- mesothelioma -

- INFORMATION and some LINKS-

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What should one ask one's doctor?, What is the main cause of Mesothelioma, Signs of the disease, Diagnosis, Stages, Pathophysiology, Incidence, Risk Factors, History, Treatment, Legal Issues, External Links

Mesothelioma is a rare cancer of the lining of the lung or abdomen. The material, Asbestos has been the
only known cause of mesothelioma since 1960. A material used by builders, and many other trades, for a large number of years, and still used to a large extent, in some lands, with even weaker, controls, than what a re usually the richer western lands. But some poorer lands, have also restricted the material. The major development in the reports that stated that asbestos was a cause, was on, 2 refinery foreman in Texas who were diagnosed with mesothelioma in 1958, with an article about their diagnosies published in 1960. If you or someone in your family has found out they have mesothelioma, treatment & care is priority number 1.

Mesothelioma victims aswell as their families may be entitled to compensation and many firms provide lawyers. But it is important not to allow the compensation costs to simply go to pay the legal bill of a lawyer, but it is important to get a decent lawyer.

What should one ask one's doctor?,


What Should one ask one's Doctor / Clinician / Social worker, health advisor about mesothelioma?

Clich here for more detail on cancer .org from What_should_you_ask_your_physician_about_malignant_mesothelioma

As someone copes with cancer, discussions should be open and free. It is important for the patient to be able to ask any question. eel free to ask any question on their mind. on your mind no matter how small it might seem.

1. What kind of mesothelioma do I have? (There are different types of mesothelioma usch as peritoneal mesothelioma and pleural mesothelioma).

2. Has my cancer spread beyond the primary site?
3. What is the stage of my cancer and what does that mean for me?
4. What treatment options are there?
5. What do you recommend and why?
6. Based on what you've learned about my cancer, what is the prognosis for me?
7. What risks or side effects are there to the treatments suggested for me?
8. What are the chances my cancer will come back for each of these treatments?
9. What should I do to be ready for treatment?
Plus write down some of your own. For instance, recovery times. Or, you may want to ask about second opinions or clinical trials possibilities.

The main cause of Mesothelioma.

Exposure to asbestos is responsible for up to 9 out of 10 mesothelioma cases. There are other rare causes of the disease but none are fully understood at present. The disease has been described in medical literature since 1870, but the first suspicion linking mesothelioma & asbestos did not appear in Britain, till 1935, and a definite link not reported untill the sixties.

Mesothelioma information
It is a rare type of cancer, usually associated with exposure to asbestos. In this disease, malignant (cancerous) cells develop in the mesothelium, a protective lining covering the internal organs. The most common site is the pleura which is the outer lining of the lungs and chest cavity, but it can also occur in the peritoneum which is the lining of the abdominal cavity or the pericardium a sac surrounding the heart. Most people who develop mesothelioma worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Manufacturing and Construction workers are vulnerable to the disease.

Symptoms of the disease
Signs of mesothelioma may not appear until 30-50 years after being exposed to asbestos. Shortnening of the breath, & pains in the chest, caused by an accumulating of fluid in the pleural space are main symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma can vary but include cachexia, weight loss, abdominal swelling and pain due to ascites, a buildup of fluid in the abdominal cavity. Other signs of peritoneal mesothelioma are bowel obstruction, blood clotting abnormalities, anemia, & fever. If cancer spreads beyond mesothelium, symptoms can include pain, trouble swallowing, or swelling of the neck and even, or just on it's own, face. The symptoms can be caused by mesothelioma or by other, less conditions.

