Mesothelioma

Mesothelioma is a form of cancer that is almost always caused by previous exposure to asbestos.In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and chest cavity), but it may also occur in the peritoneum (the lining of the abdominal cavity) or the pericardium (a sac that surrounds the heart).

Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles, or have been exposed to asbestos dust and fibre in other ways, such as by washing the clothes of a family member who worked with asbestos, or by home renovation using asbestos cement products. Unlike lung cancer, there is no association between mesothelioma and smoking..

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Asbestos Awareness

Asbestos is a serious health hazard commonly found in our environment today. This module is designed to provide an overview of asbestos and its associated hazards. It is important for employees who may work in buildings that contain asbestos to know where it is likely to be found and how to avoid exposure.
What is Asbestos?
Asbestos is the name applied to six naturally occurring minerals that are mined from the earth. The different types of asbestos are:
• Amosite
• Chrysotile
• Tremolite
• Actinolite
• Anthophyllite
• Crocidolite
Of these six, three are used more commonly. Chrysotile (white) is the most common, but it is not unusual to encounter Amosite (brown / off-white), or Crocidolite (blue) as well.

Asbestos fibers are also virtually indestructible. They are resistant to chemicals and heat, and they are very stable in the environment. They do not evaporate into air or dissolve in water, and they are not broken down over time. Asbestos is probably the best insulator known to man. Because asbestos has so many useful properties, it has been used in over 3,000 different products.
Usually asbestos is mixed with other materials to actually form the products. Floor tiles, for example, may contain only a small percentage of asbestos. Depending on what the product is, the amount of asbestos in asbestos containing materials (ACM) may vary from 1%-100%.

Where is Asbestos Found?
Asbestos may be found in many different products and many different places. Examples of products that might contain asbestos are:
•Sprayed-on fire proofing and insulation in buildings
•Insulation for pipes and boilers
•Wall and ceiling insulation
•Ceiling tiles
•Floor tiles
•Putties, caulks, and cements (such as in chemical carrying cement pipes)
•Roofing shingles
•Siding shingles on old residential buildings
•Wall and ceiling texture in older buildings and homes
•Joint compound in older buildings and homes
•Brake linings and clutch pads

At OSU, asbestos is most likely to be found in:
•Sprayed-on insulation in locations such as various mechanical rooms, steel reinforcing beams, and some ceilings in older buildings
•Ceiling tiles in buildings built prior to 1981
•Most 9" floor tiles in buildings built prior to 1981
•A few 12" floor tiles in buildings built prior to 1981
•Insulation around pipes and boilers, and
•Interiors of fire doors

Asbestos-containing ceiling tiles will not be labeled or marked. These tiles cannot be differentiated from other tile by visual means - they must be analyzed by a laboratory test.

When is Asbestos Dangerous?
The most common way for asbestos fibers to enter the body is through breathing. In fact, asbestos containing material is not generally considered to be harmful unless it is releasing dust or fibers into the air where they can be inhaled or ingested. Many of the fibers will become trapped in the mucous membranes of the nose and throat where they can then be removed, but some may pass deep into the lungs, or, if swallowed, into the digestive tract. Once they are trapped in the body, the fibers can cause health problems.
Asbestos is most hazardous when it is friable. The term "friable" means that the asbestos is easily crumbled by hand, releasing fibers into the air. Sprayed on asbestos insulation is highly friable. Asbestos floor tile is not.
Asbestos-containing ceiling tiles, floor tiles, undamaged laboratory cabinet tops, shingles, fire doors, siding shingles, etc. will not release asbestos fibers unless they are disturbed or damaged in some way. If an asbestos ceiling tile is drilled or broken, for example, it may release fibers into the air. If it is left alone and not disturbed, it will not.

Damage and deterioration will increase the friability of asbestos-containing materials. Water damage, continual vibration, aging, and physical impact such as drilling, grinding, buffing, cutting, sawing, or striking can break the materials down making fiber release more likely.

