Only about 3,000 cases of mesothelioma are diagnosed each year.  Patients and their loved ones have questions about this rare cancer.  Here are some of the answers to the some frequently asked questions.

About Mesothelioma

What is mesothelioma?

Mesothelioma is a type of malignant cancer that affects the lining of certain organs and body tissues including the lungs (pleural mesothelioma), abdomen (peritoneal mesothelioma), heart (pericardial mesothelioma) or testicles (testicular mesothelioma).

What causes mesothelioma?

Mesothelioma is almost always caused by inhalation or ingestion of the needle-like fibers of asbestos.  These small fibers may lodge in body tissues and over a long period of time, cause cells to begin dividing uncontrollably.

Is mesothelioma a rare disease?

In order for a disease to be called “rare”, it must affect less than 200,000 people each year.  Mesothelioma is a very rare type of cancer with only 3,000 new cases diagnosed each year.

Symptoms of Mesothelioma

What are the symptoms of pleural mesothelioma?

Pleural mesothelioma affects a lining of tissue surrounding the lungs.  Common symptoms include: chest pain, shortness of breath, and persistent cough. Some symptoms are caused by fluid buildup in the chest, known as pleural effusion.

What are the symptoms of peritoneal mesothelioma?

Peritoneal mesothelioma affects the lining of the abdominal cavity.  Common symptoms include: abdominal pain, difficulty breathing, and swelling of the abdomen.  Some symptoms are caused by fluid buildup in the abdomen, known as ascites.

What are the symptoms of pericardial mesothelioma?

Pericardial mesothelioma affects the sac surrounding the heart.  Common symptoms include: chest pain, arrhythmia, and difficulty breathing.  Some of the symptoms are caused by compression of the heart due to fluid buildup inside of the pericardial sac.

What is the latency period of mesothelioma?

The latency period is the time it takes for a disease to develop after exposure.  Mesothelioma has a very long latency period and symptoms do not often develop for 20 to 50 years after asbestos exposure.

Risks of Mesothelioma

Who is at most risk of getting mesothelioma?

Mesothelioma is caused by asbestos exposure.  Most mesothelioma patients had occupational exposure while working in jobs that used asbestos as insulation.

What is secondary exposure mesothelioma?

Secondary exposure is also called “bystander” mesothelioma.  It most commonly occurs when household members were exposed to asbestos through dust that was transported into the home on contaminated clothing from someone else’s job.

Are men or women most likely to get mesothelioma?

Over 80% of all mesothelioma cases are diagnosed in men.  This may be due to the greater chance that men had more occupational exposure.

Does race have anything to do with mesothelioma?

Up to 95% of all mesothelioma cases are diagnosed in Caucasians.  This does not mean that those of other races or ethnic groups do not get mesothelioma if they were exposed to asbestos.

Does age have anything to do with mesothelioma?

Because the latency time is so long (20 to 50 years), most mesothelioma patients are over 65 but it has affected some, much younger people.

Why are so many veterans diagnosed with mesothelioma?

Up to 30% of mesothelioma patients were in the military while asbestos was in common use.  There were up to 5 million veterans exposed to asbestos before 1980 when many asbestos products were in use.  Many of these veterans were exposed from insulation on ships, in boiler rooms and other high-heat areas or from work with items such as brake pads and sheeting.

What do I do if I think I was exposed to asbestos and have symptoms of mesothelioma?

Any mesothelioma symptoms should be reported to a physician.  If you think you have been exposed to asbestos, you should tell your physician who can test you for the disease.  Common tests include X-rays or other scans, blood testing and biopsy.

Diagnosis of Mesothelioma

How is mesothelioma diagnosed?

In order to diagnose mesothelioma, doctors may perform imaging tests such as X-ray, CT scan, PET scan or MRI.  Blood testing may be performed to look for certain proteins, known as biomarkers, which are released into the bloodstream by mesothelioma cells. If these tests indicate mesothelioma, a sampling of tissue, known as biopsy, may be taken through a needle or through surgery.  The tissue will be examined under a microscope to confirm mesothelioma and identify cell type.

Is mesothelioma ever misdiagnosed?

Mesothelioma is a very rare disease that takes a long time to develop (latency time).  In addition, symptoms of mesothelioma are similar to other common disorders.  These factors make it less likely that mesothelioma will be suspected and the disease may initially be misdiagnosed as other disorders affecting the lungs, abdomen, heart or intestines.  Even when cancer is suspected, pleural mesothelioma has been misdiagnosed as lung cancer and peritoneal mesothelioma may be mistaken for ovarian cancer or other cancers of abdominal organs.  It is important to contact a mesothelioma specialist as soon as possible to ensure an accurate diagnosis.

What are the “cell types” of mesothelioma?

In addition to the classification of mesothelioma by location (pleural, peritoneal, pericardial, or testicular), there are three “cell types”.  These are epithelioid, sarcomatoid, and biphasic.  The cell type will be confirmed by biopsy and helps to determine prognosis and treatment options.

What are the differences in cell types?

Epithelioid mesothelioma cells originate from cells similar to the skin.  They tend to “stick” together and though they may divide more rapidly and produce large tumors, they are less likely to spread or metastasize and are considered most treatable.

