What is Mesothelioma?
What is Mesothelioma - Continued
While most cases of mesothelioma occur around the lungs, it can also occur in the abdominal mesothelium, called the peritoneum, or the pericardium. While mesothelioma is most common in the lungs, it is important to differentiate between mesothelioma and lung cancer. They are two very different types of cancer and require different types of treatment.
How Does Asbestos Exposure Occur?
Asbestos is a naturally occurring mineral that has been used for centuries in various products. Asbestos has many attributes that make it valuable, including fire resistance. Asbestos was used in many products that were made for protection from heat and flame. This included actual clothing, such as gloves, to stuffing asbestos insulation into electrical conduit, to using asbestos to make fire proof cloth for use in power plants or petroleum refineries.
Asbestos also has excellent insulation and noise deadening qualities. This meant that asbestos was used in many construction products, including floor and ceiling tiles and wall board. Any home built before 1978 probably contains asbestos somewhere.
Asbestos exposure occurs when the asbestos that is in the products becomes damaged. Once damaged, the asbestos fibers are released into the air. The fibers are microscopic, smaller even than a grain of pollen, and invisible to the naked eye. The asbestos fibers, if inhaled or ingested, can become lodged into the body where it can create severe medical problems.
What is Asbestosis?
Asbestosis is a chronic inflammation of the lungs. The inflammation is a direct result of exposure to asbestos. Asbestosis is a progressive disease with no cure. The inflammation causes shortness of breath, which will get progressively worse as the disease progresses. Physicians can treat some of the symptoms of asbestosis with auxiliary oxygen, but it will not cure the disease. Death due to asbestosis occurs by respiratory failure.
Your Long Term Health
Asbestos related diseases do not show up until decades after exposure. Because of the long latency period between exposure and illness it can be hard to determine if you will suffer from asbestosis or mesothelioma. While asbestos exposure is the only way to develop these health problems, you may reduce or delay their development by taking care of your lungs today.
To protect your breathing:
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If you do smoke, stop. In addition to mesothelioma and asbestosis, there is research that indicates that those who suffer from asbestos exposure and smoke are at a greatly increased risk of developing lung cancer.
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Stay physically fit. Everyone’s definition of physical fitness is different, but up to thirty minutes of activity most days of the week will provide the most benefit. Physical fitness is important for healthy lungs.
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Eat well. While there is no direct correlation proven between diet and mesothelioma or asbestosis, filling your meals with leafy and fibrous vegetables as well as whole grains has been proven to reduce the risk of other types of cancer.
What to do if you Think You May be at Risk?
If you think that you may have been exposed to asbestos at any time, it is important to share your concern with a physician. While asbestosis has no cure, early intervention can slow the progression of the disease. Mesothelioma is a very aggressive form of cancer, and one of the reasons that it has such a low survival rate is because it is not typically diagnosed until the disease is fairly advanced.
If you worked in an industry that has a high rate of asbestos exposure, you should consider yourself at risk of developing an asbestos related disease. Some occupations that had high rates of exposure include ship builders, petroleum plant workers, power plant workers and construction workers.
If you are concerned about asbestos in your home you should research the best remediation methods or hire an experienced contractor to do it for you. Although the remediation is not difficult, you must be careful and follow specific guidelines to reduce the risk of suffering from accidental exposure.
Asbestosis and mesothelioma are both serious conditions that can be a death sentence. While you may not be able to undue previous exposure to asbestos, you can commit to reducing your risk of exposure in the future, and take care of your body so that it will have the best chance of battling any disease that you may develop.
Diagnosing Mesothelioma
Basic Diagnosis
Diagnosing mesothelioma often means ruling out many diseases with similar symptoms before completing the diagnostic process. The initial diagnosis of mesothelioma is often made through the family doctor. The patient will give a medical history, which will include answering questions about their history of exposure to asbestos. Other diagnostic tests include x-rays, CT scans or MRI scans. The purpose of these tests is to try to see any shadowing, or tumor growth. In the case of pleural mesothelioma, lung function tests are done.
Lung function tests are an extensive battery of tests that show the physician how much air your lungs can hold as well as how well they transport oxygen through the body and release carbon dioxide from the body. Once your general physician makes a preliminary diagnosis, you will be referred to an oncologist.