How is Mesothelioma diagnosed?
Its seen to be a cancer affecting the mesothelium, a thin membrane lining the inner surface of the chest wall, where it is known as the pleura, and abdomen, where it is known as the peritoneum. It also surrounds organs found within these cavities for example the heart, lung and intestines. It is more common to have mesothelioma in the chest than abdomen. There is approximately 1 case of peritoneal mesothelioma for every 12 cases of pleural mesothelioma. Mesothelioma is not easy to diagnose. Often a number of investigations and hospital visits are required.
Diagnosing mesothelioma is usually hard, because the symptoms are similar to many illnesses. Tests starts with reviewing the patient's medical history, occupational exposure to asbestos may increase clinical suspicion for mesothelioma. Then a physical examination is performed, followed by chest X - ray and often lung function tests. X-rays may reveal pleural thickening commonly caused by asbestos exposure and thus this can increase suspicion of mesothelioma. A CAT or CT scan or an MRI is in gernral performed. If fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. Absence of malignant cells on cytology does not completely exclude mesothelioma, but it makes it much more unlikely, especially if an alternative diagnosises can be made such as tuberculosis or heart failure. If cytology is positive or a plaque is regarded as suspicious, then a biopsy is required to confirm diagnosis of mesothelioma. A doctor removes tissue sample for examination under a microscope by a histopathologist. A biopsy is done in different ways, depending on where the abnormal area is located. If cancer is in the chest, a doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor can perform a laparoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument in the abdominal cavity. If these procedures cannot yield enough tissue, more extensive diagnostic surgery could be needed. There is not a universally agreed method for screening people who have been exposed to asbestos. However research indicates that the serum osteopontin level might be useful in screening asbestos exposed people for mesothelioma. The level of soluble mesothelin related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening.

Stages of Mesothelioma
If diagnosis is confirmed, a qualified doctor should assess the stage to help plan treatment. Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surfaces to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

Incidence
Although reported incidence rates increased in the past twenty years, mesothelioma is still a rare cancer. Incidence is approximately one per million. Populations with high levels of smoking can have a lung cancer incidence of over 1,000 in 1,000,000. Incidence of malignant mesothelioma currently ranges from 7 to 40 in 1,000,000 in Western nations, depending on the amount of asbestos exposure of the population during the past several decades. It was estimated incidence may have peaked at 15 per 1,000,000 in the US in 2004. Incidence is expected to continue increasing in other areas of the world. Mesothelioma occurs more often in males than in females and risk increases with age, but this disease can appear in either males or females of any age. Approximately one fifth to one third of mesotheliomas are peritoneal.

Risk factors
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any obvious exposure to asbestos.

Asbestos is the name for a group of minerals occuring naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

The combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer, bronchial carcinoma).

Some studies suggest simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma[4].
Generally, asbestos is only a risk if you disturb or damage it & cause fibres to be released to the air. If asbestos containing materials are in good condition and positioned where they are not going to be disturbed or damaged, it may be safer to leave them where they are , and then call for asbestos experts, and ensure any risks are properly managed. Professional advice should be sought. Asbestos was used in many different products and buildings from the fifties to the mid eighties. Many homes may, therefore, contain asbestos containing material.

If you are concerned about asbestos in your home or at work, and the potential removal, contact the Local Council.


History
Asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II.

Exposure to asbestos fibres has been recognised as an occupational health hazard since the 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques and diffuse pleural fibrosis, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours and diffuse mesothelioma of the pleura and peritoneum. Commercial asbestos mining at Wittenoom, Western Australia, occurred between 1945 & 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to MM had occurred by 1985.

In 1962 Dr McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker. The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.

In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 a article in the British Journal of Industrial Medicine established, people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.

Despite proof that the dust associated with asbestos mining and milling causes asbestos related disease, mining began at Wittenoom in 1943 and continued until 1966. It is difficult to understand why the mine and mill was allowed to initially open and operate without adequate risk control measures; and why nothing was done to force the owner (CSR) to clean them up, adopt safer work practices or close down their operations.

In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information.

By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.