Health Effects
Because it is so hard to destroy asbestos fibers, the body cannot break them down or remove them once they are lodged in lung or body tissues. They remain in place where they can cause disease.
There are three primary diseases associated with asbestos exposure:
•Asbestosis
•Lung Cancer
•Mesothelioma
Asbestosis
Asbestosis is a serious, chronic, non-cancerous respiratory disease. Inhaled asbestos fibers aggravate lung tissues, which cause them to scar. Symptoms of asbestosis include shortness of breath and a dry crackling sound in the lungs while inhaling. In its advanced stages, the disease may cause cardiac failure.
There is no effective treatment for asbestosis; the disease is usually disabling or fatal. The risk of asbestosis is minimal for those who do not work with asbestos; the disease is rarely caused by neighborhood or family exposure. Those who renovate or demolish buildings that contain asbestos may be at significant risk, depending on the nature of the exposure and precautions taken.

Lung Cancer
Lung cancer causes the largest number of deaths related to asbestos exposure. The incidence of lung cancer in people who are directly involved in the mining, milling, manufacturing and use of asbestos and its products is much higher than in the general population. The most common symptoms of lung cancer are coughing and a change in breathing. Other symptoms include shortness of breath, persistent chest pains, hoarseness, and anemia.
People who have been exposed to asbestos and are also exposed to some other carcinogen -- such as cigarette smoke -- have a significantly greater risk of developing lung cancer than people who have only been exposed to asbestos. One study found that asbestos workers who smoke are about 90 times more likely to develop lung cancer than people who neither smoke nor have been exposed to asbestos.

Mesothelioma
Mesothelioma is a rare form of cancer that most often occurs in the thin membrane lining of the lungs, chest, abdomen, and (rarely) heart. About 200 cases are diagnosed each year in the United States. Virtually all cases of mesothelioma are linked with asbestos exposure. Approximately 2 percent of all miners and textile workers who work with asbestos, and 10 percent of all workers who were involved in the manufacture of asbestos-containing gas masks, contract mesothelioma.
People who work in asbestos mines, asbestos mills and factories, and shipyards that use asbestos, as well as people who manufacture and install asbestos insulation, have an increased risk of mesothelioma. So do people who live with asbestos workers, near asbestos mining areas, near asbestos product factories or near shipyards where use of asbestos has produced large quantities of airborne asbestos fibers.

Other Cancers
Evidence suggests that cancers in the esophagus, larynx, oral cavity, stomach, colon and kidney may be caused by ingesting asbestos. For more information on asbestos-related cancers, contact your local chapter of the American Cancer Society.

Determining Factors
Three things seem to determine your likelihood of developing one of these asbestos related diseases:
1.The amount and duration of exposure - the more you are exposed to asbestos and the more fibers that enter your body, the more likely you are to develop asbestos related problems. While there is no "safe level" of asbestos exposure, people who are exposed more frequently over a long period of time are more at risk.
2.Whether or not you smoke - if you smoke and you have been exposed to asbestos, you are far more likely to develop lung cancer than someone who does not smoke and who has not been exposed to asbestos. If you work with asbestos or have been exposed to it, the first thing you should do to reduce your chances of developing cancer is to stop smoking.
Organizations that may offer programs, support, or information to help people stop smoking are:
•OSU Wellness Center
•National Cancer Institute (1-800-4-CANCER)
•American Heart Association (1-800-242-8721)
•American Lung Association (in Oklahoma: 405-524-8471)
3.Age - cases of mesothelioma have occurred in the children of asbestos workers whose only exposures were from the dust brought home on the clothing of family members who worked with asbestos. The younger people are when they inhale asbestos, the more likely they are to develop mesothelioma. This is why enormous efforts are being made to prevent school children from being exposed.
Because each exposure to asbestos increases the body burden of asbestos fibers, it is very important to reduce and minimize your exposure.

