A brief overview of mesothelioma

Introduction
Nowadays there is a lot of discussion all over the world, both offline and over the Internet, about mesothelioma. In the USA, there are mesothelioma awareness groups in almost every city in the USA. Besides discussion forums, mesothelioma legal cells, mesothelioma forums, mesothelioma awareness groups etc., today mesothelioma research is a very vast subject. There is even a Mesothelioma Memorial Scholarship that is offered every quarter. This scholarship is given in remembrance and honor of those that have been touched by mesothelioma. Billions of dollars have been spent in trying to fight this dreaded disease and find a cure. Let us begin by asking this simple question - what is mesothelioma?

What is Mesothelioma?
Asbestos and mesothelioma are infamously related. Mesothelioma is a form of cancer that affects people who have been exposed to asbestos. It is a rare form of cancer, and affects only those people who have had a history of exposure to asbestos, not others. However, there can be secondary cases, where a person may come into contact with someone who has been exposed to asbestos in the past. The key to mesothelioma, as is apparent here, is exposure to asbestos.
The primary cause of mesothelioma is exposure to asbestos. Once the patient has inhaled asbestos dust/fibers, other factors like smoking can aggravate the condition over a period of time. There can be other causes of mesothelioma too. For example, there have been cases diagnosed where the patient has had no history of asbestos exposure. People can get it from people who have had asbestos exposure. Before we proceed further, let us define mesothelioma.
Mesothelioma definition: Mesothelioma is defined as is an uncommon form of cancer, usually associated with previous exposure to asbestos. In this disease, malignant (cancerous) cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Malignant mesothelioma cells proliferate at the affected area, and are usually very hard to remove totally.
Mesothelioma came to be widely known about only from about the 60s, when the symptoms started manifesting, and mesothelioma cases were diagnosed. Across America, for people working at facilities that were asbestos-related, it became a nightmare. This was more because at that time, asbestos, because of the number of advantages it had over other metals, was widely used across industries all over the world. It was a tragedy of epic proportions waiting to be unleashed, and when it was unleashed, it wrought havoc in the lives of people all across America. Thousands lost their lives to mesothelioma, and even now, thousands more continue to fight this dreaded disease.
Even today, more than 3,000 people are diagnosed with mesothelioma in the USA. Today, mesothelioma victims and their relatives struggle to cope with the disease. For survivors of mesothelioma legal action against the industries that brought this disease on them has been one way of exorcising the pain and agony they have had to undergo. For a number of victims of mesothelioma lawyers have been able to settle cases successfully. There are mesothelioma support groups to help mesothelioma victims and their relatives cope with life in the aftermath of the disease. There are websites like http://www.mesotheliomaweb.org, http://www.mesothelioma.com, http://www.cancer.gov, etc.
Mesothelioma is considered extremely lethal for a number of reasons:
o Mesothelioma diagnosis is often very late. It manifests in a person years after exposure to asbestos, as long as 15 to 20 years.
o While the gestation period is extremely long, as mentioned above, the exposure time is extremely short, as less as two to three months. This means that a person doesn't even have to have prolonged exposure.
o The average lifespan of a person, after diagnosis, is very short, around 24 months.
o It affects not only a person exposed to asbestos; chances are that he can pass on the asbestos dust or fiber to his near and dear ones as well.
Types of Mesothelioma
Primarily, mesothelioma occurs in three areas, based on which mesothelioma is categorized into:
o Pleural mesothelioma (mesothelioma of the pleura, the outer lining protecting the chest cavity as well as the lungs)
o Pericardial mesothelioma (mesothelioma of the pericardium, the sac enclosing the heart)
o Peritoneal mesothelioma (mesothelioma of the peritoneum, the lining protecting the abdominal cavity)
Based on the types of cells seen in a mesothelioma patient, mesothelioma can again be categorized into 3 types:
o Epithelioid mesothelioma (approximately 50 to 70 percent of all mesothelial cells)
o Sarcomatoid mesothelioma (least common mesothelioma cell type, approximately 10 to 15 percent)
