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Mesothelioma Asbestos In My Body?

Mesothelioma is a cancer which is linked to exposure to asbestos fibers in 70 to 80 percent of cases. The National Cancer institute defines malignant mesothelioma as "a rare form of cancer... a disease in which cancer (malignant) cells are found in the sac lining the chest (the pleura), the lining of the abdominal cavity (the peritoneum) or the lining around the heart (the pericardium)." It is one of the most deadly cancers known to man; the average life span of an afflicted person from the time of diagnosis until death is less than 24 months.

Mesothelioma developes in approximately 3,000 United States citizens every year. Most of those diagnosed have a history of occupational exposure to asbestos, though a few have environmental or household contact. This cancer has an extremely long latency period; an exposure period of as little as one or two months can result in a mesothelioma up to 50 years later. Patients who had contact with asbestos as far back as the 1940s are now being diagnosed with this disease. In fact, the average time between exposure and the development of mesothelioma is 35-40 years.

When asbestos first came into use, its risks were unknown, and it was widely used as a fire-retardant material. Many people worked with this deadly substance, unaware that it would kill them several decades later. Workers such as bricklayers, insulaters, plasterers, electricians, mechanics, carpenters, and other tradesmen were exposed to asbestos on a daily basis as it was contained in many insulation and construction materials.

Even occassional exposure to asbestos is a health risk, and there have been many cases of mesothelioma developing in patients who only had brief contact, such as wives of asbestos-exposed workers who washed their husbands' overalls.

Due to the long latency period and vague, diffuse initial symptoms, there is often a delay in accurate diagnosis. As with many cancers, early symptoms can be mild and non-specific. Often patients present with only shortness of breath and a persistent cough; some show no symptoms at all in the initial stages, and the disease is first noticed on a routine chest X-ray. One early tell-tale sign is pleural effusion, a collection of fluid in the lungs. The right lung is affected 60% of the time, bilateral involvement being seen in 5% of cases. Less common initial complaints due to lung mesothelioma are fever, night sweats, weight loss, a raspy voice and facial swelling. Peritoneal mesothelioma can cause abdominal symptoms such as pain, abdominal swelling, nausea, weight loss, bowel obstruction, anemia and swelling of the feet. As the disease progresses, patients often develop severe cachexia (wasting).

One of the most common symptoms of mesothelioma, pleural effusion, is an accumulation of fluid between the parietal pleura, which covers the chest wall and diaphragm, and the visceral pleura, which covers the lungs. Both membranes are covered with mesothelial cells which, under normal conditions, produce a small amount of fluid that acts as a lubricant between the chest wall and the lung. Any excess fluid is removed via blood and lymph vessels, thus maintaining a balance. When more fluid is produced than can be absorbed, an effusion forms.

These effusions are called either transudates and exudates. A transudate is a clear fluid that forms not because the pleural surfaces are diseased, but because of an imbalance between the normal production and removal of the fluid. Often this is caused by congestive heart failure. An exudate, which contains many cells and proteins and is often cloudy in color, results from disease of the pleura itself, and is common to mesothelioma. To differentiate between a transudate or an exudate, a diagnostic thoracentesis, in which a needle or catheter is used to obtain a fluid sample, may be conducted.

As the volume of excess fluid increases, symptoms develop such as shortness of breath (dyspnea) , chest pain, or a non-productive dry cough. Heard through a stethoscope, normal breath sounds are muted, and tapping on the chest will reveal dull rather than hollow sounds.

A pleural effusion can be seen with a chest X-ray, ultrasound or CT scan. Since pleural effusions are often caused by congestive heart failure, the discovery of an effusion is not in itself immediately suggestive of a malignant process.

A histological examination of pleural fluid is negative in 85% of cases; a definitive diagnoses is more often is obtained by a needle biopsy or surgical biopsy of pleural tissue.

Symptomatic treatment of lung compression caused by effusion is accomplished by application of a sclerosing agent which eliminates the space between the lung and the chest cavity, a process called chemical pleurodesis. Talc is usually used, with a success rate of 95%. It can be administered either as a powder or as a slurry mixed with saline. A surgical team opens the chest wall, removes the effusion, then collapses the lung before applying the talc. Once the lung is fused to the chest wall, an effusion can no longer accumulate and compress the lung. This is strictly a palliative measure to improve the patient's quality of life, and has no effect on the progression of the disease.

Mesothelioma TREATMENT 2013

10 Options in Treating Mesothelioma

As with any cancer, treatment for Mesothelioma depends on the location of the cancer, the progression of the disease, the age as well as state of health of the patient.

It is the oncologist who specializes in the disease who will decide on the line of treatment. The disease is difficult to treat and in most cases the prognosis is poor. Treatment options include:

1. If the diagnosis is done in the early stages surgery may be recommended to remove all cancerous tissues. This means thoracoscopy, VATS or video assisted thoracic surgery, mediastinoscopy (used for staging), or laproscopy. Often, doctors will advise palliative procedures like chest tube drainage and pleurodesis, thoracoscopy and pleurodesis, pleuroperitonial shunt, or pleurectomy, which treat the symptoms of mesothelioma rather than the disease.

2. Radiation is prescribed aggressively for mesothelioma patients and is often given in combination with surgery or in order to control symptoms, palliatively. Research on using radiation therapy using implants or UV light therapy is in progress as traditional radiation therapy damages surrounding healthy tissue.

3. Chemotherapy is an option and around 12-20% of patients respond to the drugs. Anti-cancer drugs destroy cancer cells and prevent their spread. In mesothelioma, chemotherapy is not considered to be curative. The aim is to prevent spread of the disease; shrink the tumor prior to surgery, known as neoadjuvant therapy; to annihilate any remains of the tumor in the body post surgery; and to relieve pain and other discomfort, palliative chemotherapy. Experts recommend prescribing premetrexed along with cisplastin. These drugs have shown positive results and this is now standard care for Mesothelioma not treatable by surgery.

4. Biological therapy using interleukin 2.

5. Immunotherapy where the body's own immune system is stimulated to fight the disease. Biological response modifiers, BRMs, are used in treatment. These enhance the functions of the immune system; regulate metabolic reactions that promote growth of cancers; alter cancer cell division; block or reverse processes that lead to formation of cancers; and prevent spread of cancer.

6. Gene therapy, where attempts are made to correct the gene sequence that causes the cancer. This is of two kinds, replacement gene therapy and knockout gene therapy.

7. Administration of lovastatin, a cholesterol lowering drug.

8. Photodynamic treatment where a photosensitive medication is activated using a laser. This is done during the surgical removal of cancerous tissues.

9. Draining of fluid in the chest or abdominal cavity followed by introduction of medications into the cavity to prevent fluid accumulation is done for patients who have uncontrolled fluid accumulation and intense discomfort stemming from it.

10. Combination therapy or Trimodal therapy which means surgery accompanied by radiation and chemotherapy.