After a Positive Diagnosis
Most doctors will have an idea about whether you are dealing with mesothelioma or not following the battery of tests, but a definitive diagnosis will not be made until after the oncologist completes a biopsy. The biopsy is a medical procedure that removes a small section of tissue from the affected area. This tissue is then sent to a pathologist who will examine the tissue and make the official diagnosis of mesothelioma.
Levels of Mesothelioma
Once a diagnosis of mesothelioma is made, the oncologist will want to determine what stage the cancer is in. The mesothelioma is considered localized if it is contained to the mesothelium. If it has spread to the lymph nodes, the chest, abdomen or other organs, then it is considered to be in the advanced stages. Staging the tumor is important because it helps the oncologist determine the best course of treatment. When deciding on a treatment protocol, physicians use the acronym TNM to determine the progression of the cancer. Tumor refers to the size of the tumor, N for whether or not there is lymph node involvement, and M for metastasis, or whether the tumor has spread to any other organs. The correct assessment as to the stage of the tumor gives the patient the best hope for a positive outcome.
Getting the Earliest Diagnosis
Because mesothelioma mimics so many other diseases, it is important to get an accurate and early diagnosis. If you feel that you may be at risk of mesothelioma and begin to suffer from any of the symptoms, you should consult a doctor who will aggressively work to diagnose you. While the wait and see approach is fine for many minor health concerns, mesothelioma requires an early diagnosis.
Mesothelioma is too often in the advanced stage by the time that a diagnosis is made. The tumors in the mesothelium are so thin that they will not show up on an x-ray during the early stages. By the time the tumors are visible, the mesothelioma may very well have invaded other organs.
While there is currently no screening tool that will allow doctors to test for mesothelioma in the earliest stages, if you are concerned about your odds of developing mesothelioma, there are some precautions that you can take.
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If you know that you have been exposed to asbestos, either through occupational exposure, or exposure in your home, you should find a physician that has experience diagnosing patients with mesothelioma and other lung diseases. The more cases of any disease a doctor sees, the more easily he can diagnose them. If you are at risk for developing any asbestos related disease, choose a doctor that has experience in this area and see him for regular check-ups.
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Ask your doctor about the wisdom of baseline tests. These tests can be controversial. Unnecessary x-rays, CT scans or MRIs are not recommended, and many doctors feel that, in the absence of symptoms, they are a waste of time and money. Some doctors feel that having these baseline tests make it easier to spot subtle changes on follow up tests.
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Monitor your health. Although no one likes a hypochondriac, early symptoms of mesothelioma are subtle, and, in order to catch it early you must be attuned to your body. A cough that doesn't go away, heaviness in the chest or shortness of breath can all be signs of a cold or the flu, but with the absence of other symptoms such as a fever or chills, you should question whether it could be something more.
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If you smoke, stop. Smoking has not been shown to influence the development of mesothelioma, however, it is thought to be a risk factor. If you are a smoker when you develop mesothelioma, you will also be putting enormous additional stress on your lungs. When a patient develops mesothelioma, their lungs will be severely stressed by excess fluid and their body by a decrease in oxygen as their lungs are unable to work as hard. Do you really want to further tax your lungs by damaging them with smoke?
Symptoms of Mesothelioma
Early Symptoms of Mesothelioma
The early symptoms of mesothelioma are very minor, and may be mistaken for symptoms of other, less serious, diseases. Pleural mesothelioma, the most common form of mesothelioma, is cancer in the mesothelium surrounding the lungs. The early symptoms of pleural mesothelioma are shortness of breath, chest pain, or a cough. One common misdiagnosis of pleural mesothelioma is pneumonia.
Peritoneal mesothelioma is cancer that is in the mesothelioma surrounding the abdominal organs. Mesothelioma in this area causes weight loss, nausea, and swelling in the lower extremities. Symptoms of both pleural and peritoneal mesothelioma include the development of an effusion.
An effusion, either in the pleural or peritoneal mesothelium, is a build-up of excessive fluid. The excessive fluid is a result of the imbalance in the mesothelium cells. Their job is to lubricate the organs that they surround. When the mesothelium cells are invaded by cancer they overproduce the protective cells, which in turn cause fluid build-up. The fluid build-up from an effusion can cause side effects such as shortness of breath and chest pain, or, in the case of a peritoneal effusion, bowel obstruction and swelling of the abdomen. For more information about each kind of cancer, please see “Pleural Mesothelioma,” “Pericardial Mesothelioma,” and “Peritoneal Mesothelioma.”
