Abdominal Mesothelioma

Abdominal mesothelioma, also known as peritoneal mesothelioma, makes up only about 35% of all mesothelioma cases.
The mesothelium is the tissue that surrounds and covers the organs in the chest cavity and abdomen. The mesothelium allows all of the internal organs, the lungs and heart, on down to the stomach and colon, to move and perform their individual life-sustaining dances. This mesothelium tissue extends from the upper chest to the bottom of the pelvis. The more common form of mesothelioma originates in the upper part of the mesothelium, generally affecting the tissue around the lungs and heart, and is referred to as pleural mesothelioma. Abdominal mesothelioma originates in the lower part of the mesothelium, in the abdominal cavity. The mesothelium in the abdominal cavity is referred to as the peritoneum, hence the name peritoneal mesothelioma.
Only 100 to 500 cases of abdominal or peritoneal mesothelioma are reported in the United States each year. The cause of this cancer is widely attributed to exposure to asbestos. Some sources say that exposure to asbestos is the only known cause of malignant mesothelioma, while other sources mention the asbestos connection in a more non-committal way. In cases where asbestos has been identified as a contributing factor, the lag between the time of exposure to asbestos and the inception of the disease can be one or more decades.
Asbestos
Asbestos is a mineral and has been used for hundreds of years as a building material and substance in fabric. Its chief claim to fame is that it is fire retardant. Asbestos has also been recognized as a health hazard for nearly as long. The Greeks noted that the slaves who wove asbestos into cloth suffered lung damage. So, it’s interesting that it became a popular building material during the industrial revolution in the 1860s, used to insulate and provide safety from the threat of fire. It wasn’t until 1918 that a Prudential company official noted that insurance companies refuse to cover workers who are regularly exposed to asbestos because of the heath factor.
The highest risk people are construction and shipyard workers. The use of asbestos still occurs, but is highly regulated. Most contact is made by construction crews who must remove asbestos in buildings being renovated. The Occupational Safety and Health Administration (OSHA) has addressed the exposure to asbestos in policies related to general industry, shipyard employment, and the construction industry. OSHA’s general duty clause requires employers to “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”
Asbestos is a mineral with long fibers. These fibers are either ingested or inhaled into the body, where they may work themselves into the peritoneal cavity. The cells in the mesothelium produce liquid to enable the intestines to slide over one another. Once the asbestos fibers settle in, they cause the cells in the mesothelium to over-produce fluid used to keep the intestines slick and moist. Mesothelioma occurs when the cells within the mesothelium become abnormal and start to divide uncontrollably. Once it takes hold, mesothelioma is extremely aggressive. If not caught early, the cells metastasize and spread to other organs throughout the body.
Symptoms and diagnosis
The symptoms of mesothelioma are not unique or remarkable in any way, which can cause it to be difficult to diagnose. Symptoms include shortness of breath, chest pain, weight loss, coughing, possibly coughing up blood, fatigue, hoarseness, difficulty swallowing, or there may be no symptoms at all. Cases of mesothelioma can go undetected or be misdiagnosed. For those who may be at risk, it is imperative to share one’s case history and work experience with one’s physician.
The physician usually starts with an x-ray, CAT Scan or MRI of the chest and abdomen. Even if peritoneal mesothelioma is the chief concern, the doctor needs to rule out that the origin isn’t higher up. Plural mesothelioma is more common and will spread into the abdominal cavity if given the time to do so. If the results of these tests warrant, the doctor will look inside the abdomen with a peritoneoscope. The test with the peritoneoscope is done in the hospital with a local anesthetic. The scope is inserted through an opening made in the abdomen, and the mesothelium tissue is examined. If the tissue cells appear abnormal, a sample of the tissue will be collected for viewing under a microscope for malignancy.
Treatment
Many treatments are available and practiced for abdominal mesothelioma. The usual treatments of surgery, radiation and chemotherapy are at the top of the list. Most mesothelioma treatment plans include a combination of methods. Utilizing multiple treatment methods is termed the multimodality approach.
The actions taken with surgery depend on the disposition of the disease. A surgeon may remove part of the mesothelium lining in the abdomen, he or she may remove part of the diaphragm. In severe cases, a doctor might need to remove all or portions of organs.
Radiation treatment or chemotherapy are frequently coupled with surgery. Radiation treatment uses high-energy x-rays to burn cancer cells and reduce tumors. With chemotherapy, the patient is injected with chemicals to kill the cancer cells.
Other types of treatment are Intraoperative photodynamic therapy, which is a new form of treatment. A chemical is injected into the patient several days before surgery. The chemical makes cancer cells more sensitive to light. During surgery, a special light is shone into the abdominal cavity to destroy cancer cells.
Life expectancy
Studies in the United States show that men are more at risk of developing peritoneal mesothelioma, probably because more men work in the construction field. Women, however, have been found to be more vulnerable to the spreading of the disease once it is contracted. Because the disease is so aggressive, survival rates are poor. The chances of recovery depend on the size and range of the cancer and the stage of its development when treatment commences. This is why early detection is so crucial.

Radiation Enteritis in Mesothelioma Patients

Mesothelioma radiation therapy stops the growth of rapidly dividing cells, such as mesothelioma cancer cells. Since normal cells in the lining of the bowel also divide rapidly, radiation treatment can stop those cells from growing, making it difficult for bowel tissue to repair itself. As bowel cells die and are not replaced, gastrointestinal problems develop over the next few days and weeks.
Patients with acute enteritis may have the following symptoms:
Nausea
Vomiting
Abdominal cramps
Frequent urges to have a bowel movement
Rectal pain, bleeding, or mucus-like discharge
Watery diarrhea. With diarrhea, the gastrointestinal tract does not function normally, and nutrients such as fat, lactose, bile salts, and vitamin B 12 are not well absorbed.
Symptoms of acute enteritis usually get better 2 to 3 weeks after treatment ends.
Assessment of Radiation Enteritis
Patients will be given a physical exam and be asked questions about the following:
Usual pattern of bowel movements.
Pattern of diarrhea, including when it started; how long it has lasted; frequency, amount, and type of stools; and other symptoms (such as gas, cramping, bloating, urgency, bleeding, and rectal soreness).
Nutritional health of the patient, including height and weight, usual eating habits, any change in eating habits, amount of fiber in the diet, and signs of dehydration (such as poor skin tone, increased weakness, or feeling very tired).
Current level of stress, ability to cope, and changes in lifestyle caused by the enteritis.
Treatment
Treatment of acute enteritis includes treating the diarrhea, loss of fluids, poor absorption, and stomach or rectal pain. These symptoms usually get better with medications, changes in diet, and rest. If symptoms become worse even with this treatment, then cancer treatment may have to be stopped, at least temporarily.
Medications that may be prescribed include antidiarrheals to stop diarrhea, opioids to relieve pain, and steroid foams to relieve rectal inflammation and irritation. If patients with pancreatic cancer have diarrhea during radiation therapy, they may need pancreatic enzyme replacement, because not having enough of these enzymes can cause diarrhea.
Nutrition
Nutrition also plays a role in acute enteritis. Intestines damaged by radiation therapy may not make enough or any of certain enzymes needed for digestion, especially lactase. Lactase is needed for the digestion of milk and milk products. A lactose-free, low-fat, and low-fiber diet may help to control symptoms of acute enteritis. For more general discussion of nutrition, check our section on nutrition for mesothelioma patients.
Foods to avoid:
Milk and milk products, except buttermilk and yogurt. Processed cheese may not cause problems because the lactose is removed during processing. Lactose-free milkshake supplements, such as Ensure, may also be used.
Whole-bran bread and cereal.
Nuts, seeds, and coconut.
Fried, greasy, or fatty foods.
Fresh and dried fruit and some fruit juices (such as prune juice).
Raw vegetables.
Rich pastries.
Popcorn, potato chips, and pretzels.
Strong spices and herbs.
Chocolate, coffee, tea, and soft drinks with caffeine.
Alcohol and tobacco.
Foods to choose:
Fish, poultry, and meat that are cooked, broiled, or roasted.
Bananas, applesauce, peeled apples, and apple and grape juices.
White bread and toast.
Macaroni and noodles.
Baked, boiled, or mashed potatoes.
Cooked vegetables that are mild, such as asparagus tips, green and waxed beans, carrots, spinach, and squash.
Mild processed cheese, eggs, smooth peanut butter, buttermilk, and yogurt.
Helpful hints for mesothelioma patients dealing with enteritis:
Eat food at room temperature.
Drink 3 liters (about 12 eight-ounce glasses) of fluid a day.
Allow carbonated beverages to lose their fizz before drinking them.
Add nutmeg to food to help decrease movement of the gastrointestinal tract.
Start a low-fiber diet on the first day of radiation therapy.

