Mesothelioma Stages

Doctors employ the use of “stages” in both cancer diagnoses and monitoring to determine the progress of an individuals’ disease.  Staging takes a close look at cancers, like Mesothelioma, and determines to what extent it has developed and/or spread.  Most importantly, staging helps determine the course of treatment.

Currently, though there are three types of Mesothelioma – pleural, peritoneal, and pericardial – staging has thus far been established for the most frequently occurring form of this cancer - pleural - and not for the others. The three systems that stage this disease are the Butchart, TNM, and Brigham systems.

Butchart is the oldest system and is still the most commonly used.  Its four stages are based on the extent of primary tumor mass.

• Stage I: Mesothelioma is present in the right or left pleura (the thin, transparent membrane which covers the lungs and lines the inside of the chest walls) and may also involve the diaphragm (the muscle separating the chest from the abdomen) on the same side.
• Stage II: Mesothelioma invades the chest wall or involves the esophagus (food passage connecting the throat to the stomach, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
• Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may now be affected as well.
• Stage IV: There is evidence of metastasis (the spreading of the Mesothelioma) through the bloodstream to other organs.

The TNM System looks at three components:  the tumor (T), the lymph nodes (N), and the spreading of the disease, otherwise known as metastasis (M).  It is also divided into four stages.

• Stage I: Mesothelioma involves right or left pleura and may also have spread to the lung, pericardium (the fluid filled sac that surrounds the heart), or diaphragm on the same side. Lymph nodes are not involved.
• Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same side. It may also have spread into the lung, pericardium, or diaphragm on the same side.
• Stage III: Mesothelioma has now invaded the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on the same side. It may or may not have spread to lymph nodes on the same side as the primary tumor.
• Stage IV: Mesothelioma has spread into the lymph nodes in the chest on the side opposite the primary tumor, or extends to the pleura or lung on the opposite side, or directly extends into organs in the abdominal cavity or neck. Any distant metastasis is included in this stage.

The most recent system to be devised is the Brigham System.  It stages the disease according to the ability to surgically remove the tumor (resectability) and the involvement of the lymph nodes.  It, too, is divided into four stages.

• Stage I: Mesothelioma is resectable and no lymph node involvement.
• Stage II: Mesothelioma is resectable but with lymph node involvement.
• Stage III: Presence of unresectable Mesothelioma extending into the chest wall, heart, or through the diaphragm or peritoneum; with or without extra-thoracic lymph node involvement.
• Stage IV: Distant metastatic disease (widespread cancer throughout the body).

Diagnosis is achieved in a number of ways, especially because other diseases may possess similar symptoms to those presented by Mesothelioma.  A wide variety of imaging techniques may be used in diagnosis, such as CT scans, MRI, and conventional x-rays.  Some doctors also choose to test the pleural fluid for malignant cells.

Biopsy, however, is by far the most accurate way to diagnose Mesothelioma.  Needle biopsies, done under local anesthetic, may be used but provide only small tissue samples.  That means the accuracy rate might be less than desirable.  The preferred course of action in suspected Mesothelioma is an “open” biopsy, which provides a larger tissue sample.  This type of biopsy is performed in a hospital setting under general anesthesia.

Do you suspect that you or someone close to you may be suffering from Mesothelioma or do you worry about a spouse or loved ones’ previous exposure to asbestos?  Learn the facts about asbestos and the diseases it causes by ordering our free Mesothelioma Resource Kit. 

What is Asbestosis?

Sometimes referred to as "diffuse pulmonary fibrosis," asbestosis is a lung condition that results from the inhalation of asbestos fibers. Most often associated with those who work directly with asbestos or asbestos-containing products, asbestosis can lead to more dangerous forms of asbestos disease - such as mesothelioma - later in life.

How Asbestosis Develops

It isn't easy for foreign matter to enter the lungs. As a matter of fact, the nose and the bronchi act as filters and are able to stop most particles before they even gets close to one's lungs. But because asbestos fibers are thin, needle-like, and microscopic, they are able to penetrate the filters and make their way into the lungs, where they usually lodge in the lining of the lung, known as the pleura.

The presence of asbestos in the lungs eventually causes scarring or "fibrosis," which may later result in the formation of tumors and the development of cancer.

