Mesothelioma - Patient Info - Find Lawyers / Attorneys
Medical Disclaimer
Mesothelioma Lawyers / Attorneys
Between 70% to 80% of people diagnosed with mesothelioma have a history of occupational asbestos exposure.
Mesothelioma Overview
Mesothelioma is a rare cancer that originates in the lining of the internal organs of the body. Approximately three-fourths of cases of mesothelioma begin in the mesothelium in the chest cavity, near the lungs (pleural mesothelioma). Mesothelioma that begins in the tissue surrounding the abdominal area (peritoneal mesothelioma) accounts for about 10% to 20% of cases. Mesothelioma does not originate in the lungs, and is often mistakenly grouped with lung cancers. In other words, mesothelioma is not always a lung cancer.
Mesothelioma - Three Main Types:
- Epithelial type of mesothelioma. The epithelial type of mesothelioma accounts for 50% to 70% of people diagnosed with mesothelioma, and has the best prognosis (slower growth, more likely to respond to treatment).
- Sarcoma type of mesothelioma. The sarcoma type of mesothelioma accounts for 7% to 20% of people diagnosed with mesothelioma, and has a worse prognosis.
- Mixed type of mesothelioma. The mixed type of mesothelioma accounts for 20% to 35% of people diagnosed with mesothelioma, and contains both epithelial and sarcomatous types. This type of mesothelioma has an intermediate prognosis.
Mesothelioma Statistics
It is estimated that less than 2,000 cases of mesothelioma are diagnosed each year in the United States. Men in their mid-60s are most often affected, but women and children also have been diagnosed with mesothelioma.
Mesothelioma has seen an increase in the past decade that can be attributed to the long latency period between asbestos exposure and development of symptoms.
Mesothelioma and all cancer statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer in the United States each year, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with mesothelioma. Because the survival statistics are measured in five-year (or sometimes one-year) intervals, they may not represent advances made in the treatment or diagnosis of this cancer.
Mesothelioma Risk Factors
Mesothelioma risk factors are anything that increases a person's chance of developing this disease. There are risk factors that can be controlled, such as smoking, and risk factors that cannot be controlled, such as age and family history. Although risk factors can influence disease, for many risk factors it is not known whether or not they actually cause the disease directly. Some people with several risk factors never develop the disease, while others with no known risk factors do. Knowing your risk factors and communicating with your doctor can help guide you in making wise lifestyle and health-care choices.
The following mesothelioma risk factors can raise a person's chances of getting mesothelioma:
- Mesothelioma from asbestos exposure. Between 70% to 80% of people diagnosed with mesothelioma have a history of occupational asbestos exposure. Asbestos is a group of natural minerals found in the earth. Because of its strong, flexible fibers, asbestos was once commonly added to cement, insulation, roof shingles, and other products. People involved in the manufacturing of products containing asbestos or their installation and maintenance can breathe in or swallow the asbestos fibers. These fibers can also be carried in asbestos dust on clothing or personal items and expose family members of the workers to potentially high levels of the minerals. Current safety regulations require people who work with asbestos to wear protective equipment and to shower and change clothes before leaving the workplace.
- Smoking and mesothelioma. Smoking by itself does not increase the risk of mesothelioma, but smoking and asbestos exposure greatly increases the risk of certain types of lung cancer.
- Radiation exposure and mesothelioma. Radiation exposure may cause mesothelioma, as can exposure to zeolite, another type of mineral.
- Infection and mesothelioma. Infection with certain viruses, such as the simian virus 40, may cause mesothelioma.
Even though some cases of mesothelioma occur with no known risk factors, many cases of mesothelioma can be traced to asbestos or chemical exposure. Therefore, it is important to always wear protective gear when working with asbestos.
Diagnosis of Mesothelioma
Doctors use many tests to diagnose cancer and determine if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:
- Age and medical condition
- The type of cancer
- Severity of symptoms
- Previous test results
Diagnosis requires a complete medical history. A review of the person's medical history, including asbestos exposure.
Physical examination. A physical examination may include chest x-rays as well as tests to measure lung function.
Computerized tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then puts these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a vein to provide better detail. CT scans can also be used to guide a needle biopsy, in which a fine needle is inserted into the suspicious area and a sample of cells is gathered for microscopic examination.
Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body.
Biopsy. A biopsy removes a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a diagnosis for certain. The type of biopsy performed will depend on the location of the cancer. The surgeon can make a small cut between two ribs and insert a thorascope, which enables the surgeon to view the area as well as take a small tissue sample. Similarly, the surgeon can cut into the abdomen and use a peritoneoscope to view the area and collect a tissue sample.
Mesothelioma Staging
Staging is a way of describing a cancer, such as where it is located, where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis (chance of recovery). There are different stage descriptions for different types of cancers. One tool that doctors use to describe the stage is the TNM system. This system uses three criteria to judge the stage of the cancer: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to the rest of the body. The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer so doctors can work together to plan the best treatments.
TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:
- How large is the primary tumor and where is it located? (Tumor, T)
- Has the tumor spread to the lymph nodes? (Node, N)
- Has the cancer metastasized (spread) to other parts of the body? (mesothelioma metastasis)
Mesothelioma Tumor
Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the stage of mesothelioma. Some stages are also divided into smaller groups that help describe a patient's condition in more detail. This helps the doctor develop the best treatment plan for each patient. Specific tumor stage information is listed below:
TX:
The primary mesothelioma tumor cannot be evaluated.
T0:
There is no tumor.
T1:
The mesothelioma tumor invades the ipsilateral parietal pleura (the thin membrane that lines the inner chest walls on the same side of the body as the tumor), with or without involvement of the visceral pleura (the innermost of the two layers of the pleura).
T1a:
The mesothelioma tumor invades the ipsilateral parietal pleura, with no involvement of the visceral pleura.
T1b:
The mesothelioma tumor invades the ipsilateral parietal pleura, with involvement of the visceral pleura.
T2:
The mesothelioma tumor invades any of the ipsilateral pleural surfaces with at least one of the following: visceral pleural tumor, invasion of the diaphragmatic muscle, or invasion of the lung.
T3:
The mesothelioma tumor involves any of the ipsilateral pleural surfaces, with at least one of the following: invasion of the endothoracic fascia (the membrane that surrounds the thorax) and/or invasion into mediastinal fat.
T4:
The mesothelioma tumor involves any of the ipsilateral pleural surfaces, with at least one of the following: diffuse or multifocal invasion of soft tissues of the chest wall, any involvement of rib, invasion through the diaphragm to the peritoneum, invasion of any mediastinal organ(s), direct extension to the contralateral pleura, invasion into the spine, extension to the internal surface of the pericardium, pericardial effusion with positive cytology, invasion of the myocardium, and/or invasion of the brachial plexus.
Mesothelioma Node
The "N" in the TNM staging system is for lymph nodes, the tiny, bean-shaped organs that help fight infection. Lymph nodes near the chest are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.
NX:
The regional lymph nodes cannot be assessed.
N0 (N plus zero):
There is no regional lymph node metastasis.
N1:
There is metastasis to the ipsilateral bronchopulmonary and/or hilar lymph node(s).
N2:
There is metastasis to the subcarinal lymph node(s) and/or the ipsilateral internal mammary or mediastinal lymph node(s).
N3:
There is metastasis to the contralateral mediastinal, internal mammary, or hilar lymph node(s) and/or the ipsilateral or contralateral supraclavicular or scalene lymph node(s).
Distant Metastasis of Mesothelioma
The "M" in the TNM system indicates whether the cancer has spread to other parts of the body.
MX:
Distant metastasis of mesothelioma cannot be assessed.
M0 (M plus zero):
There is no distant metastasis of mesothelioma.
M1:
There is metastasis of mesothelioma to other parts of the body.
Mesothelioma and other Cancers stage grouping
Doctors assign the stage of the cancer by combining the T, N, and M classifications.
- Stage I: The tumor has invaded the ipsilateral parietal pleura, with or without involvement of the visceral pleura, and has not spread to the lymph nodes or other parts of the body (T1, N0, M0).
- Stage IA: The tumor has invaded the ipsilateral parietal pleura, without involvement of the visceral pleura, and has not spread to the lymph nodes or other parts of the body (T1a, N0, M0).
- Stage IB: The tumor has invaded the ipsilateral parietal pleura, with involvement of the visceral pleura, and has not spread to the lymph nodes or other parts of the body (T2a, N0, M0).
- Stage II: The tumor has invaded any of the ipsilateral pleural surfaces with at least one of the following: visceral pleural tumor, invasion of the diaphragmatic muscle, or invasion of the lung. The cancer has not spread to the lymph nodes or throughout the body (T2, N0, M0).
- Stage III: The cancer has invaded any of the ipsilateral pleural surfaces with at least one of the following: visceral pleural tumor, invasion of the diaphragmatic muscle, or invasion of the lung; or the tumor involves any of the ipsilateral pleural surfaces, with at least one of the following: invasion of the endothoracic fascia (the membrane that surrounds the thorax), invasion into mediastinal fat with spread to the lymph nodes, but not to distant parts of the body. The cancer has also spread to the lymph nodes, but not throughout the body (T1 or T2, N1, M0; T1 or T2, N2, M0; T3, any N, M0).
- Stage IV: The cancer involves any of the ipsilateral pleural surfaces, with at least one of the following: diffuse or multifocal invasion of soft tissues of the chest wall, any involvement of rib, invasion through the diaphragm to the peritoneum, invasion of any mediastinal organ(s), direct extension to the contralateral pleura, invasion into the spine, extension to the internal surface of the pericardium, pericardial effusion with positive cytology, invasion of the myocardium, and/or invasion of the brachial plexus. Stage IV can also mean that the tumor is of any size and the cancer has spread to distant lymph nodes, or the cancer has spread to other parts of the body(T4, Any N, M0; any T, N3, M0; or any T, any N, M1).
