Mesothelioma has become a household word to tens of thousands of U.S. citizens. It is a form of cancer associated with asbestos, and with the mesothelioma lawsuits that forced many asbestos companies into bankruptcy. Asbestos was an enormously popular material for construction products and insulation for industrial plants, commercial buildings and homes. By 1985 it was a proven carcinogen, after more than fifty years of suspicion from the medical community and denials from asbestos companies.
The Asbestos – Mesothelioma Link
Unlike most cancer, mesothelioma is almost always caused by just one source: asbestos exposure. The National Cancer Institute reports that up to 80% of all mesothelioma cases are caused by asbestos exposure. However additional causes of the disease are just guesses and include such exotic factors as exposure to a mineral in Turkey called zeolite and previous infection with the Simian monkey virus. Exposure to radiation may make the development of mesothelioma more likely.
For most of the twentieth century, asbestos was heavily used in the manufacture of all types of insulation, flooring, ceiling tiles, pipe fittings, plaster, caulking, roofing, and other construction products. Any industrial facility or power plant (including naval engine rooms) that generated heat probably had pipes, tanks and other fixtures insulated with asbestos. Some sort of asbestos product was at virtually all construction job sites up to 1985 or so.
Asbestos is a fibrous material that when disturbed, emits fibers into the air which can be inhaled by any nearby worker: a miner, a construction worker, a ship’s crewman working around the ship’s pipes and boilers, plumbers, carpenters, auto mechanics, workers in the oil business, in power plants, in chemical plants – the list goes on. The list also includes family members of workers that brought home asbestos fibers on their clothing and shoes from the job site.
Types of Mesothelioma
Mesothelioma is not just lung cancer. It begins in the lining of the chest or abdominal cavities and can impact the organs contained in or near those places: lungs, heart, reproductive organs. The mesothelium is a tissue lining for cavities in the upper body. In the pleural area, the area around the lungs, it is a double tissue with the inner portion (the visceral layer) lining the lungs themselves and the outer portion (the parietal layer) lining the chest wall.
There are three types of mesothelioma: as with the pleural area the disease can impact the lining around the heart and in the abdominal cavity. Mesothelioma is a condition of uncontrolled cell growth that causes the mesothelium layers to thicken and often results in fluid accumulating between the two layers. These cancer cells can be either malignant or benign.
Pleural mesothelioma impacts the lining of the chest cavity around the lungs. When both the inner and outer membrane layers (the mesothelium) thicken and retain fluid in the area between, pressure is put on the lungs and shortness of breath develops. Other symptoms of pleural mesothelioma include a persistent cough, chest pain, hoarseness and perhaps trouble swallowing. The more general symptoms for mesothelioma are fever, weight loss and fatigue, which explains why the initial appearance of mesothelioma symptoms are often misdiagnosed as pneumonia or some other common pulmonary problem.
Pleural mesothelioma is by far the most common form of the disease, accounting for about 75% of all cases. It is, however, a disease of the membranes surrounding the lungs. If the rogue cells are malignant and pass into the lungs, the lung cancer that results is secondary to mesothelioma. Nevertheless, lung cancer that develops as a result of mesothelioma is often referred to as asbestos lung cancer or mesothelioma lung cancer.
Pericardial mesothelioma impacts the membrane that surrounds the heart. This form of the disease is the rarest: less that 10% mesothelioma diagnoses are for the pericardial variant. One of the issues with pericardial mesothelioma is that medical researchers are unsure how asbestos fibers get into the tissue around the heart. In the case of pleural mesothelioma they are inhaled. How they migrate to the pericardial area is something of a mystery. One theory holds that they break up into smaller pieces after inhalation and somehow are carried to the pericardial area in the bloodstream.
In any case, the impact of asbestos fibers on the pericardial mesothelium is the same as in the pleural area. They cause inflammation which eventually leads to the uncontrolled growth of cells – cancerous cells. As the membrane thickens, fluid buildup occurs and pressure is put on the heart. The symptoms can include an irregular heartbeat and little or no stamina, along with chest pain. Because these characteristics are also symptomatic of heart disease, the diagnosis for mesothelioma is often overlooked initially.
This form of the disease impacts the membrane that lines the abdominal cavity, the peritoneum. It is also unclear how this form of the disease develops. The theory for pericardial mesothelioma that tiny asbestos fibers travel through the bloodstream is also applicable for the peritoneal variety. It is also quite possible that asbestos fibers work their way to the abdominal wall through the digestive tract and that they are introduced to the body through eating or drinking.
Asbestos fibers travel through the air like dust and pollen. They could certainly find their way to consumable items on a jobsite. Regardless of the source, the impact of asbestos on the peritoneal membrane is the same. Over time they act as an irritant which results in prolonged inflammation, eventually leading to the development of uncontrolled cancerous cell growth.
