Epithelial mesothelioma is a rare and deadly form of cancer affects the membrane lining the chest cavity, heart, lungs and abdominal cavity. There are three forms of epithelial mesothelioma: the most common, pleural mesothelioma; the second most common, peritoneal mesothelioma (accounting for only a quarter of the cases) and the rarest form, pericardial mesothelioma.
The vast majority of epithelial mesothelioma cases are the result of asbestos exposure. Indeed, one of the most frustrating aspects of this type of cancer is that patients who develop it were generally exposed 15 to 40 years before hand, which often makes the time and place the disease was contracted difficult to determine.
The early symptoms of epithelial mesothelioma are subtle and somewhat general. Shortness of breath and chest pain are the most common early symptoms. It is because these symptoms are so generic that epithelial mesothelioma is rarely detected early on. Usually when its discovered it is already in an advanced stage and treatment options, particularly localized options such as surgery, are somewhat limited.
If the cancer is in a less advanced stage, aggressive surgery treatments can be sought. Aggressive treatments are treatments aimed at curing the mesothelioma or at least increasing the patients longevity. In some cases an extrapleural pneumonectomy can be performed to try to stop the spread of the mesothelioma.
However this operation is risky and many medical centers will not perform it because of its high mortality rate. Additionally this procedure involves removing an entire lung, as well as extensive epithelial tissue, thereby reducing the patients breathing capacity in half. Even when it is successful it rarely eliminates the mesothelioma, but rather only slows its progress.
Palliative surgery (surgery only aimed at alleviating symptoms) is an option at any stage of the disease. Usually this comes in the form of a "fine needle aspiration" or pleural tap. A pleural tap involves injecting a long needle into the chest or abdomen cavity and draining the pleural space of fluid build up. This procedure may greatly reduces symptoms associated with mesothelioma.
Radiation therapy and chemotherapy are other options. Both are systemic treatments and have the draw back of affecting surrounding tissues as well as cancerous tissues. Radiation therapy is often used in combination with surgery treatments as a way of attempting to remove cancerous growth that could not be removed through surgery. Chemotherapy still has not proved very effective against epithelial mesothelioma but doctors and researcher continue to experiment with new techniques.
Thursday, August 21, 2008
Malignant Mesothelioma
According to The National Cancer Institute, malignant mesothelioma, a rare form of cancer, is a disease in which cancer (malignant) cells are found in the sac lining of the chest (pleura), the abdomen (peritoneum), or the heart (pericardium). Most people diagnosed with mesothelioma have worked on jobs where they breathed asbestos. Asbestos may cause a variety of diseases, from non-cancerous forms such as asbestosis, to much more serious diseases such as mesothelioma. Workers exposed to asbestos in the 1940s, 50s, 60s, and 70s, are coming down with these diseases decades later due to the long latency period associated with all asbestos disease.
The Department of Health and Human Services, the World Health Organization, and the Environmental Protection Agency have determined that asbestos is a human carcinogen. It is well documented that breathing asbestos fibers can increase the risk of cancer in people. Exposure to asbestos has been considered a major occupational health hazard since the first adverse effects were noted in the mid-20th century. At that time, there appeared to be an association between asbestos and lung cancer. Subsequently, it was noted that asbestos also caused pleural thickening. By the 1960s, a definite association between asbestos and mesothelioma, a rare cancer of the lining of the lung or the lining of the abdominal cavity was apparent.
The association between lung cancer and asbestos exposure is now well established. Although in most studies, all histologic types of cancer are seen, there appears to be a preponderance of adenocarcinoma. Lung cancer in asbestos-exposed workers is thought to occur at a slightly younger age than other lung cancers, and these cancers are more commonly located in the lower lobes of the lungs. There is what is called a "synergistic effect" between cigarette smoking and asbestos exposure, thus the risk of getting lung cancer rises to extraordinarily high levels if the exposed person is also a smoker. If you have been exposed to asbestos, you should stop smoking. This may be the most important action you can take to improve your health and decrease your risk of lung cancer.
The risk of non-cancerous asbestos-related diseases generally increases with increasing levels of exposure, however, this dose-response relationship is less clear for mesothelioma, where even short-term occupational exposure, or secondary household exposure occur. Cigarette smoking has no relationship to mesothelioma. We are all exposed to asbestos in the air we breathe, however, these levels are generally considered "acceptable". There has been no correlation drawn as to why, given the same set of circumstances and amounts of exposure, one person contracts mesothelioma and the person next to them does not, or why the more heavily exposed individual never contracts an asbestos-related disease, yet his wife is diagnosed after washing his work clothing.
