Asbestos Lung Cancer

Peritoneal Mesothelioma

2004-12-01T12:39:00.000-08:00

Many of the organs in the abdomen are enveloped by a thin membrane of mesothelial cells, known as the peritoneum.
Peritoneal mesothelioma is a tumor of this membrane. Its only known cause in the U.S. is previous exposure to asbestos, but it can be many years after exposure before the disease appears. Peritoneal mesotheliomas account for about one-fifth of all mesotheliomas.

Like pleural mesothelioma, peritoneal mesothelioma can be either benign or malignant. This discussion is only about malignant peritoneal mesothelioma.

Mesothelioma is sometimes diagnosed by coincidence, before any symptoms have appeared. For example, the tumor is sometimes seen on a routine abdominal x-ray for a check-up or before surgery.

When the symptoms of peritoneal mesothelioma appear, they typically include abdominal pains, weakness, weight loss, loss of appetite, nausea, and abdominal swelling. Fluid often accumulates in the peritoneal space, a condition known as ascites. Over time the wasting symptoms can become more and more severe.

The growing tumor can exert increasing pressure on the organs in the abdomen, leading to bowel obstruction and distention. If the tumor presses upward, it can impair breathing capacity. If the tumor pushes against areas with many nerve fibers, and the bowel distends, the amount of pain can increase.

X-rays and CT scans are, typically, the first step towards detecting peritoneal mesothelioma. The actual diagnosis is typically achieved by obtaining a piece of tissue. The medical procedure of looking at the peritoneum is known as a peritoneoscopy. It is a hospital procedure and requires anesthesia. If an abnormality is seen, the doctor will attempt to obtain a tissue sample - this is known as a biopsy. The tissue sample will be examined by a pathologist who makes a diagnosis using microscopic analysis of specialized stains.

There are at least two explanations for how asbestos fibers can get into the peritoneum. The first is that fibers caught by the mucus of the trachea and bronchi end up being swallowed. Some of them lodge in the intestinal tract and from there they can move through the intestinal wall into the peritoneum. The second explanation is that fibers that lodge in the lungs can move into the lymphatic system and be transported to the peritoneum.

Medical science does not know exactly how or why, at a cellular level, a carcinogen like asbestos causes a cell to become malignant (cancerous.) Thus it is not known whether only one fiber can cause a tumor to develop or whether it takes many fibers, or what the exact conditions and predispositions are for this change to happen.

At this time there are treatments, but no known cure, for peritoneal mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, its extent, the cell type, and whether or not the tumor responds to treatment.

However, the options for relief and treatment of people with peritoneal mesothelioma have improved, especially for those whose cancer is diagnosed early and treated vigorously. Many people receive a combination of therapies, sometimes known as multimodal therapy.

Pleural Mesothelioma

2004-11-24T14:24:00.000-08:00

Pleural mesothelioma is of two kinds: (1) diffuse and malignant (cancerous), and (2) localized and benign (non-cancerous.)
Benign mesotheliomas can often be removed surgically, are generally not life-threatening, and are not usually related to asbestos exposure. Malignant mesotheliomas, however, are very serious. Fortunately, they are rare - about two thousand people are diagnosed with mesothelioma in the U.S. each year.

The remainder of this section is about diffuse malignant pleural mesothelioma.

Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. Its only known cause in the U.S. is previous exposure to asbestos fibers, including chrysotile, amosite or crocidolite. This exposure is likely to have happened twenty or more years before the disease becomes evident, since it takes many years for the disease to "incubate." It is the most common type of mesothelioma, accounting for about 75% of all cases.

Mesothelioma is sometimes diagnosed by coincidence, before there are any symptoms. For instance, tumors have been discovered through routine chest x-rays. However, when symptoms occur, they may include shortness of breath, weakness, weight loss, loss of appetite, chest pains, lower back pains, persistent coughing, difficulty in swallowing, alone or in combination. An initial medical examination often shows a pleural effusion, which means an accumulation of fluid in the pleural space - the area between the lungs and the chest wall.

The first step in detecting pleural mesothelioma is, typically, a chest x-ray or CT scan. This is often followed by a bronchoscopy, using a viewing scope to look inside the lungs.

