Mesothelioma

The early symptoms of mesothelioma are generally non-specific, and may lead to a delay in diagnosis. Sometimes resembling viral pneumonia, pleural mesothelioma patients may present with shortness of breath, chest pain and/or persistent cough; some patients show no symptoms at all. A chest x-ray may show a build-up of fluid or pleural effusion (discussed below). The right lung is affected 60% of the time, with involvement of both lungs being seen in approximately 5% of patients at the time of diagnosis. Less common symptoms of pleural mesothelioma include fever, night sweats and weight loss. Symptoms of peritoneal mesothelioma may include pain or swelling in the abdomen due to a build-up of fluid, nausea, weight loss, bowel obstruction, anemia or swelling of the feet.

PLEASE KEEP IN MIND THAT THESE SYMPTOMS MAY BE CAUSED BY MESOTHELIOMA OR BY OTHER LESS SERIOUS CONDITIONS. ONLY A DOCTOR CAN MAKE A DEFINITIVE DIAGNOSIS.

Information on the symptoms, diagnosis, staging, and treatment of peritoneal mesothelioma.

Information on the symptoms, diagnosis, staging, and treatment of pleural mesothelioma.
Pleural Effusion

One of the most common symptoms of mesothelioma is a pleural effusion, or an accumulation of fluid between the parietal pleura (the pleura covering the chest wall and diaphragm) and the visceral pleura (the pleura covering the lungs). Both of these membranes are covered with mesothelial cells which, under normal conditions, produce a small amount of fluid that acts as a lubricant between the chest wall and the lung. Any excess fluid is absorbed by blood and lymph vessels maintaining a balance. When too much fluid forms, the result is an effusion.
Types

Pleural effusion is broken down into two categories, transudates and exudates. A transudate is a clear fluid that forms not because the pleural surfaces are diseased, but because of an imbalance between the normal production and removal of the fluid. The most common cause of transudative fluid is congestive heart failure. An exudate, which is often cloudy and contains many cells and proteins, results from disease of the pleura itself, and is common to mesothelioma. To determine whether a fluid is a transudate or exudate, a diagnostic thoracentesis, in which a needle or catheter is used to obtain a fluid sample, may be conducted.
Symptoms

As the volume of fluid increases, shortness of breath, known as "dyspnea", and sometimes pain, ranging from mild to stabbing, may occur. Some patients may experience a dry cough. When the doctor listens to the patient’s chest with a stethoscope, normal breath sounds are muted, and tapping on the chest will reveal dull rather than hollow sounds.
Diagnosis

Diagnosis of pleural effusion is usually accomplished with a simple chest x-ray, although CT scans or ultrasound may also be used. A special x-ray technique, called a lateral decubitus film, may be used to detect smaller effusions or to enable the physician to estimate of the amount of fluid present. If the underlying cause of the effusion is readily apparent (such as in the case of severe congestive heart failure), sampling of the fluid may not be necessary, however, because pleural effusion may be symptomatic of a number of disease processes from benign to malignant, a fluid sample is generally taken. Diagnostic thoracentesis, in which cells are extracted from the pleural cavity, is commonly done when the possibility of mesothelioma exists, however, in up to 85% of cases, the fluid tests negative or inconclusive even though cancer is present. It is ultimately a needle biopsy of the pleura (lining of the lung) or an open surgical biopsy which confirms a mesothelioma diagnosis.
Treatment

Pleural effusion caused by heart failure or infection can usually be resolved by directing treatment at the cause, however, when testing has realized no diagnosis, and fluid continues to build or recur, doctors may recommend chest tube drainage and chemical pleurodesis. Chemical pleurodesis is a technique in which a sclerosing agent is used to abrade the pleural surfaces producing an adhesion between the parietal and visceral pleurae. This will prevent further effusion by eliminating the pleural space. Talc appears to be the most effective agent for pleurodesis, with a success rate of nearly 95%. It is highly effective when administered by either poudrage or slurry. Poudrage is the most widely used method of instilling talc into the pleural space. Before spraying the talc, the medical team removes all pleural fluid to completely collapse the lung. After the talc is administered, they inspect the pleural cavity to be sure the talc has been evenly distributed over the pleural surface. Some doctors prefer to use talc mixed with saline solution which forms a wet slurry that can roll around the pleural cavity.

