Each year, about 3,000 people will be diagnosed with mesothelioma. Mesothelioma is a type of cancer that affects the thin membrane covering and protecting certain body organs, known as the mesothelium. Mesothelioma is most commonly caused by long-term exposure to asbestos but may also occur after severe, acute exposure. The cancer may take 20 to 50 years to develop and most commonly affects the lungs but may affect other areas such as the abdomen, chest, heart or testicles.
Because mesothelioma is rare, difficult to treat and can be fatal, it is essential that anyone diagnosed with mesothelioma find a physician who specializes in the disease. Unlike most doctors, even many oncologists, mesothelioma specialists treat the disorder on a regular basis. He or she will be able to accurately diagnose and assess the stage of the cancer and can provide the most up-to-date treatment options available, including newer treatments that are still under investigation but available in clinical trials.
About Mesothelioma
Mesothelioma is caused by exposure to asbestos, a thin, fiber-like substance that can lodge in body organs such as the lungs, abdomen, heart and testicles to cause cell mutations and inflammation which can lead to the development of cancer.
Most people who are diagnosed with mesothelioma were exposed to asbestos at work in industries such as steel manufacturing, auto work, ship building, construction, pipe-fitting and others. In other cases, family members of asbestos workers may develop mesothelioma due to dust carried in on the clothing of the family member.
Mesothelioma most commonly affects the lungs (pleural mesothelioma), but can also affect other areas such as the abdomen (peritoneal mesothelioma), the heart (pericardial mesothelioma) and the testicles (testicular mesothelioma).
Mesothelioma Treatment Options
Mesothelioma treatment is determined by the location of the tumors, the type of cells that have developed cancer, the stage of the disease and other patient specifics such as medical condition.
Treatment options for mesothelioma most often include:
Surgery
Surgical removal of the tumor(s) and a healthy area of additional tissue that surrounds the tumor known as a “margin”.
Surgery may be helpful in any type of mesothelioma but has a higher rate of success at earlier stages when lymph nodes are not affected. It is also more effective when combined with other treatments. In some cases of pleural mesothelioma, the entire lung may be removed (pneumonectomy) rather than just the tumor (pleurectomy). Surgery is also used in advanced stages to alleviate symptoms and improve the patient’s quality of life.
Chemotherapy
Medication that is targeted to kill cancer cells.
Chemotherapy is the most common treatment for mesothelioma and there are many different medications, most of which are given through an IV infusion but some are given in oral (pill) formulation or as a peritoneal (inside the abdomen) treatment. Each cancer type will be more susceptible to certain medications. Most chemo drugs have a wide range of side effects, some of which may be severe. Chemo is often used in combination with surgery or radiation to ensure that all of the cancer cells are killed. Chemotherapy may also be used before surgery to shrink tumors and make surgery easier or more successful. It may also be used in later stages to shrink tumors to provide symptomatic relief and increase the patient’s quality of life. Common medications used for mesothelioma include
- Adriamycin (doxorubicin)
- Alimta (premexetred)
- Cytoxan (cyclophosphamide)
- Doxol (doxorubicin)
- Gemzar (gemcitabine)
- Mutamycin (mitomycin)
- Navelbine (vinorelbine)
- Onconase (ranpirnase)
- Onxal (paclitaxel)
- Platinol (cisplatin)
- Taxol (paclitaxel)
Radiation
Concentrated energy waves or beams that kill tumor cells.
Traditional radiation uses X-rays to focus on tumor(s) and kill cancer cells. Radiation use has been challenging in mesothelioma because tumors are formed in and near vital organs of the lungs and heart. Newer techniques for radiation including IMRT (intensity modulated radiotherapy) can more accurately target cancerous tumor cells while avoiding healthy tissue. Radiation may be used as part of a multi-modal regimen with surgery and / or chemotherapy to ensure that all the cancer cells are killed. It may also be used before surgery to shrink tumor size and make surgery more effective or as a palliative measure to shrink tumor size and make the patient more comfortable.
Investigational therapies
Treatments that have not yet been approved for mesothelioma but are showing promising results.
New therapies and medications are constantly in development. Some of these newer treatments may be available if the patient is enrolled in a clinical trial which tests the effectiveness of new medications and procedures. Mesothelioma treatments currently under investigation include photo therapy, advanced radiation techniques, immunomodulation medications and genetic therapies.
