Mesothelioma

MESOTHELIOMA

Mesothelioma is a rare
form of cancer. The cancer cells (Malignant cells) are found in the
lining of chest (Pleura), the lining of the abdominal cavity
(Peritoneum) or the lining around the Heart (Pericardium).

Peritoneal
Mesothelioma is a cancer of the lining of the abdominal cavity. It
occurs in one fifth to one third of total number of mesothelioma.

Most people affected
had a History of breathing of Asbestos. The exposure may be from
their working environment or from their house itself. An exposure of
Asbestos for just one or two months can result in Mesothelioma in 30
or 40 years later. The present diseased individual has a History of
Asbestos exposure in the 1940s, 50s, 60s and 70s age. That is
showing that it has a long latency period.

Like all cancers the
prognosis of Mesothelioma is depend on the early diagnosis of the
disease and how aggressively it is treated.

MAIN
CAUSE OF MESOTHELIOMA- ASBESTOS EXPOSURE

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 are
commonly used in the North America during 1800s itself. The use of
asbestos enormously increased during Second World War, when shipyards
produced massive number of ships for War purpose. Since that time
the asbestos was commonly used in building construction automotive
industry, etc. During that time about 5,000 products containing
asbestos are used.

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. When the latency period for asbestos
disease is factored in, cases of mesothelioma will continue to be
diagnosed for years to come.

RACE
AND MESOTHELIOMA:

Mesothelioma has no
racial predilection. Asbestos exposure is the most important factor.
Race is not a factor.

SEX
AND MESOTHELIOMA:

Malignant mesothelioma
is more common in men, with a male-to-female ratio of 3:1. It can
also occur in children; however, these cases are not thought to be
associated with asbestos exposure.

With regard to women
with mesothelioma, a 1996 case series by Ascoli et al showed 86% of
tumors arising from the pleura, of which most were the epithelial
type. Of the patients in this series, 75% had a history of exposure
to asbestos and more than half developed the malignancy secondary to
household contact with a worker exposed to asbestos.

With regard to men with
mesothelioma, the same case series demonstrated 45.5% with a history
of exposure to asbestos and 53% with occupational exposure to
asbestos. Most who were involved were construction workers, railroad
workers, naval mechanics, bakers, explosive workers, and automobile
mechanics.

AGE
AND MESOTHELIOMA:

Malignant mesothelioma
has a peak incidence 35-45 years after asbestos exposure. It commonly
develops in the fifth to seventh decade of life.

MORTALITY/MORBIDITY:

Median survival for
patients with malignant mesothelioma is 11 months. It is almost
always fatal. Median survival based on histologic type is 9.4 months
for sarcomatous, 12.5 months for epithelial and 11 months for mixed.
Approximately 15% of patients have an indolent course.

Asbestos exposure is
linked to at least 50% of patients developing malignant mesothelioma.
Approximately 8 million people in the United States have been exposed
to asbestos in the workplace. Family members are also exposed to
asbestos embedded in the worker's clothing. The combination of
tobacco and asbestos exposure greatly increases the risk of
developing pleural mesothelioma.

SYMPTOMS
OF 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. 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.

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 of Pleural Effusion:-

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 of Pleural Effusion:-

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.

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 wet slurry that
can roll around the pleural cavity.

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