What Is Mesothelioma?

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Mesothelioma is one of many diseases caused by exposure to asbestos—an industrial material used prolifically throughout the late 20th Century. A rare and deadly form of cancer, mesothelioma develops in the lungs, abdomen or heart. There is no known cure for mesothelioma, but treatments have advanced dramatically in the past decade. Despite a poor prognosis, many patients can achieve long-term survivorship.

Mesothelioma Overview

If you or a loved one has recently been diagnosed with mesothelioma, there are some critical facts to understand about this type of cancer.

Here are the most important things to know about mesothelioma:

  • Forms in the linings that cover the lungs (pleural), heart (pericardial) or abdominal (peritoneal) organs
  • Causes 3,000 new diagnoses each year in the United States
  • Has an average 5-year survival rate of 5%
  • Most commonly diagnosed at stage 3 of 4 disease stages
  • Requires aggressive, multimodal treatment to improve life expectancy, including surgery, chemotherapy, and radiation
  • Often requires a mesothelioma specialist for effective diagnosis and treatment

What Is Mesothelioma?

Mesothelioma is a type of cancer that affects the protective linings (mesothelium) that cover different organs. Mesothelioma is becoming a well-known health crisis due to its association with asbestos exposure. By nature, mesothelioma takes 10-50 years to produce symptoms after the initial asbestos exposure, making a diagnosis shocking and devastating to patients and their families.

Depending on how the cancer forms, it can affect the linings of the lungs and chest (pleura), the abdominal organs (peritoneum) or the heart (pericardium).

Pleural Mesothelioma

Mesothelioma located within the protective lining that covers the lungs and chest wall (pleura). It accounts for roughly 80-85% of all mesothelioma cases that are diagnosed. Pleural mesothelioma is aggressive and has a poor prognosis. Ongoing research into pleural mesothelioma treatments is giving patients a better chance at long-term survival by combining chemotherapy, radiation, and surgery along with new and promising therapies.

Pleural Mesothelioma Symptoms

  • Chest pain
  • Dry, persistent cough
  • Difficulty breathing
  • Fluid buildup in the lungs (pleural effusions)
  • Unexplained weight loss
  • Fever
  • Fatigue

Peritoneal Mesothelioma

When mesothelioma forms in the lining of the abdominal organs (peritoneum) it’s called peritoneal mesothelioma. The second most common form of the disease, peritoneal mesothelioma accounts for 15-20% of mesothelioma cases.

With the best prognosis of all three primary disease locations, peritoneal mesothelioma patients benefit from effective multimodal treatments involving surgery and direct chemotherapy.

Peritoneal Mesothelioma Symptoms

  • Abdominal pain
  • Abdominal swelling
  • Feeling full
  • Fluid buildup in the abdomen (ascites)
  • Unexplained weight loss
  • Fever
  • Fatigue

Pericardial Mesothelioma

Pericardial mesothelioma occurs when mesothelioma tumors form in the protective sac that covers the heart organ (pericardium). The rarest form of the disease, pericardial mesothelioma accounts of less than 1% of all known mesothelioma cases.

Researchers are still unsure of how pericardial mesothelioma forms—an understanding made more difficult by the fact that the majority of cases aren’t diagnosed until autopsy.

Pericardial Mesothelioma Symptoms

  • Chest pain
  • Difficulty breathing
  • Heart irregularities (palpitations and murmurs)
  • Fluid buildup in the heart sac (pericardial effusions)
  • Heart inflammation (pericarditis)
  • Fever
  • Fatigue

Who Gets Mesothelioma?

Mesothelioma can affect anyone, at any age, and of any background. Sadly, it can affect even the healthiest and most active people, including young adults. However, mesothelioma predominantly affects older people over the age of 65, and the vast majority are males.

Roughly 30% of mesothelioma victims are veterans, with the majority of these victims being past Navy members.

The reason mesothelioma affects this older male demographic, is because it’s caused by asbestos. As an industrial and construction material, it was mostly men who were exposed to asbestos during their careers in the military or emergency services, or as mechanics, construction workers or other industrial trades.

Mesothelioma Latency Period

Due to the prolonged nature of this disease, many people don’t receive a mesothelioma diagnosis until 10 to 50 years after they were exposed to asbestos.

