cancer cells have spread to other parts of the body.

The process used to find out if cancer has spread outside the pleura is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage of the cancer in order to plan the mesothelioma treatment.

Malignant mesothelioma stages are grouped into localized, advanced, and recurrent stages.

Treatment Options for Malignant Mesothelioma
Malignant mesothelioma treatment options include:


* Surgery (see Mesothelioma Surgery)
* Radiation therapy (see Mesothelioma Radiation)
* Chemotherapy (see Mesothelioma Chemotherapy).


You can also learn about the mesothelioma treatment options for each stage by clicking on Mesothelioma Treatment by Stage.

Prognosis for Malignant Mesothelioma
The prognosis (chance of recovery) for malignant mesothelioma depends on the following:


* The stage of the malignant mesothelioma
* The size of the tumor
* Whether the tumor can be removed completely by surgery
* The amount of fluid in the chest
* The patient's age and general health, including lung and heart health
* The type of mesothelioma cancer cells and how they look under a microscope
* Whether the malignant mesothelioma has just been diagnosed or has recurred (come back).

Labels: Malignant Mesothelioma

The mesothelioma survival rate refers to the percentage of people with a certain type and stage of the cancer who survive for a specific period of time after their diagnosis. Most statistics focus on the 5-year survival rate. The overall 5-year relative mesothelioma survival rate for 1998-2002 was approximately 9 percent.

Mesothelioma Survival Rate: An Introduction
The mesothelioma survival rate indicates the percentage of people with a certain type and stage of mesothelioma who survive the disease for a specific period of time after their diagnosis. In most cases, statistics refer to the 5-year mesothelioma survival rate. The 5-year mesothelioma survival rate is the percentage of people who are alive 5 years after a mesothelioma diagnosis, whether they have few or no signs or symptoms of mesothelioma, are free of disease, or are receiving treatment for mesothelioma.

The mesothelioma survival rate is based on large groups of people, and it cannot be used to predict what will happen to a particular patient. No two patients are exactly alike, and mesothelioma treatment and responses to treatment vary greatly.

Factors Influencing the Mesothelioma Survival Rate
In general, the mesothelioma survival rate will depend on:


* The stage of mesothelioma (see Mesothelioma Stages)
* The size of the tumor
* Whether the tumor can be removed completely by surgery
* The amount of fluid in the chest or abdomen
* The patient's age and general health, including lung and heart health
* The type of mesothelioma cancer cells and how they look under a microscope
* Whether the mesothelioma has just been diagnosed or has come back.


Overall Mesothelioma Survival Rate
Survival rates can be calculated by different methods for different purposes. The survival rates presented here are based on the relative survival rate. The relative survival rate measures the survival of mesothelioma patients in comparison to the general population to estimate the effect of cancer. The overall 5-year relative mesothelioma survival rate for 1998-2002 was approximately 9 percent.

Below are the relative survival rates for each year following a mesothelioma diagnosis:


* Year 1 mesothelioma survival rate: 39 percent
* Year 2 survival rate: 20 percent
* Year 3 survival rate: 11 percent
* Year 4 survival rate: 10 percent
* Year 5 survival rate: 9 percent.

Labels: Mesothelioma Survival Rate

Malignant mesothelioma is a rare disease that occurs when cancerous cells develop in the mesothelium, a thin membrane covering different organs in the body. In most cases, mesothelioma affects the pleura (the thin layer of tissue that lines the chest cavity and covers the lungs). The biggest risk factor for mesothelioma involves exposure to asbestos. Because malignant mesothelioma is very difficult to control, clinical trials are being conducted that are designed to find new treatments and better ways to use current treatments.

Malignant Mesothelioma: An Overview
Malignant mesothelioma is a disease in which malignant (cancer) cells are found in the mesothelium, which is a thin layer of tissue that covers most organs in the body. Mesothelioma most commonly affects the pleura (the thin layer of tissue that lines the chest cavity and covers the lungs) or the peritoneum (the thin layer of tissue that lines the abdomen and covers most of the organs in the abdomen). This article discusses malignant mesothelioma of the pleura.

Risk Factors for Malignant Mesothelioma
Being exposed to asbestos can affect the risk of developing malignant mesothelioma. Many people with malignant mesothelioma have worked or lived in places where they inhaled or swallowed asbestos. After being exposed to asbestos, it usually takes a long time for malignant mesothelioma to occur.