Sleep Disorders in Mesothelioma Patients

Sleep disorders may be caused by tumor growth, mesothelioma therapy, or other factors. This brief summary describes sleep disorders, their causes and treatment.
Risk Factors
The sleep disorders most likely to affect patients with mesothelioma are insomnias and disorders of the sleep-wake cycle. Effects of tumor growth and mesothelioma treatment that may cause sleep disturbances include: anxiety, depression, pain, fever, cough, breathing problems, itching, fatigue, seizures, headaches, night sweats, hot flashes, diarrhea, constipation, nausea, and the inability to control bodily functions. Patients may have sleep interruptions due to treatment schedules, hospital routines, and roommates. Other factors affecting sleep during a hospital stay include noise, temperature, pain, anxiety, and the patient's age. Chronic sleep disturbances can cause irritability, inability to concentrate, depression, and anxiety. While in the hospital, sleep disorders may make it hard for the patient to continue with mesothelioma therapy.
Diagnosis
To diagnose sleep disorders in mesothelioma patients, the doctor will get the patient's complete medical history and give a physical examination. The doctor may get information about the patient's sleep history and patterns of sleep from the patient, from observations, and from the patient's family and friends. A polysomnogram, an instrument that measures brain waves, eye movements, muscle tone, heart rate, and breathing during sleep, may also be used to diagnose sleep disorders in patients with mesothelioma.
Treatment
To promote rest and treat sleep disorders the following may be considered:
Create an environment that decreases sleep interruptions by:
Lowering noise
Dimming or turning off lights
Adjusting room temperature
Keeping bedding, chairs, and pillows clean, dry, and wrinkle-free
Using bedcovers for warmth
Placing pillows in a supportive position
Encouraging the patient to dress in loose, soft clothing
Encourage regular bowel and bladder habits to minimize sleep interruptions, such as
No drinking before bedtime
Emptying the bowel and bladder before going to bed
Increasing consumption of fluids and fiber during the day
Taking medication for incontinence before bedtime.
Rest in patients with mesothelioma may also be promoted by:
Eating a high-protein snack 2 hours before bedtime
Avoiding drinks with caffeine
Exercising (which should be completed at least 2 hours before bedtime)
Keeping regular sleeping hours
Drugs may also be used to help patients with mesothelioma manage their sleep disorders.

Managing Mesothelioma Pain

Approximately 60 to 90% of mesothelioma patients experience pain as one of the early symptoms of disease, however, it is more closely associated with end-stage disease. Abdominal or pelvic discomfort often accompanies pleural mesothelioma. This pain is sometimes brought on by an increasing pleural effusion, or build-up of fluid, which causes pressure on adjacent nerves or organs. Peritoneal mesothelioma, which originates in the lining of the abdominal cavity, presents with abdominal or pelvic discomfort.
In the early stages, pain is usually controlled with over-the-counter products such as aspirin, acetaminophen, or ibuprofen. Although surgery, chemotherapy, and radiation are used to arrest the disease process and alleviate the initial pain symptoms, the treatments themselves may not be pain-free. The needs of the patient and the type of procedure done will determine the kinds of medication that can be given.
As mesothelioma progresses, the cancer may spread to areas such as the chest wall, ribs, and surrounding muscles. Because soft tissue and nearby nerves may be destroyed, pain may become more localized and chronic. In the case of peritoneal mesothelioma, bowel obstruction may lead to more severe pain. New innovations, such as implant devices that deliver pain-fighting drugs to the central nervous system, offer more relief to severe pain that is unresponsive to oral medications, intravenous infusions, or intramuscular injections of narcotics.
Click here for a glossary of medical terms related to pain and pain treatment.
When a patient can no longer get relief even from the most potent oral or intravenous medications, doctors may offer an epidural implant. This form of pain management is accomplished with a thin catheter surgically implanted beneath the skin. A combination of medicines is then programmed to flow through tubing into the epidural area of the spinal canal at pre-set amounts and intervals. This can be successfully administered at home under the supervision of home health care agencies and your doctor.

Willness Exercise

Wellness > Exercise According to an article published in the Annals of Behavioral Medicine, exercise has proven to have positive effects on the physical, psychological, and emotional well-being of those diagnosed with cancer. Researchers have consistently demonstrated that physical exercise after a cancer diagnosis has been beneficial in increasing lung capacity, muscle strength, flexibility and energy, as well as reducing nausea, fatigue, pain, and diarrhea. Psychological benefits included increased self-esteem, improvement in symptoms of depression and anxiety, and an overall greater satisfaction with life. Most physicians prefer to recommend customized programs for their patients. Statistically, 70-95% of all cancer patients who undergo surgery, chemotherapy, or radiation experience at least some degree of fatigue. This fatigue may accompany not only the treatment itself, but may last long after the treatment has been completed. A prescribed exercise program can help overcome, manage, or reduce fatigue after, or during chemotherapy and radiation. Your doctor may be able to help in finding a program suitable for you. As an option to supervised exercise, home-based programs for cancer patients are also available. These programs include an instruction manual and video. Eric Durak, MS, an exercise psychologist and co-director of the Cancer Well-Fit Program in Santa Barbara, California, has worked with more than 500 cancer patients, and has plans to expand his program nationwide. The Wellness Community, in which the late comedienne Gilda Radner was active, offers yoga, tai chi, and other conditioning programs in 26 cities nationwide. Yoga is considered ideal for cancer patients since it is low-impact, reduces stress, and promotes overall relaxation. This technique is also frequently used by patients dealing with chemotherapy or radiation treatments. All that is necessary is a quiet, comfortable place and some time each day to practice breathing, stretching, and meditation. NOTE: SOME CANCER PATIENTS MAY REQUIRE CLOSE MEDICAL SUPERVISION DURING EXERCISE; OTHERS MAY NOT BE ABLE TO EXERCISE AT ALL. ALWAYS CONSULT WITH YOUR PERSONAL PHYSICIAN BEFORE BEGINNING ANY EXERCISE REGIMEN.

Wellness Effect on Family and Friends

A mesothelioma diagnosis affects the patient's entire family. One of the first questions that comes to mind after you have absorbed the news yourself is, "Who should I tell?". Most people have found that the best choice is to share the diagnosis with those closest to them, and give them the opportunity to offer support. It will be your personal decision as to when this should be done.
Spouses Your spouse may be frightened by your diagnosis, and may feel many of the same emotions as you feel; helplessness, anxiety, and sadness. Some spouses may go into denial and may not wish to discuss the illness. If you have problems talking about your illness with your spouse, you may wish to consult a professional counselor. Ideally, your spouse should be a participant in discussions with your doctors regarding your treatment and the progression of mesothelioma. Knowledge of the facts and the feeling that he or she is part of the process, can lessen anxiety. Your spouse will also need to know how he or she will be involved in your care and what decisions will have to be made.
Adult Children Even as an adult, a child may find it difficult to cope with a parent's cancer. The dynamics of the parent-child relationship may become reversed as the children become supporters both emotionally and financially. Adult children with their own families and careers may feel guilty about having a limited amount of time to spend with you, or may live in other parts of the country where frequent visits are not possible. Your children may also be afraid of expressing feelings of anger or resentment over your diagnosis, and might want reassurance that their feelings are acceptable. It is important to work through these issues. It will also be important for them to know what role they will play in any decisions regarding your care or finances.
Parents If you have elderly parents living with you, and they have been relying on you for support and help as they age, your mesothelioma diagnosis may disrupt their life also. While you are undergoing treatment, it may become necessary to shift your caregiving responsibilities to other family members or to health care professionals.
Friends
Friends can be a great source of support when you have mesothelioma. While some friends may find it difficult to discuss your disease, you may discover hidden strengths in the least likely of companions. Many times friends are waiting for a clue from you as to what behavior is appropriate. For instance, they may call to check on you and say, "Let me know if there is anything I can do to help." Most people are grateful if there is something concrete they can do to show their friendship. When they offer assistance, look at the offer positively, and allow them to run a specific errand, or complete a specific chore. Some days, it might be pleasant just to have their company, other days you may not feel up to having visitors. Be open and honest in your communications, and you will both benefit.

Online Mesothelioma Cancer Research Tool

Mesothelioma Plus is your in-depth online research tool for malignant mesothelioma and other forms of cancer by providing a solid prescription of knowledge for those motivated to seek answers. Frustrated with inaccurate and redundant mesothelioma information? This site was created from personal mesothelioma cancer research, as a tool for patients, family, friends, or anyone looking for substantiated facts about malignant mesothelioma and cancer research methods. Although there are many resource sites that do provide relevant and useful information, your mesothelioma cancer search can be disheartening when you cannot find the answers you are searching for.
The Internet is more and more the go-to place to find information and resources about mesothelioma cancer. It provides instant gratification and results, and much of what you find is valid in content. As the NIH points out, “The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading.”¹Mesothelioma Plus provides resources needed to effectively research malignant mesothelioma online, as well as a basic starting point for other conditions such as lung cancer, breast cancer, colon cancer and various other forms of malignant cancer. We do this by combining public information that is scattered throughout different portals, most of which are hard to find if you don’t know which rock to look under. This site is intended to be a “super-site" – an Internet site that provides a comprehensive entry point for a huge array of cancer resources and services. We also discuss the legal issues; because mesothelioma is almost always caused by exposure to airborne asbestos. Many of the manufacturers of asbestos-containing products have known for years of the hazards associated with these products, yet they made the decision not to disclose the information or to warn the public. Consequently, an asbestos patient may have a right of recovery against the manufacturers through an experienced mesothelioma attorney. Dr. C. Everett Koop, the U.S. Surgeon General from 1981 to 1989, tells us: “…there is no prescription I can give you that is more valuable than knowledge." His words are a guide for all who seek help with this disease.