Palliative treatment
To alleviate symptoms of mesothelioma and make the patient more comfortable at advanced mesothelioma cancer stages.
When mesothelioma has spread into the lymph nodes or to distant parts of the body, a cure may not be likely. In these cases, treatments may be used to alleviate symptoms, reduce pain and improve quality of life. Palliative care commonly includes pain management but may also include traditional “treatment” regimens such as chemotherapy, radiation and surgery. In these cases, the treatments are not intended as a cure but may reduce symptoms caused by large tumors or that result in pain or medical difficulties.
Mesothelioma Diagnosis
Mesothelioma may take 20 years or more to develop. Some symptoms may develop suddenly, while others have been present for a long time but may have been interpreted as another disorder. Depending on the location of the disease, imaging studies such as X-ray, CT scans and PET scans will be performed. The physician may also perform blood tests to detect certain proteins and if found, a biopsy of the tumor may be ordered. Biopsy tissue will be examined microscopically to verify cancer and determine the type of cells that are involved. This diagnostic information will help to determine how far the cancer has progressed and what treatment modalities may be effective.
There are four basic types of mesothelioma including:
Lungs – Pleural Mesothelioma
- The most common type of mesothelioma involves the lining surrounding the lungs. The stage of cancer will have a great impact on treatment options and outcome. Symptoms include:
- Dry cough
- Persistent cough
- Shortness of breath
- Chest pain
- Difficulty swallowing
- Fatigue or weight loss
Abdomen – Peritoneal Mesothelioma
- The second-most common type of mesothelioma occuris in the peritoneal mesothelium, lining the abdominal cavity. Stage of peritoneal mesothelioma will determine treatment regimens and potential prognosis. Symptoms include:
- Abdominal pain
- Abdominal swelling or fluid retention
- Nausea and vomiting
- Bowel irregularity
- Fatigue or weight loss
- Seizures
Heart – Pericardial Mesothelioma
- Cancer of the pericardial mesothelium that surrounds the heart is rare and not often diagnosed while the patient is living but symptoms may include:
- Chest pain
- Shortness of breath
- Difficulty breathing
- Arrhythmia or irregular heart beat
- Fatigue and weight loss
- Fever
Scrotum – Testicular Mesothelioma
- Cancer of the lining that surrounds the testicles is the rarest type of mesothelioma and may be more difficult to diagnose but often has a better prognosis with treatment. Symptoms may include:
- Testicular pain
- Swelling of the scrotum
- Redness of the scrotum
Stages of Mesothelioma
Treatment of mesothelioma depends highly upon the location of the cancerous tumors and the type of cancer cells. The stage of the cancer will also be significant factor in determining treatment options.
Mesothelioma cancers are classified by a variety of means but most commonly include:
- Stage 1 – Localized tumor with no lymph node involvement. Due to the time difference between exposure and tumor development, mesothelioma cancers are not often caught at this early stage as symptoms of mesothelioma may be vague or interpreted as a different disease.
- Stage 2 – Tumors remain localized but some lymph nodes have become involved. At this stage, a variety of treatment options are often available. Mesothelioma symptoms will vary according to type and location of cancer.
- Stage 3 – Tumor(s) have spread into additional tissues and into more lymph nodes. Mestothelioma symptoms may be more apparent and tests will clearly indicate the source of disease. Many cases require aggressive surgery and other treatments.
- Stage 4 – Tumor development may have begun in distant parts of the body, including other organs. This is a very advanced stage and treatments may be performed to alleviate symptoms, rather than to attempt to cure the cancer.
Mesothelioma treatment costs
The cost burden of mesothelioma treatment is high. The cancer symptoms may be debilitating and treatments themselves may result in loss of productivity. Mesothelioma can also be deadly disease, resulting in death.
The medical community has shown a clear link between asbestos exposure and mesothelioma development. Certain companies and the industry as a whole have been held responsible for the damage asbestos has caused in terms of loss of income, medical costs and loss of life.
Several lawsuits against those in the certain asbestos-related industries have resulted in millions of dollars awarded to victims and families but in addition, the industry has been required to set aside a large mesothelioma fund to help victims.
Each occurrence of mesothelioma is unique and must be evaluated as a separate case by a mesothelioma specialist physician to determine appropriateness of diagnosis and options for treatment. Many of those victims may be eligible for reimbursement for costs related to the disorder and like treatment, evaluation must be done by a mesothelioma legal expert.
