Mesothelioma is an aggressive and deadly cancer in the lining of the lungs or abdomen. Mesothelioma affects the thin membrane protecting several of the body’s most important organs, the lungs, abdomen and heart.
Mesothelioma most often occurs in the tissue surrounding the lungs (pleural) but can also occur in the tissue in the abdomen (peritoneal), the tissue that surrounds the heart (pericardial) and the tissue surrounding the testicles (tunica vaginalis).
Asbestos Exposure remains the primary cause of mesothelioma.
What Is Asbestos?
Asbestos refers to six naturally occurring fibrous minerals that have the ability to resist heat, fire and electricity.
Asbestos minerals are made up of fine, durable fibers and are resistant to heat, fire and many chemicals. Once called the “miracle mineral” for such properties, asbestos was used in a slew of everyday products, from building materials to fireproof protective gear. It is now widely known that exposure to asbestos can cause mesothelioma, a fatal cancer that affects the lining of the lungs, as well as other cancers and lung-related illnesses.
Asbestos fibers are soft and flexible yet resistant to heat, electricity and chemical corrosion. Pure asbestos is an effective insulator, and it can also be mixed into cloth, paper, cement, plastic and other materials to make them stronger.
Asbestos is a fiber that was once widely used in hundreds of building, industrial, commercial, and housing products and is still present in millions of workplaces and homes.
The cancer develops when a person ingests asbestos, and it causes changes to a person’s DNA. Our genes are made of DNA. Some of the genes in our body control how cells grow, multiply and die. Changes in our genes may cause cells to divide out of control and may lead to cancer.
Signs and Symptoms
Common Mesothelioma Symptoms
Fever or night sweats
Shortness of breath
Pain in the chest or abdomen
Weakness in the muscles
Pleural effusion (fluid around the lungs)
Loss of appetite
Stages of Mesothelioma
The TNM staging system breaks down Stage I into two categories that describe where the cancer is located.
Stage IA is when the cancer is found on one side of the chest in the chest wall lining. It also covers when it is found in the chest cavity lining between the lungs and/or the lining that covers the diaphragm. The cancer has not affected the lung at Stage IA.
Stage IB is when cancer is in the chest lining on one side of the chest and on the lining that covers the lung. It includes cancer in the linings of the chest cavity and/or diaphragm.
The cancer has spread (metastasized). However, the cancer remains in the chest or has reached above it to the esophagus.
The two systems have different definitions for Stages III and IV.
The Butchart System defines Stage III as further spreading through the diaphragm to reach the lining of the abdomen or lymph nodes outside the chest. Stage IV occurs when the cancer can be found in the bloodstream and has further spread to other organs.
The TNM System defines Stage III as further spread within the same side of the chest. Stage IV is when the cancer has spread outside one side of the chest to the other side and to other organs as well.
Stage IV occurs when the cancer can be found in the bloodstream and has further spread to other organs.
Types of Mesothelioma
Most common type
Forms on soft tissue covering the lungs
Best treated with a multimodal approach
Less than 20 percent of all cases
Develops on lining surrounding the abdomen
Responds best to a combination of surgery and heated chemotherapy
Forms on soft tissue around the heart
Best treated with a multimodal approach
Develops on the lining of the testicles
Responds best to surgery
Reducing your exposure to asbestos may lower your risk of mesothelioma.
Treatment for malignant mesothelioma will depend on the patient’s health and the stage at which the cancer was caught.
The most common treatment options include:
Surgery to remove as much of the cancer as possible
Many treatments focus on maximizing life expectancy and decreasing the pain and symptoms associated with malignant pleural mesothelioma and other forms of the cancer.
There are some rays of hope for mesothelioma sufferers.
Extrapleural Pneumonectomy (EPP)
Where the surgeon removes the lung, the affected pleura and pericardium tissue, and nearby lymph nodes. An extrapleural pneumonectomy is an extremely invasive surgery that is not an option for all patients.
Pleurectomy Decortication (P/D)
Where the doctor removes the pleura lining the affected lung and the chest cavity, as well as the tissue that lines the mediastinum and the diaphragm.
Cytoreduction or debulking surgery
Which is used to treat peritoneal mesothelioma by removing all signs of the cancer from the abdominal cavity. This surgery is usually done at the same time as heated interoperative chemotherapy.
Other surgical procedures your doctor may consider include segmentectomy of the lung, or a lobectomy.
Because mesothelioma is an aggressive cancer that is often detected in the late stages, the prognosis for patients is not good.
Treatment options generally focus on keeping a patient comfortable, rather than on eradicating the cancer.
The earlier the cancer is detected, though, the better the prognosis for mesothelioma patients. So people who have been exposed to asbestos in the past should see a doctor at the first sign of symptoms.
A patient’s mesothelioma cell type also plays a significant role in prognosis and life expectancy. The three types of cells include:
Epithelioid: These cells are the most responsive to treatment, which improves prognosis and life expectancy. They comprise 50 percent of mesothelioma diagnoses.
Sarcomatoid: These cells are the least responsive to treatment. Patients with this cell type have a poorer prognosis and shorter life expectancy. These cells comprise 10 percent of diagnoses.
Biphasic: A combination of epithelioid and sarcomatoid cells. This type is less responsive to treatment. But prognosis and life expectancy depends on the ratio of both types of cells. This type accounts for 30-40 percent of diagnoses.
Factors that may increase the risk of mesothelioma include:
Personal history of asbestos exposure. If you’ve been directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.
Living with someone who works with asbestos. People who are exposed to asbestos may carry the fibers home on their skin and clothing. Exposure to these stray fibers over many years can put others in the home at risk of mesothelioma. People who work with high levels of asbestos can reduce the risk of bringing home asbestos fibers by showering and changing clothes before leaving work.
A family history of mesothelioma. If your parent, sibling or child has mesothelioma, you may have an increased risk of this disease.
Workers who may encounter asbestos fibers include: