Mesothelioma Causes

Exposure to asbestos fibers causes mesothelioma cancer. Mesothelioma can result A potentially dangerous exposure can result from very small fibers or dust particles at low exposure levels. Most such exposure would likely have occurred prior to the 1980s, but the latency period can be up to 40 years for most lung cancer to develop.

Many people have come into contact with asbestos fibers via their jobs, or occupational exposure. There is also a risk to the family members of those working in at-risk occupations; this exposure is called paraoccupational exposure. Likewise, people who live near sites likely to have asbestos around the facility are also at risk: refineries, power plants, factories, shipyards, steel mills and building demolition are types of work sites that can release asbestos fibers into the environment and contaminate nearby residential neighborhoods.

At Risk Job Locations:

-Asbestos product manufacturing (insulation, roofing, building, materials)
-Automotive repair (brakes & clutches)
-Construction/contractors
-Maritime
-Miners
-Offshore rust removals
-Oil refineries
-Power plants
-Railroads
-Sand or abrasive manufacturers
-Shipyards / ships / ship builders
-Steel mills
-Tile cutters

At Risk Occupations:

-Auto Mechanics
-Boiler makers
-Bricklayers
-Building Inspectors
-Carpenters
-Drywallers
-Electricians
-Floor Coverings
-Furnace Workers
-Glazers
-Grinders
-Hod carriers
-Insulators
-Iron workers
-Laborers
-Longshoremen
-Maintenance workers
-Merchant marines
-Millwrights
-Operating Engineers
-Painters
-Plasterers
-Plumbers
-Roofers
-Sand blasters
-Sheet metal workers
-Steam fitters
-Tile setters
-Welders
-U.S. Navy veterans
-Welders

Many occupations have an increased risk for developing lung cancer. For example, asbestos insulation workers have 92 times the risk of developing of lung cancer, and smelter workers have 3-8 times the risk of developing lung cancer. The risk of lung cancer is also increased in people who work in the manufacturing of certain industrial gases, pharmaceuticals, soaps and detergents, paints, inorganic pigments, plastics, and synthetic rubber. The risk of developing lung cancer is related to the amount of exposure to the cancer-causing agent. For example, the risk of lung cancer in humans is proportional to the number of cigarettes smoked. The risk of developing lung cancer is 8-20 times greater in smokers compared to people who have never smoked. A smaller, but real risk exists for cigar and pipe smokers. Some cancer causing agents react together to significantly worsen the risk of developing cancer. The combined exposure to asbestos and tobacco smoke clearly multiplies the risk of developing lung cancer. The risk of lung cancer is greater for those living in urban areas. This risk is approximately 1.2 to 2.3 times that of people living in rural areas. There is also an increased risk of lung cancer in smokers whose close relatives have had lung cancer. Scarring in the lungs from previous infections or injury can be associated with and increased risk of cancer.

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Mesothelioma Drug Therapy

Traditional Chemotherapy:

This traditional approach uses special anti-cancer (cytotoxic) medicines and chemicals to try to kill the malignant cells. Often, it is offered as an additional therapy alongside radical surgery and/or in combination with radiation therapy or immunotherapy, particularly when the cancer has spread beyond an operable area. Many drugs have been tried; however all have met with only limited success against malignant mesothelioma.

The chemotherapeutic agents can be administered either systemically (in the blood stream) or intrapleurally (in the pleural cavity itself.) These cytotoxic drugs are very potent and can have many severe side effects which you should discuss with your doctor.

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Mesothelioma Photodynamic Therapy

This treatment uses light to kill cancerous cells.

Initially, the patient receives a photosensitizer which collects in cancerous cells but not in healthy cells. (A photosensitizer is a drug which makes cells vulnerable (sensitive) to light of specific wavelengths.) After the cells have been sensitized, fiberoptic cables are placed in the body (usually through open-chest surgery) in order to focus light of just the right frequency on the tumor. This causes the photosensitizer to produce a toxic oxygen molecule which kills the cell.

Although this treatment is still in a very experimental stage for the treatment of mesothelioma, it has shown promising results in the treatment of other cancers.