How to Avoid Asbestos Exposure
In order to avoid being exposed to asbestos, you must be aware of the locations it is likely to be found. If you do not know whether something is asbestos or not, assume that it is until it is verified otherwise. Remember that you cannot tell if floor or ceiling tiles contain asbestos just by looking at them.
The OSU Environmental Health and Safety Department has a laboratory and a licensed asbestos abatement crew that can take samples from materials in order to determine whether or not they contain asbestos. If you need to have materials analyzed or tested for asbestos, please contact EHS at X47241. Never try to take a sample yourself unless you are licensed to do so.
If you have reason to suspect that something is asbestos, either because it is labeled as such, or because it something that is likely to contain asbestos (9" floor tile, for example), DO NOT DISTURB IT.
Never...
•Drill
•Hammer
•Cut
•Saw
•Break
•Damage
•Move
•Disturb
...any asbestos-containing materials or suspected materials.
The EHS Asbestos Abatement Department has surveyed all campus buildings for the presence of asbestos. If you need to do work that might involve asbestos (lifting ceiling tiles, repairing insulated pipelines, etc.), check with EHS to find out what can be done safely.
For example, before moving any ceiling tiles to perform maintenance work, it will be necessary to ensure they do not contain asbestos. If they do contain asbestos, they will need to be removed by licensed asbestos abatement workers before the work may be performed.

Housekeeping
Housekeepers and custodians should never sand or dry buff asbestos containing floor tiles, and only wet stripping methods may be used during stripping operations. Low abrasion pads should be used at speeds below 300 rpm.
Broken and fallen ceiling tiles should be left in place until identified. Only after they have been identified as safe may they be removed. Asbestos tiles will be removed by asbestos abatement workers.
Broken and damaged asbestos floor tiles must also be removed by asbestos abatement workers. Report any suspect broken tiles to EHS at X47241.
Spills
It is important to report any damaged asbestos-containing materials to OSU EHS at X47241 immediately. If, for example, you discover some sprayed-on asbestos insulation has been knocked off of a ceiling or wall, this would be considered a "spill." As such it would need to be cleaned up immediately by asbestos abatement workers. Do not attempt to clean up spills yourself! Disturb the material as little as possible. Also report any damaged pipe insulation, ceiling tile, 9" floor tile, fallen clumps of sprayed-on insulation, etc. Take measures to prevent others from disturbing the spill until the Asbestos Abatement crew arrives.
By knowing where asbestos is likely to be located and then taking measures not to disturb it, you will protect yourself and others from exposure to this hazardous substance.

ASBESTOS AWARENESS TRAINING QUIZ


1.Many older buildings will contain some asbestos. You are likely to find asbestos in:
a.Ceiling Tiles
b.Floor Tiles
c.Pipe Insulation
d.All of the above

2.If you suspect a material contains asbestos, you should NEVER:
a.Sand it
b.Cut it
c.Drill through it
d.All of the above

3.Asbestos fibers are so small they may stay suspended in air for hours or even days.
a.True
b.False

4.Which source of asbestos is the most friable?
a.Sprayed-on insulation
b.Undamaged ceiling tiles
c.Floor tiles
d.Lab counter top

5.Given moderate exposure to asbestos, smokers have the same chance of developing an asbestos related disease as non-smokers.
a.True
b.False

6.Asbestos-containing ceiling tiles, floor tiles, shingles, and siding will not normally release asbestos fibers unless disturbed or damaged in some way.
a.True
b.False

7.If you accidentally knock off a chunk of sprayed-on asbestos insulation, you should:
a.Carefully sweep it into a ziplock bag
b.Leave it for a custodian to clean up
c.Report it immediately
d.Get a vacuum

8.Three asbestos-related diseases are:
a.Lung cancer, mesothelioma, asbestosis
b.Lung cancer, mesothelioma, AIDS
c.Hepatitis B, mesothelioma, asbestosis
d.Colon cancer, asbestosis, malaria

9.Three main things seem to be important in determining your likelihood of developing an asbestos related disease.
These are:
a.Smoking / the amount and duration of your exposure / and your gender
b.Type of asbestos mineral to which you are exposed / whether or not you smoke / and your age
c.Your age / whether or not you smoke / and the amount and duration of your exposure
d.None of the above

10.There is no evidence to suggest that ingesting or drinking asbestos is harmful.
a.True
b.False