The actual diagnosis usually requires obtaining a piece of tissue through a biopsy. This could be a needle biopsy, an open biopsy, or through a tube with a camera (thoracoscopy or chest scope.) If an abnormality is seen through the camera then a tissue sample can be taken at the same time, using the same tube. This is a hospital procedure that requires anesthesia, but is not usually painful. The tissue sample is tested by a pathologist.

Fluid build-up from the pleural effusion can generally be seen on a chest x-ray and heard during a physical examination, but a firm diagnosis of mesothelioma can only be made through a biopsy and pathological testing. This is important because there are also benign pleural effusions and other tumors that have a similar appearance to mesothelioma. Diagnosing mesothelioma can be quite difficult; it requires special lab stains, and much experience in understanding them.

The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle. With the lungs restricted, they get smaller and less functional, and breathing becomes more difficult. At first a person with mesothelioma may be breathless only when he or she exercises, but as lung function drops, he or she can become short of breath even while resting.

The tumor spreads by direct invasion of surrounding tissue. As it spreads inward it can compress the lungs. As the tumor spreads outward it can invade the chest wall and ribs, and this can be extremely painful.

Current medical science does not know exactly how and why, at a cellular level, asbestos fibers cause mesothelial cells to become abnormal (malignant or cancerous.) Thus it is not known whether only one fiber causes the tumor or whether it takes many fibers. It seems that asbestos fibers in the pleura can start a tumor as well as promote its growth; the tumor does not depend on any other processes for its development.

There is as yet no known cure for malignant mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment. The Firm has represented many clients who lived for five to ten years after diagnosis, most of them in good health for a majority of those years. Some mesothelioma victims succumb within a few months; the average survival time is about a year.

The treatment options for people with mesothelioma have improved significantly, especially for those whose cancer is diagnosed early and treated vigorously. Many people are treated with a combination of therapies, sometimes known as multimodal therapy.

Specific types of treatment include:

Chemotherapy and other drug-based therapies
Radiation therapy
Surgery and
Intra-operative photodynamic therapy.
There are also experimental treatments like gene therapy and immunotherapy, angiogenesis inhibitors, and clinical trials for various new treatments and combinations of treatments.

Treatments that reduce pain and improve lung function, are becoming more successful (although they cannot cure mesothelioma.) Pain control medications have become easier to administer. Debulking is a surgical process of removing a substantial part of the tumor and reducing the pleural thickening; this can provide significant relief. X-ray therapy has also been successfully used to control the tumor and the pain associated with it for a while.

Early Signs of Malignant Mesothelioma

2004-11-11T04:37:00.000-08:00

Early symptoms of malignant mesothelioma may include difficulty in breathing (dyspnea) and/or chest pains, fever, nausea or anemia; other signals are hoarseness, difficulty swallowing (dysphagia), or coughing up blood (hemoptysis). For many suffering from pleural mesothelioma, there may be pain in the chest or lower back. Those people with peritoneal mesothelioma may experience an expanding waist size or abdominal pain resulting from the growth of cancer cells in the abdomen. Since many of these symptoms are also caused by less serious illnesses, it can be difficult to recognize asbestos-related diseases in the early stages. Due to this difficulty of early detection of asbestos cancer and mesothelioma, the best way to determine your health risk is to consult a doctor for an initial examination, which may include a pulmonary function test (PFT) and x-rays.

Mesothelioma: Surgery

2004-11-07T20:38:00.000-08:00

here are two main types of surgical treatment for pleural mesothelioma: extra-pleural pneumonectomy (EPP) and pleurectomy/decortication.
EPP involves the removal of the pleura, diaphragm, pericardium, and the whole lung involved with the tumor. Pleurectomy/decortication involves the removal of the pleura without removing the entire lung.

Which treatment is recommended depends on many factors, including the stage of the tumor. (The NCI has a detailed description of mesothelioma stages.) However, it is unclear if EPP provides significantly greater benefits than pleurectomy/decortication, and indeed if either is significantly more effective than non-surgical options.