Moving On After Treatment

Completing treatment can be both stressful and exciting. You will be relieved to finish treatment, yet it is hard not to worry about cancer coming back. (When cancer returns, it is called recurrence.) This is a very common concern among those who have had cancer.
It may take a while before your confidence in your own recovery begins to feel real and your fears are somewhat relieved. You can learn more about what to look for and how to learn to live with the possibility of cancer coming back in the American Cancer Society document, Living with Uncertainty: The Fear of Cancer Recurrence, available at 1-800-ACS-2345.
Follow-up Care
After your treatment is over, it is very important to keep all follow-up appointments. During these visits, your doctors will ask about symptoms, do physical exams, and order blood tests or imaging studies such as CT scans or x-rays. Follow-up is needed to check for cancer recurrence or spread, as well as possible side effects of certain treatments. This is the time for you to ask your health care team any questions you need answered and to discuss any concerns you might have.
Almost any cancer treatment can have side effects. Some may last for a few weeks to several months, but others can be permanent. Don’t hesitate to tell your cancer care team about any symptoms or side effects that bother you so they can help you manage them.
It is also important to keep medical insurance. Even though no one wants to think of their cancer coming back, it is always a possibility. If it happens, the last thing you want is to have to worry about paying for treatment. Should your cancer come back the American Cancer Society document, When Your Cancer Comes Back: Cancer Recurrence, gives you information on how to manage and cope with this phase of your treatment. You can get this document by calling 1-800-ACS-2345.
Seeing a New Doctor
At some point after your cancer diagnosis and treatment, you may find yourself in the office of a new doctor. Your original doctor may have moved or retired, or you may have moved or changed doctors for some reason. It is important that you be able to give your new doctor the exact details of your diagnosis and treatment. Make sure you have the following information handy:
a copy of your pathology report from any biopsy or surgery
if you had surgery, a copy of your operative report
if you were hospitalized, a copy of the discharge summary that every doctor must prepare when patients are sent home from the hospital
finally, since some cancer-treatment drugs can have long-term side effects, a list of your drugs, drug doses, and when you took them
Lifestyle Changes to Consider During and After Treatment
Having cancer and dealing with treatment can be time-consuming and emotionally draining, but it can also be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long-term.
Make Healthier Choices
Think about your life before you learned you had cancer. Were there things you did that might have made you less healthy? Maybe you drank too much alcohol, or ate more than you needed, or smoked, or didn’t exercise very often.
Now is not the time to feel guilty or to blame yourself. However, you can start making changes today that can have positive effects for the rest of your life. Not only will you feel better but you will also be healthier.
You can start by working on those things that you feel most concerned about. Get help with those that are harder for you. For instance, if you are thinking about quitting smoking and need help, call the American Cancer Society’s Quitline® tobacco cessation program at 1-800-ACS-2345.
Diet and Nutrition
Eating right can be a challenge for anyone, but it can get even tougher during and after cancer treatment. If you are still in treatment and are having eating problems related to your treatment, please ask for a copy of our Nutrition for the Person with Cancer.
One of the best things you can do after treatment is to put healthy eating habits into place. You will be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Try to eat 5 or more servings of vegetables and fruits each day. Choose whole grain foods instead of white flour and sugars. Try to limit meats that are high in fat. Cut back on processed meats like hot dogs, bologna, and bacon. If you drink alcohol, limit yourself to 1 or 2 drinks a day at the most. And don't forget to get some type of regular exercise. The combination of a good diet and regular exercise will help you maintain a healthy weight and keep you feeling more energetic.
Rest, Fatigue, Work, and Exercise
Fatigue is a very common symptom in people being treated for cancer. This is often not an ordinary type of tiredness but a “bone-weary” exhaustion that doesn’t get better with rest. For some, this fatigue lasts a long time after treatment, and can discourage them from physical activity. However, exercise can actually help you reduce fatigue.
If you are ill and need to be on bed rest during treatment, it is normal to expect your fitness, endurance, and muscle strength to decline some. Physical therapy can help you maintain strength and range of motion in your muscles, which can help fight fatigue and the sense of depression that sometimes comes with feeling so tired.
Any program of physical activity should fit your own situation. Talk with your health care team before starting, and get their opinion about your exercise plans. Then, try to get an exercise buddy so that you’re not doing it alone.
If you are very tired, though, you will need to balance activity with rest. It is okay to rest when you need to.(For more information about fatigue, please see the publication Cancer Related Fatigue and Anemia Treatment Guidelines for Patients.
Exercise can improve your physical and emotional health.
It improves your cardiovascular (heart and circulation) fitness.
It strengthens your muscles.
It reduces fatigue.
It lowers anxiety and depression.
It makes you feel generally happier.
It helps you feel better about yourself.
And long term, we know that exercise plays a role in preventing some cancers. The American Cancer Society recommends that adults take part in at least one physical activity for 30 minutes or more on 5 days or more of the week. Children and teens are encouraged to try for at least 60 minutes a day of energetic physical activity on at least 5 days a week.
How About Your Emotional Health?
Once your treatment ends, you may find yourself overwhelmed by emotions. This happens to a lot of people. You may find that you think about the effect of your cancer on your family, friends, and career. You may also begin to re-evaluate your relationship with your spouse or partner. Unexpected issues may also cause concern -- for instance, as you become healthier and have fewer doctor visits, you will see your health care team less often. That can be a source of anxiety for some.
This is an ideal time to seek out emotional and social support. You need people you can turn to for strength and comfort. Support can come in many forms: family, friends, cancer support groups, church or spiritual groups, online support communities, or individual counselors.
The cancer journey can feel very lonely. It is not necessary or realistic to go it all by yourself. And your friends and family may feel shut out if you decide not include them. Let them in -- and let in anyone else who you feel may help. If you aren’t sure who can help, call your American Cancer Society at 1-800-ACS-2345 and we can put you in touch with an appropriate group or resource.
You can’t change the fact that you have had cancer. What you can change is how you live the rest of your life -- making healthy choices and feeling as well as possible, physically and emotionally.

Some Questions to Ask Your Doctor

As you cope with cancer and cancer treatment, you need to have honest, open discussions with your doctor. You should feel free to ask any question that's on your mind, no matter how small it might seem. Here are some questions you might want to ask. Be sure to add your own questions as you think of them. Nurses, social workers, and other members of the treatment team may also be able to answer many of your questions.
Would you please write down the exact kind of cancer I have?
Has my cancer spread beyond the place where it started?
What is the stage of my cancer and what does that mean for me?
What treatment choices do I have?
What do you recommend and why?
What is the goal of this treatment?
What are the risks or side effects of the treatment?
What should I do to be ready for treatment?
What are the chances my cancer will come back after the treatments you suggest?
What are my chances of survival, based on my cancer as you see it?

After the Tests: Staging

Staging is the process of finding out how far the cancer has spread. This is very important because your treatment and the outlook for your recovery depend on the stage of your cancer.
At this time, there is a staging system only for mesothelioma around the lung (pleural mesothelioma). The AJCC (American Joint Committee on Cancer) staging system uses Roman numerals from I to IV (1 to 4) for the different stages. In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means a more serious cancer.
After looking at your test results, the doctor will tell you the stage of your cancer. Be sure to ask your doctor to explain your stage in a way you understand. This will help you both decide on the best treatment for you.
While the stage of this cancer is important in looking at a patient's chances for survival, other factors should also be taken into account. Some of these factors include being too sick to perform the normal tasks of daily life, chest pain, shortness of breath, weight loss, high levels of a substance in the blood called LDH, low red blood cell count, high white blood cell count and others. Most people with all of these factors usually die within 6 months. Few live two years. Most people with none of these factors will live at least one year and have a 40% chance of living 2 years.

How Is Mesothelioma Found?