MESOLTHELIOMA ACTION DAY

Hundreds of thousands of people in the UK could die from asbestos-related cancer, latest estimates suggest. Just one deadly asbestos cancer, mesothelioma is now killing 2,000 people each year in the in the UK - one death every five hours. But for every mesothelioma death at least one person - and probably many more - will die from asbestos related lung cancer. Latest estimates suggest this could mean at least 120,000 people and probably substantially more are still to die as a result of Britain's asbestos disease epidemic - an epidemic predicted by unions and campaign groups, who have for decades called for stricter controls on asbestos. The price paid by working people is spelled out in a new YouTube video from the Forum of Asbestos Victim Support Groups. Elizabeth Bradford, a teacher, Yvonne Lowe, a school caretaker and Andrew Burns, a 37-year-old who was exposed to asbestos as an apprentice electrician are among those who explain the everyday circumstances that led to them developing mesothelioma, a condition which usually kills within two years. Nationwide, asbestos groups are involved in events on 27 February, Action Mesothelioma Day, to increase awareness of the problem and to press for better treatment for those affected and for more research to find a cure. The Forum's video will also be screened on BBC's outdoor big screens. Amicus has produced an Action Mesothelioma Day poster and is urging its workplace reps to get involved. Amicus health and safety officer Rob Miguel said: 'Mesothelioma can develop up to 60 years after exposure to asbestos and because of this long delay it has been calculated that the number of UK cases will continue to rise until 2015.' Amicus general secretary Derek Simpson said: 'People have died needlessly from this most painful horrific disease, we will continue to fight for better working conditions, so our children do not suffer the same fate. We are determined that those who are affected by mesothelioma receive justice, and get the care and support they need.

• Great Manchester Asbestos Victims Support Group news release. Amicus news release and Action Mesothelioma Day poster [pdf]. BLF news release on Action Mesothelioma Day and on the new asbestos mortality estimates.
• Daily Mail. Daily Record. Daily Mirror.
• Action Mesothelioma Day, 27 February 2007. For a full 27 February events listing, see the International Ban Asbestos Secretariat website. Also see the Hazards Campaign website. BLF events listing [pdf].
• Hazards asbestos webpages.

MoD admits asbestos 'cancer hug' liability
The Ministry of Defence (MoD) is to compensate a Plymouth woman who said she developed an asbestos-related cancer from hugging her father. Debbie Brewer, who has been diagnosed with mesothelioma, stands to receive a six-figure damages payment. The MoD said it had admitted liability and would agree a suitable settlement. Mrs Brewer believes she was exposed to the asbestos brought home on her father's clothing and hair when he was a lagger at Devonport Dockyard in 1966. Philip Northmore died from asbestos-related lung cancer last August. Mrs Brewer, 47, said she was very pleased the MoD had admitted liability as the money would help her enjoy the time she had left with her children and also provide for them after her death. 'This is about the issue and it's also about what I'm going to lose and no price can be put on what I'm going to lose,' Mrs Brewer said. In a statement, the MoD said it 'has admitted liability for the asbestos-related mesothelioma suffered by Deborah Brewer and is now endeavouring to agree as swiftly as possible a suitable settlement.' In November last year, 45-year-old Michelle Campbell, who developed mesothelioma as a result of exposure to asbestos from her grandfather's work clothing, was awarded a £145,000 MoD payout (Risks 282). She used to sit on granddad Charles Frost's knee and enjoy a chat when he popped in to visit on his way home from his job at Portsmouth dockyards.

The Role of Radiotherapy in the Treatment of Malignant Pleural Mesothelioma

Radiation therapy for the treatment of malignant pleural mesothelioma has historically been limited by its efficacy. However, the increasing incidence of this tumour and the emergence of new technologies present a number of opportunities and challenges for this treatment modality. Radiotherapy is used to palliate mesothelioma patients with chest wall pain.

Responses of over 60% have been seen, although the duration of response is often disappointing. The optimum dose has not been shown and many of the previous studies were small retrospective studies. An improved response has been seen in several studies where hyperthermia was added to radiotherapy. However, further investigation of this technique, which is not widely available, is required. There has not been any comparison of radiotherapy with chemotherapy in the palliation of patients with malignant pleural mesothelioma.