More Advanced Symptoms of Mesothelioma
By the time that a patient is diagnosed with mesothelioma, the cancer is often well advanced. The patient may cough up blood, have abnormal blood clotting, experience fatigue, and suffer with night sweats.
Diagnosis is normally made through x-ray, but CT scans or ultrasound can be used as well. About five percent of the patients that are diagnosed with pleural mesothelioma have it in both lungs at the time of the initial diagnoses. Often, by the time a diagnosis is made, the tumors have metastasized and moved to other areas of the body.
What to do if You Suspect You have Mesothelioma
Mesothelioma is a very serious disease, and diagnosis is complicated. The early symptoms of mesothelioma mimic many other more benign health problems, and many people have no early symptoms at all. The turning point in the progression of mesothelioma is in the development of effusions. At the point where the mesothelium starts to manufacture a surplus of cells, the cancer is often well advanced.
Of course, no one wants to live a life in fear. One can not run to the doctor every time one has a cough or chest pain. However, it is argued that the best prognosis for mesothelioma patients is tied to an early diagnosis. Here are some tips on how to balance concerns for your health with the desire for a normal life:
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Assess your risk. Do you, or did you at any time, work in an occupation with a high incidence of exposure to asbestos? If so, it makes sense to be more vigilant about any health issue, particularly any problems associated with your lungs or breathing.
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Have regular check-ups. By choosing a doctor that understands the dangers of asbestos exposure and has seen many cases of mesothelioma, you increase the odds that your doctor will recognize the early symptoms, should you develop them.
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Have your level of exposure tested. Although there is no definitive amount of asbestos that presents an increased health risk, for your peace of mind you can have a lung wash, which will give your doctor an idea about your level of exposure.
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Keep your lungs healthy. Mesothelioma is most common in the pleural cavity. While strong and healthy lungs are not immune to mesothelioma, if your respiratory system is in top shape, through regular exercise, you will be better prepared to undergo the stressful treatments surrounding mesothelioma.
Preventing Mesothelioma
The only sure way to prevent mesothelioma is to avoid exposure to asbestos. Unfortunately, this is easier said than done. Asbestos was widely used throughout the country for both domestic and industrial uses. Once the dangers of asbestos exposure became widely known, use was reduced. Unfortunately, it was too late for an ever-growing number of people. The health risks associated with asbestos exposure may not show up for 50 years. Given the long latency period, it is expected that there will be an increase in the cases of mesothelioma as generations of workers age.
Today, exposure to asbestos often occurs in remodeling and repair projects. While stringent guidelines are in place for the abatement of asbestos in schools and other public buildings, most areas give the homeowner the option of removing or repairing asbestos building materials themselves. However, a licensed professional should perform all forms of repair and abatement of asbestos-contaminated materials.
If you decide to undertake an asbestos abatement project, it is important to understand the importance of wearing protective clothing and breathing apparatus, as well as cleaning the areas thoroughly and preventing dust from the project area from contaminating the rest of the home. If done incorrectly, you run the risk of exposing not only yourself, but the rest of your family to asbestos.
Pleural Mesothelioma
Mesothelioma is a rare disease caused as a result of malignant cancerous cells lining the patient's body cavities such as chest, abdominal region or the area surrounding the heart. It is typically associated with exposure to asbestos which has been documented in as many as 70-80% of all mesothelioma cases. This disease is very difficult to assess consistently due to the great variability in time before diagnosis and the rate of progression of malignant mesothelioma.
What is Meso?
Mesothelioma is a rare disease caused as a result of malignant cancerous cells lining the patient's body cavities such as chest, abdominal region or the area surrounding the heart. It is typically associated with exposure to asbestos which has been documented in as many as 70-80% of all mesothelioma cases. This disease is very difficult to assess consistently due to the great variability in time before diagnosis and the rate of progression of malignant mesothelioma.
