Mesothelioma
What is 'malignant mesothelioma'?
Malignant mesothelioma is a type of a cancer which develops most commonly in relationship to asbestos exposure. Virtually all malignant mesotheliomas develop in the chest cavity, but rarely they can also develop in the abdominal cavity.
What is the mesothelium?
The mesothelium is a lining that covers many of the organs in our body, and depending on which organ we are discussing, it has a different specific name. For example, in the chest cavity the lining that covers the lungs and the inside of the chest cavity is known as the pleura. The lining that covers the heart is known as the pericardium, and in the abdominal cavity the lining that covers the stomach and the intestines and so forth is known as the peritoneum.
How common is mesothelioma?
Mesothelioma's a relatively rare condition. In terms of looking at our country, you're talking about a disease in which there may be twenty to thirty diagnosed cases per million people. That's obviously a rare condition. However, in the appropriate workplace setting, it can unfortunately be a more common condition. Asbestos use, which is widely acknowledged to be the cause of mesothelioma, reached its peak in the 1970's. Because this disease has a latency of anywhere from twenty to thirty to forty years, many of the people who were heavily exposed in the 1960's and 1970's are only coming to medical attention now.
How is mesothelioma diagnosed?
Mesothelioma is diagnosed first and foremost on the basis of an appropriate clinical history. Mesothelioma is a very rare diagnosis in the absence of asbestos exposure, although it does occasionally come up in individuals where we're never able to document prior exposure to asbestos. The vast majority of people worked in an industry where there was significant asbestos exposure, so that's going to be the first point. The second point is appropriate findings on physical examination and on chest imaging, which could include a chest x-ray and a CAT scan of the chest. Finally, some sort of a biopsy of the affected portion of the lung is needed to document the presence of this malignancy.
How is mesothelioma treated?
The treatment of malignant mesothelioma, unfortunately, can be quite difficult because, often times, if not most of the time, the diagnosis is made when the disease is in a relatively advanced stage when no significant treatment is available. Sometimes, palliative chemotherapy, which means a type of a chemotherapy given just to slow down the progression of the disease, or a chemotherapy to perhaps add several months to somebody's life can be offered, but more often than not, the treatment choices are really quite limited. On occasions, if the disease is caught early enough, there can be very aggressive surgical procedures where the entire lung as well as the pleura are removed in one block, and then that individual is given additional radiation and chemotherapy, and there are certain specialized centers around the country that perform this type of procedure and this type of care. They've actually had some limited success in treating this condition, but again that's really reserved for a relatively small percentage of people in whom the disease is caught at a treatable stage. For most individuals, treatment at best is going to be some type of chemotherapy to perhaps add some period of time to someone's life. But very often, individuals unfortunately go directly into a hospice care program, where they're basically just given palliation and pain control and support for whatever time they have remaining.
What are the symptoms of mesothelioma?
The common symptoms of malignant mesothelioma can be quite different depending on how the disease presents. It can be anything from chest pain to weight loss, to shortness of breath, to fever. It's quite varied. Certainly, if somebody is having any of those symptoms that doesn't mean that one has the diagnosis of malignant mesothelioma, but certainly those symptoms should prompt somebody to go see their doctor or go to see their pulmonologist for additional evaluation.