Prophylactic chest wall radiotherapy to intervention sites successfully reduces the incidence of malignant seeding along the intervention tracts. However, the optimum dose and timing of treatment are not clear. There is no role for radical radiotherapy alone, but the role of radiotherapy as part of multimodality therapy is discussed. There have been studies of intensity-modulated radiotherapy as part of multimodality therapy and this technique needs to be evaluated further.

5 Questions About Mesothelioma Answered

Mesothelioma is a rare cancer that often forms as the result of asbestos exposure over an extended period of time.

It is important to be informed about mesothelioma to prevent this oftentimes fatal cancer from affecting you and your loved ones.

The following 5 questions are ones that everyone should ask in regards to mesothelioma, and answers that are beneficial to read.

What is Mesothelium?

The mesothelium is the membrane that covers the internal organs of the body and protects them from becoming harmed in any way.

The mesothelium contains two layers; the first one surrounds the organ while the other forms a sac around it. A fluid is released by the mesothelium between the layers, which enables organs, like the heart and lungs, to move easily around nearby structures in the body.

What Risks are Associated with Mesothelioma?

About 70 to 80 percent of mesothelioma cases are due to the exposure of asbestos in humans.

Asbestos is a group of minerals that forms into fibers and is often found in industrial products like cement, brake linings, flooring products and insulation.

Inhaling or swallowing asbestos particles, which typically float in the air, can increase lung cancer risks and other cancers, as well as be detrimental to the mesothelioma.

The U.S. Occupational Safety and Health Administration, (OSHA), has set limits for asbestos in the workplace because of its severe health risks.

What are Symptoms of Mesothelioma?

Mesothelioma can oftentimes not develop until 30 to 50 years after exposure but there are some obvious signs that those at risk should be aware of, including:
· Shortness of breath and chest pain
· Weight loss
· Abdominal pain
· Fever
· Trouble swallowing and swelling around the neck

How is Mesothelioma Treated?

Depending on the stage of the cancer and area in which its located, different treatments can be initiated, such as:
· Surgery- Doctors can remove the part of the lining in the chest or abdomen that is effected by the cancerous cells
· Radiation Therapy- High-energy rays can kill cancer and shrink any tumors that have formed
· Chemotherapy- This treatment can help to kill and reduce the amount of cancerous cells in the body

Are There New Treatments to Cure Mesothelioma Being Studied?

Although Mesothelioma is difficult to control, the National Cancer Institute, (NC), is constantly holding clinical trials that help in designing new treatments and are beneficial to research.

Participation in these trials is important for patients suffering from this unique cancer.

Cancer Terms Mesothelioma Patients Should Know

Being diagnosed with mesothelioma is traumatic enough, but all too often, a patient’s feelings of insecurity and confusion after diagnosis are only exacerbated by unfamiliar medical jargon and terminology. If you or a loved one has been diagnosed with mesothelioma, the following glossary can help you have a better understanding of common cancer-related terms:

Adjuvant therapy refers to various forms of treatment such as chemotherapy, hormone therapy, radiation therapy administered after primary treatment to drive the cancer into remission or increase the chance it will be cured.

Biopsy involves the removal of tissues or cells to be examined under a microscope. This removal can be done by way of incision or needle. To diagnose mesothelioma, a pleural biopsy is necessary.

Biphasic is a term used to describe mixed mesothelioma, or a mesothelioma that has both sarcomatoid and epithelial elements.

Dyspnea is an early symptom of mesothelioma characterized by labored and painful breathing or shortness of breath and caused by fluid accumulation in the chest.

Empyema, or pus/infected fluid in the chest, is a complication that can occur after mesothelioma surgery.

Extrapleural pneumonectomy refers to a surgical procedure used to treat malignant mesothelioma by removing the diseased part of the lung.

Metastasis is a term to describe the spread of cancer.

Multimodality treatment involves the use of multiple methods of treatment as therapy.

Oncology is the study of cancer.

Palliative—a medicine used to alleviate the symptoms of, but not cure, a patient’s condition.

Prognosis refers to the outcome of the disease, i.e. its progression and the patient’s chance of recovery.

Pulmonary embolism is a blood clot that usually originates in the legs and then migrates to the heart, resulting in artery blockage, shortness of breath, and in some cases death. It is sometimes a complication associated with mesothelioma surgery.