Because asbestos exposure is the direct cause of mesothelioma, many victims wonder about what asbestos is and how it can cause such a deadly disease. They may feel confused and seek out answers as to why asbestos was even used in the first place. Frustration is common, and empowering yourself with information regarding asbestos use and mesothelioma can help you to cope with your diagnosis.

What Causes Mesothelioma?

Asbestos is the only known cause of developing mesothelioma. Classified as a group of minerals, asbestos is extracted from the ground in places around the world, including the United States and Canada. When asbestos mining began in the mid 20th Century, it was seen as a tremendous industrial discovery. Asbestos was used extensively in the military and construction projects across the globe.

It soon became apparent to asbestos producers that there were severe health risks associated with handling asbestos. Instead of informing asbestos purchasers of these dangers, the manufacturers ignored the signs in what is now considered a well-known cover-up attempt.

How Asbestos Leads to Mesothelioma

Asbestos is dangerous because if distributed through handling, it releases its fibers into the air. Anyone working around the materials is at risk of inhaling or ingesting asbestos fibers. However, because the fibers are so tiny, victims never know they’re swallowing or breathing them in.

After inhaling or ingesting asbestos fibers, mesothelioma victims feel no effect. Instead, the fibers remain unnoticed inside the body and make their way into the deep tissue linings of the lungs, abdomen or heart. Where the fibers end up depends on how you contacted the asbestos. You could have breathed them in, or you could have swallowed them if they ended up in your drinking water or food.

The Mesothelioma Formation Process:

  1. Over time, the asbestos fibers further lodge themselves deeper and deeper into the mesothelium of the organs.
  2. Following decades of dormancy, the fibers can start to irritate the tissues, causing inflammatory reactions within healthy cells.
  3. After enough irritation, the once healthy cells may become triggered and turn into abnormal, cancer cells.
  4. When enough cancer cells form within the organ linings, they can soon outnumber healthy cells. As cancer cells clump together and form tumors (masses of cancerous tissue), it becomes the condition known as mesothelioma.

What’s My Life Expectancy?

The general life expectancy for mesothelioma patients is very short compared to some other, more well-researched cancers, like lung and breast cancers.

After diagnosis, the average mesothelioma life expectancy is only 12 to 21 months.

It’s important to note that mesothelioma statistics are based on historical data and don’t always reflect the truth about what a mesothelioma patient can expect. The truth is that mesothelioma affects each patient differently. Your life expectancy has a lot to do with your individual circumstances.

Some factors that will determine your life expectancy include:

  • Where the mesothelioma is located
  • The mesothelioma cell-type
  • The stage at which you were diagnosed
  • Your body’s response to treatments
  • Your age and personal health level, including lifestyle and medical history

For example, if doctors detect mesothelioma in the early stages, the average life expectancy is greater than 21 months. But late-stage mesothelioma patients have an average life expectancy of only 12 months.

Mesothelioma Survival Rates

Doctors determine your life expectancy based on your unique case as well as past cases that they can draw expectations from. One of the ways doctors determine life expectancy is by looking at survival rates of mesothelioma.

By taking a specific timeframe and determining the percentage of people who survived that long, experts come up with the “survival rate”. Here are examples of mesothelioma survival rates that may indicate how long patients will live after diagnosis:

Some patients don’t wish to see survival statistics.

Here are some of the typical mesothelioma survival rates:

  • 55% of patients survive 6 months
  • 33% of patients survival 1 year
  • 9% of patients survive 5 years

Though these statistics may seem bleak, it’s important for mesothelioma patients to know that these numbers encompass decades of cases. In earlier years, mesothelioma was virtually untreatable as little was known about it.

Today, long-term survivorship has improved dramatically thanks to new therapies and better research. With aggressive treatments, many patients have survived longer than 10 years, and there are many long-term survivors still alive today.

“I remain optimistic that we can, in the next decade, put together the right combination of patients and treatments to effect a cure, which is our holy grail.” — Dr. David Sugarbaker

What Mesothelioma Treatments Are Available?

Mesothelioma treatments are advancing all the time, thanks to more research, funding and clinical trial developments. A patient’s prognosis can greatly improve based on the types of treatments they receive and how soon after diagnosis they receive them.

