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 linings of 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:

What Is Mesothelioma?

Mesothelioma is a type of cancer that affects the protective linings (mesothelium) that cover different organs. Mesothelioma is becoming a better-known health crisis due to its association with asbestos exposure.

Mesothelioma takes 10-50 years to produce symptoms after the initial asbestos exposure, making a diagnosis shocking and devastating to patients and their families.

Pleural Mesothelioma

Mesothelioma located within the protective lining that covers the lungs and chest wall (pleura) is called pleural mesothelioma. It accounts for roughly 70-80% of all mesothelioma cases that are diagnosed. Pleural mesothelioma is aggressive and has a poor prognosis and low life expectancy compared to other, more common cancers.

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

Common pleural mesothelioma symptoms and warning signs include:

  • 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 20-30% 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

Common peritoneal mesothelioma symptoms and warning signs include:

  • 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 for 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

Possible pericardial mesothelioma symptoms and warning signs include:

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

What Treatments Are Right for Your Mesothelioma Diagnosis?

Mesothelioma is a complex disease requiring specialized treatments. The Mesothelioma Help Guide helps patients understand their diagnosis and get the best treatments to improve prognosis.

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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. A large group of mesothelioma victims is veterans, with the majority of these victims being past Navy and Coast Guard members.

Mesothelioma predominantly affects older people over the age of 65, and the vast majority are males.

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

Mesothelioma Symptoms Update

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.

What Causes Mesothelioma?

Asbestos is the only known cause of mesothelioma and the majority of patients have a history of working with asbestos or being exposed to it through secondhand exposure.

When asbestos mining began in the mid 20th century, it was seen as a tremendous industrial discovery. But 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 it’s distributed through handling, it releases sharp 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 inhaling 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.

Mesothelioma forms in 4 steps:

  1. Over time, 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 inflammation within healthy cells.
  3. After enough irritation, the once healthy cells may undergo mutations and turn into abnormal, cancer cells called mesothelioma cells.
  4. When enough mesothelioma cells form within the organ linings, they can soon outnumber healthy cells. As mesothelioma cells clump together and form tumors (masses of cancerous tissue), the cells can invade nearby organs and eventually become fatal.

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 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, Pleural Mesothelioma Specialist

Find the Right Specialist for Your Diagnosis

Mesothelioma doctors across the country are accepting new mesothelioma patients now. Our Doctor Match Program connects you with a nearby specialist to help improve your prognosis.

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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.

Palliative Surgery Update

Another possible type of surgery is called palliative surgery. 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 surgeries 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 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
  • 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?

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

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.

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. 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

Mesothelioma Diagnosis Update

A tissue biopsy is the only way doctors have to diagnose mesothelioma conclusively.

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.

Do You Have A Specialized Mesothelioma Treatment Plan?

Mesothelioma is a complex disease requiring specialized treatment plans prescribed by experienced doctors. The Mesothelioma Help Guide helps patients understand their diagnosis so they can get the best treatments to improve prognosis.

Request Your Free Mesothelioma Help Guide Now

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 centers specializing in diagnosing and treating mesothelioma. Because it’s such a rare, complex cancer, general oncologists don’t always have the expertise required to diagnose and treat 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 Patient Advocates.

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

Call us today at (800) 584-4151 or register to receive a FREE Mesothelioma Help Guide to understand your treatment options and next steps after 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: June 19, 2018