Symptoms of Asbestosis

The symptoms of asbestosis do not appear quickly. It can take as long as 10 to 40 years to begin to recognize symptoms that indicate a problem with the lungs. The most common symptoms of this occupational disease are:

• Shortness of breath (dyspnea) - This is often the first symptom to appear and, as mentioned before, it may be ten or more years before shortness of breath is evident. In the early stages of the disease, the shortness of breath will occur only after extreme exertion, but as the asbestosis progresses, the dyspnea will occur on a more regular basis.
• Persistent, dry cough - This troublesome cough, which often makes it difficult to sleep and eat, may be accompanied by chest pain. The victim may also find blood in the sputum.
• Chest tightness - Many victims of asbestosis believe they have heart disease or are having a heart attack because the pain can be similar. The pain or tightness is caused by scar tissue that does not expand properly or with ease during the breathing process.
• Loss of appetite - This is often a result of the combination of the other annoying symptoms of the disease. Some victims also report difficulty swallowing, which makes eating uncomfortable.
• Clubbing of fingers (advanced stages) - This increased curvature of the nails and thickening of the digits is often indicative of a serious pulmonary disorder such as asbestosis.

Diagnosing Asbestosis

If you're experiencing symptoms consistent with asbestosis, you'll probably decide to visit your general practitioner. That's a good first step. It is essential, however, that the doctor be familiarized with the occupational background of those who worked with asbestos so that he/she can more readily make the correct diagnosis.

After discussing work and medical history, your doctor will probably order a chest x-ray, which may show scarring or calcifications. The results of the chest x-ray may determine the need for the use of a more sophisticated form of imaging, such as a CT scan or MRI. These can provide a more complete and clearer picture of the lung area and any scarring or tumors that may be present.

By far, however, the most accurate way to make a diagnosis of asbestosis is by means of an open lung biopsy. This procedure involves surgery under general anesthesia. During the surgery, a sample of lung tissue will be taken and sent to a pathologist for analysis. Results will be available at a later date. Most doctors maintain that this is the best way to determine whether patients have asbestosis or the more serious asbestos-related disease, mesothelioma, which is a cancer of the lining of the lungs.

There is no cure for asbestosis but there are ways to alleviate the uncomfortable affects of the disease. Humidifiers may help relieve the dry coughing and doctors may recommend additional respiratory treatments to ease breathing difficulties.

However, if you are a smoker and have been diagnosed with asbestosis, it is essential to STOP SMOKING NOW! The combination of smoking and asbestosis is a lethal one and smokers with asbestosis have a 55% higher chance of developing mesothelioma than non-smokers.

Who Gets Asbestosis?

Anyone who has had ongoing direct or secondary exposure to asbestos or asbestos-containing products can develop asbestosis. Not everyone who is exposed to asbestos will develop the disease, but everyone who develops the disease has indeed been exposed to asbestos.

Those at highest risk work or have worked at jobs where they encountered asbestos on a regular basis. Those occupations include shipyard workers, railroad employees, power plant employers, steel mill workers, oil refinery workers, contractors/construction workers, firefighters, and those employed at vermiculite or talc mines or in factories that produce asbestos-containing products.

Family members of someone who has had daily contact with asbestos have also been known to develop asbestosis, caused by exposure to asbestos particles brought home on the clothes of that person.

Asbestosis can also occur among individuals who live in communities near an asbestos mine or in the vicinity of a factory that manufactures asbestos or asbestos-containing products. Such secondary exposure is being reported more and more often and is a genuine concern. Be sure to tell your doctor if you lived near an asbestos factory or mine.

Asbestos Fibers

Asbestos is a hazardous material that, if inhaled, can be very detrimental to a person's health. When asbestos was commonly used (dating back to early Roman times) people did not know the adverse reactions that the microscopic fibers caused. Asbestos was so widely used because it is heat and chemical resistant, has no odor or taste. Another distinct characteristic of asbestos material is that it does not evaporate or dissolve in water (this is a helpful aspect to be aware of when removing material from a home or building). These fibers are able to stay airborne for an extended period of time and can also be moved by wind or water. Whether or not they settle depends on how much space the fibers have to travel and for how long they are suspended. The larger the fiber, the more likely it is to settle rather than those that are small and lighter. Many industries took advantage of the material's strength and multi-purpose uses.

