Practice Area: Mesothelioma

Malignant mesothelioma is an asbestos-related cancer that is difficult to accurately diagnose and is unresponsive to many therapies. It occurs in the pleura, or lining of the lung, and, in very rare cases, in other areas of the body as well. While malignant mesothelioma remains an uncommon cancer, its documented three-fold increase in males between 1970-1984 can be traced to environmental and occupational exposure.

Asbestos products, which were used primarily for insulation and heat retardation, have been banned in construction since 1975. Asbestos still presents a danger to anyone doing maintenance, repair, or demolition work in buildings containing asbestos. Mesothelioma is difficult to diagnose and even harder to treat; patients often suffer from a great deal of pain and face a poor treatment outcome.

Early symptoms of mesothelioma can be very non-specific and are often ignored. Most people with this type of cancer have definitive symptoms only 2 to 3 months before the cancer is found, but by then it is often advanced.

These symptoms can also have other origins. But if you have worked with asbestos and have any of these symptoms, you should see your doctor immediately. Fleming & Associates believes anyone who has developed mesothelioma subsequent to asbestos exposure should have their case evaluated.

Mesothelioma Diagnosis

If there is reason to suspect you might have mesothelioma, the doctor will ask you about your health and do a physical exam to determine if you have fluid in the chest, abdomen, or heart. This fluid can be a sign of mesothelioma.

Imaging tests allow doctors to see the inside of your body. These could include x-rays, CT scans (computed tomography), MRI (magnetic resonance imaging), or PET scans. The x-rays might show thickening of the lung lining or other signs of asbestos exposure. CT scans are often used to first find the mesothelioma, and they are also helpful in finding out how far it has spread.

A PET scan uses glucose that contains a radioactive substance. Cancer cells in the body absorb the radioactive sugar and a special camera can detect the radioactivity. This test can indicate whether a thickening of the tissues is cancer or just scar tissue. It can also spot the spread of cancer. MRI scans are useful in looking at the diaphragm where the mesothelioma may have spread.

Fluid or tissue samples may be taken from the chest, stomach, or heart area with a needle and sent to the lab to see if cancer cells are present. Surgery allows the doctor to remove a larger sample of tumor or, sometimes, the whole tumor. It can be hard to identify mesothelioma by looking at the cells and tissue from the fluid around the lungs, so your doctor may want to do other tests as well.

Treatment for Mesothelioma

If you are diagnosed with mesothelioma, you doctor will suggest one or more ways to treat it. Options include surgery, chemotherapy and radiation therapy. Because this is a rare cancer, you may be referred to a specialist at a large medical center. A second opinion can give you more information and help you feel more secure about your treatment decision. Some insurance companies require a second opinion before they will pay for treatments.

Surgery

For some types of mesothelioma, surgery may be done to remove the cancer or relieve symptoms. Surgery to relieve symptoms, called palliative surgery, is often done when the cancer has spread, or when the patient is too weak to withstand more treatment.

Extensive surgery may be done if the patient is in good health (other than the cancer) and if the tumor is confined to one place. This type of surgery is complex and is done only in large medical centers. Unfortunately, mesothelioma has often spread before it is found.

Chemotherapy

Chemotherapy refers to the use of drugs to kill cancer cells. The drugs can be swallowed in pill form or they can be injected by needle into a vein or muscle. In treating mesothelioma, these drugs may also be given directly into the chest cavity at the site of the tumor. More than one drug may be used to make the treatment more effective. Depending on the type and stage of the cancer, chemotherapy may be given as the main treatment or as an adjunct to surgery.

• Chemotherapy can have side effects, depending on the type of drugs given, the amount taken, and how long treatment lasts. Side effects may include the following:
• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores
• Increased risk of infection
• Bleeding or bruising after minor cuts
• Tiredness
• Shortness of breath

Radiation

Radiation therapy is concentrated exposure to high energy rays, such as x-rays, to kill or shrink cancer cells. The radiation may come from outside the body or from radioactive materials placed in the tumor (implant radiation). External radiation is most often used to treat mesothelioma. Treatments are usually given daily for three to five weeks.

Radiation may be the primary treatment for patients who are not healthy enough to have surgery. It can also be used along with surgery, or as a way to ease symptoms such as shortness of breath, pain, bleeding, or trouble swallowing. If fluid builds up in the chest, radioactive drugs can be put into the space after the fluid is withdrawn to help keep the fluid from returning.

Like chemotherapy, radiation also has side effects. The skin in the area treated may look sunburned and then become darker. The patient may also feel tired.

For more information on mesothelioma visit the following Web sites:

• National Cancer Institute - Mesothelioma: Questions and Answers
• The American Cancer Society - All About Malignant Mesothelioma
• American Lung Association - Mesothelioma Fact Sheet
• OSHA - Safety and Health Topics: Asbestos
• Department of Health and Human Services - Asbestos: Health Effects
  

Websites to Help Patients Find Quality Care

• M.D. Anderson Cancer Center - Mesothelioma Treatment
• National Cancer Institute - Comprehensive Cancer Centers
• WebMD - Cancer Health Center

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