Mesothelioma

What is mesothelioma?

The tissue that lines your lungs, stomach, heart, and other organs is called mesothelium. Mesothelioma is a tumor of that tissue. It usually starts in the lungs, but can also start in the abdomen or other organs. It can be benign (non-cancerous) or malignant (cancerous).
 
Malignant mesothelioma is a rare but serious type of cancer that occurs in the thin layer of tissue that covers the majority of your internal organs. Caused primarily by the inhalation of asbestos fibers, mesothelioma is most commonly diagnosed in older individuals who worked with asbestos in an industrial setting. After being exposed to asbestos, it usually takes a long time for the disease to form. Prognosis for mesothelioma is poor, but early detection and newer treatment methods have given many patients hope for survival. 
 
 
Forms of mesothelioma:
 
  • Pleural mesothelioma is the most common form, often presenting with symptoms in the chest area
  • Peritoneal mesothelioma is much less common. This can affect the organs in the abdomen, and its symptoms are related to this area of the body, that is, abdominal swelling, nausea, vomiting, and bowel obstruction. 
  • Pericardial mesothelioma is the rarest form of mesothelioma and involves the sac surrounding the heart.

There are two major cell types of mesothelioma, epithelial and sarcomatoid. Sometimes both of these cell types can be present. The sarcomatoid type is rarer and occurs in only about 15% of cases; it portends a poorer prognosis. In very rare cases, mesothelioma can originate from benign, non-malignant cells. This so-called benign mesothelioma can be cured surgically.

 
 
Risk factors
 
  • Exposure to asbestos is the leading risk factor associated with mesothelioma. Asbestos is an insulating material comprised of magnesium-silicate mineral fibers. A popular building material for many years due to its low heat conductivity and resistance to melting and burning; however, since researchers have identified increasing 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. If you've been directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.
  • Living with someone who works with asbestos. People who are exposed to asbestos may carry the fibers home on their skin and clothing. Exposure to these stray fibers over many years can put others in the home at risk of mesothelioma. People who work with high levels of asbestos can reduce the risk of bringing home asbestos fibers by showering and changing clothes before leaving work.
  • A family history of mesothelioma. If your parent, sibling or child has mesothelioma, you may have an increased risk of this disease.
  • Smoking alone is not linked to mesothelioma, but smokers who are exposed to asbestos have a much higher chance of developing asbestos lung cancer (as much as fifty to ninety percent higher) and as much as double the risk of developing mesothelioma.
 
 
Diagnosis
In most cases, cancer specialists will approach a mesothelioma diagnosis by first testing to see if another, more common disease is causing the symptoms. As part of this process, the doctor will obtain a full medical history from the patient, which may include asking about any exposure to asbestos.
 
From there, the doctor will usually perform a series of tests, such as imaging scans and blood tests. If these initial tests indicate a potential for mesothelioma, a biopsy will be taken. A biopsy procedure is the only test that can positively confirm a mesothelioma diagnosis.
 
  • Diagnostic imaging tests, like X-rays, CT scans, and MRIs, help doctors obtain information about the cancer, including how far it has progressed.
  • X-rays are commonly used to diagnose many conditions, illnesses, and injuries. They can be particularly helpful in finding fluid in the lungs, often an early sign of mesothelioma.
  • Computer tomography (CT) scans provide a series of X-ray images to form a 3D image, allowing tumors to be spotted more easily.
  • Magnetic resonance imaging (MRI) scans provide a 3D model with much higher resolution than other imaging methods. This can be helpful in diagnosing metastasis (spreading) of the mesothelioma.
  • Positron emission tomography (PET) scans use a radioactive isotope injection that can be viewed by the scanner. PET scans can help distinguish benign versus malignant tumors.
 
  • Blood tests and biomarkers: in recent years, a number of blood tests have been developed to identify substances in the blood that can point to the presence of mesothelioma cancer cells. The presence of these substances, known as biomarkers can provide useful information that can demonstrate a need for a biopsy
  • MESOMARK®: looks for the presence of mesothelin, a glycoprotein (sugar and protein molecule) that is produced in excessive amounts by mesothelioma cells. Specifically, MESOMARK® tests for soluble mesothelin-related peptides (SMRPs), which are created when mesothelin is dissolved in the bloodstream.
  • N-ERC/Mesothelin is a protein fragment that is soluble in the blood stream. Early test results still need to be confirmed for this potential blood test with a sensitivity rate of about 95%.
  • Fibulin-3 is similar to mesothelin as it is produced in higher concentrations by mesothelioma cells. However, existing research has shown irregular results, with some question as to the accuracy of the test. Fibulin-3 assays may nonetheless be useful in distinguishing between malignant and benign lung diseases.
  • HMGB1: recent studies have shown that testing for a certain protein – high mobility group box protein 1 (HMGB1) – can not only positively detect individuals with mesothelioma, but also can identify individuals who have been exposed to asbestos but have not yet developed the disease. Additional trials are needed to confirm the results.
  • Osteopontin is a glycoprotein like mesothelin, is also produced in high amounts by mesothelioma. Unfortunately, this particular biomarker is a less accurate diagnostic tool than other assays, as osteopontin is also produced by other types of cancer, as well as kidney stones and ischemic stroke.
 
