Malignant mesothelioma, otherwise known as mesothelioma cancer, commonly develops in the lungs of people exposed to asbestos. Effective treatments are available to ease symptoms and improve your prognosis.
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The cancer usually affects the thin, protective membrane surrounding the lungs, heart or abdominal cavity. Doctors diagnose an estimated 3,000 cases a year in the United States, and the majority of those are traced to job-related asbestos exposure.
Although asbestos use declined dramatically in recent decades in this country, the incidence of malignant mesothelioma remains steady. That difference can be traced to the distinct latency period linked to the cancer. The disease can take anywhere from 20 to 50 years after exposure to asbestos before it shows obvious symptoms and an oncologist can make a definitive diagnosis. While no cure for the disease exists and the prognosis is typically poor, researchers made significant progress in recent years in understanding the cancer and developing new treatment options and alternative therapies.
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How Asbestos Causes Cancer
Mesothelioma typically develops after exposure to asbestos in the workplace – in industrial settings, shipyards, auto repair shops, old houses, schools and public buildings. While it usually takes long-term exposure to put someone at risk, short-term and one-time exposures are also known to cause mesothelioma cancer.
70-80% of all mesothelioma cases are caused by asbestos exposure at work
Asbestos inhalation occurs
Fibers lodge in mesothelial tissue
Fibers cause cellular damage, resulting in tumor growth
Dr. Fontaine explains what mesothelioma is.
Microscopic asbestos fibers are breathed in or swallowed, and the human body has difficulty destroying or getting rid of them. Over decades, fibers cause biological changes that result in inflammation, scarring and genetic damage. The most susceptible area to these fibers is the lining of the lungs, called the pleura, although fibers also can become trapped in the lining of the abdominal cavity (peritoneum). Once fibers cause biological damage, the stage is set for the decades-long latency period for the development of malignant mesothelioma.
Pleural malignant mesothelioma is the most common type of the disease, representing about 75 percent of cases. Peritoneal is the second most common type, consisting of about 10 to 20 percent of cases. Approximately 1 percent of cases are of the pericardial variety. Another rare type known as testicular mesothelioma represents less than 1 percent of cases.
This type forms in the lining of the lungs. An increased incidence rate led to more studies to improve treatment methods and survival rates.
Developing in the lining of the abdominal cavity, peritoneal cancer responds best to a combination of surgery and heated chemotherapy.
Emerging from the lining of the heart, pericardial cancer is the most challenging to treat because of where tumors are located.
Symptoms of malignant mesothelioma cancer are so mild that few people notice or recognize them, and many don't experience any of them until later stages of the cancer. Fatigue and slight pain around the tumor may surface in early stages. Late-stage symptoms are more noticeable and commonly provoke someone to visit the doctor.
These late-onset signs can include shortness of breath, chronic pain near the tumor, weight loss, fluid buildup or bowel obstruction. Effective therapies can relieve symptoms, and some treatments, like talc pleurodesis, can even prevent symptom recurrence.
- Pain Near Tumor
- Shortness of Breath
- Weight Loss
- Fluid Buildup
- Bowel Obstruction
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How It is Diagnosed
All patients have a unique path to a diagnosis, but the most important factors to an accurate diagnosis are imaging scans and biopsies. Doctors use several tests to diagnose malignant mesothelioma.
Most people initially undergo a basic chest X-ray to check for any abnormalities. If abnormal growth is detected, a doctor will recommend a more detailed imaging scan like a PET scan, CT scan or MRI.
If cancer is suspected, a biopsy will be recommended. In a biopsy, a tissue sample is collected to confirm the presence of mesothelioma cells.
Blood tests are also available, but they do not confirm the presence of mesothelioma. Research and development is underway to determine if blood tests can aid in early diagnosis for at-risk former asbestos workers.
There are at least five systems that doctors use for the staging of pleural cancer. Older systems like those created by Drs. Butchart and Sugarbaker did not classify tumors with tumor-node-metastasis (TNM) descriptors, so the International Mesothelioma Interest Group (IMIG) developed the detailed IMIG staging system in 1995. This system is the most widely used staging system for mesothelioma.
Treatment options for mesothelioma include surgery, chemotherapy and/or radiation therapy. Many specialists prefer to combine two or more of these treatments, an approach known as multimodal therapy. Clinical trials show this approach has improved survival rates.