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# posted by QinX @ 10:18 PM 0 Comments

*Causes of Mesothelioma

At some point in our lives, nearly all of us have been exposed to asbestos in the air we breathe and the water we drink; from natural deposits in the earth, and from the deterioration of asbestos products around us. Most of us, however, do not become ill as a result of our exposure. More commonly, those who at some point are diagnosed with asbestos disease, have worked in jobs where more substantial exposure occurred over longer periods of time. Nevertheless, cases of mesothelioma have been documented as the result of lesser exposure, affecting family members of workers who came into contact with asbestos and brought it home on their clothing, skin or hair, or affecting those who lived in close proximity to asbestos manufacturing facilities. Symptoms of asbestos disease usually are not be apparent until decades after exposure.

Asbestos was used commercially in North America as early as the late 1800s, but its use increased dramatically during the World War II era when shipyards produced massive numbers of ships for the war effort. Since that time, asbestos-containing products were used by the construction and building trades, the automotive industry and the manufacturing industry. All told, more than 5,000 products contained asbestos.

For more than 50 years, products containing asbestos remained unregulated, and the manufacturers of those products continued to prosper, knowing full well that many of the millions of workers who came into contact with their products would ultimately suffer as the result of their actions. Finally, in the late 1970s, the Consumer Products Safety Commission banned the use of asbestos in wallboard patching compounds and artificial ash for gas fireplaces because the fiber could easily be released during use. In 1989, the Environmental Protection Agency banned all new use of asbestos, but uses established prior to that time were still allowed. Although awareness of the dangers of asbestos and public concern over the issue have led to a decline in domestic consumption over the years, a total ban on asbestos has not come to fruition. Asbestos is still imported, still used and still dangerous.

Although it is suggested that the number of mesothelioma cases in the U.S. has reached its peak and has begun to drop, a forecast released by the National Cancer Institute's Surveillance, Epidemiology, and End Results Program (SEER), in April, 2003, projected the total number of American male mesothelioma cases from 2003-2054 to be approximately 71,000. This number, however, does not take into consideration events such as the World Trade Center disaster on September 11, 2001, when millions of New Yorkers were potentially exposed to air filled with carcinogenic asbestos particles. The incidence of mesothelioma cases by state and county are shown in these tables. When the latency period for asbestos disease is factored in, cases of mesothelioma will continue to be diagnosed for years to come. See our page on mesothelioma risk factors.

Does exposure to asbestos always cause mesothelioma? No, less than 10% of people with a history of heavy asbestos exposure develop mesothelioma. But 80% of those with pleural mesothelioma have a demonstrated history of asbestos exposure. There is no doubt that exposure to asbestos fibers increases the risk of mesothelioma. This is why you should mention any history of asbestos exposure to a doctor attempting a diagnosis.
Questions Regarding the Risk Level of Asbestos Exposure

Research data has shown that there is a definite correlation between exposure to asbestos particles and asbestos-related diseases, especially for those that are exposed to the fibers in their workplace. Even though data shows a connection between these factors, there is ongoing debate as to just "how much of a risk is present" in environments where asbestos fibers can be found.

Questions have been raised because some of the factors relating to asbestos exposure can vary considerably sometimes making it difficult to define absolute asbestos-related exposure relationships. Some of these variables include asbestos fiber sizes and types, the type of asbestos-related disease, and the duration and level of exposure to the fibers.