Asbestos is a natural fibrous mineral that is widely distributed in nature. The name derives from the Greek explanation of the word ‘inextinguishable’, which suggests an ability to resist heat and fire was always been understood. It is the ability to resist heat and fire that resulted in asbestos being used widely in industry, shipbuilding and construction particularly during and after World War II. Currently the largest producers of asbestos are Russia, China and Canada. Russia and China use a majority within their own country however Canada dominates the export market. There are still over 100 countries producing asbestos containing pipes & sheets to be used as low cost building material.

There are three main types of asbestos, blue (crocidolite), brown (amosite) and white (Chrysotile). They are all harmful but blue and brown asbestos are recognised as the most hazardous and have not been imported into the UK since 1985. White asbestos was only banned in the U.K. in 1999.


Treatment
Treatment of MM using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.


Surgery
Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing.

Radiation
Although the tumor is highly resistant to radiotherapy and chemotherapy, these regimens are sometimes used to relieve symptoms arising from tumour metastases such as obstruction of a major blood vessel.


Immunotherapy
Treatment regimens involving immunotherapy yielded variable results. Intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient, while it may benefit patients with bladder cancer. Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this therapy experienced major side effects. The trial was suspended in view of unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Other trials involving interferon alpha proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.


Heated Intraoperative Intraperitoneal Chemotherapy
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute. The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained. This technique permits administration of high concentrations of selected drugs into abdominal and pelvic surfaces. Heating chemotherapy treatment increases penetration of drugs into tissues. Also, heating itself damages the malignant cells more than normal cells.


Legal issues

In the United States, the average mesothelioma-related settlement was a million dollars; for cases that go to trial awards averaged six million dollars, according to a investigation by the RAND Corporation. Only a small fraction of thousands of asbestos-related lawsuits in the US every year are related to mesothelioma. In 2004, a bill in the United States Senate aimed an asbestos litigation reform failed to reach a floor vote. In January of 2005, Senate Judiciary Committee Chairman Arlen Specter announced he would again try to pass an asbestos litigation reform bill.

A separate bill introduced on the 17th of March , 2005, the Fairness in Asbestos Injury Resolution Act of 2005 (FAIR act of 2005), seeks to ensure a set amount of compensation dependent on symptoms of the victim. The range is from Medical Monitoring for victims with Asbestosis or Pleural Disease to $35,000 for victims with Mixed Disease With Impairment reaching to over $1,000,000 for Mesothelioma victims and nonsmoking Lung Cancer victims. FAIR act of 2005, full text. FAIR act of 2005. There have been many documentries, in Britain, and America on the subject on the dangers, of Asbestos, and still today there are places built out of teh substance, indeed the work place where I used to work, has a asbestos garage, but they planned to take this down, and stuck stickers, around the place stating it had that material, with investigators used to see how much there was, and decide what to do.


Our links

http://en.wikipedia.org/wiki/Mesothelioma Wilkpedia information on Mesothelioma

http://www.mesolink.org/

http://www.marf.org/ Mesothelioma Applied Research Found

What_should_you_ask_your_physician_about_malignant_mesothelioma_29.asp?sitearea=

Mesothelioma: Questions and Answers from the National Cancer Institute
American Cancer Society
Asbestos Newspaper Archive Free archive of 50,000 newspaper pages dedicated to Asbestos
Cancer.gov: Malignant Mesothelioma
CancerBACUP: Mesothelioma Information Centre
Medlineplus: Mesothelioma
Worksafe, Western Australia

http://www.cancer.org/docroot/home/index.asp Cancer

http://www.mesothelioma.uk.com Mesothelioma UK

http://www.nccc.org/ Northern Californian Cancer Center

Common misspellings of Mesothelioma: MesotheliomaMessofelimia, messothemilia, Mesiothemila, Mesothelima, Messothelima, Messothelima, Messothemlina, MESOTHELIMA, MESOTHELIOMAA, MASOTHELIOMA, Abestos, Asbestas, Asbeastos, Meslopthain. Mesotheolima, Mesohtimal;ima, Mesotheolmima, Mesothemelina