The fibers found in asbestos are extremely dangerous when let loose into the air. This makes people who are exposed to the material prone to the inhalation of the fiber dust. The fiber dust then finds itself lodged in the lining of the lungs where scar tissue is formed. Many people do not realize that because asbestos is so strong, the body is unable to break it down and eliminate it.. The more people exposed to asbestos exposure, the more likely it is they will develop health complications because of the scar tissue left behind. The fibers and scar tissue are able to remain dormant in a person's body for more than thirty years before symptoms become prevalent. By the time a person becomes aware of the symtoms, treatment and diagnosis procedures are less likely to be effective.

Some employers, however, did know of the adverse reactions of this substance and chose not to tell their employees what asbestos fibers could do to their bodies in future years. These manufacturers and employers are currently being severely reprimanded for their actions. Also, there have been many federal and state laws implemented that have banned the use of asbestos in the making of homes and commercial buildings. Those who worked with asbestos many years ago are now fighting deadly illnesses such as asbestosis, different forms of lung complications, and mesothelioma.

Asbestos Cancer

Asbestos cancer is a malignant tumor caused by exposure to asbestos fibers. Asbestos exposure is most commonly associated with mesothelioma and lung cancer. Mesothelioma is a rare cancer affecting the lining of the lungs, heart, and abdomen, while traditional lung cancer occurs in the tissue of the lung’s lobes..

Pleural Mesothelioma and Asbestos

Pleural mesothelioma, the most common variety, is caused by inhaled asbestos fibers which lodge themselves in the pleural lining of the lungs. Asbestos fibers, which are microscopic but durable, then irritate the inner tissue, causing the growth of harmful scar tissue and eventually mesothelioma.

Peritoneal Mesothelioma and Asbestos

Peritoneal mesothelioma is less common and doctors have not exacted relationship between the asbestos exposure and the malignancy. However, nearly all peritoneal mesothelioma patients have a history of asbestos exposure. Peritoneal mesothelioma occurs in the lining of the abdominal cavity, near the digestive tract. Doctors surmise that ingested asbestos fibers lodge in the outer tissue of the organs and cause a similar inflammation as in the pleura.

Pericardial Mesothelioma and Asbestos

Pericardial mesothelioma occurs in the lining of the heart and is extremely rare. Like peritoneal mesothelioma, very little is known about the relationship between the malignancy and asbestos exposure but nearly all patients have asbestos exposure history. Physicians surmise that because the cancer occurs in the heart’s lining, the asbestos fibers may impact the heart through the bloodstream.

Lung Cancer and Asbestos

Asbestos has also been linked to cancers of the lung, as opposed to the pleural lining of the lungs. These are likely the result of malfunction caused due the exposure and inhalation of asbestos fibers, which can also cause chronic respiratory conditions such as asbestosis.

What is Asbestos?

Asbestos Fiber - For most individuals, especially those born in the last 40 years, the mention of asbestos conjures up thoughts of a dangerous substance that's sickened many people and caused myriad deaths around the world. That's an accurate description.

A common misconception on the part of many individuals, however, is that asbestos is a hazardous man-made substance, conjured up in factories around the world for commercial use. The truth is, however, that asbestos is a naturally-occurring mineral that can be found in hundreds of countries on just about every continent. As a matter of fact, asbestos is still mined in several of these countries, including Canada and Russia. Other countries have outlawed the mining of asbestos.

Asbestos is a highly-fibrous mineral with long, thin, separable fibers. The thin fibers can be spun and woven together, and possess valuable heat-resistant properties that make asbestos suitable for insulation and other such products. Indeed, for decades, asbestos was the material of choice for many industries that were manufacturing products for which heat resistance, low electrical conductivity, flexibility, and high tensile strength were essential factors. Today, there are other alternatives.

There are two kinds of asbestos. The serpentine variety is curly. Chrysotile asbestos, most commonly used for industrial purposes, is from the serpentine family. Other asbestos fibers, from the amphibole family, are very straight and needle-like. Amosite, crocidolite, tremolite, actinolite, and anthophyllite are amphibole asbestos varieties.

Currently, chrysotile asbestos is the only type mined on a wide-scale though a handful of countries continue to mine other forms. However, worldwide outrage about the use of dangerous asbestos has forced many countries to reconsider their position on mining.

Why is Asbestos a Health Concern?