Mesothelioma is a rare disease caused as a result of malignant cancerous cells lining the patient's body cavities such as chest, abdominal region or the area surrounding the heart. It is typically associated with exposure to asbestos which has been documented in as many as 70-80% of all mesothelioma cases. This disease is very difficult to assess consistently due to the great variability in time before diagnosis and the rate of progression of malignant mesothelioma.
Mesothelioma is a rare disease caused as a result of malignant cancerous cells lining the patient's body cavities such as chest, abdominal region or the area surrounding the heart. It is typically associated with exposure to asbestos which has been documented in as many as 70-80% of all mesothelioma cases. This disease is very difficult to assess consistently due to the great variability in time before diagnosis and the rate of progression of malignant mesothelioma.
Diagnosing Mesothelioma
Basic Diagnosis
Diagnosing mesothelioma often means ruling out many diseases with similar symptoms before completing the diagnostic process. The diagnosis of mesothelioma is often difficult and typically occurs in a late stage of development. The patient will give a medical history, which will include answering questions about their history of exposure to asbestos. Other diagnostic tests include x-rays, CT scans, or MRI scans. The purpose of these tests is to try to see any shadowing, or tumor growth. In the case of pleural mesothelioma, lung function tests are performed.
Lung function tests are an extensive battery of tests that show the physician how much air your lungs can hold and how well they transport oxygen through the body and release carbon dioxide. Once a physician makes a preliminary diagnosis, you will be referred to an oncologist.
After a Positive Diagnosis
Most doctors will have an idea about whether you are dealing with mesothelioma or not following tests, but a definitive diagnosis will not be made until after the oncologist completes a biopsy. A biopsy is a medical procedure that removes a small section of tissue from the affected area. This tissue is then sent to a pathologist who will examine the tissue and make the official diagnosis of mesothelioma.
Stages of Mesothelioma
Once a diagnosis of mesothelioma is made, the oncologist will want to determine what stage the cancer is in. Mesothelioma is considered localized if it is contained to the mesothelium. If it has spread to the lymph nodes, the chest or other organs, then it is considered to be in the advanced stages. Staging the tumor is important because it helps the oncologist determine the best course of treatment. When deciding on a treatment protocol, physicians use the acronym TNM to determine the progression of the cancer. The 'T' refers to the size of the tumor, 'N' signifies whether or not there is lymph node involvement, and 'M' stands for metastasis, or whether the tumor has spread to any other organs. The correct assessment as to the stage of the tumor gives the patient the best hope for a positive outcome.
Getting the Earliest Diagnosis
Because mesothelioma mimics so many other diseases, it is important to get an accurate and early diagnosis. If you feel that you may be at risk for developing mesothelioma and begin to suffer from any of the symptoms, you should consult a doctor who will aggressively work to diagnose you. While the "wait and see" approach is fine for many minor health concerns, mesothelioma requires an early diagnosis for any chance of curing the disease.
Mesothelioma is all too often in the advanced stage by the time a diagnosis is made. The tumors in the mesothelium are so thin that they will not show up on an x-ray during early stages. By the time tumors are visible, the mesothelioma may very well have invaded other organs.
While there is currently no screening tool that will allow doctors to test for mesothelioma in the earliest stages, if you are concerned about your odds of developing mesothelioma, there are some precautions you can take.
-
If you know that you have been exposed to asbestos, through occupational exposure, exposure in your home, or by some other means, you should find a physician that has experience diagnosing patients with mesothelioma and other lung diseases. The more cases of any disease a doctor sees, the more easily he can diagnose them. If you are at risk for developing any asbestos related disease, choose a doctor that has experience in this area and see him for regular check-ups.
-
Ask your doctor about baseline tests. These tests can be controversial. X-rays, CT scans, or MRIs are not always recommended, and many doctors feel that, in the absence of symptoms, they are a waste of time and money. Some doctors feel that having these baseline tests make it easier to spot subtle changes on follow up tests.
-
Monitor your health. Early symptoms of mesothelioma are subtle and in order to catch it early you must be attuned to your body. A cough that doesn't go away, heaviness in the chest or shortness of breath can all be signs of a cold or the flu, but with the absence of other symptoms such as a fever or chills, you should question whether it could be something more, such as plural mesothelioma.
