Mesothelioma

Compared to many cancers, mesothelioma is still quite rare. Only 2,500-3,000 cases are diagnosed in the United States each year. There was a sharp increase in reported mesothelioma diagnoses between 1970 and 1984 which was linked to increased industrial exposure 40-60 years prior to this time, particularly prevalent in the WWII-era military industrial cycle, including navy shipyards.

While exposure was common across the United States in nearly all industries, it is much more common in men over the age of 60. Although less common, mesothelioma in women and children has been documented as well. Mesothelioma causes for diagnosis in women and children are mainly attributed to secondary exposure to asbestos by men who worked in asbestos-related jobs to bring back into the home on their bodies or clothing.

Mesothelioma is diagnosed through a comprehensive combination of biopsy and imaging scans.

Signs and symptoms of Pleural mesothelioma, which affects the tissue that surrounds the lungs, may include:

• Unusual lumps of tissue under the skin on your chest
• Unexplained weight loss
• Chest pain under the rib cage
• Painful coughing
• Shortness of breath

Peritoneal Mesothelioma

Signs and symptoms of Peritoneal mesothelioma, which occurs in tissue in the abdomen, may include:

• Lumps of tissue in the abdomen
• Unexplained weight loss
• Abdominal pain
• Abdominal swelling

How is Mesothelioma Diagnosed?

Mesothelioma is often misdiagnosed. Symptoms of mesothelioma include chest pain, chronic cough, effusions of the chest and abdomen, and the presence of blood in lung fluid.

Mesothelioma can be difficult to diagnose because the symptoms of the disease closely resemble other respiratory conditions. The pathology can be very difficult to distinguish from adenocarcinoma of the lung.

Mesothelioma is diagnosed through a comprehensive combination of biopsy and imaging scans.

Diagnostic surgeries, including a biopsy, will typically be required to determine the type of malignant cells that are present in the body. Typically a body imaging scan, including an MRI, CT scan, and PET scan, will be required to determine the extent and location of the disease. A formal staging classification exists only for pleural mesothelioma because of how rare mesothelioma is.

See your doctor if you have signs and symptoms that may indicate mesothelioma and tell your doctor if you've been exposed to asbestos fibers.

Due to the rarity of mesothelioma, signs and symptoms of mesothelioma aren't specific to this disease and are more likely to be related to other conditions. If any persistent signs and symptoms seem unusual or bothersome, ask your doctor for further tests and evaluation.

As pleural mesothelioma spreads in the chest, it puts pressure on the structures in that area which can cause complications including:

• Swelling of the neck and face caused by pressure on the large vein that leads from your upper body to your heart
• Pain caused by pressure on the nerves and spinal cord
• Accumulation of fluid in the chest which can make breathing difficult
• Difficulty breathing
• Chest pain
• Difficulty swallowing

Mesothelioma is an aggressive, but manageable, malignancy. While mesothelioma is not often diagnosis until it is in its advanced stages and there is no cure at this time treatment, options are available. These treatments may include surgery, chemotherapy, and radiation therapy. There are also newer medications available.

Talk to your doctor about treatment options. Some people may choose aggressive treatment for their cancer while others prefer treatments that make them comfortable so that they can live their remaining time as symptom-free as possible. There are no right or wrong answers, only choices.

Treatment Options

• Radiation Therapy
  Radiation therapy is often used in conjunction with other treatment methods like surgery and chemotherapy. Radiation therapy focuses high-energy beams, such as X-rays, to a specific spot or spots on your body to reduce signs and symptoms of pleural mesothelioma. Radiation therapy is sometimes used after biopsy or surgery to prevent mesothelioma from spreading to the surgical incision.
• Chemotherapy
  

  Chemotherapy uses chemicals to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of a mesothelioma that can't be removed using surgery. Chemotherapy may also be used before surgery to make an operation easier or after surgery to reduce the chance that cancer will return.

  Chemotherapy drugs may also be heated and administered directly into the abdominal cavity of peritoneal mesothelioma, or into the chest cavity in the case of pleural mesothelioma.

• Chemotherapy

  Chemotherapy uses chemicals to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of a mesothelioma that can't be removed using surgery. Chemotherapy may also be used before surgery to make an operation easier or after surgery to reduce the chance that cancer will return.

  Chemotherapy drugs may also be heated and administered directly into the abdominal cavity of peritoneal mesothelioma, or into the chest cavity in the case of pleural mesothelioma.

• Surgery
  

  Surgeons work to remove mesothelioma when it's diagnosed at an early stage. Sometimes it isn't possible to remove all of the cancer. In those cases, surgery may help to reduce the signs and symptoms caused by mesothelioma spreading in your body. In some cases this may cure the cancer.

• Surgery to decrease fluid buildup where a tube or catheter is inserted into the patient’s chest to drain the fluid. Doctors may also inject medicine into the patient’s chest to prevent fluid from returning.
• Surgery to remove the tissue around the lungs or abdomen won’t cure mesothelioma, but may relieve signs and symptoms.
• Surgery to remove as much of the cancer as possible allows doctors to more accurately direct radiation treatments to relieve pain and fluid buildup caused by mesothelioma.
• Surgery to remove a lung and the surrounding tissue may relieve signs and symptoms of pleural mesothelioma. If you'll be receiving radiation therapy to the affected area after surgery, this procedure will allow the doctors to use higher doses, without the worry of protecting your lung from damaging radiation.

A diagnosis of mesothelioma can be devastating to the person diagnosed and for their family and friends. Some suggestions to help you cope include:

• Educate yourself. Learn enough about mesothelioma to make decisions about your care. Write down questions and bring them to your doctor and treatment team. Use the internet to find information on the disease from credible sources including the National Cancer Institute and the American Cancer Society.
• Find Support. Use or create a support network that can include coworkers, church members, close friends or family. These people can help you with everyday tasks including appointments and treatment. Don’t be afraid to ask for help and don’t be afraid to accept it.
• Seek out other people with cancer. Look for cancer support groups in your community and online. Ask your health care team for suggestions. Support groups can answer questions that can other people with cancer can understand.
• Plan ahead. It may be hard to do, but ask your health care team about advance directives. Taking these steps now will give your family guidance on your medical choices if or when you can no longer speak for yourself.

Sources: Mayo Clinic, Mesothelioma.com and the American Cancer Society

Medical treatment costs can be significant with a mesothelioma diagnosis. Individuals diagnosed with mesothelioma that have been known to be exposed to asbestos may be eligible for financial compensation from asbestos manufacturers for their illness to help offset those costs. Talk to your doctor, search online or consult an attorney who specializes in medical cases.