Other risk factors for malignant mesothelioma include the following:


* Living with a person who works near asbestos.
* Being exposed to a certain virus.


Symptoms and Diagnosis of Malignant Mesothelioma
For information on malignant mesothelioma symptoms, see the full eMedTV article called Mesothelioma Symptoms.

In order to make a malignant mesothelioma diagnosis, a doctor will perform a medical history and physical exam, followed by specific tests and procedures to confirm the diagnosis. Some of these tests may include CT scans, biopsy, and surgery. A malignant mesothelioma diagnosis is often difficult to make because the symptoms associated with the disease are similar to those of many other medical conditions.

Labels: Malignant Mesothelioma

Asbestos–Related Disorders At A Glance

* Asbestos is a naturally occurring mineral that has been linked to human lung disease.

* There are three types of asbestos–related lung disease; scarring (asbestosis), cancer and non–cancerous disease of the tissue lining the surface of the lung (pleural disease), and lung cancer.

* All forms of asbestos increase the risk of lung disease.

* Treatment of asbestos–related diseases includes appropriate vaccinations, treatment of lung infections, smoking cessation, and the use of oxygen if necessary.

* If asbestos is suspected in a building, an expert in asbestos abatement should be consulted for inspection, correction, and maintenance.

Labels: Mesothelioma Abestos

How can exposure to asbestos be reduced?

The basic principle for asbestos is to leave material that is in good condition alone. Periodic inspection and maintenance by an expert in asbestos abatement should be undertaken for areas with sealed or contained asbestos. Local health, environmental, and building safety officials are good sources for local and state regulations on asbestos handling, disposal, and certified workers. If you discover even a very small amount of asbestos in your building, contact a professional for repair, removal, or remodeling.

For more information please:

* Read the Asbestos FAQ article.

* Visit Mesothelioma Web.

* The Environmental Protection Agency offers an assistance Line (202–554–1404) to help you find out about training and certification programs in your state for asbestos removal contractors and about the EPA's Asbestos programs. You should also read the "Asbestos in The Home" (CPSC Document #453). This brochure, prepared by the American Lung Association, the U.S. Consumer Product Safety Commission, and the U.S. Environmental Protection Agency, discusses common products and building materials that may contain asbestos. It also discusses how to control asbestos and the role of asbestos professionals. The latest updates in EPA asbestos information can be found at Asbestos Resources.

What kind of asbestos is used today?

Chrysotile is the only form of asbestos that is currently in production today. Despite their association with lung cancer, chrysotile products are still used in 60 industrialized and developing countries, according to the industry–sponsored Asbestos Institute. Chrysotile is still being used in cement building materials (90% of the world production of chrysotile), friction materials, gaskets, and certain plastics. Although the asbestos industry proclaims the "safety" of chrysotile fibers, which are now imbedded in less "friable" and "dusty" products, little is known about the long term effects of current asbestos products because of the long delay to the development of disease. In spite of their potential health risks, the durability and cheapness of these products continue to attract commercial applications. Asbestosis remains a significant clinical problem even after marked reductions in on–the–job exposure to asbestos. Again, this is due to the long period of time between exposure and the onset of disease.

Labels: Mesothelioma Abestos

Does asbestos exposure cause lung cancer?

Although exposure to asbestos alone can lead to lung cancer, the risk increases dramatically in smokers of cigarettes or other forms of tobacco.

* In nonsmokers who have been exposed to asbestos, the risk of lung cancer is five times that of unexposed workers.

* In smokers who have not been exposed to asbestos, the risk of lung cancer is eleven times that of non–smokers.


* In heavy smokers with asbestos exposure, the risk of lung cancer is at least 16 times higher than that of unexposed nonsmokers.

Lung cancer in asbestos–exposed and unexposed individuals is similar in both the type of cancer and its signs and symptoms. The link between cigarette smoking, asbestos and cancer of the lung itself does not apply to cancer of the lining of the lung (see malignant mesothelioma section below). Diagnosis and treatment of lung cancer is a complex topic and a pulmonary specialist should be involved in the workup of a suspected lung cancer.

What is malignant mesothelioma?

Asbestos is the only known risk factor for malignant mesothelioma, a cancer that affects the tissue lining the lung (pleura) or abdomen (peritoneum). Malignant mesothelioma is not associated with cigarette smoking but is strongly linked with the degree of asbestos exposure. However, 20% to 40% of patients with malignant mesothelioma have no prior asbestos exposure. In malignant mesothelioma, there is a very long duration between exposure and the onset of disease, usually greater than 30 years.