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Mesothelioma Immunotherapy and Gene Therapy

Immunotherapy, also referred to as biological therapy, is based on the theory that it is possible to mobilize the body's own immune defenses against cancerous cells. Another name often applies to this therapy, biological response modifiers (BRMs), and is described in this article.

There are several new experimental treatments that try to enhance the immune system's ability to combat malignant mesothelioma. These include gene therapy and the use of cytokine proteins such as interferons and interleukins. These treatments are also being tested in combination with chemotherapy and other treatments.

Gene Therapy:

This a new treatment which is currently in clinical trials. Using an adenovirus for delivery, a "suicide gene" is inserted directly into the tumor. This gene makes the cells sensitive to a normally ineffective drug, such as glanciclovir. Treatment with the drug then destroys those cells that are rapidly dividing - which are the cancer cells - leaving the healthy cells unharmed.

In theory, this approach allows treatment to target the tumor specifically, as opposed to treatments such as chemotherapy which also kill healthy cells.

Gene therapy for mesothelioma is being researched at the University of Pennsylvania, with Dr. Steven Albenda as the principal investigator. This treatment is not without risk, as became apparent in the death of Jesse Gelsinger, a University of Pennsylvania gene therapy trial participant. (Note that Mr. Gelsinger was not a participant in the mesothelioma trial.)

Cytokines - Interferons (IFN) and Interleukins (IL):

Cytokines are small proteins that occur naturally in the human body. They are similar to hormones and have specific effects on the behavior of other cells.

In 1976 Dr. Robert Gallo (later head of the National Cancer Institute, and famous for his work on HIV) isolated a cytokine protein molecule called interleukin-2 (IL2) which is capable of stimulating the growth of immune system cells called T-cells. T-cells are sometimes called "killer cells" because they search out malignant or virally infected cells and kill them. Using IL2 as a treatment for pleural mesothelioma is still in the experimental stages, but researchers hope that injecting IL2 intrapleurally will promote a significant anti-tumor response.

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Mesothelioma Angiogenesis Therapy

Cancer cells, like other cells in the human body, rely for their growth on a rich supply of blood. They must be surrounded by an effective network of capillaries and larger blood vessels that nourish the cells. The medical term for the process of developing this network is angiogenesis.
In fact, fast-growing cancers are highly efficient at promoting angiogenesis. They produce angiogenesis promoters that create capillaries and a network of blood vessels around the tumor. The tumor is nourished with an increasing supply of oxygen-rich blood, and it grows and spreads (or metastasizes).

Understanding that angiogenesis is fundamental to the process of how tumors grow and metastasize, medical researchers started to investigate how they could slow down, stop, or reduce angiogenesis. If they could do this, they reckoned, they could starve the tumor to death - or at least slow its growth significantly. The National Cancer Institute has created an illustrated teaching tool to better understand how angiogenesis works.

A number of antiangiogenesis drugs, also called angiogenesis inhibitors or angiogenic inhibitors, have been developed. When administered to laboratory animals with tumors, they have caused the tumors to shrink or even disappear. Endostatin, combrestatin, angiostatin, thrombospondin, and vascular endothelial growth inhibitor (VEGI) are among these experimental drugs.

A few of these drugs are now being tested on humans. One of them, combrestatin, destroys the lining of blood vessels around tumors. Another, endostatin, acts by impeding the growth of new blood vessels around the tumors. For endostatin there have recently been some promising developments. Harvard's Dana-Farber Cancer Institute released an updated report on Phase 1 trials of the angiogenic inhibitor and says it exhibits virtually no toxicity even at high doses, while shrinking tumors in two of 28 advanced cancer patients and slowing disease progression in four others for more than six months.

This area of cancer research holds promise for the treatment of mesothelioma tumors, but it is very much in the early and experimental stages.

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Mesothelioma Litigation

Mesothelioma litigation has increased during the second half of the 20th century as asbestos-exposed workers begin to show the underlying symptomology associated with mesothelioma cancer. In order to properly allocate liability and legal-financial responsibility for the ongoing mesothelioma cancer mortalities linked to asbestos exposure, trial attorneys are organizing class action lawsuits in order to represent victims' rights and interests.