Mesothelioma specialists take the latest in treatment research and put together tailored treatment plans for each patient. Treatment plans typically combine multiple approaches executed at different times to deliver the most effective results.

Mesothelioma patients generally have 3 broad treatment options that can be used separately or together:

1. Surgery for Mesothelioma

Mesothelioma surgery involves a few possibilities. The most aggressive surgical option is to remove the organ that’s affected by the mesothelioma. An example of this is removing the diseased lung from a pleural mesothelioma patient. When surgeons remove the organ, they also remove as much of the tumor as possible.

Another possible type of surgery is called palliative surgery, which is for end-stage patients. Surgeons cut into the affected organ to drain fluid buildup (effusions), which helps alleviate painful pressure and swelling so the patient can be more comfortable.

While there are several types of surgical procedures for mesothelioma patients, the main types of mesothelioma surgery are:

  • Extrapleural Pneumonectomy: For pleural mesothelioma patients, the doctor removes the diseased lung as well as the lining around the heart, abdomen and/or diaphragm.
  • Pleurectomy/Decortication: For pleural mesothelioma patients, the doctor removes the diseased pleura, which covers the lungs and chest.
  • Cytoreduction: For peritoneal mesothelioma, the doctor removes all visible tumors within the abdomen.

2. Chemotherapy For Mesothelioma

Chemotherapy is a type of treatment administered to many cancer patients. Chemotherapy is a broad term that describes types of drugs designed to kill cancer cells. These drugs can be administered intravenously or can be taken orally in pill form.

Here’s an overview of how chemotherapy for mesothelioma works:

  • Patients undergo several rounds of chemotherapy over a set period of multiple weeks
  • Drugs build up in the patient’s bloodstream and
  • Over time, the drugs become more effective at killing off mesothelioma cells

Chemotherapy is often administered in conjunction with surgery. Once doctors have removed as much of the visible tumor as possible, they then prescribed chemotherapy drugs to kill off remaining cancer cells.

3. Radiation Therapy for Mesothelioma

The third primary type of mesothelioma treatment is radiation therapy. As a common type of cancer treatment, radiation therapy is also administered to mesothelioma patients in conjunction with surgery and/or chemotherapy.

Here’s an overview of how radiation for mesothelioma works:

  • Radiologists aim high-energy rays, such as x-rays, directly at tumor sites
  • High-energy beams scramble the mesothelioma cells’ DNA
  • Damaged DNA prevents mesothelioma cells from multiplying and spreading

Radiation therapy is a non-invasive way of shrinking mesothelioma tumors. Advanced types of radiation therapy can be extremely accurate and strike tumors from various angles, which improves the therapy’s success rate.

How is Mesothelioma Diagnosed?

Diagnosing mesothelioma is a complex process. Because it’s such a rare disease, mesothelioma is often overlooked in the early diagnostic steps. Mesothelioma symptoms are also very vague, and can often be confused with other lung conditions like bronchitis. Doctors frequently rule out other possible conditions before considering mesothelioma.

Because of how rare and complex mesothelioma is, patients should always see a mesothelioma specialist for their diagnosis.

Mesothelioma specialists follow these steps when diagnosing this type of cancer:

1. Physical Exam

Doctors first conduct physical examinations. They ask about symptoms, medical history and past exposure to asbestos.Based on the findings of the physical exam, doctors can determine whether their patient has signs of mesothelioma that require further investigation.

2. Imaging Tests

If doctors suspect signs of mesothelioma, they’ll order tests to look for abnormalities such as tumors. Imaging tests like X-rays, CT scans, and MRIs look inside the patient’s body for signs of mesothelioma.

Imaging tests help doctors see:

  1. Whether tumors are present
  2. Where the tumors are located
  3. How far cancer has spread.

Depending on what the results show, doctors may order multiple imaging tests.

3. Biopsies

The final step in diagnosing mesothelioma is through a biopsy. It is the only way to diagnose mesothelioma conclusively. A biopsy is a procedure where doctors take samples of tissue from the tumor and test them for mesothelioma cancer cells.

Though there are several types of biopsies, they all get tested in a pathology lab.

The types of biopsies include:

  • Needle biopsies
  • Surgical biopsies
  • Endoscopic biopsies

Pathologists look at the tissue samples under a microscope, which tells them what type of cancer cells are present. The type of cells they find allows the doctors to confirm whether or not it’s mesothelioma.