What other cancers have been linked to asbestos exposure?

Other malignancies have been linked to asbestos, including cancers of the voice box (larynx), upper throat (oropharynx), kidney, esophagus, and gallbladder.

Labels: Mesothelioma Abestos

How is asbestosis treated?

Patients with asbestosis, like others with chronic lung disease, are at a higher risk of serious infection, low oxygen levels in the blood, and heart failure. These patients also may not recover as quickly from viral and bacterial infections. In addition, they may be at increased risk for certain fungal and unusual infections that take advantage of diseased or scarred lung tissue. The medical management of these patients should focus special attention on preventing and rapidly treating these infections. Flu and pneumococcal vaccinations are a part of routine care for these patients. There is, however, no treatment or cure for asbestosis. In particular, steroid and immune–based therapies have not been shown to benefit these patients.

Other key elements in treating patients with asbestosis are smoking cessation, early detection of worsening disease or cancer, and avoidance of further exposure to asbestos. Supplemental oxygen during exercise or at rest (depending on the need) may be provided to improve daily function.

What is pleural disease?

Another type of lung disease that is linked to asbestos exposure involves the lining of the lungs, called the pleura. Harmless disease of the pleura is often the only manifestation of asbestos exposure. There are a number of different changes that can occur in the pleura with asbestos exposure. Pleural plaques (discussed above) may develop from fibers that migrate out to the outside edge of the lungs and cause scarring of the pleura. Pleural "calcification" may occur from calcium deposits in areas of prior damage.

Fluid may accumulate around the lung. This fluid collection, called an effusion, can be the first sign of asbestos–related disease. Often, these fluid collections have no associated symptoms, resolve on their own, and recur sporadically. However, some patients may experience pain or bleeding around their lungs. "Diffuse pleural thickening," which means a generalized thickening of the lining of the lung, can occur as well. The thickened pleura may form a peel of scar tissue and even affect the lung's ability to expand. This condition may cause a significant shortness of breath. Diffuse pleural thickening is considered a later–onset consequence of repeated fluid accumulations.

Labels: Mesothelioma Abestos

What is asbestosis?

Asbestosis is a process of lung tissue scarring caused by asbestos fibers. Because many other diseases also lead to lung scarring, other causes must be excluded first when a patient is found to have lung scarring (pulmonary fibrosis). Patients with particular x–ray findings or biopsy results must also have a remote history of asbestos exposure and a characteristically delayed development of the condition in considering asbestosis as a diagnosis. Smoking appears to increase the frequency and/or the rate of progression of asbestosis, possibly by preventing the efficient elimination of inhaled fibers from the airways.

What are symptoms and signs of asbestosis?

The clinical symptoms usually include slowly progressing shortness of breath and cough, often 20 to 40 years after exposure to asbestos. Breathlessness advances throughout the disease, even without further asbestos inhalation. In the absence of cigarette smoking, sputum (mucus coughed up from the lungs) production and wheezing are uncommon. The exception is workers who have been exposed to very high concentrations of asbestos fibers. Those workers may also develop symptoms as soon as 10 years after exposure. Other indications of asbestosis include abnormal lung sounds on examination, changes in the ends of the fingers and toes ("clubbing"), a blue tinge to the fingers or lips ("cyanosis"), and failure of the right side of the heart ("cor pulmonale").

What tests and studies are used to evaluate asbestosis?

Breathing abnormalities can be identified with lung function tests (pulmonary function tests or PFTs) or exercise tests that are performed at specialized laboratories. Asbestosis can produce both obstruction of airflow and restriction of lung inflation. In addition, the disease can affect the ability to transfer oxygen into the blood. With advanced disease, patients may have markedly reduced blood oxygen at rest and may need supplementary oxygen.

X–ray abnormalities include thickening of the lining of the lungs and tiny lines marking the lower portions of the lungs. However, up to 20% of patients have completely normal–appearing chest x–rays. These patients may demonstrate more subtle changes on computerized x–ray studies (computerized tomography, or CT scans). Up to 30% of patients with a normal chest x–ray who have been exposed to asbestos will have an abnormal high resolution (high definition) CT. The CT scan may be very useful in separating true asbestosis from other conditions that may have similar findings. However, even a CT scan may not identify disease of the lining of the lung (pleural disease) in patients with asbestosis. The proper role of CT scanning has not been fully established.

