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Mesothelioma - What is Mesothelioma

Learning More About Mesothelioma

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Updated July 31, 2009

Mesothelioma is a type of cancer that is primarily caused by exposure to certain types of asbestos, a material once used in building construction. The disease can affect the lungs, the abdomen, or the heart. There are three types of mesothelioma:
  • Pleural: Pleural mesothelioma affects the pleura - the lining of the lungs. It is the most common type of mesothelioma.
  • Peritoneal: Peritoneal mesothelioma affects the peritoneum - the lining of the abdomen.
  • Pericardial: Pericardial mesothelioma affects the pericardium, the membrane that surrounds the heart. It is the least common type, affecting about 5 percent of people with the disease.

Causes of Mesothelioma

Asbestos exposure is the number one cause for mesothelioma. Asbestos is a fibrous mineral that was once found in many types industrial building supplies and equipment. Asbestos was used until the mid 1970's when the risks of exposure were becoming evident. It is still used today, yet in a very limited capacity.

Asbestos exposure doesn't result immediately in cancer. It takes years for the cancer to form and cause symptoms. Workers exposed in the 1950's, 60's, and 70's are just now being diagnosed with mesothelioma.

Symptoms of Mesothelioma

Symptoms of mesothelioma do not appear immediately after being exposed, taking about 25 to 50 years after the initial exposure to develop. It is a very slow progressing disease that usually strikes middle age to senior adults long after their exposure to asbestos.

Symptoms of mesothelioma vary based on the type of mesothelioma, but general symptoms include:
  • shortness of breath
  • chest pain
  • persistent cough
  • wheezing
  • abdominal swelling
  • abdominal pain
  • changes in bowel habits
  • abdominal mass

Many of these symptoms are non-specific, meaning they aren't exactly red flags for mesothelioma. However, when combined with previous exposure to asbestos, it may suggest to your physician to evaluate for mesothelioma. It is very important that your doctor is aware of any prior exposure to asbestos. Mesothelioma is also a rare disease, so it can be overlooked in the diagnostic process.

Diagnosing Mesothelioma

Mesothelioma diagnosis is difficult as the symptoms are very similar to many other diseases and conditions. With any respiratory symptoms, a chest x-ray is usually the first step in getting a diagnosis for any lung related condition. Many people with mesothelioma have a pleural effusion that is seen on the chest x-ray. A pleural effusion is a condition marked by the accumulation of fluid between the lung and chest wall.

Other imaging tests, like MRI, CT scans, and PET scans may be used to examine the chest and abdomen to investigate for abnormalities.

Ultimately, it is a biopsy that confirms or rules out mesothelioma. A biopsy is the removal of a small amount of tissue to be examined by a pathologist. A biopsy to screen for mesothelioma is done during a procedure called a thoracoscopy.

If mesothelioma is confirmed through microscopic analysis by a pathologist, it is then necessary to determine how advanced the mesothelioma is and to develop a treatment plan.

Treatment of Mesothelioma

This section references pleural mesothelioma, the most common type of mesothelioma.

Treatment of mesothelioma varies based on how far the disease has advanced and factors like age and other health considerations like cardiopulmonary function. In most cases of mesothelioma, surgery is performed to palliatively relieve the symptoms or complications of the disease, not necessarily to cure it. Surgery, combined with other methods of treatment, may increase life span, however. Rarely is surgery performed with a goal of "curing" mesothelioma. Surgery performed to treat mesothelioma include:
  • Pleurectomy: This type of surgery is reserved for early stage mesothelioma patients. During a pleurectomy, part of the pleura is removed, in attempt to eliminate all cancerous tissue. Sometimes during pleurectomy surgery, it is evident that a pluerectomy will not be effective at removing all cancerous tissue and a more aggressive surgery may be done instead, like a pneumonectomy.
  • Extrapleural Pnemonectomy:
This type of surgery removes the lung, the pleura, pericardium, and a good portion of the diaphragm. It is a very aggressive surgery and is reserved for those who have the lung and heart function to sustain such a surgery. Only physicians highly experienced in extrapleural pneumonectomy surgery should perform it. It is a very complex procedure and even those who may be healthy enough to undergo it, choose not to.

Pleural effusions are common with people with mesothelioma and can cause severe breathing difficulties and chest pain. The fluid can be drained and a procedure called pleurodesis can be done to prevent effusions from recurring. Again, not a curative approach, but certainly one that increases quality of life and reduces pain and discomfort.

Radiation Therapy to Treat Mesothelioma

Radiation therapy is also an option for treating some people with mesothelioma. This type of treatment uses certain types of high-energy beams of radiation to shrink tumors or eliminate cancer cells. Radiation therapy works by damaging a cancer cell's DNA, making it unable to multiply. Although radiation therapy can damage nearby healthy cells, cancer cells are highly sensitive to radiation and typically die when treated. Healthy cells that are damaged during radiation are resilient and are often able to fully recover.

In mesothelioma, radiation therapy is utilized as adjuvant therapy, given along with surgery or chemotherapy. Sometimes all three methods are used in a treatment sequence called, trimodality therapy.

Chemotherapy may be prescribed to treat mesothelioma. Treatment drugs work by eliminating rapidly multiplying cancer cells; however, there are other healthy cells in the body that multiply just as quickly, such as hair follicle cells. Unfortunately, many chemotherapy drugs may not be able to discern the two, attacking healthy cells and causing side effects, such as hair loss.

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