A recent study followed about 400 mesothelioma patients who, between 1983 and 1998, had pleurectomy/decortication, or extra-pleural pneumonectomy (EPP), or thoracotomy. The results indicate that no one type of surgery was more effective than another in extending the survival rate. Rather, other factors seemed to determine how long people survived. These factors included the stage and cell type of the tumor, the gender of the patient, and the type of treatment(s) given together with the surgery. Click here for the text of this study.

Surgery can provide symptomatic relief and sometimes the bulk of the tumor can be removed. Surgery is often used in combination with other treatments (known as multi-modal treatments), but its value is very limited if the tumor is near any vital organs.

Both EPP and pleurectomy/decortication are complex surgeries, not performed frequently by most surgeons. They require referral to centers dedicated to such treatments. Many of these centers also specialize in other forms of mesothelioma treatment, either alone or in combination (multi-modal therapy.) You should discuss referrals with your doctor.

Multimodal Treatment of Mesothelioma

2004-10-24T05:37:00.000-07:00

Doctors specializing in mesothelioma treatment frequently adopt a multimodal approach: they treat a patient with a combination of therapies. Due to the relative lack of effectiveness of single-modality treatment in affecting patient survival, the multimodal combination of treatments holds more promise for survival of malignant mesothelioma patients. For an over view of single-mode and multimodal treatment regimens, see the abstract of "Treatment of Malignant Mesothelioma" by M.T. Jaklitsch, S.C. Grondin, and D.J. Sugarbaker and published in the World Journal of Surgery in 2001.
The December 1999 issue of the medical journal, Chest, published a clinical case presentation that illustrates a fairly typical multimodal treatment. The patient was a 52-year-old man with an early diagnosis of Stage I pleural mesothelioma. Doctors performed a pleurectomy (i.e. surgery) and then delivered intrapleural doses of chemotherapy drugs. Then he received additional localized radiation and chemotherapy. Two years after the surgery he did not show evidence of the tumor.

Mesothelioma - Cancer of the Lung Lining

2004-09-13T23:44:00.000-07:00

Mesothelioma is a very rare form of lung cancer that arises in the mesothelium. The mesothelium is made up of parietal and visceral membranes, thin layers of tissue, which surround organs and body cavities, such as the lungs or abdomen. The visceral membrane immediately surrounds the organ, and the parietal membrane is a sac covering the visceral membrane. The visceral and parietal membranes that make up the mesothelium. This fluid helps organs move easily among surrounding structures. In the case of the lung, it helps reduce friction between the lung and chest wall during normal breathing as the lung expands.

The mesothelioma is referred to by different names, depending on what part of the body it is found in. In the abdomen, it is called the peritoneum, in the lungs, the pleura, and in the heart, the pericardium. These correspond to peritoneum mesothelioma (cancer of the abdomen/stomach), pleural mesothelioma (cancer of the lung lining) and pericardium mesothelioma

Lung Cancer

2004-07-25T04:27:00.000-07:00

This blog contains information about asbestos lung cancer. My grandfather passed away suffering from this disease. I thought i would start a blog telling people how to avoid this killer disease.

Lets start by knowing what causes asbestos lung cancer.

Causes of Asbestos Lung Cancer

Smoking cigarettes combined with the exposure to asbestos leads to asbestos lung cancer. Due to the exposure of asbestos, other thoracic carcinomas like adenocarcinoma are also caused.

Relationship between Smoking and Asbestos Lung Cancer

The relationship between smoking and asbestos lung cancer invites great attention. This relationship has automatically been assumed by many people. So it is of utmost importance for understanding that smoking is not the sole cause of lung cancer in humans, though it is the potential cause of lung cancer. Statistics reveal that the risk of lung cancer is increased by a factor of 10 or so, by cigarette smoking alone.

The risk of lung cancer is increased by five times, due to the heavy exposure of asbestos alone. The risk factor is increased to about 50 times by a combination of the two independent carcinogens.

Asbestos Lung Cancer - Synergetic Effect Due to the Combination of Smoking and Asbestos

The risks posed by asbestos cannot merely be added to the risks posed by cigarette smoking. The risk factor is multiplied by an unquantifiable, but significantly greater factor due to the combination of asbestos and smoking. The synergetic effect due to the combination of smoking and asbestos is referred by this relationship. Here one plus one equals to five or more instead of two.