As a rule, a chest x-ray is not useful in finding mesothelioma early. One test being studied is a blood test. This test measures the levels in the blood of a certain protein that is higher in people who have lung damage due to asbestos. It is even higher if the person has mesothelioma.
Early symptoms of mesothelioma can be very general. Thus, they are often ignored. Most people with this type of cancer have symptoms for only 2 to 3 months before the cancer is found.
Symptoms of pleural mesothelioma (lining of the chest) can include:
pain in the lower back or at the side of the chest
shortness of breath
trouble swallowing
hoarseness
cough
fever
sweating
tiredness
weight loss
swelling of the face and arms
muscle weakness
Symptoms of peritoneal mesothelioma (lining of the abdominal cavity) include:
belly pain
weight loss
nausea
vomiting
fluid or a lump in the abdomen
Of course, these same symptoms can also be caused by other minor ailments. But if you have worked with asbestos and you have any of these symptoms, you should see your doctor right away.
If there is reason to suspect you might have mesothelioma, the doctor will ask you questions about your health and do a complete physical exam. The exam can help tell if you have fluid in the chest, abdomen, or heart. This fluid can be a sign of mesothelioma. Then one or more of the methods below can be used to find out whether you really have cancer.
Imaging Tests
These tests allow the doctor to see a picture of the inside of your body. These could include x-rays, CT scans (computed tomography), MRI (magnetic resonance imaging), or PET scans.
Chest x-ray: The x-rays might show thickening of the lining of the lungs or other signs of asbestos exposure leading to mesothelioma.
CT scans: A CT scan (also known as a CAT scan) is like an x-ray but it produces detailed cross-sectional images of your body. Instead of taking one picture, as does a regular x-ray, a CT scanner takes many pictures as it rotates around you. A computer then combines these pictures into an image of a slice of your body.
Often after the first set of pictures is taken, you will receive an intravenous injection of dye that helps better outline parts of your body. A second set of pictures is then taken. You will need an intravenous (IV) line through which the dye can be given. Some people are allergic to the dye and get hives, a flushed feeling, or, rarely, more serious reactions like trouble breathing and low blood pressure. Be sure to tell your doctor if you have ever had a reaction to any dye used for x-rays.
CT scans take longer than regular x-rays, and you need to lie still on a table while they are being done. But they are getting faster and your scan might be pleasantly short.
CT scans are often used to first find the mesothelioma, and they are helpful in finding out how far it has spread.
PET scan: A PET scan uses glucose (a form of sugar) that contains a radioactive substance. Cancer cells in the body absorb large amounts of the radioactive sugar and a special camera can detect the radioactivity. This test, which is still being studied, can help tell whether a thickening of the tissues is cancer or just scar tissue. It can also spot the spread of cancer.
MRI scans: This test uses radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of tissue and by certain diseases. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of your body.
A contrast material might be injected just as with CT scans. MRI scans provide the same kind of information that CT scans do, but sometimes they can provide a different and more helpful picture.
MRI scans are useful in looking at the diaphragm (the thin muscle at the bottom of the lung cage that goes up and down during breathing). The mesothelioma may have spread to the diaphragm.
MRI scans take longer than CT scans – often up to an hour. Also, you are placed inside a narrow tube, which is confining and can upset people with a fear of enclosed spaces. The machine makes a thumping noise, and some places will provide headphones with music to block out the noise.
While there is a blood test to track the progress of the disease during and after treatment, it is not really useful in telling whether a person has this cancer. But a high level of a certain protein (osteopontin) is a cause for concern.
Fluid or tissue samples may be taken from the chest, stomach, or heart area with a needle and sent to the lab to see if cancer cells are present.
Other methods of looking inside the body involve making a small cut (incision) in the chest or stomach area and then using a small tube with a video camera to allow the doctor to look directly at the area in question and take a tissue sample.
In another approach, the doctor can insert a lighted tube through the mouth and into the chest. This is called a bronchoscopy (bron-kahs-kuh-pee). If the tube is placed under the chest bone and then moved down into the chest, it is called a mediastinoscopy (me-de-uh-stine-AHS-kuh-pee).
Surgery allows the doctor to remove a larger sample of tumor or, sometimes, the whole tumor.
It is often hard to identify mesothelioma by looking at the cells (or even tissue) from the fluid around the lungs, stomach, or heart. So your doctor may want to do other tests as well. Sometimes an electron microscope is used to look at cells in greater detail.

What Causes Mesothelioma? Can It Be Prevented?

A risk factor is anything that increases a person's chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, such as smoking, can be controlled. Others, like a person's age or family history, can't be changed. But having a risk factor, or even several, doesn’t mean that a person will get the disease.
The main risk factor for mesothelioma is contact with asbestos. In the past, asbestos was used in insulation as well as in other products such as floor tiles, door gaskets, roofing, patching compounds, and more. Since asbestos is a natural mineral, it can also be found in dust and rocks in certain parts of the United States. Most use stopped after 1989, but it is still used in some products.
When asbestos fibers are breathed in, some can travel to the ends of the small air passages and reach the lining of the lungs. There they can damage the cells lining the lungs, which can lead to pleural mesothelioma. If swallowed, these fibers can also reach the lining of the abdominal cavity where they play a part in causing peritoneal mesothelioma.
People who may be at risk for asbestos exposure include some miners, factory workers, makers of insulation, railroad workers, ship builders, gas mask makers, and construction workers. Several studies have shown that family members of people exposed to asbestos at work have an increased risk of mesothelioma because asbestos fibers are carried home on the clothes of the workers.
The risk of getting mesothelioma depends on how much asbestos a person was exposed to and for how long. Mesotheliomas take a long time to develop. The time between the first exposure and finding the disease is often between 20 and 50 years. Another important point about asbestos is that the risk of mesothelioma does not drop over time. The risk appears to be lifelong and it does not go down.
There is some evidence linking Thorotrast, a material once used in certain x-rays, to mesothelioma. But Thorotrast has not been used for many years.
Some recent studies have raised the suggested that infection with simian virus 40 (SV40) might increase the risk of mesothelioma. Some polio vaccines prepared between 1955 and 1963 were contaminated with SV40. Research into this question is still going on.
While tobacco smoke has not been shown to cause mesothelioma, smokers exposed to asbestos have a much higher risk of lung cancer. More asbestos workers die of lung cancer than of mesothelioma.
Can Mesothelioma Be Prevented?
The best way to prevent this disease is to avoid contact with asbestos in homes, public buildings, and at work. People who could be exposed to asbestos at work include miners, factory workers, insulation workers, railroad workers, ship builders, makers of gas masks, and construction workers.
If there is a chance of exposure, say, in fixing up old buildings, then workers should take special measures to protect themselves. If you live in an older home, there may be asbestos in the insulation or in other materials. An expert can check your home to see if there is any danger. If so, you might decide to have the asbestos removed. You should hire a qualified person to do this job. You should not attempt to do it yourself.

How Many People Get Mesothelioma?

Mesothelioma is fairly rare. There are about 2,000-3,000 new cases per year in this country. Most people who get mesothelioma are over 65 years old. Men are much more likely than women to get this disease.
Although rare, this is a serious disease. It is often advanced before symptoms appear, so the outlook is not as good as it is for cancers that are found earlier. The average survival time is about 1 to 2 years.

Leading Physicians

Alabama - [ back to top ]
James W. Ballard, M.D.Norwood Clinic1528 No. 26th StreetBirmingham, AL 35283
California - [ back to top ]
Dr. Robert CameronP. O. Box 951741Los Angeles, California 90095-1741Phone: 310.794.7333rcameron@mednet.ucla.edu
Dr. David JablonsUCSF Mt. Zion Medical Center2330 Post St., Suite 420San Francisco, CA 94115(415) 885-3882
Dr. Theirry Jahan2356 Sutter, 7th FLSan Francisco, CA 94115(415) 567-5581
Dr. Mark Lischner2 Medical Plaza, Suite 100Roseville, CA 95661(916) 786-7498
Connecticut - [ back to top ]
Mark Cullen, M.D.Yale University School of MedicineOccupational and Environmental135 College Street, 3rd floorNew Haven, CT 06510-2483
Jack A. Elias, M.D.Pulmonary MedicineYale Cancer Center
Michael Grey, M.D.UConn Health Center263 Farmington AvenueFarmington, CT 06032
Bruce G. Haffty, M.D.Therapeutic RadiologyYale Cancer Center
Graeme L. Hammond, M.D.Cardiothoracic TherapyYale Cancer Center
Michael Kashgarian, M.D.PathologyYale Cancer Center
Ronald Ponn, M.D.Thoracic Surgeon333 Orchard St, Suite 107New Haven, CT 06511
Carrie A. Redlich, M.D., M.P.H.Occupational MedicineYale Cancer Center
Florida - [ back to top ]
Lary A. Robinson, M.D.H. Lee Moffitt Cancer Center & Research InstituteAt The University of South Florida 12902 Magnolia Dr.Tampa, FL 33612
John Ruckdeschel, M.D.H. Lee Moffitt Cancer CenterTampa, FL 33612-9497
Maryland - [ back to top ]
Stephen C. Yang, M.D., F.A.C.S, F.C.C.P. Chief, Division of Thoracic Surgery / Associate Professor of Surgery and OncologyThe Johns Hopkins Hospital600 North Wolfe StreetBaltimore, Maryland 21287 (410) 614-3891
Massachusetts - [ back to top ]
Richard Kraiden, M.D.Pulmonary PathologistMassachusetts General HospitalBoston, MA 02114
David Sugarbaker, M.D.Dana Farber Cancer Institute & Brighams & Womens Hospital75 Francis StreetBoston, MA 02115
New York - [ back to top ]
Manjit Bains, M.D.Memorial Sloan Kettering Cancer Center1275 York AvenueNew York, NY 10021
Philippe A. Chihanian, M.D.Mt. Sinai Hospital5 East 98 St.New York, NY 100291-212-241-6368
David Ilson, M.D.Borys Mychalczak, M.D.Sloan-Kettering Cancer CenterNew York, NY
Dr. Valerie RuschMemorial Sloan-Kettering Cancer Center1275 York AvenueNew York, NY 10021Phone: 212.639.5873ruschv@mskcc.org
Harvey Pass, M.D.NYU Medical CenterSchool of Medicine530 First Avenue, New York, NY 10016(212) 263-7300
Stephen Rush, M.D.North Shore University HospitalManhasset, NY
Roman Perez-Soler, M.D.Nw York University Kaplan Cancer Center550 First AvenueNew York, NY 10016(212) 263-8043(212) 263-6485
Robert N. Taub, M.D.Professor of Clinical Medicine, Program DirectorColumbia-Presbyterian HospitalAtchley Pavilion Room 907161 Fort Washington Ave.New York, NY
North Carolina - [ back to top ]
Dr. David H. Harpole, Jr.Associate Professor of SurgeryDuke University Medical CenterDUMC Box 36173582 Duke Hospital SouthDurham, NC 27710(919) 684-3683harpo002@mc.duke.edu
Pennsylvania - [ back to top ]
Dr. Larry KaiserUniversity of Pennsylvania4th Floor, Philadelphia, PA 19104. Phone: 215.662.7538; Kaiser@mail.med.upenn.edu
Rhode Island - [ back to top ]
David Ettensohn, M.D.Pulmonary Medicine109 Beechwood AvenuePawtucket, RI
David Kern, M.D.Memorial Hospital of RIOccupational Health Clinic111 Brewster StreetPawtucket, RI 02860
John Pella, M.D.St. Joseph HospitalPulmonary Fatima Unit200 High Service AvenueNorth Providence, RI 02904
S.T. Sambandan, M.D.Oncologist1180 Hope StreetBristol, RI
Anthony Testa M.D.Oncologist100 Highland AvenueProvidence, RI 02904
South Carolina - [ back to top ]
James Bradof, M.D.South Carolina
Tennessee - [ back to top ]
Spencer McCachren, M.D.Thompson Cancer CenterKnoxville, TN(423) 541-1812
Texas - [ back to top ]
Department Of Clinical InvestigationUniversity of Texas, MD Anderson Cancer Center1515 Holcombe Blvd, Box 39, Rm R7.2215 Houston, Texas 77030Phone: 713.792.7959
Washington - [ back to top ]
Dr. Eric VallieresBox 3563101959 NE PacificSeattle, WA 98195-6310Phone: 206.543.3093
Washington, D.C. - [ back to top ]
Cesar A. Moran, M.D.Department of the ArmyArmed Forces Institute of PathologyWashington, DC 20306
Dr. Paul SugarbakerSugarbaker Oncology Associates, P.C.110 Irving St., NWWashington, DC 20010Phone: 202.877.3908
Wisconsin - [ back to top ]
Joan H. Schiller, M.D.H. Ian Robins, M.D.University of WisconsinMadison, Wisconsin