Your Question or Comment:
The Department of Health and Human Services, the World Health Organization, and the Environmental Protection Agency have determined that asbestos is a human carcinogen. It is well documented that breathing asbestos fibers can increase the risk of cancer in people. Exposure to asbestos has been considered a major occupational health hazard since the first adverse effects were noted in the mid-20th century. At that time, there appeared to be an association between asbestos and lung cancer. Subsequently, it was noted that asbestos also caused pleural thickening. By the 1960s, a definite association between asbestos and mesothelioma, a rare cancer of the lining of the lung or the lining of the abdominal cavity was apparent.
The association between lung cancer and asbestos exposure is now well established. Although in most studies, all histologic types of cancer are seen, there appears to be a preponderance of adenocarcinoma. Lung cancer in asbestos-exposed workers is thought to occur at a slightly younger age than other lung cancers, and these cancers are more commonly located in the lower lobes of the lungs. There is what is called a "synergistic effect" between cigarette smoking and asbestos exposure, thus the risk of getting lung cancer rises to extraordinarily high levels if the exposed person is also a smoker. If you have been exposed to asbestos, you should stop smoking. This may be the most important action you can take to improve your health and decrease your risk of lung cancer.
The risk of non-cancerous asbestos-related diseases generally increases with increasing levels of exposure, however, this dose-response relationship is less clear for mesothelioma, where even short-term occupational exposure, or secondary household exposure occur. Cigarette smoking has no relationship to mesothelioma. We are all exposed to asbestos in the air we breathe, however, these levels are generally considered "acceptable". There has been no correlation drawn as to why, given the same set of circumstances and amounts of exposure, one person contracts mesothelioma and the person next to them does not, or why the more heavily exposed individual never contracts an asbestos-related disease, yet his wife is diagnosed after washing his work clothing.
Your Question or Comment:
Clinical Trial Basic
Clinical trials are studies of the safety and/or effectiveness of new drugs being tested on humans. For mesothelioma, trials are being conducted to find a better and more effective means of treatment. Anyone interested in participating in a clinical trial should discuss the particular trial thoroughly with their doctor before a making a decision on whether it is right for them.
All clinical trials carry potential benefits and risks, and it is important that you have a complete understanding of what you might expect. For instance, since clinical trials are often conducted at larger cancer centers, in many cases, travel may be necessary to receive treatment and routine tests. On the other hand, care is provided at top-notch facilities by physicians who are leaders in the field of cancer research. Another benefit would be having access to the new drug before it is widely available, however, the new drug may ultimately be proven not as effective as the “standard” of care.
Eligibility requirements for clinical trials are not the same; each study has specific guidelines to participate. Some trials allow participation after other treatments have failed, while others require that the patient have no prior treatment. Your doctor should be able to advise you which trial might be the best fit in your particular case.
Some treatment trials are “randomized”, meaning the new treatment is compared with a current standard of treatment. Depending on which arm of the protocol you are assigned, you may receive the new treatment or the standard. You should be informed in advance of this eventuality by the doctor conducting the trial. Placebos (pills that contain no active ingredient) are rarely used in cancer trials.
All clinical trials carry potential benefits and risks, and it is important that you have a complete understanding of what you might expect. For instance, since clinical trials are often conducted at larger cancer centers, in many cases, travel may be necessary to receive treatment and routine tests. On the other hand, care is provided at top-notch facilities by physicians who are leaders in the field of cancer research. Another benefit would be having access to the new drug before it is widely available, however, the new drug may ultimately be proven not as effective as the “standard” of care.
Eligibility requirements for clinical trials are not the same; each study has specific guidelines to participate. Some trials allow participation after other treatments have failed, while others require that the patient have no prior treatment. Your doctor should be able to advise you which trial might be the best fit in your particular case.
Some treatment trials are “randomized”, meaning the new treatment is compared with a current standard of treatment. Depending on which arm of the protocol you are assigned, you may receive the new treatment or the standard. You should be informed in advance of this eventuality by the doctor conducting the trial. Placebos (pills that contain no active ingredient) are rarely used in cancer trials.
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