Laboratory studies may be abnormal (certain antibodies and markers of inflammation), but they do not specifically suggest asbestosis.

Occasionally, a biopsy and microscopic examination of the lung is used to diagnose asbestosis. Under microscopic examination, certain coated fibers (asbestos bodies) can be seen in association with a pattern of scarring. The amount of both coated and uncoated (transparent) asbestos has been linked to the severity of asbestosis. Because other particles may resemble asbestos, a conclusive identification may require scanning electron microscopy. Currently, detection of asbestos fibers in the lung tissue and fluids (sputum, secretions) can be used to make the diagnosis, along with a history of asbestos exposure and characteristic x–ray or CT results.

The currently available commercial form of asbestos, chrysotile, does not form asbestos bodies as easily as previously used fibers.

Labels: Mesothelioma Abestos

What are the types of asbestos fibers?

There are two major groups of fibers, the amphiboles and chrysotile fibers. Chrysotile (white asbestos), also called "Serpentine" fibers, are long and curled. The amphiboles, long straight fibers (including actinolite, amosite, anthrophyllite, crocidolite, and tremolite) are much more likely to cause cancer of the lining of the lung (mesothelioma) and scarring of the lining of the lung (pleural fibrosis). Either group of fibers can cause disease of the lung, such as asbestosis.

The risk of developing asbestos–related lung cancer varies between fiber types. Studies of groups of patients exposed chrysotile fibers show only a moderate increase in risk. On the other hand, exposure to amphibole fibers or to both types of fibers increases the risk of lung cancer by two fold. Although the Occupational Safety and Health Administration (OSHA) has a standard for workplace exposure to asbestos (0.2 fibers/milliliter of air), there is debate over what constitutes a safe level of exposure. While some believe asbestos–related disease is a "threshold phenomenon," which requires a certain level of exposure for disease to occur, others believe there is no safe level of asbestos.

In most buildings, asbestos does not become airborne. However, surfaces that are damaged or disturbed can cause asbestos to become inhalable. High concentrations can occur after cutting, sanding, or remodeling asbestos– containing materials.

Reducing asbestos exposure involves either the removal or sealing of asbestos–containing materials. Inexperienced attempts to remove asbestos can release dangerous levels of the fibers.

what does fiber size have to do with asbestos–related lung disease?

Depending on their shape and size, asbestos fibers deposit in different areas of the lung. Fibers less than 3 mm easily move into the lung tissue and the lining surrounding the lung (pleura). Long fibers, greater than 5 mm (1/5 inch), cannot be completely broken down by scavenger cells (macrophages) and remain in the lung tissue. These asbestos fibers can cause inflammation. Substances damaging to the lungs are then released by the cells of inflammation that are responding to the foreign asbestos material. The persistence of these long fibers in the lung tissue and the resulting inflammation seem to initiate the process of cancer formation.

As inflammation and damage to tissue around the asbestos fibers continues, the resulting scarring can extend from the small airways to the larger airways and the tiny air sacs (alveoli) at the end of the airways. Some of these fibers can move to the surface of the lung where they form plaques (white–gray regions of scarred tissue) in the tissue lining of the lung (pleura). In severe cases of asbestosis, scarring of both the lung and its lining tissue can occur.

Labels: Mesothelioma Abestos

Patients may wish to try alternative mesothelioma treatment to supplement their standard treatment. Some patients have found that alternative treatments help ease stress or reduce side effects or symptoms. Types of alternative mesothelioma treatment include acupuncture, massage therapy, herbal products, and meditation. Patients considering alternative treatments for mesothelioma should talk to their doctor to learn how it may affect standard treatment.

Alternative Mesothelioma Treatment: An Overview
In addition to medical treatment, some cancer patients want to try alternative mesothelioma treatment to ease stress or to reduce side effects and symptoms. Some patients feel that these alternative treatments offer some benefit.

Alternative Mesothelioma Treatment Options
Some types of alternative treatments used for mesothelioma include:


* Acupuncture
* Massage therapy
* Herbal products
* Vitamins or special diets
* Nutritional supplements
* Visualization
* Meditation
* Spiritual healing
* Yoga
* Biofeedback.


Alternative Mesothelioma Treatment: Recommendations
Before you try any alternative mesothelioma treatment, you should discuss its possible benefits and side effects with your medical doctors. If you are using any alternative mesothelioma treatment, you need to tell your doctors about it. These alternative treatments should never be used instead of medical treatment. Be aware that these therapies may be expensive; some are not paid for by health insurance. You should consider asking the therapist for evidence of how the therapy has helped others, possibly by giving you references.