Ask Your Doctor

Being diagnosed with mesothelioma is a life changing event. Patients are suddenly faced with trying to understand a disease that they may have never heard of before as well as how far it has progressed, available treatment options and overall prognosis. As you move through the process of diagnosis and treatment it is important to ensure that you maintain clear communication channels with your health care team. To assist you in planning for this important communication with your doctors we have provided a framework below to help you get the information that you will find most helpful at the start of care. Remember - every question is important! Here are some questions that you might want to ask your doctor:
What type of mesothelioma have I been diagnosed with?
Is the cancer localized or has it spread to other organs in the body
Have you identified what stage my cancer has progressed to? What does that mean for me?
Is there a treatment protocol that you can recommend?
How effective do you believe the treatment will be?
Are there any risks or side effects associated with these treatment options? If so, how severe are they?
Given your findings to date what do you believe my prognosis to be?
If you believe my cancer is curable, is there a chance that it will come back?
What kind of recovery times can I expect?
Are there any clinical trials available for me to participate in given my diagnosis?
How can I go about seeking a second opinion?
How can I begin preparing now for any recommended treatment options?
Asking these questions will provide you with a good start to developing open communications with your provider. It is entirely probable, however, that you will have additional questions of your own. Please think about these in advance and write them down before you get to the doctors office. We hope that you find this framework useful in establishing a good rapport with your cancer care team.

What are the risk factors for malignant mesothelioma?

There are several risk factors that increase the likelihood that a person will develop mesothelioma. The primary risk factor is asbestos exposure. Exposure to this very harmful substance can significantly enhance the chances of contracting the disease. Other secondary factors include exposure to radiation, zeolite, simian virus 40 (SV40) and tobacco. We discuss each of these risk factors in more detail below.
Asbestos
Exposure to asbestos is the leading risk factor associated with mesothelioma. Asbestos is an insulating material comprised of magnesium-silicate mineral fibers. It was favored by builders and contractors for many years for its low heat conductivity and resistance to melting and burning. Since researchers have identified more and more links between mesothelioma and exposure to asbestos, the material is now less widely used. Prior to this discovery, however, millions of Americans have experienced serious exposure to this harmful substance.
Over 700,000 schools and buildings in the United States today contain asbestos insulation as reported by the US Environmental Protection Agency. Asbestos exposure doesn’t stop there, however. Asbestos is often found in ship yards, manufacturing facilities, railway facilities and construction sites. Blue collar workers are at the highest risk for developing mesothelioma due to occupational exposure and include those who work in mines, factories, shipyards, construction sites, railroads and for insulation manufacturers and gas mask manufacturers. The occupations most widely affected are miners, factory workers, railroad workers, ship builders and construction workers - especially those who install asbestos containing insulation. Sometimes family members related to the workers receive second hand exposure to asbestos from the dust and fibers that were brought home on the workers clothes and also become at risk for contracting mesothelioma.
Serpentine fibers and amphiboles are the 2 primary types of asbestos used. Chrysotile is a form of serpentine fiber and the most frequently used. These fibers tend to be curly and flexible. Amphibole fibers, however, are generally straight and thin and usually comprise one of five types: crocidolite, amosite, anthrophylite, tremolite, and actinolyte. The crocidolite type of Amphiboles is thought to be the leading contributor to cancer caused by asbestos. Serpentine fibers are dangerous as well, however, and have also been linked to mesothelioma.
Some research points to the fact that inhaled asbestos fibers cause a physical irritation resulting in cancer rather than the cancer being caused by a reaction that is more chemical in nature. As fibers are inhaled through the mouth and nose they are cleared from the body by adhering to mucus in the nose, throat and airways and then get expelled by coughing or swallowing. The Amphibole fibers (long and thin) do not clear as easily and it is therefore thought that they can embed into the lining of the lungs and chest and result in mesothelioma.
Asbestosis (scar tissue in the lungs) or lung cancer can also be caused by the inhalation of asbestos fibers. In fact, people exposed to asbestos are seven times more likely to develop lung cancer over the general public. Workers who sustain high levels of asbestos exposure are more likely to die from asbestosis, lung cancer or mesothelioma than any other disease. It is also believed that the action of coughing up and swallowing asbestos could contribute to a form of mesothelioma originating in the abdomen called peritoneal mesothelioma. Mesothelioma has been found to exist in other organs of the body as well such as the larynx, pancreas and colon, but those instances are extremely limited compared to lung cancer incidents.
The chance of developing mesothelioma is in direct proportion to the duration and amount of asbestos exposure that an individual sustains. Those who are exposed to high levels of asbestos at a young age, for long periods of time have a greater risk of being diagnosed with mesothelioma than those who have short, low level exposure. Another important consideration is that Mesothelioma can take a long time to manifest. Often, twenty to forty years can elapse from the time of exposure to diagnosis. Genetic factors can also play a role which explains why not everyone exposed to asbestos develops and asbestos related disease.
Radiation
Thorium dioxide (Thorotrast), a substance used in x-ray tests in the past has reported links to pleural mesothelioma and peritoneal mesothelioma. The use of Thorotrast has been discontinued for many years due to this discovery.
Zeolite
Some mesothelioma cases in the Anatoli region within Turkey have been linked to Zeolite, a silica based mineral with chemical properties similar to asbestos found in the soil there.
Simian Virus 40 (SV40)
Some scientists have found the simian virus 40 (SV30) in mesothelioma cells from humans and have been able to create mesothelioma in animals with the virus. The relationship between this virus and mesothelioma is still unclear, however, and further research is being conducted to gain clarity on this potential link.
Tobacco
Smoking alone is not linked to mesothelioma, but smokers who are exposed to asbestos have a much higher chance of developing lung cancer (as much as fifty to ninety percent higher). Research indicates that lung cancer is the leading cause of death among asbestos workers.

What are the warning signs of mesothelioma?

Mesothelioma is difficult to diagnose because the early signs and symptoms of the disease can be subtle at best. Symptoms are all too frequently ignored or dismissed by people who are inclined to attribute them to common every day ailments. Sometimes patients live with symptoms for up to 6 months before being diagnosed but usually the symptoms are present for two to three months prior to diagnosis.
About 60% of patients diagnosed with pleural mesothelioma experience lower back pain or side chest pain and there are frequent reports of shortness of breath. Lower numbers of people may experience difficulty swallowing, or have a persistent cough, fever, weight loss or fatigue. Symptoms to also consider are muscle weakness, loss of sensory capability, coughing up blood, facial and arm swelling and hoarseness.
Peritoneal mesothelioma originates in the abdomen and as a result, symptoms often include abdominal pain, weight loss, nausea, and vomiting. In the event that there is a hernia present, fluid build up may occur in the abdomen as well.
Anyone previously exposed to asbestos displaying any of these symptoms should seek medical attention right away.

What are the different types of mesothelioma?