Pericardial Mesothelioma Breakdown

Mesothelioma is a potentially deadly disease that takes on various forms and often can’t be detected until several years after initial exposure.

One of the more rare forms of mesothelioma is known as pericardial mesothelioma.

About five percent of those suffering from this illness are living with pericardial mesothelioma.

This form of the disease affects the lining surrounding the heart and as with all cases of mesothelioma, can be deadly if not treated within its early stages.

What Causes Pericardial Mesothelioma?

Asbestos exposure is the main reason people develop pericardial mesothelioma. Inhaling asbestos dust and fibers can affect your health in the future and ultimately lead to the development of illnesses such as mesothelioma.

Only a couple of months of exposure to asbestos fibers can lead to pericardial mesothelioma 30 to 50 years later.

Who Is At Risk?

The majority of those suffering from mesothelioma are older men between the ages of 60 and 70.

Elderly men are typically associated with the disease because their generation was most exposed to asbestos through work, before the risks of the substance were known.

Symptoms

Pericardial mesothelioma can be detected through a variety of symptoms including:
· Persistent coughing
· Shortness of breath
· Chest pain
· Loss of appetite
· Weight loss

Finding a Cure

Although a cure for pericardial mesothlioma has not been found, scientists and pharmaceutical are working together to fight this illness.

Mesothelioma Statistics

Mesothelioma has been plaguing the country for decades with several people being exposed to asbestos daily. Although so many are affected by these harmful fibers, there are still facts and statistics about mesothelioma and its affects that many Americans aren’t aware of.
By being educated on the disease, its causes, and the proper treatments available, you may prevent yourself and others from becoming a victim of mesothelioma.

How Many Americans Will Develop Mesothelioma?

According to research, close to 8 million Americans have already been exposed to asbestos.

2,500-4,000 people living in the United States have already been diagnosed with mesothelioma and asbestos-related diseases.

Asbestos exposure is not only a problem in the United States but has been an ongoing issue worldwide throughout the years.

When Can Mesothelioma Be Detected?

Mesothelioma can develop anywhere between 15-50 years of the initial exposure.

Therefore, most victims die within 18 months due to the fact that once the disease is detected; the cancer has already spread throughout the body.

Are There Variables That Enhance the Illness?

Although there is nothing found that will actually increase the rate of the cancer or cause the case to be worsened, there are some variables that don’t add positive contribution to those living with the disease. Some variables include:
· Old age
· Heart problems
· Nonepithelial histology

Mesothelioma Lawyer

Every year, thousands of individuals are diagnosed with malignant mesothelioma - a rare form of cancer that affects the lining of the heart, lungs, and abdominal cavity and is primarily attributable to asbestos exposure . Asbestos is a fibrous mineral that was commonly used prior to the 1970s in building materials and a number of consumer products. Health and government officials now deem asbestos a carcinogen and strictly regulate its use.

Unfortunately, symptoms of mesothelioma often take decades to appear. And the prognosis for individuals with mesothelioma tends to be poor since the cancer has already progressed to advanced stages by the time they are diagnosed.

People who have developed mesothelioma as a result of asbestos-exposure may be eligible to seek compensation for their losses through a mesothelioma lawsuit . If you or a loved one suffers from mesothelioma because of asbestos exposure, a qualified mesothelioma lawyer can help you understand and maximize your legal rights.


Why Contact A Mesothelioma Lawyer?

A qualified mesothelioma lawyer can evaluate your claim and provide you with competent legal counsel. You may be entitled to seek financial assistance to compensate your damages, in which case a mesothelioma lawyer can litigate your case.

Over the years, mesothelioma lawyers have helped their clients recover millions of dollars in compensation for losses suffered. With the help of a mesothelioma lawyer, you may be able to recover both economic and non-economic damages including: lost wages and earning capacity, medical expenses, pain and suffering, and more.

If you or someone you love has developed mesothelioma as a result of asbestos-exposure, you do not have to suffer in vain. Our mesothelioma attorneys have a wealth of experience litigating asbestos-related cases and can help you bring responsible parties to justice. Also, our mesothelioma lawyers work on a "contingency fee" basis, which means that they work for free unless your case is successfully resolved.