You may want to ask your doctor these questions:


* What benefits can I expect from this approach?
* What are its risks?
* Do the expected benefits outweigh the risks?
* What side effects should I watch for?
* Will this alternative treatment change the way my mesothelioma treatment works? Could this be harmful?
* Is this approach under study in a clinical trial? If so, who sponsors the trial?
* Will my health insurance pay for this approach?

Labels: Alternative Mesothelioma Treatment

Medical Author: John P. Cunha, DO
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

* What is asbestos?
* What are the types of asbestos–related lung disease?
* What are the types of asbestos fibers?
* What does fiber size have to do with asbestos–related lung disease?
* What is asbestosis?
* What are symptoms and signs of asbestosis?
* What tests and studies are used to evaluate asbestosis?
* How is asbestosis treated?
* What is pleural disease?
* Does asbestos exposure cause lung cancer?
* What is malignant mesothelioma?
* What other cancers have been linked to asbestos exposure?
* How can exposure to asbestos be reduced?
* What kind of asbestos is used today?
* Asbestos Related Disorders At A Glance

What is asbestos?

Asbestos is a family of naturally occurring silica compounds (similar to, but not the same as, the silica of window glass and computer chips). These substances form fibers with varying shapes and sizes and are found throughout the earth. There are three commonly available types of asbestos; chrysotile (white asbestos), amosite (brown asbestos), and crocidolite (blue asbestos). All three have been associated with cancerous and non–cancerous lung disease.

Asbestos has been used frequently in a variety of building materials for insulation and as a fire retardant. Today, it is found most commonly in older homes – in pipes, furnaces, roof shingles, millboard, textured paints, coating materials, and floor tiles.

What are the types of asbestos–related lung disease?

Lung disease from exposure to asbestos can be divided into three main types: 1) asbestosis, 2) disease of the lining of the lung (pleura), and 3) lung cancer.

1. Asbestosis is a process of widespread scarring of the lungs.

2. Disease of the lining of the lungs, called the pleura, has a variety of signs and symptoms and is the result of inflammation and the hardening (calcification) and/or thickening of the lining tissue.

3. Lung cancer, either of the internal portions of the lungs or the outer lining (pleura).

All of the commonly available commercial forms of asbestos have been linked to cancerous and non–cancerous lung disease.

Asbestos–related lung disease occurred at very high rates toward the middle of the 20th century, when patients who were exposed decades earlier to asbestos eventually developed disease. British asbestos workers were among the first who were observed to have lung cancer related to asbestos.

Most current patients were once exposed to asbestos in:

* mines,

* mills,

* factories, or

* homes with asbestos, either in the process of carrying, installing, or removing asbestos, or while cleaning items laden with asbestos dust.

Some workers have been exposed to high concentrations of asbestos in:

* automotive repair,

* boilermaking,

* construction,

* pipefitting,

* launderers of asbestos–containing clothing.

Continuing sources of exposure are asbestos removal and general construction industries. The delay between exposure to asbestos and the development of cancer is generally 20 or more years.

The number of deaths from asbestosis has increased over the past two decades, but is believed to have plateaued due to increased awareness of the risks.

Labels: Mesothelioma Abestos

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

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

A recent study involving L-NDDP (brand name: Platar) produced two cases of remission in mesothelioma patients. Another study found that a drug known as Lovastatin may 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 kinds of resources are 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)

MesotheliomaWeb
(http://www.mesotheliomaweb.org)

The above content is supplied with kind permission from MesotheliomaWeb (www.mesotheliomaweb.org).
Mesothelioma At A Glance

* Mesothelioma is a cancer that arises from the cells lining the chest or abdominal cavities.
* Mesothelioma typically results from exposure to asbestos.
* When mesothelioma affects the chest the doctor may look inside the chest cavity with a special instrument called a thoracoscope.
* When mesothelioma affects the abdomen, the doctor may look inside the abdomen with a special tool called a peritoneoscope.
* Mesothelioma is diagnosed by a biopsy.
* The outlook for patients with mesothelioma depends on how early the disease is detected and how aggressively it is treated.

Labels: What is Mesothelioma

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.

Mesothelioma Treatment Options (Traditional & New Treatments Being Studied)

Treatment options are often determined by the stage of mesothelioma a patient is in. There are three staging systems currently in use and each one measures somewhat different variables.