Malignant Mesothelioma
Malignant mesothelioma is an uncommon form of cancer and of all asbestos related diseases, the most serious. The symptoms associated with the disease make it difficult for doctors to diagnose. Often, by the time that a proper diagnosis is made, the disease has progressed to a point where patients do not respond well to treatment therapy. Malignant mesothelioma is caused almost exclusively by the inhalation of airborne asbestos particles. Another unique factor associated with the disease is that there can be a long latency period between the time an individual is exposed to asbestos and the actual manifestation of the disease in the form of malignant mesothelioma.
Pleural Mesothelioma – affects the chest and lungs
Malignant pleural mesothelioma often originates within the chest cavity and can, at times, involve the lung. This particular form of mesothelioma can metastasize to numerous organs in the body – even the brain - and tends to do so more frequently than not.
Pleural mesothelioma is not always easily detectable. Frequently, in the early stages of the disease, symptoms may be mild. Patients usually report pain in one area of the chest that never seems to go away, weight loss and fever. Occasionally, other symptoms are more severe and include problems with breathing due to fluid build up in the chest. A CT Scan of the chest area has proven to be the best test for identifying how far along the disease has progressed.
Frequently serum markers are used to diagnose of various forms of cancer. Mesothelioma cannot be diagnosed using this method as no serum markers currently exist. If high levels of hyaluronic acid are present it may be possible to distinguish mesothelioma from other types of cancer or to determine the effectiveness of a treatment protocol.
The survival rate for patients diagnosed with pleural mesothelioma typically is not high. Patients typically do not live beyond seventeen months from the onset of symptoms. Only 8% of those diagnosed with mesothelioma will live three to five years from the onset of symptoms.
Peritoneal Mesothelioma – affects the abdomen
Peritoneal mesothelioma originates in the abdomen and will frequently spread to other organs in area including the liver, spleen or bowel. Severe abdominal pain is the most common complaint that patients present to their doctor. There may also be a discomfort level with fluid build up in the abdomen as well. Other symptoms of peritoneal mesothelioma may include difficult bowel movements, nausea and vomiting, fever and swollen feet.
The survival rate is even worse for those diagnosed with peritoneal mesothelioma will patients typically surviving only ten months from time that they first started experiencing the symptoms noted above.
Pericardial Mesothelioma – affects the heart
Pericardial mesothelioma is the least common form of mesothelioma. Pericardial mesothelioma, as the name suggests, involves the heart. This rare type of mesothelioma invades the pericardium, the sac that surrounds the heart. As the cancer progresses, the heart is not able to deliver oxygen as efficiently to the body causing further decline in health at an increasingly rapid rate. The symptoms most commonly associated with pericardial mesothelioma mimic those of a heart attack: nausea, pain in the chest and shortness of breath.
Benign Mesothelioma – affects the peritoneum
Cystic mesothelioma primarily affects women of younger age and affects the peritoneum. This type of mesothelioma is not frequently diagnosed and is also not a malignant form of the disease. It is, however, extremely difficult to identify and requires specialized microscopes and immunologic techniques to aid in diagnosis.
Mesothelioma in Uncommon Sites
A form of cardiac cancer that is rarely seen involves the pericardium. Tumors associated with this type of mesothelioma are not easily detectable and patients presented with this diagnosis tend to have a very low survival rate. There have also been reports of mesothelioma involving ovaries in women and the scrotum in men. Treatment for all of these rare forms of mesothelioma will vary depending on what stage a patient has progressed to but in most all cases the projected outcome is not favorable.

What are the key statistics about mesothelioma?

Recent reports show that an estimated 2,500 to 3,000 new cases per year of mesothelioma are diagnosed in the United States each year. Although mesothlioma is relatively uncommon, projections show that its incidence is expected to rise over the next decade.
The first diagnosis of mesothelioma on average occurs between 50 - 70 years of age. Mesothlioma affects men more often than women mostly dues to increased occupational exposure. The disease is also less common in African Americans than it is in white Americans.
As mesothelioma is disease that is difficult to detect in its early stages, often the disease is advanced at its first diagnosis. Accordingly, the average survival period using current treament protocols is a little over one year. When fortunate enough to find the cancer early and treat it aggressively, chances increase significantly of reaching the two year survival point. Approximately 20% or patients diagnosed with mesothelioma are able to achieve a five year survival rate.
Those who live at least five years after their cancer is diagnosed have a good chance to continue living a productive life for many additional years. As treatment therapies continue to advance for mesothelioma, we can expect survival rates to continue to improve as well for those recently diagnosed.

What Are The Key Statistics About Malignant Mesothelioma?

Mesothelioma is fairly rare. There are an estimated 2,000 to 3,000 new cases of mesothelioma each year in the United States. The incidence of mesotheliomas in the United States increased from 1970 to 1990 and then stabilized. It may now be decreasing. Most of the past increase in cases, as well as the recent decrease in cases, has been in men. The rate, although lower, has been fairly steady for women. In European countries, the rate of mesotheliomas is still increasing.
Mesothelioma is rare in people under age 55. Its incidence increases with age. Three-fourths of people with mesothelioma are over 65 years old. The disease affects men 5 times more often than women. Mesothelioma is less common in African Americans than in white Americans.
Mesothelioma is a serious disease. By the time the symptoms appear and cancer is diagnosed, the disease is often advanced. The average survival time is about 1 year. The 5-year relative survival rate is around 10%, but this rate has been slowly improving.
The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Many of these patients live much longer than 5 years after diagnosis, and 5-year rates are used to produce a standard way of discussing prognosis. Five-year relative survival rates do not include patients dying of other diseases and are considered to be a more accurate way to describe the prognosis for patients with a particular type and stage of cancer. That means that relative survival only talks about deaths from mesothelioma. Of course, 5-year survival rates are based on patients diagnosed and initially treated more than 5 years ago. They may no longer be accurate. Improvements in treatment result in a more favorable outlook for recently diagnosed patients.

What you can do if you have mesothelioma

One of the hardest things to cope with can be the feeling that the cancer and its treatment have taken over your life and that you have lost control. This is a common feeling and is partly true, but over time people usually find things they can do that help them to cope.
There may be times when you feel too tired and helpless even to think about what could help. It is not unusual to feel like this when you have cancer. You'll have good and bad days, and it's important for you and your family to realise this.
If you are overwhelmed by these feelings, let your doctor or nurse know. It may be that you have depression, and this is very treatable so they should be able to help.
For some people it is important to try to live life as normally as possible. Staying in contact with friends and trying to continue with your usual activities can reassure you that life has not changed too much.
An experience of cancer may help some people decide on new priorities in their lives. This may mean spending more time with family members, taking the holiday they have long dreamed about, or taking up a new hobby. Just thinking about these things and making plans can help you realise that you still have choices.
Understanding the cancer and its treatment helps many people to cope. It means that they can discuss plans for treatment, tests and check-ups with their doctors and nurses, and play a real part in the decisions that are made. Being involved in these choices builds confidence and can help give you back control of your life.
Some people may decide to improve their general health by eating a more healthy diet or by getting fitter. Finding a complementary therapy which helps you to relax can be a very positive way of becoming involved in your illness.

Staging of mesothelioma

The stage of a cancer is a term used to describe its size and whether it has spread beyond its original site. Knowing the extent of the cancer helps the doctors to decide on the best treatment. There are several staging systems for pleural mesothelioma.
A commonly-used system is described below:
Localised malignant mesothelioma
Stage 1 The cancer cells are found in the pleura near the lung and heart or in the diaphragm or the lung.
Advanced malignant mesothelioma
Stage 2 The cancer has spread beyond the pleura to lymph nodes in the chest.
Stage 3 The cancer has spread into one or more of the chest wall, the centre of the chest, the heart, the diaphragm, the abdominal lining, and the nearby lymph nodes.
Stage 4 The cancer has spread to distant organs or tissues.
A staging system has not yet been established for peritoneal mesothelioma. But sometimes doctors may use the TNM staging system for this cancer. The initials T, N and M stand for 'tumour', 'nodes' and 'metastases'.
T describes the size of the tumour
N describes whether the cancer has spread to the lymph nodes
M describes whether the cancer has spread to another part of the body.

How mesothelioma is diagnosed

Most people begin by seeing their GP when they have symptoms. Your GP will examine you and may arrange for you to have some tests or x-rays. You may be referred to hospital for these tests and for specialist advice and treatment. At the hospital, the doctor will take your medical history and occupational history before doing a physical examination.
Chest x-ray
CT scan
Pleural or peritoneal aspiration
Biopsy
Waiting for your test results
Chest x-ray
A chest x-ray will be taken to check for any abnormalities in your lungs, such as thickening of the pleura or fluid around the lungs. However, there can be other causes of thickening of the pleura and peritoneum (and fluid around the lungs or in the abdomen) apart from mesothelioma.
The following tests may also be needed to diagnose mesothelioma, and your doctor may arrange for you to have one or more of them at the hospital.
back to top
CT scan
A CT scan (computerised tomography scan) takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. The scan is painless but takes from 10 to 30 minutes. CT scans use a small amount of radiation, which will be very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
CT scans of the chest and of the abdomen will show the size and position of the mesothelioma and whether it has spread to other parts of the body.
You may be given a drink or injection of a dye that allows particular areas of your body to be seen more clearly. For a few minutes, this may make you feel hot all over. If you are allergic to iodine, or have asthma, you could have a more serious reaction to the injection, so it is important to let your doctor know beforehand.
You will probably be able to go home as soon as the scan is over.