PERITONEAL MESOTHELIOMA

Peritoneal mesothelioma is one of three types of a rare cancer related to asbestos exposure: peritoneal mesothelioma describes the type of cancer that occurs in the tissues lining the abdominal cavity. Most peritoneal mesothelioma patients are men in their 50s to 70s; woman make up less than one-fifth of all peritoneal mesothelioma cases.
Peritoneal mesothelioma, a cancer of the lining of the abdominal cavity, is less common than the pleural form, comprising approximately one-fifth to one-third of the total number of mesothelioma cases diagnosed. According to the SEER (Surveillance, Epidemiology, and End Results) database, these diagnoses are approximately 54.7 per cent male versus 45.3 per cent female, with the median age being 65-69. The latency period appears to be shorter for asbestos-exposed individuals with symptoms appearing 20-30 years after exposure rather than the 30-40 year latency more commonly associated with pleural mesothelioma.

Symptoms

Clinical symptoms at the time of presentation may include abdominal pain, abdominal mass, increased abdominal girth, distention of the abdomen, ascites (fluid in the abdomen), fever, weight loss, fatigue, anemia and digestive disturbances. Some patients complain of more non-specific symptoms for a number of months prior to a confirmed diagnosis. In a percentage of cases, peritoneal mesothelioma is found incidentally when the patient has sought help for another health problem such as gallbladder, hernia or pelvic mass.

Diagnosis

As with all mesotheliomas, the diagnosis of peritoneal mesothelioma can be challenging. CT findings may help differentiate between the two clinical types of peritoneal mesothelioma, termed “dry” or “wet”, since their appearances are very different upon imaging. In the “dry” type, CT may reveal multiple small masses or a single dominant localized mass. There is normally little or no ascites. In the “wet” type, CT may reveal widespread small nodules, but no dominant mass. Ascites is usually present.

If fluid is present, it may be removed in a procedure called paracentesis. Unfortunately, as is the case with pleural mesothelioma, fluid analysis offers limited diagnostic value. It is normally a tissue biopsy obtained in a laproscopic exploratory that will yield a definitive diagnosis.

Staging

There is currently no established staging system for peritoneal mesothelioma, and if the disease is staged, it is normally done in accordance with the TNM system, the most common general cancer staging system. This system refers to the status of the tumor (T), lymph nodes (N) and metastases (M). There are general categories which may also be somewhat helpful in determining stage.

The first category shows a localized lesion able to be completely resected (entirely removed). In the second category, the disease is contained within the abdominal cavity on peritoneal and organ surfaces where debulking (the removal of as much, but not all of the tumor) is possible. Category three shows disease contained within the abdominal cavity with invasion of organs such as the colon or liver. Category four shows disease extending outside the abdominal cavity.

Treatment

In recent years, multimodality treatment of peritoneal mesothelioma has become more common for a select patient population, since surgery alone and/or intraperitoneal chemotherapy alone have proven to be similarly ineffective. Cytoreductive (debulking) surgery involves the removal of all or nearly all visible tumor, and, depending on the physician’s choice, may be combined with Intra-Peritoneal Hyperthermic Chemotherapy (IPHC), intraperitoneal chemotherapy and/or radiation. Since it is not always possible to remove all tumors, the prognosis for long-term survival may be based on the completeness of cytoreduction as established by the following criteria:
Complete cytoreduction:

CC-0 No peritoneal seeding is visualized within the operative fields.

CC-1 Nodules of less than 2.5 cm persist after cytoreduction. Nodules of this size are thought to be penetrable by intracavitary chemotherapy, therefore cytoreduction is termed complete.
Imcomplete cytoreduction:

CC-2 Nodules of between 2.5 and 5 cm persist after cytoreduction.

CC-3 Nodules of greater than 5 cm or a merging of unresectable tumor nodules at any site within the abdomen or pelvis.

For patients found to have widespread disease, where surgery is not looked at as “potentially curative”, palliation of symptoms may be accomplished by debulking. Since peritoneal mesothelioma is a rare malignancy, specialized treatments should be conducted by doctors familiar with the disease.