Palliative treatments that ease symptoms are quite common for patients of all stages, and experimental therapies like immunotherapy show progress for the future. Additionally, many survivors tout less-traditional alternative treatments for helping them to live longer.
Curative surgery is available for early stage patients, while palliative surgery is best for late-stage patients and helps to ease symptoms.
Chemotherapy is a standard treatment to kill malignant cells, shrink tumors, prevent recurrence and relieve symptoms.
Radiation therapy is used alone or in combination with chemotherapy or surgery to kill cancer cells, manage tumors and prevent tumor seeding.
Asbestos-related cancer specialists encompass a number of specialties, including surgeons, medical and radiation oncologists, radiologists, pathologists and palliative care specialists. All can be part of a treatment team. Working with a doctor who has experience with mesothelioma treatment can make all the difference.
Top Treatment Centers
The most-regarded treatment centers attract patients from across the country. Renowned for their cutting-edge technology and groundbreaking research, these centers connect patients with a multidisciplinary team of physicians with years of experience in treating asbestos-related diseases.
Research & Clinical Trials
Funding for mesothelioma research falls far short of that for other cancers, but new drugs and treatment options are facilitated through important clinical trials. These experimental studies are small and controlled opportunities for scientists to develop effective drugs like Cisplatin and Carboplatin. New cutting-edge clinical trials are being introduced all the time at cancer centers around the world.
How Do I Pay for Treatment?
If diagnosed, individuals should consider taking steps to protect themselves legally and financially. Treatment is expensive, and insurance companies may not always cover the cost of experimental treatments or some diagnostic tests that a doctor recommends. Patients who do not have medical insurance will face an even harder battle.
Trust Funds for Mesothelioma
Financial assistance may be available to people who were exposed to asbestos while on the job. Some corporations set up trust funds specifically for those injured by their asbestos products.
VA Claims & Benefits
Veterans who served in the U.S. Armed Forces between 1940 and 1970 may be eligible for Veteran Affairs (VA) benefits that cover asbestos-related diseases.
Prognosis is most affected by the stage cancer. Both early and late-stage cancers have treatment options that can help. Many patients can live longer than their doctors first estimate, and such outcomes depend on a number of prognostic factors.
- Stage of cancer
- Type of mesothelioma
- Tumor cell type
- Overall health
- Size and location of tumor
- Blood characteristics
Despite the often poor prognosis of someone who has malignant mesothelioma, there are a number of encouraging stories of success – bios of people who live to celebrate special days with spouses, kids and grandkids. Each survivor has a tale to tell, and there is something to take away from every story.
Many people with malignant mesothelioma enjoy legal rights because of the cause of the disease - exposure to asbestos. Options include filing a claim with an established asbestos trust fund or filing a lawsuit against the company or companies believed to be responsible for the exposure. A winning claim, a winning lawsuit or a case settlement can help families recoup medical expenses and can secure financial future.
Fast Fact: A 2011 report from the Government Accountability Office reported that $36.8 billion remained in asbestos trusts. This money was set aside to help compensate patients and their families.
These legal options exist because of liability. Asbestos-related diseases are considered 100 percent preventable. Asbestos mining companies, manufacturers of asbestos-containing products, and employers who did not inform workers about potential exposure all could have some liability issue if they fail to prevent exposure to asbestos. Communicating with an experienced lawyer helps patients and families understand how legal options can help cover other damages.
Most asbestos-disease-related lawsuits are settled out of court - before they to go trial. A paper trail of occupational exposure can lead defendants to get out from under lawsuit costs as soon as possible. Settlements can range from moderate to large sums.
The outcome of an asbestos-related lawsuit can vary because each case comes with its own set of facts, but juries have returned with verdicts of $337.million (for Alfred Todak), $30.3 million (for Susan Buttitta) and $22 million (for Eugene McCarthy and Walter Koczur).
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Researchers at the National Cancer Institute recently uncovered a better way to use immunotoxin drugs like SS1P to kill malignant cancer cells without harming the healthy ones. The key was finding the right drug combination to work as immune suppressors, which allowed the immunotoxin to work more effectively. The results were impressive, as a large percentage of patients with advanced mesothelioma found their tumors shrink during a recent trial with SS1P.
University of Pennsylvania researchers also came up with a recent advancement in the staging of the cancers, which should allow doctors to diagnose the disease earlier and treat it more effectively. Their study involved previously overlooked posterior intercostal lymph nodes, which were examined for the first time in patients who had undergone radical pleurectomies.