Studies estimate that approximately 3,000 different types of commercial products include asbestos. In and of itself, the mineral is not harmful, as long as it's intact. However, when the asbestos in these products is damaged and the fibers become airborne, concerns begin to arise.

"Friable" asbestos - that which is dry and can be easily crumbled with the hand - is the culprit. Such asbestos is more likely to release fibers into the air. Spray-applied asbestos fireproofing, which was used in millions of buildings throughout the world, is of the friable variety. However, some non-friable asbestos can also release airborne fibers, particularly when sanded, chopped, hammered, cut, or otherwise manipulated. That's why, when demolishing a building that contains asbestos, proper removal and disposal in a designated asbestos landfill is essential before the building is torn down.

Why are Airborne Fibers Dangerous?

Inhaled asbestos fibers remain in the body and cannot be expelled. Because of this, the fibers can easily penetrate body tissues and may deposit themselves in airways and in the lung tissue. The more you're exposed, the more likely you might develop an asbestos-related disease. Most people exposed to asbestos on a very casual basis probably will not develop such a disease.

Once the fibers are lodged in the body, they will cause inflammation which may eventually result in the formation of cancerous tumors, particularly on the mesothelium - the lining of the lungs. Other affected areas may include the peritoneum - the lining of the abdomen - and the pericardium - the lining around the heart. There are various type of mesothelioma treatment options for each type.

With some recent exceptions found in workers at the World Trade Center disaster, asbestos-related diseases, such as pleural mesothelioma, usually surface several decades after exposure. That's why current cases of mesothelioma and other asbestos-related diseases involve many individuals who were employed in shipyards during World War II, performing jobs that exposed them to friable asbestos on a daily basis. Shipyard workers are among those most affected by aggressive asbestos cancer.

Is Asbestos Banned?

Contrary to what many people believe, asbestos is not and has never been banned in the United States. In 1976, Congress passed a law to regulate toxic substances (known as the Toxic Substances Control Act) but a total ban was not suggested. In 1989, the Environmental Protection Agency finalized regulations to ban asbestos under the aforementioned act, but two years later, a New Orleans circuit court of appeal overturned the regulation. The result was that new uses of the dangerous mineral were banned but old ones remained.

Many other industrialized nations have banned asbestos including the European Union and a handful of other countries, such as Chile, Croatia, Australia, Argentina, and Saudi Arabia. Several countries, especially those who continue to make money from the mining of asbestos, consistently fight against asbestos bans.

A few current U.S. senators, with the assistance of asbestos watchdog groups, hope to encourage the government to reconsider a ban on all asbestos products. A new bill, called the "Ban Asbestos in America Act of 2007" (S.742), was introduced by Senator Patty Murray on March 1, 2007.

Pericardial Mesothelioma

Pericardial mesothelioma is a very rare cancerous disease of the tissue layers surrounding the heart. The mesothelium membrane is comprised of two layers, one that adheres to a moving internal organ such as the heart or lungs, and the other which forms a sac around the organ. The tissues secrete a lubricant that allows the active organ to move easily against adjacent structures, such as the rib cage and diaphragm. The peritoneum is the mesothelial layer that lines the abdominal cavity, the pleura lines the chest cavity, and the pericardium surrounds the heart. Abnormal growth (cancer) in the cells of any of these mesothelial structures is referred to as mesothelioma.

The primary cause of mesothelioma is exposure to asbestos in the workplace, even for brief periods, with symptoms sometimes taking up to 50 years after exposure to become apparent. Among the populations most effected by mesothelioma are miners who were employed in South Africa and Australia (including a large number of Italian immigrants), who often worked in dusty conditions without protective equipment. Among Americans and Europeans, most cases have arisen among those who worked with asbestos in the construction trades and shipbuilding, where asbestos was used extensively for its insulating properties and as a fire retardant. At this point, however, there is insufficient evidence to link pericardial mesothelioma to asbestos exposure. Similarly, smoking does not appear to be a risk factor for mesothelioma.

Pleural mesothelioma often spreads to the pericardium in its advanced stages. Primary pericardial mesothelioma (where the tumor starts in the pericardium) is rare, making up less than 1% of total mesothelioma cases. Histological types include epithelial, sarcomatous, and mixed.