-
If you smoke, stop. Smoking has not been shown to influence the development of mesothelioma, however, it is a risk factor. If you are a smoker when you develop mesothelioma, you will also be putting enormous additional stress on your lungs. When a patient develops plural mesothelioma, their lungs will be severely stressed by excess fluid and their body will be stressed by a decrease in oxygen, as their lungs are unable to work as hard.
Mesothelioma Staging
Staging cancer helps doctors and specialists determine how far the disease has advanced. Information gained during staging is also important for determining the type of treatment a given patient will receive. Different types of treatment tend to be used in different stages.
Basic Staging Information
During the process of diagnosing mesothelioma, your doctor or specialist must determine the extent that the cancer has spread within the affected area and whether it has metastasized (spread to distant locations via the bloodstream). To do this, you will undergo imaging procedures such as x-ray, MRI scan, CT scan, and PET scan, which create detailed images of the inside of the body. Your specialist can then “read” these images to determine where cancer is located, and how large tumors are. Based on this information, cancer is staged, and this information is used to determine the best course of treatment.
Mesothelioma cancers, and all other cancers, are broken down into four basic stages.
Basic Stage One: The cancer is localized to one small section of the chest or abdomen (depending on the type of mesothelioma involved). The point at which the cancer first develops is called the primary tumor site.
Basic Stage Two: The cancer is said to be “advanced,” and has spread from its point of origin in the mesothelium to the organ directly beside it (in the case of pleural mesothelioma, for example, it has spread from the lining of the lungs to the lung itself).
Basic Stage Three: The cancer has spread from the mesothelium to adjacent organs, and has also spread to the lymph nodes closest to the primary tumor site.
Basic Stage Four: The cancer has metastasized to areas not adjacent to the primary tumor, usually via the bloodstream. Mesothelioma most often metastasizes to the brain, as well as other major organs.
There are various specific staging systems that are used to diagnose and treat cancers, including mesothelioma. Each of the systems uses slightly different methods of staging cancers.
Staging Systems: Butchart
The Butchart system is the oldest staging system developed, and is the one that is most commonly used to diagnose and treat mesothelioma. The Butchart system is based mainly on tumor mass, and is generally used to stage only pleural mesothelioma.
Butchart Stage One: Mesothelioma has developed in the right or left side of the chest cavity. It has not spread to the other side of the chest but may be seen in the diaphragm.
Butchart Stage Two: Cancer has been found in the lining of the heart, pleura or esophagus on both sides of the chest. Lymph nodes may be affected.Butchart Stage Three: Mesothelioma has spread to the abdominal cavity. Lymph nodes past the chest may be affected.
Butchart Stage Four: Cancer has entered the bloodstream and spread to distant organs.
Staging Systems: TNM
The TNM System is a more modern staging system that is based on the extent of the tumor, metastasis, and lymph node involvement. This system can be used to stage both peritoneal and pleural mesothelioma.
TNM Stage One: Cancer is present in the left or right pleural membrane, and may have spread to the lung, to the lining around the heart (the pericardium), or to the diaphragm on the same side of the body. Lymph nodes are not involved at this stage.
TNM Stage Two: Mesothelioma has spread from the chest cavity to nearby lymph nodes on the same side. The cancer has also spread to the diaphragm, pericardium or the lung on the same side as the primary tumor.
TNM Stage Three: Ccancer has penetrated one or more of the chest lining, heart, esophagus, muscle, ribs, and vital organs within the chest cavity on the same side as the cancer.
TNM Stage Four: Cancer has metastasized to the opposite side of the chest from its point of origin. It may have reached the chest cavity or lungs on both sides, or has spread to vital organs in the abdomen.
Staging Systems: Brigham
The Brigham System is the newest of the four cancer staging systems. This system evaluates the stage of a cancer based on the involvement of the lymph nodes and the ability to remove tumors via surgery (this is referred to as the resectability of the tumor).
Brigham Stage One: The mesothelioma tumor is resectable and the lymph nodes are not affected.
Brigham Stage Two: The tumor is resectable, but the cancer has spread to nearby lymph nodes.
Brigham Stage Three: The mesothelioma tumor is not resectable. The cancer has penetrated the chest wall, heart, abdominal cavity, or diaphragm. Lymph nodes may or may not be affected.
Brigham Stage Four: The tumor is not resectable and the cancer has entered the bloodstream and metastasized to organs and tissues distant from the primary tumor site.