Having a CT scan
back to top
Pleural or peritoneal aspiration
If there is fluid in your chest or abdomen, the doctor can take a sample by using a local anaesthetic and passing a needle through the skin into the fluid. Some of the fluid is then drawn off into a syringe and can be analysed in the laboratory to look for mesothelioma cells.
Taking fluid from between the pleura is known as a pleural aspiration and taking fluid from the abdomen is known as drainage of ascites (or peritoneal aspiration).
back to top
Biopsy
If you need a biopsy, your doctor will take a sample of tissue from the thickened pleura or peritoneum. A local anaesthetic is used to numb the area and a special type of needle is passed through the skin into the tumour. The needle has a tip that can cut out a sample of the tumour. The doctor may use ultrasound or a CT scanner to position the needle accurately. An ultrasound uses sound waves to build up a picture of the organs in a part of the body. A small device is passed over the skin to show the doctor where the tumour is and guide the needle into the right place.
Sometimes the doctor will want to look at the area of the pleura or the peritoneum directly to get a sample of tissue from the right area. This is done by using a thin flexible tube with a light and camera at the end. The tube (endoscope) can be passed through the skin of the chest, where it is called thoracoscopy, or the abdomen, where it is called laparoscopy. The procedure is done under a general anaesthetic by a surgeon. You will usually be able to go home the same day.
Your doctors may want to check for any signs of spread of the cancer to the nearby lymph glands in the centre of the chest. This central area, around the lower part of the windpipe, is called the mediastinum and the lymph glands which are found there are the mediastinal lymph nodes. This test is called a mediastinoscopy. The test is done under a general anaesthetic and will mean a short stay in hospital. A small cut is made through the skin at the base of the neck. A tube, like a small telescope, is passed into the chest through the hole created by the cut. The doctor can use this tube to examine the area. Samples can be taken for examination under a microscope.
Analysing the biopsy in the laboratory is the only way your doctors can make the diagnosis of mesothelioma. Sometimes, even after taking a biopsy, the doctors may not be sure of the diagnosis, because mesothelioma can be very difficult to distinguish from other illnesses. In this situation, the biopsy samples may be sent to other laboratories to confirm the diagnosis, some of your tests may need to be repeated or you may be referred to another hospital for a second opinion.

Symptoms of mesothelioma

Mesothelioma often starts as a lot of tiny lumps (nodules) in the pleura, which may not show up on scans or x-rays until they are quite large. The main symptoms of pleural mesothelioma are breathlessness and chest pain. Some people find that their voice becomes hoarse and they have a cough that does not go away.
Peritoneal mesothelioma often causes swelling and pain in the abdomen.
General symptoms
Both types of mesothelioma can cause other general symptoms, such as loss of appetite, sweating (especially at night), weight loss and tiredness. As many of these symptoms can also be caused by other illnesses, your doctor will need to do a series of tests before a diagnosis can be made.

Causes of mesothelioma

Asbestos is the most common cause of mesothelioma. Up to nine out of ten cases of mesothelioma are caused by exposure to asbestos. Asbestos is a natural mineral, mined from rock found in many countries. It is made up of tiny fibres that are as strong as steel but can be woven like cotton and are highly resistant to heat and chemicals.
During the 1960s the first definite link between mesothelioma and asbestos was made. In the past asbestos was imported to the UK in large quantities. It was used in construction, ship-building and in household appliances. Asbestos was very widely used in insulation materials, such as amosite insulation board, and building materials, including asbestos cement.
When asbestos is disturbed or damaged, it releases tiny fibres that can be breathed into the lungs. Asbestos fibres are very fine and, when breathed in, they can make their way into the smallest airways of the lung, so they cannot be breathed or coughed out. Once the fibres are in the lungs, the body's defence mechanism tries to break them down and remove them, which leads to inflammation in the lung tissue.
The asbestos fibres can also penetrate through the lung tissue to settle in the pleura (the membrane around the lung). Over many years they can cause mesothelioma or other lung diseases to develop.
Asbestos fibres can also be swallowed, and some of the fibres can stick in the digestive system. They can then move into the membrane that lines the abdomen (the peritoneum), where they cause inflammation.
The people most likely to have been exposed to asbestos include:
construction workers
plumbers
electricians
boilermakers
shipbuilders
demolition workers
people who worked in other places where asbestos was present and
people who lived near to asbestos factories.
Family members of people who worked with asbestos and brought the dust home on their clothes have also sometimes developed mesothelioma.
There are three types of asbestos: blue, brown and white. Blue and brown asbestos are the types most commonly linked with mesothelioma. They are now very rarely used and cannot be imported into the UK. Originally, white asbestos was thought not to be dangerous but recent studies have now shown that it is also harmful.
In the 1980s, imports of blue and brown asbestos into the UK were stopped, and in 1999 the importation and use of all asbestos was banned. However, as mesothelioma develops so slowly, it is estimated that by 2015 approximately 3000 people will be diagnosed with mesothelioma each year. The number of people who develop mesothelioma will then start to reduce each year.
Mesothelioma does not usually develop until many years after exposure to asbestos. It can take any time from 10 to 60 years, although the average is about 30 to 40 years after exposure to asbestos.
Occasionally, mesothelioma develops in people who have never been exposed to asbestos. The other causes of the disease are not fully understood, but in rare cases the development of mesothelioma has been linked to exposure to radiation.
Research has not found any evidence that smoking increases a person's risk of developing mesothelioma. It is also thought that exposure to other building materials such as fibreglass does not increase the risk.
Mesothelioma is not contagious and cannot be passed on to other people. It is not caused by inherited faulty genes and so family members do not have an increased risk of developing it, unless they have been in contact with asbestos.

Introduction

For people living with Mesothelioma and their familiesThe benefits system can be very confusing. However, once the necessary claim forms have been completed following a diagnosis of Mesothelioma, entitlement to some benefits and allowances is automatic. There is a common belief that most benefits and allowances are means-tested, and that people will not be able to claim them if they have savings or own their house. This is not true, even if you do own your house you will still be able to claim many of the benefits or allowances listed on this website. However, the benefits and allowances mentioned in steps 5 and 6 may be affected if you have savings.The Benefits System can be divided into Six Basic Steps. This section of the website includes:
The Six Basic StepsBenefit Claim ExampleFactsheets - Covering all the individual benefits included in the Six Basic Steps and related issues
For help to check exactly which benefits you are able to claim, help to fill in the necessary forms or to discuss any problems you have with your benefits call:Macmillan Benefits Helpline on freephone 0808 801 0304Mon, Tues, Thurs & Fri 10am – 5pm and Weds 12 noon – 5pmAlternatively, you can contact an Asbestos Support Group, your local Citizens’ Advice Bureau or a local specialist nurse for advice and assistance.AcknowledgementMesothelioma UK would like to acknowledge the author of the Benefits Section and Factsheets - Carolynne Radcliffe. The information contained within this section is protected by Mesothelioma UK Copyright but remains the intellectual property of the author.© Mesothelioma UK

Peritoneal Mesothelioma

The peritoneum also has two layers the inner (visceral) layer which is next to the abdominal organs and the outer (parietal) layer which lines the abdominal wall. Peritoneal mesothelioma causes the peritoneum to thicken and fluid to collect in the abdomen. This collection of fluid is called ascites and causes the abdomen to swell. Because pleural mesothelioma is more common and often spreads to the peritoneal cavity, it is sometimes necessary to determine if pleural mesothelioma is the primary cancer.

Pleural Mesothelioma

The pleural lining has two layers: the visceral (inner) layer is next to the lung and the parietal (outer) layer lines the chest wall. The pleura produces fluid that lubricates the space between the two layers, this allows the two layers to slide comfortably over each other as we breathe in and out.Pleural mesothelioma causes the pleura to thicken. This thickening of the pleura might begin to press onto the lungs or attach itself to the inside of the chest wall. In either case the expansion of the lung becomes progressively restricted by the tumour. Fluid, sometimes several litres, can collect between the two layers of the pleura; this affects the lungs ability to expand and causes the person to feel breathless. This is known as a pleural effusion.

What is Cancer?

Firstly it is important to understand that cancer is not a single illness, there are very many different types and mesothelioma is just one type. Our bodies are made of tiny building blocks called cells, cancer is a disease of these cells. Cells from different parts of the body look and work differently and millions of new cells are made everyday to replace those lost through old age or wear and tear. Throughout the body new cells are produced when existing cells divide into two and there is normally a perfect balance between those that are dying and those that are dividing. This vital balance is controlled by a very complicated process, if control of this process is lost it can lead to too many cells being produced which results in a tumour. Most tumours are not cancerous (sometimes described as benign) and they remain in the area where they first developed. A wart is a common example. The development of cancer involves a change in the quality of the cells as well an increase in the quantity. They become more aggressive, destructive and independent of normal cells. They are able to invade surrounding tissues, glands and blood vessels and thus spread away from where they started to divide and grow. When the cancer cells reach a new site they may go on dividing and form a new tumour, this is often referred to as a secondary or metastasis (secondary).

What is Mesothelioma?

Malignant pleural mesothelioma (MPM) is a rare form of cancer that originates in the pleura, the membrane which lines the chest cavity. Most cases of mesothelioma are related to exposure to asbestos, a naturally occurring fibrous mineral used extensively in the past in the construction, automotive and manufacturing industries.
Asbestos fibers are easily inhaled, and tend to settle in the lower portions of the lung near the pleura. The fibers can cause inflammation and scarring and lead to lung damage or asbestosis. Occasionally, asbestos fibers cause changes to occur in the pleura, leading to the development of MPM 15 to 45 years after exposure.
Because of this long latency period, many of the 2,000-3,000 cases diagnosed annually in the United States are patients who had been exposed to asbestos many years earlier while working at shipbuilding or naval yards, or in mechanical, insulation or manufacturing industries.
Men are three to five times more likely to develop mesothelioma than women. There are three cell types of mesothelioma:
Epithelioid accounts for 50% to 70% of all cases. It also has the best prognosis.
Sarcomatoid accounts for 10% to 15% of all cases. It is a more aggressive form of mesothelioma.
Biphasic or Mixed accounts for 10% to 15% of cases. This form has characteristics of both epithelioid and sarcomatoid mesotheliomas but is associated with worse survival than epithelioid mesothelioma.