In the history of medicine pericardial mesothelioma has also been called endothelioma, coelothelioma, and endothelial carcinoma. There are other types of pericardial tumors, but about half are mesothelioma. The others are usually sarcoma (angiosarcoma) and can be difficult to distinguish from sarcomatoid pericardical mesothelioma.

The disease occurs across all age groups, almost equally in both sexes. With the elimination of asbestos in many building products and an overall improvement in working conditions and health monitoring, it is likely that the overall incidence of mesothelioma will decline in the next decade or so. In the absence of the identification of a principle causative agent, it is less clear whether the incidence rate of primary pericardial mesothelioma will change.

Results from an extensive study of autopsy records from 500,000 people who had died from cancer showed that primary tumors of the pericardium were responsible in only 0.0022% of the cases. With respect to all pericardial and cardiac primary tumors, only 2 or 3 percent are associated with mesothelioma, well behind the numbers for angiosarcoma (33%) and rabdomyosarcoma (20%).

Symptoms

The symptoms are dyspnea and pain pleural effusion, inflammation of the pericardium (called pericarditis). A dangerous symptom is cardiac tamponade in which blood accumulates in the pericardium and can lower the heart’s pumping stroke volume. These symptoms are common to other forms of mesothelioma and to a number of other conditions affecting the heart and lungs, such as pneumonia and lung cancer. In many cases, symptoms are not apparent until the disease has progressed to advanced stages, leaving few options for effective treatment.

Diagnosis

While doctors can examine fluid from the pericardial cavity (similar to the examination of pleural effusion fluid in diagnosis of pleural mesothelioma), malignant cells are found only 30% of the time, which is another reason this cancer is so hard to diagnose. CT scans can sometimes reveal thickening of the pericardium and a tumor mass is visible, although less than half of the time. Diagnosis of pericardial mesothelioma often takes place when the disease is quite advanced, at a point when the tumor and associated swelling are constricting other thoracic structures such as veins, arteries and airways. Pericardial swelling can also be associated with tuberculosis, rheumatoid arthritis, and other conditions. There was even a recent Japanese report about a patient who appeared to have pericardial constriction, which later turned out to be mesothelioma. A British case report about a young man with pericardial mesothelioma that confounded doctors “illustrates the difficulty in establishing this diagnosis by echocardiography and computed tomography.”

Pericardial mesothelioma often can appear to be rheumatic fever, lupus erythematocous, and tuberculosis pericarditis.

Radiography and other imaging techniques (e.g., echocardiography and magnetic resonance angiography) can be used to demonstrate swelling of the pericardium. In some cases, the myocardium and coronary arteries might also be involved. Isotope scans with gallium or technetium as well as cardiac catheterization can be used to measure decreased function in the heart and blood vessels. Post-contrast computerized tomography can be used to differentiate the tumor mass from the rest of the swollen tissue surrounding the heart. However, even with the identification of a tumor, the use of imaging techniques alone will not result in a definitive diagnosis because melanoma, leukemia and lymphoma can also involve the pericardium. Precise diagnosis requires demonstrating that the tumor has no relationship with the pleural surfaces.

Standard laboratory tests of blood, urine, and sputum are of little help in detecting mesothelioma. Liquid extracted from the swollen area can provide adequate cytological evidence for accurate diagnosis, but in some cases this method has resulted in a misdiagnosis, indicating other cancers (e.g., adenocarcinoma).

A biopsy carried out on a tissue sample obtained by thoracoscopy or sternoscopy is the only way to substantiate a positive identification of mesothelioma. In terms of specific laboratory indicators for the presence of mesothelioma, the cancer cells stain positive for cytokeratin, vimentin, epithelial membrane antigen, and calretinin and negative for CEA, CD15, CD34 and S-100. In 60 to 80 percent of cases, accurate diagnosis based on histological analysis of tissue samples is only accomplished after the death of the patient.

Treatment

The choice of treatment regimen is dependent on how far the cancer has progressed at the time a positive diagnosis is made, and is also be based on the age, weight, medical history, and general well-being of the patient.

With early detection, when the tumor mass is small and localized, radical surgery for removal of cancerous tissue is possible but risky, given the proximity to the heart and lungs. If the cancer has spread to the lymph nodes, lungs, chest wall, or other organs (as it does in 25 to 45 percent of cases), surgical removal is no longer an option.