- Recurrent: This is cancer that has come back after treatment. It may return in the chest or in another part of the body.
Mesothelioma Treatment
The treatment of mesothelioma depends on the size and location of the tumor, whether the cancer has spread, and the person's overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan. For mesothelioma, there are three main types of treatment: surgery, radiation therapy, and chemotherapy.
Mesothelioma and Surgery
The type of surgery for mesothelioma depends on the stage and location of the cancer. Surgeons may remove the affected lining. In the case of pleural mesothelioma, this is called a pleurectomy, and in peritoneal mesothelioma it is called a peritonectomy. Generally all of the tumor cannot be removed with these procedures. A more aggressive surgery for pleural mesothelioma is called an extrapleural pneumonectomy. This involves removal not just of the lining of the lung, but also the entire lung itself, a portion of the diaphragm, and often a portion of the lining around the heart. This is a difficult surgery to have done and is recommended only for very fit patients with relatively early stage disease. If the entire tumor cannot be removed, other treatments such as radiation therapy or chemotherapy may be recommended.
Mesothelioma and Radiation Therapy
Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy.
Side effects from radiation therapy include tiredness, mild skin reactions, upset stomach, and loose bowel movements. Most side effects go away soon after treatment is finished.
Mesothelioma and Chemotherapy
Chemotherapy for mesothelioma is the use of drugs to kill cancer cells. Systemic chemotherapy uses drugs to target cancer cells throughout the body. The side effects of chemotherapy vary for each individual and depend on the drugs used.
The chemotherapy treatment best studied in mesothelioma is the combination of pemetrexed (Alimta) and cisplatin (Platinol). These medications are given intravenously (by vein) every three weeks. The most common side effects include, but are not limited to, nausea, vomiting, damage to the kidneys, numbness and tingling in the fingers or toes, decreased hearing, rash, fatigue, lowering of the white blood count making one susceptible to infection, or lowering of the red blood count (anemia). Patients on this treatment take vitamins (B12 and folic acid) to decrease the risk of these toxicities. Other medications are also available, such as antinausea medications, to counteract many of these side effects.
Mesothelioma Palliative Care
The goal of palliative care is to relieve the symptoms that result from the cancer and cancer treatment. Examples of palliative care for mesothelioma include draining fluid that has built up in the patient's chest or abdomen or using radiation therapy or chemotherapy to relieve symptoms.
Mesothelioma - Seeking Understanding
Questions for your Doctor
Regular communication with your doctor is important in making informed decisions about your health care. Consider asking the following questions of your doctor:
- What is the stage of my mesothelioma / cancer and what does that indicate for treatment options?
- What type of side effects from treatment can I expect?
- What is my prognosis of mesothelioma / cancer?
- How can I keep myself as healthy as possible during treatment for mesothelioma / cancer?
- What treatments are available for mesothelioma patients to improve my symptoms (such as, pain medications, appetite stimulants, etc.)?
Mesothelioma Research
Mesothelioma research involving more advanced diagnostic procedures and treatment for mesothelioma is ongoing. The following advancements may still be under investigation in clinical trials and may not be approved or available at this current time. Always discuss all diagnostic and treatment options with your doctor.
Mesothelioma research is ongoing evaluating new treatments for mesothelioma, including intrapleural interferon gamma, photodynamic therapy, and immunotherapy. Research projects at various universities are underway to identify genes that become mutated to cause mesothelioma and to find DNA methylation markers that could help detect early stage mesothelioma.
Additional Mesothelioma Patient Information
Rare Cancer Alliance
http://www.rare-cancer.org/
National Organization for Rare Disorders
55 Kenosia Avenue
PO Box 1968
Danbury, CT 06813-1968 United States
Phone: 203-744-0100
Fax: 203-798-2291
http://www.rarediseases.org/
More Resources:
Mesothelioma Clinical Trials
Doctors and scientists are always looking for better ways to treat patients with mesothelioma. A clinical trial is a way to test a new treatment in order to prove that it is safe, effective, and possibly better than a standard treatment. Patients who participate in clinical trials are among the first to receive new treatments, such as new chemotherapy drugs, before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.
Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that this is the only way to make progress in treating mesothelioma, such as finding new drugs. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with mesothelioma.
In order to join a clinical trial, patients must complete a learning process known as informed consent. During informed consent, the doctor should list all of the patient's options, so that the person understands the standard treatments, and how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different than the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment. Learn more about clinical trials, including patient safety, phases of a clinical trial, deciding to participate in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.
Search for "Mesothelioms Clinical Trial"
Keywords: mesothelioma, malignant pleural mesothelioma, mesothelioma attorneys, lawyers, cancer, epithelial, sarcoma, mixed,