Fifteen to twenty percent of all mesothelioma cases are peritoneal. The fact that it is more common than pericardial mesothelioma would suggest that the causal theory based on ingestion makes sense. Lung cancer can also be a secondary development of peritoneal mesothelioma; in addition one of the rare forms of peritoneal mesothelioma can impact the testicles. The membrane within the scrotum is an extension of the peritoneal mesothelium.
Symptoms of peritoneal mesothelioma usually begin with abdominal pain as the fluid buildup caused by the mesothelioma cells begins to impact the abdominal cavity. It can also be accompanied by shortness of breath and a cough, although these symptoms are less common. What peritoneal mesothelioma does share with other types of the disease is a lag of some months between manifestation of the symptoms and a diagnosis.
Years Between Asbestos Exposure and Mesothelioma
Mesothelioma is difficult to diagnose and there are a number of reasons for it. One is that the symptoms mimic those of much more common diseases. Another is that mesothelioma cancer itself does not result in tumor development; that occurs only after the disease has fully developed and metastasized into a nearby organ. But perhaps the most difficult factor is the reality that it takes years and often decades for those asbestos fibers to do their work.
In the case of pleural mesothelioma, the fibers are inhaled and slowly work their way through the lung wall into the mesothelium as the body tries to rid itself of this irritant. Once lodged in the membrane around the lungs, the fibers slowly create a situation where they trigger the development of malformed cancerous cells that begin the process of thickening the membranes which in turn begins the fluid accumulation process.
The result is a remarkably lengthy period of latency for the disease. By the time the symptoms appear – the shortness of breath, fatigue and fever – many years will have elapsed since the asbestos exposure. The patient may be a Navy veteran that spent four years on a ship three decades ago. The asbestos exposure will be long forgotten and the symptoms mirror indications of other more common diseases. The fact that mesothelioma is most often shrouded in a lengthy latency period means that it usually isn’t diagnosed until it has had time to fully develop as a malignant threat. The common latency period for mesothelioma is twenty to fifty years and twenty to thirty years for asbestosis.
Developing Mesothelioma Treatment Options
If mesothelioma is in an early stage it can be treated with surgery in combination with radiotherapy and chemotherapy. For pleural mesothelioma a pleurectomy – removing the diseased pleura – or an extrapleural pneumonectomy, which removes a lung in addition – are the two likely options. Peritoneal mesothelioma, when treated surgically, involves removal of the peritoneum in addition to adjacent malignant tissue.
Whether or not surgery is viable chemotherapy and radiotherapy are employed to slow or halt the disease. Efforts generally focus on slowing or stopping the growth of the cancerous cells. There are a number of approaches to this concept. One chemotherapy drug called cisplatin that is used for mesothelioma treatment has at its core molecules of platinum, which has proven to damage the DNA in certain types of cancer cells, resulting in their inability to reproduce. This sort of targeted chemotherapy does less damage to surrounding healthy cells than some more general formulations of anti-cancer cell agents.
Another chemotherapy drug approved by the FDA for mesothelioma treatment is pemetrexed, a medication that targets enzymes vital to certain types of cancer cells. This is another successful approach to narrowing the focus of chemotherapy and limiting collateral damage; however some mesothelioma cancer cells have shown resistance to pemetrexed. For that reason, mesothelioma clinical trials have recently been completed that utilize cisplatin and pemetrexed in combination. The result was a significant extension of survival time for many of the participants. Radiotherapy remains an adjunct form of mesothelioma treatment used to target certain types of malignant cells. It is also used to treat symptoms such as pleural effusion which can have a debilitating effect on the patient.
Early Diagnosis: the Key to Mesothelioma Survival
Practitioners working on mesothelioma cancer are faced with the difficult combination of a disease that is usually fully developed when diagnosed and that is a diffuse spread of cancer cells that are not gathered in the form of a tumor, often creating a situation where surgery isn’t a viable option. In addition, its initial symptoms are often readily assumed to be the result of some more common problem such as a pulmonary illness or heart problems.
In order to achieve some pattern of early diagnosis, people who know they have been exposed to asbestos must consult with their doctors and seek some preliminary tests to ensure that there are no signs of the disease. CT and MRI scans can today detect thickening of the mesothelium membrane in some cases. If diagnosis can be made before the physical symptoms appear, the doctor may have some chance of bringing growth of the cell mass to a halt before it is too late.
Mesothelioma in the Courts
The toxic nature of asbestos has been evident to some since the 1930s. By 1985 enough people had become sick from asbestos exposure that the relationship between asbestos and mesothelioma was incontrovertibly established. For years, asbestos companies and industrial giants that manufactured products using asbestos denied the health problems associated with it.
