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Mesothelioma Frequently Asked Questions (FAQ)
In dealing with the fear and apprehension that invariably accompanies a diagnosis of cancer, knowledge is power. By gaining a better understanding of your condition, you will be able to play a more active role in its treatment. This in turn will enable you to live as normal a life as possible as you deal with the disease.
What follows are the most common questions asked regarding mesothelioma, its causes, prognosis and treatment.
What is mesothelioma?
Mesothelioma (mez-oh-thee-lee-OH-muh) is specific type of cancer which invades the mesothelium. As with all cancers, it consists of cells that begin to grow in an uncontrolled manner. As these cells grow and multiply, they damage the healthy tissue around them. Cancer can metastasize, or spread from their place of origin, affecting other parts of the body. Mesothelioma starts in what is known as the pleura, or peritoneum.
What is the mesothelium?
It may be helpful to think of the mesothelium as a lubricant, like that found in machinery. Many internal organs are in contact with each other, and therefore require a lubricant layer in order to move easily against each other without causing irritation.
This is the function of the mesothelium. If you are familiar with automobile engines, it may help to think of the mesothelium as “Slick 50” for your internal organs.
The peritoneum is a specific type of mesothelium that covers the organs located inside abdominal cavity (the stomach, intestines, liver, etc.) The pleura is yet another type, covering the lungs and the inner walls of the chest cavity. (You may have heard of pleurisy, which is an inflammation of this lining, and is often fatal). Human reproductive organs have yet another type of mesothelium.
Is mesothelioma common?
While cancer diagnoses have increased dramatically over the past quarter century (over 25% of the U.S. population will suffer from some type of cancer in their lifetime), mesothelioma is still relatively rare. Around 2,000 new cases are reported in the U.S. every year; most of these patients are older men. However, women are also known to suffer from the disease, and it can strike at any age.
What causes mesothelioma?
Those who have been exposed to asbestos are most likely to develop mesothelioma. 70 to 80% of all mesothelioma cases diagnosed are in patients who had worked with the substance at some point in their lives. There have been cases in which the patient had had no known asbestos exposure, however.
Tobacco usage by itself does not increase the likelihood of contracting mesothelioma, but smokers who are exposed to asbestos run a far greater risk of lung cancer.
What is asbestos?
Asbestos refers to a group of naturally occurring minerals that have long been known to have useful properties such as strength, flexibility, and heat resistance. These minerals are essentially a type of stone that can be woven into fabric and used in construction materials.
How is asbestos used?
In addition to construction materials, asbestos has also been used in automotive brake linings, gaskets and fire resistant fabrics. It was also used in vermiculite, or talc products.
The use of asbestos in manufacturing has been outlawed in the U.S. since 1989; however, it is still present in products and buildings constructed prior to that time.
When and where does asbestos exposure occur?
Almost everyone is exposed to low levels of asbestos in their lives. It exists in the air at extremely low concentration; levels are highest in urban and industrial areas. These fibers are released into the air during demolition work, remodeling, or other activity in which the material containing asbestos is disturbed.
Asbestos may occur in tap water where such water passes through cement pipes containing the substance.
The greatest exposure occurred in industries in which asbestos was commonly used prior to 1989, including ship building, mining and the manufacture of heating products.
Who is at risk for mesothelioma?
Those who have worked in building, construction and demolition, or in the manufacture of products that involve heating or are designed for heat exposure have an elevated risk for developing this disease.
The longer and more concentrated the exposure, the greater the risk of contracting the disease. However, there have been cases of mesothelioma in patients who had little or no exposure. Conversely, not everyone who is exposed to the substance develops the disease.
The U.S. Occupational Safety and Health Administration (OSHA) has set limits for asbestos exposure in workplaces, as well as safety regulations. Asbestos workers are required to have protective equipment. Because family members and those who live with asbestos workers risk exposure because of asbestos residue on clothing and in hair, asbestos workers are usually required to shower and change clothing before leaving the workplace.
What are common symptoms of mesothelioma?
Symptoms of mesothelioma usually do not appear until decades after initial exposure. In addition, many symptoms mimic those of other, less serious conditions.
Nonetheless, if you experience any of the following symptoms, you should see a physician at the earliest opportunity:
- shortness of breath
- chest pain, especially after exertion
- unusual weight loss
- abdominal pain
- bowel obstruction
- abnormal blood clotting or excessive bleeding
- anemia (unusual fatigue and listlessness)
If the cancer has metastasized, you may also experience neck and/or facial pain and difficulty in swallowing.
How is one diagnosed for mesothelioma?
Diagnosing mesothelioma can be challenging. Generally, a physician will perform a full physical exam during which s/he may take x-rays of the chest and abdomen and test for respiratory (lung) function. X-rays may be supplemented with advanced imaging techniques such as a CAT scan or an MRI.
If your physician has concerns, s/he will refer you to an oncologist, or cancer specialist. This person will take a biopsy, or tissue sample from inside your chest or abdomen, which will be examined under a microscope.
If the pathologist finds that mesothelioma is present, the oncologist will need to determine whether the disease is localized (present only on the mesothelium) or advanced (has spread to other parts of the body.
What treatment options are available for mesothioma?
Treatment will depend on the stage of the disease. If it is localized, surgery is the normal procedure. The oncologist will remove the affected part of the chest lining and surrounding tissue. If the pleura is affected, it may necessitate a pneumonectony, or removal of a lung, as well as part of the diaphragm.
Radiation therapy is another option. This procedure uses targeted ionizing radiation (similar to that present in nuclear reactors) to destroy malignant cells.
If the cancer has metastasized, chemotherapy – the use of specific anti-cancer medications – is the best option.
Relief of pain and other symptoms is usually done by draining fluid from the chest or abdomen. These involves inserting a small tube, and is known as thoracentisis or paracentisis.
What mesothelioma research is being done?
Currently, the National Cancer Institute (NCI) is sponsoring clinical trials that are attempting to find alternative treatments as well as improve present ones. If you are interested in participating, discuss this with your doctor, then call 1-800-4CANCER.
You can also find more information on the World Wide Web by going to http://www.cancer.gov. Here, you will find news on clinical trials and a catalogue of useful publications. Those considering participating in a clinical trial should order and read Taking Part in Clinical Trials: What Cancer Patients Need To Know in order to understand the benefits and risks.
- National Cancer Institute. “Mesothelioma: Questions and Answers”. Cancer.gov.
- Agency for Toxic Substances and Disease Registry. “ToxFAQs™ for Asbestos”. Department of Health and Human Services. January 31, 2007.
- Agency for Toxic Substances and Disease Registry (ATSDR). 2001. Toxicological Profile for Asbestos. Update. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service.