Mesothelioma litigation reflects a cause of action undertaken by contingency law firm specialists on behalf of a large population segment that has been linked to asbestos exposure during their workplace environment. Individually, in order for you or your family member to qualify for inclusion within a mesothelioma litigation cause of action suit, you'll need to produce verifiable records evidencing your employment by the firm which goes to trial as defendant. Judicial due process rules also require that mesothelioma litigation evidence scientifically that you and the other victims have been exposed to asbestos and that pathology tests verify the presence of malignant mesothelioma.

Legal standards in a mesothelioma litigation cause of action are set at a high threshold for both plaintiff (victims' side) and defendant (company). In essence, the Court rules that the mesothelioma litigation plaintiff argument prevails if direct causality can be shown, linking verifiable evidence of asbestos contamination during the specific period when plaintiff was employed. With the spate of mesothelioma litigation over the past twenty years, many defendant companies have filed for Chapter 11 bankruptcy protections, their financial condition and vanishing insurer support rendering them cash-less and judgment proof in regards to collecting against a court judgment. A further complicating factor over-hanging mesothelioma litigations in America is the political lobbying in Washington DC which has caused Congress to weigh in to "cap" asbestos related class actions. In effect, mesothelioma litigation "over kill" has killed the "goose", and now little money is left to satisfy the compensatory damage claims ordered by the courts.

The pathway into mesothelioma litigation necessitates that you or your family member produce evidence of asbestos exposure, which could be minimal yet could have occurred 45 years ago. Many current mesothelioma cancer cases can be linked back to the US naval shipbuilding yards in World War II where over 4 million American men and women contributed to the war effort. As mesothelioma litigation court motions now set forth, workers handling piping and drywall materials were continuously exposed to asbestos, which was a significant insulating and protective covering bonded to pipes, wells, and certain dry wall insulating materials. Other mesothelioma litigation court documents have identified victims who were actually engaged in the asbestos extraction fields, dealing almost exclusively with asbestos each day. One additional plaintiff group has emerged in mesothelioma litigation, which includes those family members or other factory sites which experienced asbestos contamination due to "second hand" exposure where fibrous asbestos either migrated on wind currents between factories, or was brought into the home by Mom or Dad on work clothing, shoes, caps, hair and so on.

A planning consideration when participating in mesothelioma litigation procedures is to have your estate and financial affairs completely sorted out, so that any future jury-ordered award passes uninterruptedly to your heirs and assigns, according to law.

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Mesothelioma Legal Assistance

Mesothelioma lawsuits are divided into two categories - one, where the person suffering from mesothelioma is living (a personal injury case) and the second, where the person with mesothelioma has died (wrongful death case), and the plaintiff is a spouse, relative and/or representative of the deceased person's estate.

When the person who would normally be the plaintiff is deceased, an alternate individual (usually the spouse or a close relative) stands in as the plaintiff, and the injuries claimed include the loss of life itself. The most important part of a wrongful death case is locating persons who worked with the plaintiff to provide testimony that the deceased individual would have provided regarding work history and asbestos exposure.

If you or someone you love has recently been diagnosed with Mesothelioma, call our office today for a free confidential consultation no matter where you live. We will gladly help you understand the critical medical and legal issues surrounding mesothelioma diagnosis, treatment and financial recovery.

Because of the aggressive nature of mesothelioma it is important that the patient and his or her family move quickly to document the facts and circumstances particular to the individual’s exposure to asbestos. This includes gathering information on work history, the types and brands of asbestos products encountered in ones past as well as the different work locations where exposure may have occurred and names of co-workers.

We are able to assist in this research by providing access to asbestos documents, catalogs and advertisements (dating from 1940 to 1970). These resources and images are often crucial in jogging the memory and aiding in the proper identification of products.

Because we are able to work with local mesothelioma attorneys in any state. There is never a need to travel or inconvenience the mesothelioma patient and his or her family in any way.

When a mesothelioma patient hires our firm, a complete investigative procedure is immediately initiated and this documentation will speed this process along so that we may quickly determine the appropriate course of legal action. With most of our mesothelioma patients, a lawsuit must be filed immediately in order to obtain sworn statements of work history, evidence of exposure and product identification, and the client’s physical and mental condition.

