Mesothelioma and Asbestos

Asbestos is a naturally occurring mineral that comes in thin, long fibres. People who are exposed to asbestos may develop lung diseases, such as mesothelioma.

The symptoms of these diseases might not be evident for a long time after exposure to asbestos. Different asbestos types can cause different symptoms.

Pleural Mesothelioma

Pleural mesothelioma is a type of cancer that occurs in the outer lung the lining (pleura). It is the most common type of mesothelioma, making up between 70 and 79% of all diagnosed cases. Patients suffering from this condition feel chest pain and shortness of breath, and they may feel an ache or heaviness in the chest.

This type of cancer is often caused through exposure to asbestos, which is a collection of minerals that are composed of microscopic fibers. When inhaled, these fibers stick inside the lung and cause irritation that leads to scarring and DNA mutations. The pleura is the area that surrounds the chest cavity and lungs and therefore, these irritations could affect both the lungs as well as a person's heart. Mesothelioma symptoms are usually not apparent until 30 to 50 years after exposure.

The most commonly reported symptoms of pleural melanoma are chest pain and shortness of breath. Some patients have coughing problems, trouble breathing or chest tightness. Patients with this type of cancer have a history that includes asbestos lawsuit exposure at work. The most prevalent jobs that expose workers to the risk of developing pleural cancer are manufacturing, construction and shipbuilding. People who served in the military are at greater risk due the frequent use of asbestos in Navy vessels and bunkers for the Army.

The most popular staging system for pleural mysothelioma has been the TNM (tumor, lymph nodes and metastases) staging system. The stage a patient is in upon diagnosis will assist their doctor in determining the most appropriate treatment plan for them. Patients who have pleural mesothelioma which is in stage three or four will have a less favorable prognosis compared to those who are in a lower stage. Stage four mesothelioma may be spread to the liver, heart, or diaphragm. This makes the cancer more difficult to treat and increase the chance of complications for patients.

Peritoneal Mesothelioma

Contrary to pleural cancer that develops in the lining of the lung it develops in a membrane that covers the abdominal cavity, which includes organs such as the intestines and liver. Like pleural mesothelioma, peritoneal mesothelioma is triggered by asbestos exposure. There are only 300-500 cases diagnosed annually this is less than pleural asbestosis.

As with pleural asbestosis, symptoms can take a long time to show. Patients generally experience abdominal pain, and may also have a lump in their abdomen. Symptoms of this type of mesothelioma could also include nausea, weight loss and fever. A lot of these symptoms can be misinterpreted as digestive issues and can lead to a mistaken diagnosis.

The doctors can detect mesothelioma through looking over the medical history of the patient and performing a physical exam. Imaging tests such as X-rays or CT scans can be used to identify mesothelioma. These tests can show cancerous tumors or other signs of cancer that aren't visible on an X-ray.

These test results allow doctors to diagnose mesothelioma and determine the stage of the disease and suggest treatment options. The stage is determined by the kind of cell and if the cancer has spread.

The most important mesothelioma risk factor is exposure to asbestos. People who have been in occupations that involve asbestos, like plumbing or manufacturing, electrical work, or construction, are at a higher risk of developing the disease. Even if someone isn't employed in one of these fields however, they may be exposed to asbestos compensation through family members or other sources. Anyone who suspects that they are at risk should speak with a doctor. A mesothelioma specialist can help those with a previous history of asbestos to find out more about their risk.

Risk Factors

Asbestos is the most significant risk factor in mesothelioma. It accounts for as much as 80% of all cases. Exposure to asbestos may occur through work, military service or by living with a person who is exposed to asbestos or was previously exposed to doing so. When exposed to asbestos, small particles can be inhaled into the lungs and abdomen. These irritate the linings and trigger cancerous cells to develop in the mesothelium. Mesothelioma can take between 15 and 60 years to develop following exposure to asbestos.

Other risk factors include smoking, genetics and the advancing age. The people in their 40s or 50s are at a higher chance of developing mesothelioma to people who are younger or more. This is because mesothelioma usually lasts between 20 and 60 years from the first time of exposure before the first signs of cancer appear. It is also important to note that mesothelioma is a possibility in people who have been exposed to asbestos but did not engage directly with it. This is known as indirect or secondary exposure to asbestos. It could be as hazardous as direct exposure.

Smoking increases a person's chances of developing mesothelioma due to the fact that it causes mesothelium damage and makes it more prone to asbestos. Furthermore, mesothelioma is worsened by certain diseases like pneumonia and asbestosis. Men are more likely to develop mesothelioma compared to women. This is because men are more likely to be exposed to asbestos and endure a a longer period of exposure than women. Also, men are more likely to live with someone who has was exposed to asbestos and bring asbestos fibers that have escaped home on their clothing. Women are less likely to come into contact with asbestos and don't typically carry asbestos settlement around on their clothes.

Diagnosis

Mesothelioma is difficult to recognize because the symptoms can be similar to other diseases. This could lead to patients being misdiagnosed.

NYU Langone doctors will perform a physical examination and record the patient's medical history, including asbestos exposure. Doctors can also request an X-ray chest or CT scan to check for lumps and other abnormalities, as well as evidence of previous asbestos exposure like plaques in the pleura (thickened pleura with calcium deposits) and the formation of fluid between the lung and chest wall (known as pleural effusion).

Other diagnostic tests include an echocardiogram which examines the blood vessels and the heart, and a magnetic resonance imaging, or MRI test, which uses radio waves and magnets to make a series of precise images of the inside of the body. Another way doctors can diagnose mesothelioma is by performing a surgical biopsy. In a surgical biopsy, doctors remove a tiny piece of tissue from pleura or the peritoneum, to be further examined. A pathologist can then examine the tissue using an magnifying glass to determine whether it contains cancerous cell.

The type of mesothelial cell involved, the malignant or benign nature of the cells and the location and stage of the cancer are used to classify the disease. Certain mesothelioma types have a higher chance of metastasizing or spreading, so it's important to get a definitive diagnosis so doctors can treat it before it becomes out of control.

Doctors may also conduct laboratory tests on tumors to identify specific proteins, genes or other factors that will help them identify cancer characteristics and determine the best treatment. These results are referred to as staging.

Treatment

A mesothelioma diagnosis is a frightening prospect. However, it is important to keep in mind that the cancer can be treated, particularly in its initial stages. Many patients with mesothelioma survive for years with the disease without it spreading to other parts of their body.

Exposure to asbestos can cause mesothelioma through a variety of ways. Asbestos fibres, too small to be felt or viewed through the naked eye can be airborne and irritate the lining of the lung (pleura). As time passes irritation can lead to formation of scar tissue, which can cause changes in the cell structure that can eventually grow into tumors.

The Pleura is a protective layer that protects the lungs, heart and abdomen. Mesothelium consists of cells that react to asbestos which causes it to become inflamed and form scar tissue. Overtime, these changes result in the growth of malignant mesothelioma tumors.

The signs of pleural mesothelioma can include shortness of breath and chest pain, or the accumulation of fluid on the lung (pleural effusion). In rare instances, the cancer can be spread to the tissues around the heart and reproductive organs.

If scans of imaging reveal an underlying mass in the stomach or lungs doctors will recommend biopsies. During the procedure, doctors will remove tiny amounts of tumor or fluid for lab analysis. The results will confirm a mesothelioma diagnosis and provide the most effective treatment plan.

There are many types of treatment for mesothelioma including surgery and chemotherapy. Most doctors use a combination of these treatments. Participating in clinical trials for mesothelioma treatments that are new could be beneficial to patients. To learn more, patients should speak with a mesothelioma specialist who has had experience treating the disease.