By the end of the 1990s the courts had ruled that people who suffered from an asbestos-related disease were entitled to liability compensation from asbestos companies who mined the material and corporations that used it to make consumer and construction products. The result has been over one hundred bankruptcies and the establishment of several trusts holding billions of dollars to compensate people who can prove personal damage or damage to a deceased family member as the result of asbestos exposure.
Asbestos is the Cause of Many Illnesses
While the lethal nature of mesothelioma cancer has drawn a lot of the attention given to asbestos toxicity, there are several other afflictions that can be attributed to the material. One of the most common and most harmful is asbestosis. This disease is the result of scarred lung tissue that has been damaged by asbestos fibers. It is a permanent, progressive, restrictive lung illness also known as pulmonary fibrosis. Asbestosis causes shortness of breath, reduced lung capacity and chest pain.
The most common affect of asbestos exposure is pleural plaques. These are smooth, raised strips of fibrous tissue that develop on the pleura. One third to one half of individuals with significant asbestos exposure will develop this condition. They are not pre-malignant and are not believed to lead to further health problems. They will calcify however, and show up on X-rays as an indication of asbestos exposure. Pleural thickening can also be a benign condition that is caused by the presence of asbestos fibers, leading to chest pain and possible pleural effusion.
Mesothelioma Treatment Research
Historically the treatment of mesothelioma has been palliative. However if the disease is diagnosed early enough, pleural or peritoneal surgery is possible. An important part of this decision making process, along with the stage of the cancer, is the health of the patient. But oncologists have gotten more aggressive in recent years about performing partial resections on mesothelioma malignancy and using powerful forms of chemotherapy to treat it. In virtually all cases radiotherapy and chemotherapy are recommended for both post-operative and non-surgical treatment.
The use of targeted chemotherapy is an example of how researchers are approaching mesothelioma today along with a number of other cancer types. Cells that can be programmed to attack or compromise cancer cells and then introduced into the afflicted area have become a common strategy for cancer treatment. Methods of targeting radiotherapy have also been introduced, in order to minimize the destruction of healthy cells adjacent to cancerous cells.
In general, researchers are looking for combinations of radiotherapy and chemotherapy that work best with certain types of mesothelioma cells (there are two) and in certain stages of the disease. Because there are so many late stage diagnoses, palliative care is still an important component of mesothelioma research. The National Cancer Institute sponsors many clinical trials for mesothelioma treatment, with nearly one hundred under way as of June 2010.
Doctors and Lawyers
Asbestos has affected the health of tens of thousands of people that we are aware of; there is a massive additional population of individuals who were never diagnosed or were exposed and died at a time when asbestos-related industries were in the throes of professional denial.
The courts have slowly come to the realization that this has been a national tragedy of sorts and that there is a large class of people who worked around asbestos, and their families that also suffered as a result, who are entitled to compensation. Asbestos companies have been forced to take financial responsibility to a degree uncommon in product liability law. Today there are trust funds established by these companies that hold billions of dollars to pay for claims against those companies for lives damaged or ruined by asbestos.
There are still many thousands of asbestos and mesothelioma claims to be filed because of the fact that mesothelioma has such a long latency period. Workers who were exposed to asbestos products on the job site daily during the 1970s may only now be showing the symptoms of asbestos toxicity. If you or a family member may be one of those individuals, it is important to both your health and your financial well being to confirm any potential asbestos health problems with your doctor.
If your physician detects asbestos damage, a mesothelioma lawyer with expertise in the field can obtain fiscal damages for you. If you’d like to discuss this possibility, fill out our simple form or give us a call and we’ll put you in touch with an experienced professional who can talk you through the details of your case and go over your options. There will be no financial obligation on your part; that will fall to the asbestos companies if yours is a viable case.
- Mesothelioma: Questions and Answers, National Cancer Institute, http://www.cancer.gov/cancertopics/factsheet/Sites-Types/mesothelioma
- What is Malignant Mesothelioma? American Cancer Society, http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_malignant_mesothelioma_29.asp?sitearea=
- Mesothelioma Overview, Mayo Clinic, http://www.mayoclinic.org/mesothelioma/
- Pemetrexed plus Cisplatin…Malignant Pleural Mesothelioma, Journal of Thoracic Oncology, July 2008, http://journals.lww.com/jto/Fulltext/2008/07000/Pemetrexed_Plus_Cisplatin_or_Pemetrexed_Plus.11.aspx
- Malignant Mesothelioma: …Diagnosis and Therapeutic Approaches, PubMed, National Institutes of Health, http://www.ncbi.nlm.nih.gov/pubmed/20021458
- Clinical Aspects of Benign Asbestos Pleural Disease, Medscape, http://www.medscape.com/viewarticle/460443_2
- National Cancer Institute, Database of Clinical Trials, http://www.cancer.gov/clinicaltrials
- Small Cell Lung Cancer