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

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

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

Traditional care

There are three traditional kinds of treatment for patients with malignant mesothelioma:

* Surgery (taking out the cancer)
* Radiation Therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
* Chemotherapy (using drugs to fight the cancer)

NOTE: Often two or more of these are combined in the course of treatment.

New Approaches Being Studied

New approaches to treat malignant mesothelioma are currently being tested. They often combine traditional treatments or include something entirely new. They include:

* Promising drugs
o L-NDDP or Platar. Intrapleural administration of this platinum product is designed to overcome the toxicity and drug resistance currently limiting the usefulness of platinum drugs like Cisplatin. NOTE: A recent trial produced remission in two patients.
o Endostatin, shown to work with angiostatin in destroying a tumors' ability to grow blood vessels without harming normal cells.
o Lovastatin is a cholesterol drug shown in a recent study to potentially inhibit mesothelioma cancer cell growth.
o Intrapleural interferon gamma is the direct administration of the anti-cancer drug Interferon Gamma.
* Photodynamic therapy kills cancer cells using the energy of light
* Immunotherapy treats cancer by helping the immune system fight the disease.
* Gene therapy treats cancer by correcting the genetic deficits that allow tumors to develop. A September 1999 study found that Interferon interleukin prevented the growth of mesothelioma cells in mice.

Additional Information

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

* A pleurectomy is the removal of part of the chest or abdomen lining and some of the tissue around it.
* Depending on how far the cancer has spread, a lung also may be removed in an operation called a pneumonectomy.
* In an extrapleural pneumonectomy, the lung is removed along with the lining and diaphragm (the muscle that helps you breathe) on the affected side. In this surgery, the lining around the heart is also removed.
* Sometimes a pleurectomy/decortication is performed. In this surgery, the lining of the lung is removed along with as much of the tumor as possible.

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 found (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 use gentle suction to remove the fluid. If fluid is removed from the chest, this is called thoracentesis. If fluid is removed 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.

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be administered by pill, or it may be put into the body by a needle in the vein or muscle.

Chemotherapeutic agents can be administered either systemically (through the blood stream) 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.

Butchart System extent of primary tumor mass

* Stage I: Mesothelioma is present in the right or left pleura and may also involve the diaphragm on the same side.
* Stage II: Mesothelioma invades the chest wall or involves the esophagus, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
* Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may also be involved.
* Stage IV: There is evidence of metastasis or spread through the bloodstream to other organs.

TNM System -- variables of T (tumor), N (lymph nodes), M (metastasis)

* Stage I:Mesothelioma involves right or left pleura and may also have spread to the lung, pericardium, or diaphragm on the same side. Lymph nodes are not involved.
* Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It may also have spread into the lung, pericardium, or diaphragm on the same side.
* Stage III:Mesotheliomas is now in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side with or without spread to lymph nodes on the same side as the primary tumor.
* Stage IV:Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, or extends to the pleura or lung on the opposite side, or directly extends into organs in the abdominal al cavity or neck. Any distant metastases is included in this stage.

Brigham System: (variables of tumor resectability and nodal status)

* Stage I: Resectable mesothelioma and no lymph node involvement
* Stage II: Resectable mesothelioma but with lymph node involvement
* Stage III: Unresectable mesothelioma extending into chest wall, heart, or through diaphragm, peritoneum; with or without extrathoracic lymph node involvement
* Stage IV: Distant metastatic disease

Labels: What is Mesothelioma

Mesothelioma

* What is mesothelioma?
* How do you get mesothelioma?
* How much exposure does it take to get mesothelioma?
* How long does it take after exposure for mesothelioma to show up?
* How is mesothelioma diagnosed?
* What is the prognosis for mesothelioma?
* Is there any promising research or are there promising drugs for mesothelioma?
* What kinds of resources are available for people with mesothelioma?
* Mesothelioma At A Glance

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).

How do you get mesothelioma?

Most people with malignant mesothelioma have worked on jobs where they breathed asbestos. Others have been exposed to asbestos in a household environment, often without knowing it.

How much 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.

How long does it take after 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 is mesothelioma diagnosed?

Mesothelioma is diagnosed by pathological examination from a biopsy. Tissue is removed, placed under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid build-up 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:

* Thoracoscopy

For pleural mesothelioma the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital with a local anesthetic or painkiller.

If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis.

* Peritoneoscopy

For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.

If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.

* Biopsy

If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.

Labels: What is Mesothelioma