A course of palliative surgery for draining fluid from the pericardium, as a means of relieving pressure on proximal structures, can be used to alleviate symptoms and as a way to obtain a tissue sample for biopsy. This procedure can be used to help prolong life while other treatment modalities are administered.

Radiation therapy can be used to kill the cancer cells and shrink tumors, but this approach carries with it the risk of damaging the heart and lungs. As well as the more familiar practice of external exposure to radioactive materials, treatment might involve delivering radioactive materials directly to the cancer site through plastic tubing (internal therapy).

No chemotherapeutic agents have been shown to be effective in the treatment of pericardial mesothelioma. There was a recent case report from India about success in one patient using a combination of pemetrexed and cisplatin, the same regimen used in treatment of pleural mesothelioma.

Prognosis

Although there are few cases of primary pericardial mesothelioma, it appears that the prognosis for this cancer is worse than it is for pleural or peritoneal mesothelioma. As a direct consequence of the difficulties in definitively diagnosing pericardial mesothelioma and the fact that it usually only minimally symptomatic until its advanced stages, the prognosis for patients is very poor, with a mean survival time of only six months following diagnosis. Death often occurs as the result of congestive heart failure or occlusion of the superior vena cava. This situation is unlikely to change without significant advances in early detection techniques and treatment regimens.

Peritoneal Mesothelioma

Peritoneal mesothelioma is a malignant tumor developing in the lining of the abdominal cavity. Mesothelioma can manifest itself in a number of ways. While the pleural cancer of the lining of the lungs - is the most prevalent form of the disease, peritoneal mesothelioma accounts for about 15% to 20% of all mesothelioma cases diagnosed throughout the world, making it the second most common form.

With this type of mesothelioma, the mesothelial lining of the abdomen - known as the peritoneum - is affected. That's why this form of cancer is sometimes referred to as abdominal mesothelioma.

What Causes Peritoneal Mesothelioma?

As with any form of mesothelioma, the only known cause at this time is exposure to hazardous asbestos. While most asbestos fibers tend to lodge in the lining of the lungs, doctors have a few theories as to why some individuals develop peritoneal rather than pleural mesothelioma.

Some experts believe the fibers may be inhaled and transported through the lymphatic system to the peritoneal cavity. Others maintain that after the fibers are ingested and make their way to the intestinal tract, they may work themselves into the peritoneal cavity and peritoneum. Still, some researchers believe that that the fibers are captured and then held by the mucus in the trachea or bronchi and are eventually swallowed.

Regardless of how the fibers reach the peritoneum, their presence in the abdominal area causes inflammation, and eventually, tumors form. The malignancy will grow and ultimately cover the abdominal cavity, spreading aggressively to other areas of the body.

Symptoms of Peritoneal Mesothelioma
Like all forms of asbestos-caused cancer, peritoneal mesothelioma can mysteriously lay dormant in the system for up to five decades. Victims of this cancer are usually difficult to diagnose because when the symptoms finally surface, it's often difficult to make the connection with asbestos, especially when the individual hasn't been exposed to the substance for many, many years. This means, of course, that by the time diagnosis is confirmed, the disease has reached its advanced stages and treatment is difficult.

Furthermore, the symptoms of peritoneal mesotheliomacan be easily confused with those of other more common diseases. Therefore, many victims go undiagnosed or are improperly diagnosed for months before the proper conclusion is determined. Symptoms of peritoneal mesothelioma can include:

    * Abdominal pain, acute to severe
    * Swelling of the abdominal region due to fluid accumulation
    * Breathing difficulties
    * Loss of appetite resulting in weight loss
    * Bowel obstruction
    * Nausea
    * Vomiting
    * Weakness
    * Fever
    * Anemia

Symptoms may vary with each patient and can be affected by the location of the tumors, the size of the tumors, and the age and general health of the individual in question. When presenting symptoms for diagnosis, it's important for patients to tell the doctor about their exposure to asbestos, even if the exposure occurred many years ago. This knowledge will aid in diagnosis and possibly spare the patient a number of unnecessary tests.