Mesothelioma In Uk

Mesothelioma Cases on the Rise in the UK
The Health Safety Executive or HSE as it is popularly known has published the latest statistics for asbestos induced mesothelioma deaths. And the statistics are not looking good for UK residents. Mesothelioma is a rare type of cancer that affects those workers and people who have directly or indirectly inhaled asbestos. A painful disease with devastating long terms effects, mesothelioma is gaining wide coverage due to awareness created in the print and electronic media.
According to the HSE statistics the number of deaths has increased to 1,969 victims in the year 2004 from 153 people that died due to mesothelioma in the year 1969. Within the next 4-8 years it is expected that the deaths will escalate to an estimated 2,450 per year. An alarmingly high increase that should ring alarm bells in the government corridors and medical boards.
The statistical information with regards to mesothelioma and asbestos related deaths are thoroughly verified and checked by HSE using a comprehensive system of records, death certificates and cross-checking cancer registrations. This information is also up on the internet for general public reading and can be easily accessed and downloaded from the HSE website.
According to HSE statistical report, the workers from the following businesses are most vulnerable to asbestos induced cancers. All these industries made extensive use of asbestos fibers before strict rules and regulations were enforced to limit asbestos.
Construction business
Energy business
Water supply business
Manufacturing business
Shipbuilding business
Railway engineering business
You can also find the geographical distribution of mesothelioma deaths in the HSE report, which gives a breakdown of statistics in areas with such high incidence rate of mesothelioma deaths. The reason for such high mesothelioma rates in these locations is due to a large presence of ports, shipyards and dockyards. In Scotland these are some of the geographical locations with high mesothelioma deaths: West Dunbartonshire, East Dunbartonshire, Fife, Glasgow City, Inverclyde and Renfrewshire.
In the North East parts of Great Britain mesothelioma mortalities are usually in:
Hartlepool
Middlesbrough
Redcar
Cleveland
Stockton on Tees
All LAs in Tyne and Wear Metropolitan County
Blythe Valley in Northumberland
In the South East divisions of Great Britain mesothelioma mortalities are usually in:
The UAs of Isle of White
Medway
Portsmouth
Southampton
The LAs of Farehma
Gosport
Havant
New Forest in Hampshire
You can find other geographical locations for increasing mesothelioma mortalities in the detailed and updated HSE report. A major consequence of mesothelioma deaths has been a sharp rise in the number of lawsuits filed by victims and their families to get monetary compensation. Another consequence has been that all the industries are now pumping money in research to find suitable replacements for asbestos fibers. What will this eventually lead to is something to watch out for in the coming years.

Ban on Asbestos

Banning Asbestos
Strong calls are being made in the government lobbies to ban asbestos laden products in countries such as Canada, UK, South Africa and USA. Demands are coming in the form of outright bans, phasing out, placing of stringent rules and limited usage. Despite the persistent calls and known hazards of asbestos these measures will be unsuccessful because of the huge amounts of money involved along with the numerous benefits of asbestos.
The connection of asbestos with huge amounts of money is that it is used in some heavy duty industries in which significant investments are at stake. This investment is done by the industrialists and businessmen that are worth millions of dollars. For instance one heavy duty industry in which asbestos is applied is in the construction and engineering industry.
Construction and Engineering Industry: Asbestos
With new geographical locations being discovered by land surveyors, architects and industrialists, there is tremendous pressure to construct new houses, office buildings and apartment blocks. Besides building new structures, there is a rise in the trend to improve and restore old building structures.
For these buildings asbestos is useful as it is used in roof tiles, floor tiles, geysers, pipe insulation, firebrick, window caulking, duct connections and spray on fire proof insulation. It is also utilized to strengthen the concrete pillars, insulation around boilers and is added in cement mixtures to solidify and reinforce it.
Asbestos Use in the Shipping Industry
Another industry that makes heavy use of asbestos is the shipping industry. The global shipping industry is quite robust and active although it did experience a bit of lull in the interim time period. It is going through a phase of expansion and thus new shipping vessels are being constructed on a massive scale. Shipping is experiencing boom in freight, cruises and oil transportation. It is used to insulate pipes, boilers and engines. All these structures generate a great amount of heat and hence asbestos being heat resistant is used for insulation purposes.
Auto Industry and Asbestos
Asbestos is also used in the auto industry. The industry is involved in the design and production of vehicles. Most of the vehicle makers are located in US, Japan, Germany, Italy, France and South Korea. These vehicle makers make extensive use of asbestos due to its numerous qualities. It has high insulation and tensile strength. A naturally occurring light mineral, it is fire and heat resistant as well. That is why asbestos is used in brake and accelerator pedals, brake pads, clutches and brake drums.
Due to its high usability in crucial heavy industries, it is not possible that asbestos will be completely banned in the world. But it will be continued to be applied in a limited manner as no good substitute has been discovered as yet for asbestos.

Mesothelioma Attorneys - Make your Mesothelioma Claim

Its essential when you are fighting for your life that you get the very best. That is why when you decide that you want to hire an attorney to fight against the injustice of contracting mesothelioma it is necessary that you hire a mesothelioma attorney who knows what needs to be done.It was stated in the Wall Street Journal that if a mesothelioma case goes to trial the average award in 2001 was $6 million. Of course no one can guarantee that you will win but if you can prove that the cause of your mesothelioma was unsafe workplace procedures and practices then you have a better chance of winning. Either way even if you lose you do not make any financial contribution to the cost of the legal proceedings.
Just send us an e-mail with and we will send you the contact information of mesothelioma attorney and law firms most suited to your needs. Make a Claim by finding and having the Top Mesothelioma Law Firms and Attorneys represent you.
Mesothelioma laws have been created to ensure that victims are compensated by their employers if they have been exposed to asbestos in the workplace. Not every law firm can professionally and successfully handle a case that has to prove carelessness on part of the employer. You must hire a firm or attorney that specializes in Mesothelioma cases and knows exactly how to help you.We will help you choose the firm or Mesothelioma attorney that best suits your needs and rights. Just fill the form below so that we can help you retain the top mesothelioma attorney that will ensure you get the compensation you deserve!

Mesothelioma Lawsuits

Lawyers may be considered sharks or grave diggers, the lowest of the lowest as they search for clients who are dead and dying, they are admittedly not the most loved of human professionals. Yet, while they may seem to be without a conscience the fact is, they give you hope.
If you suffer from mesothelioma because of the negligence of an employer or organization then you are due compensation. No, getting a lawyer will not cure mesothelioma, nor will it alleviate your suffering. However, being compensated for someone's negligence will allow you to ensure that the expensive treatment required for mesothelioma does not alter your life nor the life of your loved ones.
Mesothelioma law is basically about being compensated by the makers and distributors of asbestos.The best way to get compensation is by hiring the right lawyer!
If you want to legally claim that the mesothelioma you or your loved one contracted was a result of exposure to an asbestos zone, you must be able to prove that exposure. Try your best to remember the details of your exposure, the product name, or the location, your lawyers and investigators will get the details all you need to give them is the basics.

Mesothelioma Attorney, Facts and Figures in Different Regions:

Mesothelioma Attorney, Facts and Figures in Alabama
Mesothelioma Attorney, Facts and Figures in Alaska
Mesothelioma Attorney, Facts and Figures in Arizona
Mesothelioma Attorney, Facts and Figures in Arkansas
Mesothelioma Attorney, Facts and Figures in California
Mesothelioma Attorney, Facts and Figures in Delaware
Mesothelioma Attorney, Facts and Figures in Florida
Mesothelioma Attorney, Facts and Figures in Georgia
Mesothelioma Attorney, Facts and Figures in Hawaii
Mesothelioma Attorney, Facts and Figures in Idaho
Mesothelioma Attorney, Facts and Figures in Illinois
Mesothelioma Attorney, Facts and Figures in Indiana
Mesothelioma Attorney, Facts and Figures in Iowa
Mesothelioma Attorney, Facts and Figures in Kansas
Mesothelioma Attorney, Facts and Figures in Kentucky
Mesothelioma Attorney, Facts and Figures in Louisiana
Mesothelioma Attorney, Facts and Figures in Maryland
Mesothelioma Attorney, Facts and Figures in Massachusetts

Mesothelioma Attorney, Facts and Figures in Michigan
Mesothelioma Attorney, Facts and Figures in Minnesota
Mesothelioma Attorney, Facts and Figures in Missouri
Mesothelioma Attorney, Facts and Figures in Montana
Mesothelioma Attorney, Facts and Figures in Nebraska
Mesothelioma Attorney, Facts and Figures in Nevada
Mesothelioma Attorney, Facts and Figures in New Jersey
Mesothelioma Attorney, Facts and Figures in New Mexico
Mesothelioma Attorney, Facts and Figures in New York
Mesothelioma Attorney, Facts and Figures in North Dakota
Mesothelioma Attorney, Facts and Figures in Ohio
Mesothelioma Attorney, Facts and Figures in Oklahoma
Mesothelioma Attorney, Facts and Figures in Oregon
Mesothelioma Attorney, Facts and Figures in Pennsylvania
Mesothelioma Attorney, Facts and Figures in Texas
Mesothelioma Attorney, Facts and Figures in Vermont
Mesothelioma Attorney, Facts and Figures in Washington