Even with the uncertainty, progress has been made in regards to these variables and their effects on human health over the last 25 years. This information may present an issue for regulating authorities and agencies because it may require a deviation from their current opinions on asbestos exposure and its effects on health.
Differing Characteristics of Asbestos Fibers as They Relate to Health Conditions

People that have inhaled asbestos fibers have been shown to develop health conditions such as asbestosis, mesothelioma, and lung cancer. There is confusion as to which asbestos types pose a greater risk of asbestos-related disease and to what degree. Additionally, there are questions regarding which exposure conditions present this risk.

One problem in regards to establishing clear-cut asbestos-related factors may be the use of the term "asbestos", as a catch-all or general term used to represent various asbestos fibers that have different toxic characteristics and tendencies that cause related diseases.

More than 150 studies of asbestos particles has been used to determine the relationship between incidences of asbestos disease and suspected factors; however, this research has had little value in determining level of risk due to limited data on levels of human exposure, fiber types, and other possible contributing factors (i.e. smoking or other lifestyle practices). Other obstacles that contribute to the limitations of this research include the use of many different fiber types or the lack of defining fiber types used in studies.

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*Common questions about mesothelioma

What is Mesothelioma? What is the difference between pleural mesothelioma and peritoneal mesothelioma?
Malignant mesothelioma is a disease in which a cancerous tumor grows on the mesothelium - the sac lining the internal body cavities. The specific type of mesothelioma is named for the tissue where the cancer started. Pleural mesothelioma starts in the chest, in the pleura that surrounds the lungs (outer lining of the lungs and internal chest wall). It makes up about 70% of mesothelioma cases. Peritoneal mesothelioma starts in the lining of the abdominal cavity.

pleural cavity

Although sometimes referred to as "asbestos lung cancer", mesothelioma is not the same as lung cancer. Lung cancers occur inside the lung itself; mesothelioma occurs in the lining of the lung. Mesothelioma is rare, striking fewer than 3000 Americans per year.

What happens inside the body?
The cancerous cells clump together in a malignant tumor. As it grows, the tumor pushes against and into other organs and healthy tissue, causing symptoms. Because the mesothelium is a flat thin lining, the mesothelioma tumor often takes a diffuse shape.

In its advanced stage the cancer metastasizes through the lymph system and spreads to other parts of the body. It is still referred to as mesothelioma because it started in the mesothelium.

What are the symptoms of mesothelioma?
Our mesothelioma symptoms page goes into detail about the signs of this cancer. It is important to seek professional medical advice when trying to diagnose for mesothelioma because the symptoms can be confused with symptoms of other diseases.

Major symptoms of pleural mesothelioma include:

* Shortness of breath caused by expanding pleural effusion
* Persistent dry cough
* Chest pain

Major symptoms of peritoneal mesothelioma include:

* Ascites (fluid in the abdomen)
* Swelling or lumps in the abdomen
* Abdominal pain

Some patients experience few of the visible symptoms. Formal diagnostic procedures are needed to determine if the cancer is present.

How do you get malignant mesothelioma?
Mesothelioma is caused by asbestos exposure. Asbestos, once regarded as a miracle mineral, was popular due its lightweight but tough characteristics as well as for its heat-resistant properties. This naturally occurring mineral was used in many commercial and consumer products, from construction materials such as cement, roofing shingles and insulation, to consumer and industrial applications such as hair dryers, automobile brake pads and pipe insulation.
Anatomy of the Lung Mesothelioma and how it effects the lung

Most people with malignant mesothelioma worked on jobs where they breathed asbestos. Others were exposed to asbestos in a household environment, often without knowing it.

How much exposure does it take to get the disease? What is the latency period?
Very little exposure can result in mesothelioma. Sometimes people who worked with asbestos for as little as one or two months get mesothelioma. The "latency period" refers to the time between asbestos exposure and diagnosis of the disease. For mesothelioma, the latency period can be decades long, and people exposed in the 1940s, 50s, 60s, and 70s are now being diagnosed.

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# posted by QinX @ 10:06 PM 0 Comments