Diagnosis and treatment

Diagnosis of this rarer form of mesothelioma is much the same as with pleural mesothelioma. Your doctor may order such tests as a traditional x-ray or perhaps a more sophisticated test, such as an MRI or CT scan. While the x-rays can provide some answers the doctor may be seeking, he or she will usually order a tissue biopsy in order to make a conclusive diagnosis. These biopsies take a sample of the tissue around the abdominal cavity, which is then analyzed to determine whether tumors are present. The biopsy can be uncomfortable but is quick and over in just a few minutes.

Once a diagnosis is determined, an oncologist will help decide which treatment is best for the patient. Because peritoneal mesothelioma is often diagnosed in its very late stages, tumor removal by surgery is usually not an option. If, however, surgery is in order, it may involve removing a portion of the lining and tissue from the abdominal area in order to remove the tumor. If the tumor is unusually large, a lung or a section of the diaphragm may need to be removed as well.

More often, radiation and are recommended in the treatment of peritoneal mesothelioma. Radiation may be aimed directly at the tumors or used as a palliative measure to relieve pain or lessen symptoms. Common chemotherapy techniques for this kind of mesothelioma include intra-peritoneal chemo, which involves injecting chemotherapy drugs directly into the abdomen. Different chemo drugs in various combinations are recommended, depending on each individual case. Like radiation, chemotherapy can be a palliative measure, relieving uncomfortable symptoms and improving the quality of life for mesothelioma patients.

Clinical trials are offered through many clinics and health centers for those diagnosed with mesothelioma. These trials usually offer the opportunity to try experimental medications or treatments that have not yet been approved by the government organization that oversees the sale of drugs.

Prognosis and Outlook

Because it takes so long to diagnose peritoneal mesothelioma, the outcome is not positive. As with other types of the disease, many victims live for less than a year after diagnosis. Doctors and research scientists continue to make strides towards finding a way to cure mesothelioma and/or prolong the life of the patient.

Pleural mesothelioma

Pleural mesothelioma is a disease that affects the lining of the lungs, or lung pleura. Sometimes doctors refer to this disease as mesothelioma of the pleura. It is a common misconception that mesothelioma is a type of primary lung cancer; it is not. Mesothelioma is a cancer of the serous membranes. These membranes enclose a number of organs throughout the midsection of the body, including the lungs. The most common type of mesothelioma, pleural mesothelioma, affects the serous membranes of the lungs.

Mesothelioma can also affect the serous membranes surrounding the abdomen, called peritoneal mesothelioma, and the membranes surrounding the heart, or pericardial mesothelioma. When mesothelioma spreads to the lungs from the serous linings of the lungs, abdomen or heart, it is considered secondary lung cancer. Also, pleural mesothelioma is sometimes referred to as an asbestos lung cancer. Technically, cancers that do not originate in the lungs are not considered lung cancer; thus, terms such as secondary lung cancer and asbestos lung cancer (pleural mesothelioma) are misleading. Asbestosis is a type of asbestos lung disease that does originate in the lungs and is often confused with mesothelioma.

Pleural Mesothelioma Cancer

Pleural mesothelioma cancer represents about 75 percent of all mesothelioma cases. This disease is caused by the inhalation of asbestos fibers, which then settle in the lungs. These asbestos fibers become imbedded in the lining of the lung (the pleura). Over time, they cause chronic inflammation that eventually leads to growth of cancerous tumors or, in some cases, asbestosis.

Pleural mesothelioma cancer normally appears as multiple tumor masses affecting the parietal surface (outside; further from the lung) and visceral surface (inside; closer to the lung) of the pleura. Typically, the parietal surface has greater involvement than the visceral. There is a slightly higher incidence of mesothelioma in the right lung, apparently due to the fact that the right lung is larger and has a greater amount of pleural surface area. Also, the lower lungs typically show more tumor masses than the upper lung. This is thought to be due to gravitational factors influencing how the asbestos fibers settle in the lungs after they have been inhaled.

Large growths in the pleura are normally noted in patients upon diagnosis. As the diseases progresses, these growths lead to a complete obliteration of the lung cavity. The tumors can spread from the lung pleura to other organs, including the heart and abdomen. Mesothelioma can also invade the lymph nodes and circulatory system.

Tumors unrelated to pleural mesothelioma also grow in the pleura. These tumors start in other parts of the body and metastasize to the pleura. The most common form of non-pleural mesothelioma cancer that occurs is lung cancer, representing about 36 percent of the cancer occurring in the pleura. The next most common forms are breast cancer (25 percent), ovarian cancer (5 percent) and gastric cancer (2 percent). Lymphoma also accounts for a small portion of cancers that metastasize to the pleura.

