Although malignant mesothelioma is rare, the number of new cases is still rising in many countries. This slow-growing disease is difficult to diagnose and treat, and is a frequent subject of compensation claims against negligent employers.
Malignant Mesothelioma, Cancer of the Mesothelium
Malignant mesothelioma is a form of cancer that is usually caused by exposure to the fibrous mineral asbestos. It leads to tumours in the mesothelium – a protective membrane that covers the inside of the chest and abdomen and the outer surface of most of the body’s organs.
The most common type is pleural mesothelioma, which arises in the outer lining of the lungs and the chest wall. Other types of malignant mesothelioma include peritoneal (in the abdominal cavity) and pericardial (in the sac that surrounds the heart). A very rare form starts in the cells around the testicles.
Most victims of malignant mesothelioma are men who were exposed to asbestos in their workplace. Asbestos was once widely used as insulation in the construction industry, and in the manufacture of products as diverse as brake pads and ironing board covers.
Malignant mesothelioma (and other asbestos-related conditions such as asbestosis and benign pleural disease) occurs when fibres of asbestos are inhaled and penetrate the lung, or are accidentally swallowed. The risk of developing the disease increases with the amount and duration of exposure. Unlike other types of lung cancer, smoking is not a risk factor for malignant mesothelioma.
Malignant Mesothelioma Symptoms
Malignant mesothelioma develops very slowly. As many as 20 to 50 years may pass between a worker’s first exposure to asbestos and the appearance of the symptoms.
Pleural mesothelioma usually causes chest pain and breathlessness due to pleural effusion (an accumulation of fluid between the lung and the chest wall). Peritoneal disease may cause abdominal pain and fluid in the abdomen. The disease can also spread to other parts of the body by a process called metastasis, leading to seemingly unrelated symptoms such as swelling of the face and neck or anaemia.
Anyone who may have been exposed to asbestos and is concerned about such symptoms, or any other problem, should not hesitate to see his doctor for advice. After a physical examination, the doctor will be able to organize imaging (X-rays, CT or MRI scanning) and the taking of tissue and fluid samples for testing to confirm or refute the diagnosis.
Malignant Mesothelioma Treatment Options
Patients diagnosed with malignant mesothelioma are usually referred to a specialist. Mesothelioma treatment options generally involve combinations of:
- surgery, to remove a localized tumour from the mesothelium or control symptoms
- radiotherapy, to relieve pain or reduce tumour mass
- chemotherapy, to slow the progression of the disease.
Complementary therapy is sometimes used to improve the well-being of patients with cancer. Acupuncture may help relieve pain, while meditation can reduce stress.
This asbestos-related cancer of the mesothelium commonly goes undetected until it has reached an advanced stage and thus often has a poor prognosis. The life expectancy for victims of malignant mesothelioma depends on various factors including the general health of the patient and the extent of the disease when it is diagnosed. Patients who are suitable for surgery may enjoy a long period of remission after the removal of an early-stage tumour, though the outlook is worse for frail patients with extensive cancer. Research into new treatments such as immunotherapy and gene therapy is ongoing.
Mesothelioma Claims, Support and Advice
Various organizations, including the Meso Foundation, the Mesothelioma Center and Mesothelioma UK, offer information on malignant mesothelioma, along with patient and family support. Many countries provide state compensation for workers affected by asbestos-related disease. Support groups may be able to give advice on entitlement to benefits for those with malignant mesothelioma, claims against employers who failed to provide adequate protection against asbestos exposure, and other information.
References:
Muscat JE, Wynder EL. Cigarette Smoking, Asbestos Exposure, and Malignant Mesothelioma. Cancer Res 1991; 51: 2263–7.
Rudd R. Asbestos and the Lung. Medicine 2004; 32(1): 111–113.
Disclaimer
The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
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