Like mesothelioma, a latency period is present in this case - between the time of asbestos exposure to the manifestation of a disease like lung cancer. 20-40 years is the latency period of asbestos related lung cancer. No specificity of cell types appears to be there as all types of cancers of the lung have been linked to asbestos by various reports.

Even in the absence of the radiological evidence of asbestosis, asbestos-related bronchogenic carcinoma has occurred in individuals exposed to asbestos. However additional supportive evidence is required by a case of this nature like asbestos bodies present in the tissues of the lungs.

Clinical Signs of Asbestos Related Lung Cancer

The state of the tumor when detected is dependant on the clinical features of asbestos related lung cancer. The prospects of surgical care are enhanced by early detection. Cough, pain in the chest, difficulty in breathing, detection of a new mass in x-ray, etc., are some of the symptoms of asbestos related lung cancer.

Staging of the tumor is largely dependant on the management of asbestos related lung cancer. The survival rate is increased by the early diagnosis and surgical resections of the tumor. Surgical intervention may be affected by the presence of severe associated asbestosis. Additionally in the overall therapeutic program, radiation and chemotherapy may be helpful.

After diagnosis, the treatment options and procedures must be understood by the asbestos lung cancer patient. This information can be provided by the doctor or oncologist.

Mesothelioma Asbestos Lung Cancer

Excerpts form a Health Care Article Contributed by Kanchana Gunasekaran

Mesothelioma asbestos is a rare type of lung cancer. It is a cancerous tumor. The mesothelial cells of the organs of the lungs, heart and abdomen are involved in this type of tumor. Pleural mesothelioma which is the cancer formed in the lining of the lung is the most common among all forms of mesothelioma asbestos cancers. The next most common form is the peritoneal mesothelioma where cancerous cells are formed in the lining of the stomach.

The process of the formation of mesothelioma asbestos lung cancer is very slow. The most common symptoms of mesothelioma asbestos are pain in the chest and at the back. In most of the cases the pain is also accompanied by shortness of breath, coughing and loss of weight.

The progress of this disease is very fast. So once a person has been diagnosed of mesothelioma asbestos, he has to go in for treatment at the earliest.

Causes of Mesothelioma Asbestos

The main cause of developing mesothelioma asbestos is the exposure to asbestos which is a naturally occurring mineral. Since the hazardous effects of asbestos came to be known widely, the use of this material is now banned in the United States. But there are more than 9 million Americans who might have been already exposed to asbestos through their jobs because many industries before 1970's used asbestos for manufacturing their various products. Asbestos was not only exposed in the factory surroundings.

It is still found in many of the schools in America. The fibers of asbestos sticks up to the clothes of the people around which increases the risk of mesothelioma asbestos lung cancer.
Diagnosis of Mesothelioma Asbestos

A thorough physical examination is done to the person who is suspected to have mesothelioma asbestos. The person who is diagnosed of pleural mesothelioma suffers from Pleural effusion, which is the fluid getting collected in the chest cavity. In case of peritoneal mesothelioma, the fluid gets collected in the abdominal region which is called ascites.

There are many diagnostic methods used to find out the presence of mesothelioma asbestos. They are physical examination, imaging tests, Testing of the collected fluid and tissue samples, surgery etc.
Imaging Tests for the Diagnosis of Mesothelioma Asbestos

If the results of the chest X-ray shows irregular thickening of the pleura, deposits of asbestos, lowering of the lung fissures and fluid in the pleural space, then it confirms the presence of mesothelioma asbestos. The imaging tests includes X-ray, CT scan and MRI scans.

A rotating X-ray beam is used by the CT scan. Pictures of the body from many angles are created by this x-ray beam. These pictures are put together by the computer which produces elaborate cross sectional images of a particular part of the body. Magnetic Resonance Imaging scan also creates images of a particular part of the body by using magnetic fields. Exactly as in the case of CT scan, these pictures are also put together by the computer to produce a detailed cross-sectional image.