If the diagnosed client is unable to come to our offices, depositions (interviews) may be conducted at their home, hospital or any other location which is comfortable and convenient to the client. If a deposition is not possible due to the progressed stage of the disease, other methods of obtaining the required proof of exposure and resultant illness will be pursued with the assistance of the client’s closest relatives.

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Mesothelioma Support Groups

A diagnosis of cancer, especially a rare cancer like mesothelioma, can feel isolating. Taking advantage of the many national and local support groups available to people diagnosed with mesothelioma and other asbestos-related diseases can help open the lines of communication, easing the emotional toll of diagnosis, providing information on available treatments, and helping patients weather the storm of potential side effects.

Many groups provide educational programs, counseling, and can be a good source of the latest information on mesothelioma. Family support can be an important part of a patient's treatment and health; many of the support groups provide resources to caregivers and other family members.

• Association of Cancer Online Resources (ACOR)
  ACOR manages a mailing list for Mesothelioma patients.
• Alliance for Lung Cancer, Advocacy, Support and Education Support Groups
  The ALCASE is affiliated with lung cancer support groups all over the country. Visit this site to find the support group in your area.
• Alliance for Lung Cancer, Advocacy, Support and Education Support Hotline
  For lung cancer support, contact the ALCASE Support Hotline at: 1-765-298-2436. This hotline is available Monday through Friday, 8AM to 5PM Pacific time.
• American Institute for Cancer Research (AICR) Cancer Resource
  This is a free information program from the American Institute for Cancer Research to help cancer patients and their families understand more about cancer, its treatment and the resources available to help them in overcoming this disease.
• Cancer Care Counseling
  Cancer Care offers free professional counseling individually or through professionally faciliated support groups. Both types of these services are available in three different ways: online, by telephone and on-site at a Cancer Care location in New York, Long Island, New Jersey or Connecticut.
• Cancer Information and Counseling Line (CICL)
  This service of the AMC Cancer Research Center is a national toll-free telephone information line designed to help people with cancer and their families. Call 1-765-525-3777, Monday to Friday (8:30 am - 5:00 PM Mountain Time) or within the Denver Metro Area call 303-239-3422. You can also pose questions online, and join their online discussion group.
• Cancer Survivors Network
  This is an online community, part of the American Cancer Society, is designed for cancer survivors and their families and friends.
• Gilda's Club®, Inc.
  Gilda's Club provides social and emotional support to cancer patients, their families, and friends. Lectures, workshops, networking groups, special events and a children's program are available.
• Hospicelink
  The Institute is an independent, not-for-profit organization, offers information about hospice and palliative care and can refer cancer patients and their families to local hospice and palliative care programs.
• Hotline, Alliance for Lung Cancer, Advocacy, Support and Education Support
  For lung cancer support, contact the ALCASE Support Hotline at: 1-765-298-2436. This hotline is available Monday through Friday, 8AM to 5PM pacific time.
• I Can Cope
  This program through the American Cancer Society offers several courses that are designed to help participants cope with their cancer experience by increasing their knowledge, positive attitude, and skills.
• Look Good... Feel Better
  This program was developed by the Cosmetic, Toiletry, and Fragrance Association Foundation in cooperation with American Cancer Society and the National Cosmetology Association. It focuses on techniques that can help people undergoing cancer treatment improve their appearance.
• National Hospice and Palliative Care Organization (NHPCO) Organization Database
  Search the NHPCO database for a hospice and palliative care program in your area.
• R.A. Bloch Cancer Foundation, Inc.
  Foundation honoring one of the founders of H&R Bloch who had died from cancer. Their Cancer Survivor's Park in Kansas City is designed to "tribute the living" and empower those with cancer so they do not give up. Information on how to start hotlines and other cancer-related programs can be found on this site.
• The SemiColon Club
  The Colorectal Cancer Network's national support group. Find the branch in your area.
• Stories of Hope
  Through the American Cancer Society, inspirational stories of people whose lives have been touched by cancer.
• Taking Charge of Money Matters
  A workshop through the American Cancer Society that addresses money issues that arise during and after cancer treatment.
• Taking Charge of Money Matters
  A workshop through the American Cancer Society that addresses money issues that arise during and after cancer treatment.
• The Wellness Community
  A free national program of emotional support, education and hope for people with cancer and their loved ones.