One of the major problems in diagnosing patients with this cancer is that the early symptoms of peritoneal mesothelioma often resemble those of the flu, with stomach pains, and fever. Many peritoneal mesothelioma victims do not realize that there may be something severely wrong until the peritoneal mesothelioma tumors cause severe abdominal swelling. In some cases, the pressure created by peritoneal mesothelioma on internal organs can also cause an extreme amount of pain. The diagnosis of peritoneal mesothelioma begins with an X-ray or CT scan. After a doctor identifies the possibility of peritoneal mesothelioma, exploratory surgery and a biopsy are usually scheduled. If possible, surgery to remove the peritoneal mesothelioma tumors is performed. However, most treatments focus on improving the quality of life of the peritoneal mesothelioma patient, as it is often too late for treatment to be effective.
The links between peritoneal mesothelioma and asbestos exposure often mean that an outside party can be held accountable financially for peritoneal mesothelioma costs, including medical bills, lost wage, and punitive fees.

Types of mesothelioma

There are 2 main types of mesothelioma

* Pleural mesothelioma
* Peritoneal mesothelioma

The pleural type grows in the tissues covering the lungs. The peritoneal type grows in the tissue lining the inside of the abdomen (tummy). Pleural mesothelioma is much more common than peritoneal mesothelioma.

Between 7 and 8 out of 10 (70-80%) cases of mesothelioma are pleural mesothelioma. Peritoneal mesothelioma is much less common, making up between 1 and 2 out of every 10 cases (10 - 20%).
Cell types
Mesothelioma is also grouped according to how the cells look under a microscope. When mesothelioma is grouped this way, there are 3 types

* Epitheloid
* Sarcomatoid or fibrous
* Mixed type (also called Biphasic type)

Between 5 and 7 out of 10 cases (50-70%) of mesothelioma diagnosed are the epitheloid type.

Between 7 and 20 out of every 100 cases (7 – 20%) of mesothelioma diagnosed are sarcomatoid type.

Between 20 and 35 out of every 100 cases (20 – 35%) of mesothelioma diagnosed are mixed and have both epitheloid and sarcomatoid cells.

These types of mesothelioma cells can further divide into other types of cancerous cells called

* Clear cell
* Small cell
* Acinar cell
* Tubopapillary cell

With so many different types of cells capable of developing into mesothelioma, it makes it very difficult to diagnose this disease.

What is mesothelioma?

Mesothelioma is a type of cancer. It is a cancer of mesothelial cells. These cells cover the outer surface of most of our internal body organs, forming a lining that is sometimes called the mesothelium. So this is where this type of cancer gets its name.

Mesothelioma cancer can develop in the tissues covering the

* Lungs
* Abdomen

The pleura

The tissues lining (or covering) the lungs are called the pleura. There are two pleura. These can be called pleural membranes. The gap between them is called the pleural space. The pleura are fibrous sheets. They help to protect the lungs. They produce a lubricating fluid that fills the gap between the two pleura. This helps the lungs to move smoothly in the chest when they are inflating and deflating as we breathe.
Mesothelioma is most often diagnosed in the pleura. This is known as pleural mesothelioma. Because it is so close, pleural mesothelioma can also affect the sheet of tissue covering the heart - the pericardium. Doctors call the pericardium the lining, although it is on the outside of the heart. It protects the heart and allows it to move smoothly within the sac that surrounds it. So it does much the same job for the heart as the pleura do for the lungs.
The peritoneum

The tissue lining the abdomen is called the peritoneum.It helps to protect the contents of the abdomen. It also produces a lubricating fluid. This helps the organs to move smoothly inside the abdomen as we move around.
Mesothelioma of the tissues lining the abdominal cavity is known as peritoneal mesothelioma. It is much less common than pleural mesothelioma.
It is unusual for mesothelioma to spread to other parts of the body.But if it does, it does not usually cause troublesome symptoms.
Benign mesothelioma

There is a form of non cancerous (benign) mesothelioma that can develop in the lining of the lungs, or in the lining of the reproductive organs. It can occur in either men or women.