Mesothelioma can’t be diagnosed with these blood tests alone, but high levels of these substances can make the diagnosis more likely. These tests are not routinely used in most doctors’ offices because of their limited value.
 
  • A biopsy is a procedure to remove a small portion of tissue for laboratory examination, is the only way to determine whether you have mesothelioma. Depending on what area of your body is affected, your doctor selects the right biopsy procedure for you.
  • Fine-needle aspiration: the doctor removes fluid or a piece of tissue with a small needle inserted into your chest or abdomen.
  • Thoracoscopy allows the surgeon to see inside your chest. In this procedure, the surgeon makes one or more small incisions between your ribs. A tube with a tiny video camera is then inserted into your chest cavity — a procedure sometimes called video-assisted thoracoscopic surgery (VATS). Special surgical tools allow your surgeon to cut away small pieces of tissue for testing.
  • Laparoscopy allows the surgeon to see inside your abdomen. Using one or more small incisions into your abdomen, the surgeon inserts a tiny camera and special surgical tools to obtain a small piece of tissue for examination.
  • Thoracotomy: surgery to open your chest between the ribs to allow a surgeon to check for signs of disease. A sample of tissue may be removed for testing.
  • Laparotomy: surgery to open your abdomen to allow a surgeon to check for signs of disease. A sample of tissue may be removed for testing.
 
 
Treatment
Doctors offer three primary types of treatment to malignant mesothelioma patients: Surgery, chemotherapy and radiation. The types of treatment you receive depend on your diagnosis, the stage and type of your mesothelioma and your overall health.
 
If the cancer has not yet spread, a combination of radiation, surgery and chemotherapy likely will be offered to you. This combined approach to treatment is called multimodal therapy.
 
If the mesothelioma already has spread significantly, doctors typically recommend palliative treatments that can help alleviate pain, breathing problems and other cancer symptoms that lessen your quality of life. You are still likely to be offered radiation and chemotherapy, but probably not major surgery options.
 
Radiation therapy can soothe pain and correct breathing issues by shrinking tumors that press on your nerves, veins and airways. Chemotherapy also shrinks tumors, helping with chest pain and night sweats. Non-curative surgeries can remove tumors that cause troublesome symptoms, or drain fluid that builds up in the chest or abdomen.
 
You may also want to talk to your doctor about other treatment options beyond surgery, chemotherapy and radiation therapy. Experimental treatments exist, mostly in clinical trials, and sometimes they can make a huge difference.
 
 
 
 
# MESOTHELIOMA BY THE NUMBERS #
  • Over a 40-year period from 1973 – 2013, the survival rate for mesothelioma has remained steady, with only about 7-9% of mesothelioma patients living 5 years or longer.
  • Approximately 3,000 people in the U.S. are diagnosed with mesothelioma each year. 
  • On average, about 2,500 mesothelioma-related deaths occur in the U.S. each year. 
  • Between 1999-2010, more than 31,000 people in the U.S. died due to mesothelioma.
  • About 14 out of every 1 million people in the United states die from mesothelioma. 
  • The average age at diagnosis of mesothelioma is 75 for males and 72 for females.
 
mesothelioma about
 
 

Sources
  • "Mesothelioma Treatments and Drugs." Mayo Clinic. Mayo Foundation for Medical Education and Research, 23 Oct. 2015. Web. 24 May 2017.
  • "Mesothelioma Statistics and Facts." Mesothe
  • "Top Mesothelioma Treatment Options for You or a Loved One." Mesothelioma Center - Vital Services for Cancer Patients & Families. N.p., 24 May 2017. Web. 24 May 2017.
  • "How Is Malignant Mesothelioma Diagnosed?" American Cancer Society. N.p., n.d. Web. 24 May 2017.
  • FCCP, George Schiffman MD. "Mesothelioma: Read About Symptoms, Treatment and Prognosis." MedicineNet. N.p., n.d. Web. 24 May 2017.

 

The main cause of mesothelioma is exposure to asbestos: a combination of six fibrous minerals, which were commonly used by commercial companies throughout the 20th century. In fact, most structures built before 1980 contain asbestos. Commercial and industrial workers are most likely to develop mesothelioma due to their frequent exposure to asbestos. To reduce the risk of exposure in the workplace, here are three best practices to prevent asbestos exposure:
 
about mesothelioma

 

NOTE: The information on this page and any information found on healtheo360 is not a substitution for professional medical advice, diagnosis or treatment. If you think you may have a medical emergency, CALL 911 immediately. See additional information about our Terms & Conditions.