o Biphasic mesothelioma. (approximately 20 to 40 percent of all mesothelial cells)
Symptoms of Mesothelioma
The symptoms of mesothelioma depend on the kind of mesothelioma a patient may have. If a patient is suffering from malignant pleural mesothelioma, he would generally feel a pain in the chest region, accompanied by shallow breathing. These symptoms occur owing to the deposition of fluid in the pleura.
Peritoneal mesothelioma symptoms differ from those of pleural mesothelioma. In the case of localized peritoneal mesothelioma, the symptoms include:
o Fever
o Difficulties in bowel movements
o Anemia
o Abnormalities observed during blood clots
In the case of advanced peritoneal mesothelioma, the symptoms would further include pain, a swelling of the face or the neck, and difficulties in ingestion.
Mesothelioma symptoms usually map to those of other, lesser serious ailments. Therefore it is prudent to consult a specialist to ensure what the symptoms indicate.
Mesothelioma Diagnosis
Mesothelioma diagnosis is not an easy task, as the symptoms map to other lesser ailments, as mentioned above. The first step to diagnosing mesothelioma is a review of the patient's medical history. It is important to know if the patient has had any illnesses whose symptoms mesothelioma too displays. At this time, it is also important to know if the patient has had prior exposure to asbestos. If the patient hasn't had any illnesses displaying the symptoms related to mesothelioma, and has had exposure to asbestos, then there can be suspicion of mesothelioma.
It is important to do a detailed physical examination of the patient, including x-rays, CT scans, and MRIs. The focus would usually be on the abdominal and chest regions. If there is anything suspicious at the end of these examinations, it is advisable to do a biopsy.
A biopsy is usually done by a specialist, either an oncologist or a surgeon. Biopsy involves taking a tissue sample from the patient and subjecting it to specific tests to determine the presence or absence of mesothelioma. Biopsy in the case of mesothelioma can be:
o Thoracoscopy (done by taking tissue samples from inside the chest region, using a thoracoscope)
o Peritoneoscopy (done by taking tissue samples from the abdominal region, using a peritoneoscope)
Once the diagnosis is made, it is vital to learn the stage at which mesothelioma has been detected. Depending on whether the cancer is still at the original site or whether it has spread to other parts of the body, the mesothelioma can be called:
o Localized (still at the original site)
o Advanced (spread to other parts of the body)
Mesothelioma Treatment
Mesothelioma treatments vary depending on the type of mesothelioma, as also the stage at which it has been detected. The three most commonly used treatment forms against mesothelioma are:
o Surgery - Surgically removing the cancerous body part. For example, malignant pleural mesothelioma treatment could involve removal of the affected lung by performing a pneumonectomy.
o Radiation therapy - Exposing the affected part to high-energy rays to kill the malignant cells
o Chemotherapy - Using chemicals/drugs to destroy the malignant cells, either by injecting them into the patient, or intravenously, or by direct placement in the chest or abdomen (intracavitary chemotherapy).
Besides these three options, research is underway to find newer and more effective treatment options. Clinical trials have played a major role in developing newer treatment options.
Mesothelioma Prognosis
In the case of mesothelioma, prognosis is not as accurate as it is with other lesser serious ailments. This is because prognosis usually depends on the phase at which an illness is detected. Mesothelioma is usually detected quite late in a patient, so it becomes difficult to state the cure percentage or lifespan of a patient after treatment. Whatever statistics are available are not as reliable as one would like them to be. While it has not been easy to determine which of the two - pleural or peritoneal - mesothelioma is harder to stage, experts are generally in agreement that a prognosis is quite difficult for both.
However, latest studies and research have shown that mesothelioma patients might not be as bad off as was initially believed. This data is tabulated below.
Stage of Mesothelioma Detection Chances of Survival (No. of Years) Percentage of Patients
Mid to advanced stages 3 years 10%
5 years 5%
Early stages 2 years 50%
5 years 20%
This is just general data on mesothelioma prognosis. There is specific data available n the Internet for specific scenarios and situations.

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