Sarcomatoid cells originate from soft tissue and produce “disorganized” or fibrous tumors which may have fluid centers.  They are considered the most aggressive and may metastasize more easily as cells break free, making them less susceptible to treatment.

Biphasic cells or tumors are actually a combination of both epithelioid and sarcomatoid.  Tumor behavior may depend on which type of cell is most prevalent, but may also be unpredictable.  Treatment of this mesothelioma cell type is the most challenging because both types of cells must be addressed.

Stages of Mesothelioma

What are the stages of mesothelioma?

Like other cancers, mesothelioma is usually classified into one of 4 stages which indicate how advanced the cancer is.  In some cases however, mesothelioma may only be classified by whether or not surgery is a treatment option.

How is the stage of mesothelioma determined?

Mesothelioma stages are determined by tumor size, lymph node involvement and whether the cancer has spread to other organs or metastasized.  Earlier stages have smaller tumors with little or no lymph node involvement.  Later stages have larger or more tumors and greater lymph node involvement which may spread the cancer.  The stage may also help to determine prognosis and what treatment options may be available.

Which stage is the most serious?

Stage 4 mesothelioma is the highest level and the most advanced.  Stage 4 mesothelioma indicates that there are one or more tumor(s) which are large, lymph nodes that are farther away contain many cancer cells, and new tumors have begun to grow on other organs such as the liver, brain, bladder or kidneys.

What is the prognosis of mesothelioma?

The prognosis indicates how severe the disease is and how likely it is that treatment will work. Prognosis is also used to estimate life expectancy.

What is the life expectancy of mesothelioma?

Life expectancy is determined by the mesothelioma type or location, cell type, stage of mesothelioma and other factors such as age, gender and general health.  Most mesothelioma cases have a life expectancy which can range from 6 to 24 months, but may be much higher, particularly when the cancer is caught in early stages and aggressive treatment are used.  Some patients have lived for many years despite being given a poor prognosis with short life expectancy.

What are the treatment options?

Depending on the mesothelioma type or location, cell type, and stage of the cancer, treatment options may include surgery, chemotherapy, radiation and newer medications or procedures.  In some cases, new treatments may be available as part of an investigational study or clinical trial.

In very advanced mesothelioma, treatment options may be limited to palliative care which is used only to reduce symptoms and relieve discomfort. Seeking treatment from a mesothelioma specialist will help to ensure that all treatment options are considered.

About Asbestos

What is asbestos?

Asbestos is a naturally-occurring mineral comprised of needle-like fibers.  It comes from mining of mineral deposits which may also contain other minerals.  It was commonly used in many products for its insulation properties until the 1970s and 80s, when it was found to be toxic but some products still contain asbestos.

Where is asbestos found?

Asbestos is found in most regions of the world.  In the U.S., there are over 900 asbestos deposits located in 20 states.  Some of these are located near or alongside other minerals such as vermiculite and talc.  Most of the asbestos are located in mountainous areas, though asbestos can occur in any area that is mainly limestone rock.

The largest deposits in the Western part of the U.S. are located in the northern Rocky Mountains, largely in Montana, Wyoming, Washington and Idaho and in the Sierra Nevada, including many locations in California along with a large deposit recently discovered in Nevada.  In the Eastern U.S. asbestos was widely mined throughout Appalachians, particularly in Vermont, Pennsylvania, Virginia and Georgia.

Are there different types of asbestos?

There are two main types of asbestos, serpentine and amphibole.  Serpentine asbestos has a curly shape and is more flexible. Amphibole asbestos is sharper, more brittle and more likely to stick into body tissues and cause mesothelioma.

Is asbestos still used in North America?

Though the U.S. has largely discontinued use of asbestos, it is only a partial ban.  It is still used in some products where fibers are unlikely to become airborne such as cement pipes but many older products still contain asbestos.  Other areas such as the European Union, Australia, New Zealand, and Japan have banned all asbestos use in new construction but many countries continue widespread use including India, Indonesia, Russia, Brazil and China.

Where is asbestos used?

Asbestos was used mainly for its insulation properties.  Serpentine sub-type chrysotile was the most commonly used form of asbestos in the U.S. and used in the production of many products such as pipe insulation, flooring, fireproof clothing, brake pads and drywall. Amphibole sub-types, amosite and crocidolite were used in low density insulating boards and ceiling tiles, and asbestos-cement products but it was also a contaminant in automotive parts.  In addition, asbestos was a constituent of some surprising products including cigarette filters, artificial snow (flocking), gas mask and other filters, stage curtains, dental cast linings and as an additive to drilling fluids.

What should I do if I find asbestos in my home?

Asbestos is still present in many older homes and buildings.  If asbestos is found, it should not be disturbed by individuals but should be addressed by a specialist company.  The Environmental Protection Agency maintains a list of asbestos removal and containment companies.  One of these companies should be contacted if asbestos is discovered.

Are some people more susceptible to asbestos than others?

No differences have been found that increase a person’s susceptibility to asbestos. Men are more likely to have asbestos-related illnesses including mesothelioma, largely due to greater occupational exposure in the military or industries such as steel production, construction, firefighting, and automotive manufacturing.