Pleural Mesothelioma Symptoms

The most common symptom for pleural mesothelioma patients is chest pain. But, the pain often is not associated directly with the lung pleura and often appears in the shoulder or upper abdomen. Shortness of breath, called dyspnea, is also a symptom. Cough, weight loss and anorexia are present in some patients, but are less common. Finally, the rapid growth of the pleural mesothelioma cancer tumors enlarges the pleural space, causing it to fill with fluid. Oftentimes, this buildup of fluid known as a pleural effusion causes the discomfort or pain associated with first detection of the disease.

Pleural mesothelioma patients display all three types of mesothelioma cancer cells: epithelioid mesothelioma, sarcomatoid mesothelioma and biphasic mesothelioma.

Prognosis

Currently, the prognosis for those diagnosed with pleural mesothelioma is not good. Many patients die within six months of diagnosis, some last up to a year, but few survive much beyond that length of time. Clinical trials are constantly underway in hopes that a cure for the disease or a way to further prolong the life of a pleural mesothelioma sufferer will be discovered.

Types of Mesothelioma

Mesothelioma is a rare form of cancer that originates in the mesothelium. The mesothelium is a thin layer of flat cells that protect the body's internal organs. Our body's internal organs often require the ability to move within the chest and abdominal cavity. These are normal bodily motions of expansion and contraction. For organs to move freely in the body they require the lubrication of the mesothelium. Not only does it spread easily to other parts of the body, mesothelioma initiates within these areas, causing a serious health consequence to the normal body functions.

Among types of mesothelioma, there are generally three recognized forms in which it can manifest. The first and most common is malignant pleural mesothelioma, which develops in the pleural lining of the lung. The second and less common variety is malignant peritoneal mesothelioma, a cancer of the abdominal lining. The rarest form of mesothelioma is malignant pericardial mesothelioma, a cancer of the pericardial lining of the heart.

The only known cause for each of these three forms is exposure to asbestos. While there have been instances in which a patient's history did not include, or did not directly include asbestos exposure, it is blamed in the vast majority of cases. There is no known cure for mesothelioma and prognoses are generally poor. Treatments are readily available in most cases, the most widely used being chemotherapy and radiation therapy. Surgery may be an option but by the time mesothelioma manifests itself in terms of symptoms, stage at diagnosis may have already ruled this mesothelioma treatment route out.

New treatments are being diligently pursued, including multi-faceted treatment programs incorporating two or more of the above treatment programs into a single patient's care. Through awareness of mesothelioma, asbestos, and the potential health consequences we can begin ridding ourselves of this unfortunate disease.

Mesothelioma

Mesothelioma is a form of cancer that we are hearing more and more about every year as many people are being diagnosed with the disease. This type of cancer has developed in many people that worked with asbestos or have been exposed to asbestos frequently in their homes or apartments growing up.

There is more than one type of mesothelioma and the one type that is not as commonly seen is malignant mesothelioma. This form of the disease causes malignant cancer cells to form in the sac lining the chest, the lining of the abdominal cavity, and also the lining around the heart.

In recent years many people have been diagnosed with mesothelioma due to the high amounts of asbestos that was in use in the forties, fifties, sixties, and seventies. Usually the disease will develop after a lengthy period of time, and usually this happens around twenty-five to forty years, this is why it is becoming so common in the last decade or two. Mesothelium is the protective lining that protects most of the body's organs and this is where mesothelioma occurs.

Often times mesothelioma is misdiagnosed at first because some of the symptoms of this asbestos disease are similar to other conditions that could affect your health. If you have ever worked with asbestos or lived in a place with asbestos then you need to be sure to let the doctor know so they consider mesothelioma right away. With an x-ray the doctors can see if there is pleural thickening around the lungs and they will also do various lung tests and breathing tests. Tuberculosis and heart failure can sometimes show similar symptoms so they will do tests to check for these as well.

Mesothelioma is a very dangerous cancer and even if it is caught early on there is still at this point only a very slim chance of beating it. So if you have ever been exposed to asbestos be sure to see your doctor and there are also many mesothelioma lawyers that can help you with any legal issues involving asbestos and mesothelioma.