Mesothelioma

By Levin Simes
August 31, 2011

Mesothelioma is a relatively rare form of cancer that develops in the tissue that surrounds certain internal organs of the body, including the chest, heart and abdomen. In fact, mesothelioma is named for that protective membrane, the mesothelium. The mesothelium protects the body’s vital internal organs, mainly by producing a lubricating fluid which provides a slick surface for these internal organs to slide past each other during movement.

Malignant mesothelioma is a serious type of asbestos cancer that has proven to be incurable thus far. This rare disease is three times more common in men than women and commonly develops when a person is between 50 and 70 years old.

Although malignant mesothelioma is relatively rare, instances of the disease have been on the rise over the course of the last 20 years. In the United States alone, there are approximately 2,000 to 3,000 new cases of malignant mesothelioma diagnosed each year. Worldwide, estimates suggest that nine cases of mesothelioma are diagnosed for every 1 million persons.

There are a number of treatments available to slow the progression of malignant mesothelioma and provide relief of its symptoms. However, the average post-diagnostic survival time is a mere one or two years.

Mesothelioma Causes
The main cause of mesothelioma is exposure to asbestos, a naturally-occurring material created through the amalgamation of several different minerals with fiber-like structures. These fibers are extremely friable and hard, allowing them to break into tiny pieces that can enter the body and burrow into internal tissues. Until very recently, asbestos saw heavy usage and was a popular and cost effective component of a number of construction materials and consumer products. In addition to its low cost, its popularity largely derived from the material’s strong resistance to heat, chemicals and electricity.

However, the 1960s saw the discovery and publication of the extremely negative effects that exposure to asbestos can have on an individual’s health. Among these negative side effects was the development of mesothelioma, which can impact those exposed for decades after. Although most usage stopped after 1989 legislation regulated the use of asbestos, it is still permitted in some products. Furthermore, the long latency period of this disease means individuals might not be aware of past exposure for as many as five decades later, when symptoms finally begin to appear.

Mesothelioma Symptoms

Malignant mesothelioma symptoms may be chronic, uncomfortable, painful and life threatening. The symptoms are not specific to this rare asbestos cancer, meaning that they are the same as those associated with a number of other conditions.
Although mesothelioma symptoms vary depending on the type, they often involve the lungs. As such, malignant mesothelioma is often misdiagnosed as bronchitis, asthma or pneumonia.

Pleural Mesothelioma Symptoms
Of the three types of malignant mesothelioma, pleural mesothelioma is the most common. Pleural mesothelioma affects the pleura, a serous membrane lining the lungs. Its symptoms are associated with a diminished lung capacity and may include:

  • Shortness of breath
  • Chest pain
  • Difficulty breathing
  • Chronic cough
  • Hoarseness
  • Sleep loss
  • Weight loss

These symptoms may result from pleural effusion or pleural thickening. Pleural effusion is an accumulation of fluid within the pleural space (between the chest cavity and lungs) that can cause shortness of breath and other breathing problems. The fluid may be drained to relieve the pressure and its associated symptoms.
Pleural thickening is the scarring and hardening of the pleural tissue. The development of tumors on the pleura can affect the flexibility of the serous membrane, impeding lung expansion. This may result in breathing problems and chest pain.

Peritoneal Mesothelioma Symptoms
Peritoneal mesothelioma affects the peritoneum, a serous membrane lining the abdomen. Although peritoneal mesothelioma is the second most common type of mesothelioma, it is significantly less common than pleural mesothelioma. The symptoms of peritoneal mesothelioma are often associated with abdominal discomfort and may include:

  • Weight loss
  • Abdominal swelling
  • Chronic cough
  • Chest pain
  • Breathing problems

The chest pain, coughing and breathing problems associated with peritoneal mesothelioma often result from tumors putting upward pressure on the peritoneum.

Pericardial Mesothelioma Symptoms
Pericardial mesothelioma affects the pericardium, a serous membrane lining the heart. Pericardial mesothelioma is the least common type of mesothelioma, accounting for less than 10 percent of all confirmed cases of the rare cancer. The symptoms of pericardial mesothelioma are similar to those of pleural mesothelioma; this can be attributed to the pericardial tumor’s proximity to the lungs. Pericardial mesothelioma symptoms may include:

  1. Shortness of breath
  2. Chest pain
  3. Chronic cough
  4. Heart palpitations (irregular heartbeat)
  5. Weight loss

An effusion can cause fluid to build up within the pericardium. This fluid can be drained to relieve pressure and prevent heart problems. Pericardial effusion may affect heart functionality, causing heart palpitations or other life-threatening irregularities.

Mesothelioma Diagnosis
Typically, onset of one or more of the aforementioned symptoms serves as the first step toward a mesothelioma diagnosis. Due to the chronic nature of mesothelioma symptoms, sufferers typically must make frequent visits to their physician.
If mesothelioma is suspected, a number of diagnostic tests may be used to confirm a diagnosis. These tests may include X-rays, CT scans, MRI scans and positron emission tomography (PET). Although such imaging tests may suggest the presence of mesothelioma cancer, a biopsy is required for confirmation.
In addition to confirming a case of mesothelioma, a biopsy can be used to determine type (pleural, peritoneal or pericardial) and stage. This information is integral in treatment planning.

Types of Mesothelioma

Each type of mesothelioma affects a different serous membrane (a type of membrane that lines certain body cavities):

Pleural: This form of cancer develops in the chest cavity and comprises about 75 percent of all mesothelioma cases.
Peritoneal: This form of cancer develops in the abdomen and accounts for about 20 percent of the cases of mesothelioma.
Pericardial: Developing around the heart, this form of cancer is rare and accounts for only about five percent of the mesothelioma cases seen.
Testicular: Extremely rare, this form of cancer can be seen in less than one percent of all mesothelioma patients.

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