Mesothelioma and Asbestos

Asbestos, a natural mineral, occurs naturally in the form of long, thin fibers. People who are exposed to asbestos are at risk of developing lung diseases, such as mesothelioma.

It may take decades for symptoms to appear after exposure to asbestos. Different asbestos types may cause different symptoms.

Pleural Mesothelioma

Pleural mesothelioma is a type of cancer that affects the lung's outer the lining (pleura). It is the most prevalent form of mesothelioma and accounts for 70% to 79% all diagnosed cases. People with this condition experience pain in the chest and breath shortness and may also feel a sensation of heaviness in the chest.

Exposure to asbestos, a group of minerals comprised of microscopic fibers, typically causes this type of cancer. These fibers, when inhaled cause irritation and DNA mutations. Pleura surrounds both the chest cavity and the lungs, so irritations can also affect the heart. Mesothelioma typically doesn't manifest until 30 to 50 year after exposure.

The most frequent symptoms of pleural melanoma are chest pain and shortness of breath. Patients may also experience coughing, difficulty breathing, or chest tightness. Patients with this type of cancer have a history that includes asbestos exposure at work. Construction, manufacturing and shipbuilding are among the most frequent jobs that put people at a high risk of developing pleural mesothelioma. People who have served in the military may be at risk due to the widespread asbestos use in Navy vessels and bunkers for the army.

The TNM (tumors lymph nodes and metastases staging system) is the most commonly used staging system used for the pleural adenocarcinoma. The stage a patient is in at the time of diagnosis can help determine what treatment plan they should receive. For example, patients with mesothelioma that is pleural in stage three or four have a worse prognosis than those in lower stages. Stage four mesothelioma often spreads to the diaphragm, the liver or even the heart of a patient. This makes it more difficult to treat and increases the likelihood of complications for patients.

Peritoneal Mesothelioma

Unlike pleural mesothelioma, which develops in the lung lining, peritoneal mesothelioma develops in the peritoneum -- a membrane that lines the abdominal cavity as well as organs such as the liver and intestines. Like pleural mesothelioma, asbestos exposure is the cause of peritoneal msothelioma. The disease is much less prevalent than pleural mesothelioma. There are only about 300-500 cases diagnosed each year.

As with pleural mesothelioma symptoms can take years to show. Most patients experience abdominal pain and an abdominal mass. Symptoms of this type of mesothelioma can also include nausea as well as weight loss and fever. Many of these symptoms can be mistaken for gastrointestinal problems and can lead to a mistaken diagnosis.

Doctors can detect mesothelioma by examining the patient's medical history and performing a physical examination. They can also use imaging tests like Xrays, CT scans and PET/CT scans to help find mesothelioma. These tests can reveal tumors and other signs of cancer which aren't evident on X-rays.

These test results enable doctors to diagnose mesothelioma and determine the stage. They can also recommend treatments. The stage is determined by the type of cell and whether the cancer has spread.

The most significant mesothelioma risk factor is asbestos exposure. People who have worked in asbestos-related jobs, such as electrical or plumbing work or in construction and manufacturing are more likely to contract the disease. Even if someone does not work in any of these areas they could still be exposed through family members and other sources. Anyone who suspects that they're at risk should speak with an expert. If they have an history of exposure to asbestos and mesothelioma is a concern, a specialist will assist them in learning more about the risk.

Risk Factors

Asbestos exposure is the primary risk factor for mesothelioma making up as much as 80 percent of all cases. Exposure to asbestos can occur through work, military service, or by living with someone who works with asbestos law or has previously done such. When exposed to asbestos, small particles can be inhaled into the lungs and abdomen. The particles cause irritation to the linings, causing cancerous cells to grow in the mesothelium. After asbestos exposure mesothelioma can develop between 15 and 60 years old.

Other risk factors include smoking, genetics, and age. People in their 40s and 50s are more likely to develop mesothelioma than those who are younger or older. Mesothelioma can take between 20 and 60 years to manifest cancer symptoms after the first exposure. It is important to keep in mind that mesothelioma can develop in people who have been exposed to asbestos, but without having directly worked with it. This is referred to as indirect or secondary asbestos exposure, and is as dangerous as direct asbestos exposure.

Smoking increases the chance of mesothelioma because it damages the mesothelium. It can also make it more vulnerable. Furthermore, mesothelioma is caused by certain illnesses, such as asbestosis and pneumonia. It is also important to note that mesothelioma is more common in males than females. Men are more likely than women to have been exposed to asbestos for a longer time and to work with asbestos for longer durations and to work with it. Men are also more likely to have lived with someone who had worked with asbestos, and to have asbestos case-containing fibers on their clothing. Women are less likely to come exposed to asbestos, and don't typically carry asbestos on their clothing.

Diagnosis

Mesothelioma is a difficult disease to recognize because the symptoms are often similar to other conditions. This could lead to patients being misdiagnosed.

The first step in identifying mesothelioma is for NYU Langone doctors to perform a physical exam and take notes on the medical history of a patient, including asbestos exposure. Doctors will also order a CT scan or chest X-ray in order to look for lumps, abnormalities and evidence of exposure to asbestos. These include pleural plaques, thickened pleura and calcium deposits.

Other diagnostic tests include a magnetic resonance imaging, or MRI test, that uses magnets and radio waves in order to create a series detailed images of the inside of the body. Another way for doctors to detect mesothelioma is by performing a surgical biopsy. In a surgical biopsy, doctors remove a tiny piece of tissue from the pleura or the peritoneum to be examined further. A pathologist can then examine the tissue with a magnifying glass to determine if it is a cancerous cells.

The type of mesothelial cell involved, the malignant or benign nature of these cells, as well as the location the cancer, its type and the stage of the cancer are used to classify the disease. Some types of mesothelioma are more likely to grow or spread which is why it is crucial to establish a definitive diagnosis to ensure that doctors are able to treat the disease before it becomes out of control.

Doctors can also perform laboratory tests on tumors to determine specific proteins, genes or other elements that can help them describe cancer characteristics and determine the best treatment. These results are called staging.

Treatment

A mesothelioma diagnose can be frightening. However, it's important to remember that the disease is treatable, especially in its earlier stages. A lot of people suffering from mesothelioma endure the disease for many years without it expanding.

Asbestos exposure can trigger mesothelioma via a variety of mechanisms. Asbestos fibers, which are too small to be felt or observed by naked eyes, can become airborne, irritating the lung's lining (pleura). In time irritation can lead to formation of scar tissue, which causes changes in the structure of cells which eventually lead to tumors.

The pleura covers the lungs and the heart, as well as the abdomen. Mesothelium is composed of cells that respond when exposed to asbestos. They cause inflammation to the tissue and cause it to scar. These changes eventually lead to malignant mesothelioma tumours.

Symptoms of pleural mesothelioma include breathing problems and chest pain, or an accumulation of fluid in the lung (pleural effusion). In rare instances cancer may spread to the tissues that surround the reproductive organs and the heart.

A doctor may request a biopsy if imaging scans reveal a possible tumor in the lungs or stomach. The procedure involves the removal of a small amount of liquid or tumor for laboratory testing. The results can confirm a mesothelioma diagnosis and determine the best treatment plan.

There are a variety of treatment for mesothelioma including chemotherapy and surgery. The majority of doctors use a combination of these methods. Patients can also benefit by participating in a clinical study of new mesothelioma treatment. To learn more about the trials, patients should consult mesothelioma specialists who have experience treating the condition.