Mesothelioma Diagnosis Factors

During the diagnostic process, mesothelioma specialists consider different information about the patient’s case. The different factors they look at help them determine the exact type of mesothelioma the patient has. With this information, they can recommend the right treatment plan.

Specialists use the following factors to help them determine a mesothelioma diagnosis:

  • Mesothelioma location (pleural, peritoneal or pericardial)
  • Mesothelioma stage (stages 1 to 4 for pleural mesothelioma)
  • Mesothelioma cell type (epithelioid, sarcomatoid or biphasic)

Doctors provide as much information to their patients as possible about their condition. For example, a doctor might tell a patient they’re diagnosed with stage 3 epithelioid pleural mesothelioma. This means it’s pleural mesothelioma of the epithelioid cell type that has advanced to stage 3. This information helps the patient better understand their condition and what to expect.

Mesothelioma Cell Types

During diagnosis, doctors determine the mesothelioma cell type—the type of mesothelioma cell present in the biopsy sample. Different mesothelioma cell types have unique sets of behaviors and characteristics that determine how tumors will grow and spread.

A patient’s cell type is critical information that doctors use to develop the most effective treatment plans.

Epithelioid Cell Type

When pathologists (doctors who examine diseased cells) look at epithelioid cells under the microscope, the cells display certain physical characteristics and behaviors, including:

  • Elongated shape
  • Uniform, regular appearance
  • Lump together as they divide
  • Most common mesothelioma cell type diagnosis
  • Easiest cell type to treat
  • Spreads to lymph nodes

Sarcomatoid Cell Type

Sarcomatoid mesothelioma cells appear differently under the microscope compared to epithelioid cells. When pathologists look at sarcomatoid cells under the microscope, they see the following behaviors and characteristics:

  • Spindle-shaped cells
  • Irregular appearance
  • Divide and spread quickly
  • Least common mesothelioma cell type diagnosis
  • Most difficult to treat
  • Forms nodal tumors

Biphasic Cell Type

When both mesothelioma cell types form in one tumor, it’s known as a biphasic cell type. Biphasic cell type characteristics  and criteria include:

  • Also called “mixed cell type”
  • Tumors composed of both epithelioid and biphasic cells
  • Must contain at least 10% of each cell type
  • Treatments depend on ratio between two cells

Working With a Mesothelioma Specialist

Doctors, experts, and advocates strongly advise mesothelioma patients work with physicians and cancer center that specialize in diagnosing and treating mesothelioma. Because it’s such a rare, complex and relatively unknown cancer, general oncologists do not have the specific expertise required to fully understand and properly diagnose mesothelioma.

Without the correct diagnosis, mesothelioma patients might not receive the appropriate treatments. Misdiagnoses can also cause a lot of grief, confusion and wasted time for patients and their families.

By working with mesothelioma specialists, patients can ensure they get the correct information and undergo the best treatment to increase their chance at survival.

Getting Mesothelioma Support from Patient Advocates

If you or a loved one has mesothelioma, then get in touch with our Mesothelioma Help Now advocates.

We have a dedicated staff committed to helping victims and their families with:

We’re happy to help you with the next steps toward finding treatment and compensation for your mesothelioma diagnosis.

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Sources
  1. Medical News Today, “Mesothelioma: Causes, Symptoms and Outlook” Retrieved from: https://www.medicalnewstoday.com/articles/140859.php. Accessed on November 6, 2017.
  2. American Cancer Society, “What Are the Key Statistics About Malignant Mesothelioma?” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/about/key-statistics.html. Accessed on November 6, 2017.
  3. American Cancer Society, “What is Malignant Mesothelioma?” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/about/malignant-mesothelioma.html. November 6, 2017.
  4. Mayo Clinic, “Mesothelioma: Treatments and Drugs.” Retrived from: https://www.mayoclinic.org/diseases-conditions/mesothelioma/basics/treatment/con-20026157. Accessed on November 6, 2017.
  5. American Cancer Society, “Radiation Therapy for Malignant Mesothelioma.” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/treating/radiation.html. Accessed on November 6, 2017.

Last modified: March 17, 2018