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Mesothelioma Diagnosis

Because mesothelioma's symptoms are not unique to it and the disease's relative rarity, cases of mesothelioma misdiagnosed are not uncommon. A review of the patient's medical history is an important part in assessing the risk of mesothelioma.

As a first step in diagnosing the disease, the doctor may order an x-ray of the chest or abdomen or a CT (or CAT) scan or MRI may be performed. Although mesothelioma typically cannot be seen on an x-ray, the tumor often causes a pleural effusion, or fluid collection between the lung and chest wall. This abnormal finding is associated with shortness of breath and warrants clinical follow up. Lung function tests may also be completed.

The doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test, called thoracoscopy, is usually done in the hospital. Before the test, the patient will be given a local anesthetic (a drug that causes a loss of feeling for a short period of time). Some pressure may be felt, but usually there is no pain.

The doctor may also look inside the abdomen (peritoneoscopy) with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is also usually done in the hospital. Before the test is done, a local anesthetic will be given.

If tissue that is not normal is found, the doctor will need to cut out a small piece and have it reviewed under a microscope to see if there are any cancer cells. This is called a biopsy. Biopsies are usually done during the thoracoscopy or peritoneoscopy.

Diagnosing mesothelioma is very difficult, and cases of mesothelioma misdiagnosed are unfortunately not uncommon. It is important to share your case history of work experience (especially in shipyards and at construction sites) and asbestos exposure potential with your physicians if you feel mesothelioma is a risk. Asbestos fibres can also be carried into the home on clothing, inadvertently exposing the deadly fibres, and the risk of mesothelioma, to family members.

A mesothelioma diagnosis is serious, but treatments are available. The chance of recovery (prognosis) depends on the size of the cancer, where the cancer is, how far the cancer has spread, how the cancer cells look under the microscope, how the cancer responds to treatment, and the patient's age. As with most types of cancer, early diagnosis is an excellent first step in fighting the disease.

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Mesothelioma Radiation Therapy

This treatment involves the localized use of high-dose radiation (like x-rays) on malignant tumors. Usually, it is not a primary treatment but is used in conjunction with other therapies such as surgical resection and chemotherapy. It is generally used to reduce the size of the symptomatic tumor and help relieve symptoms like pain and shortness of breath.

Factors which can limit the application of this treatment include the volume of the tumor and how near it is to vital organs

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Mesothelioma Unconventional Treatments

A number of mesothelioma treatments are outside the mainstream of both established and experimental therapies. As lawyers, not doctors, we are not qualified to judge the value of such unconventional or unproven treatments. In our experience, most doctors disapprove of these treatments, and there is no clear, non-anecdotal evidence of the success of any of these treatments. However, we believe you have the right to all the information available so that you can discuss all possibilities with your physician and make an informed decision about your options.

Antineoplastons:

Dr. Stanislaw Burzynski has been working on antineoplastons as a treatment for cancer since 1967. Antineoplastons are naturally occurring peptides which Dr. Burzynski claims can "reprogram" cancerous cells to behave like "normal" cells again. The success of antineoplaston treatments has been highly controversial, however. The American Cancer Society reports that they have no reliable evidence of the objective benefits of antineoplastons. Dr. Burzynski was also charged in 1995 with fraud and violation of Federal Drug Administration regulations. The Burzynski Research Institute is currently conducting clinical trials of antineoplastons.

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Mesothelioma Breakthrough

NEW hope is on the horizon for the growing number of Australians with the deadly asbestos-caused cancer, mesothelioma.

Caused by the inhalation of asbestos fibres, mesothelioma has been incurable and almost always leads to death.

However, a promising new compound appears to kill the cells of both mesothelioma and another notoriously difficult to treat cancer, melanoma.

Together the lung and skin cancers claim hundreds of Australian lives every year, and federal government health experts predict about 10,000 more mesothelioma cases will be identified in Australia by 2020.

Professor Michael Millward and his team at Perth's Sir Charles Gairdner Hospital hope their research will lead to a new drug that will beat those cancers and others.

They have recently begun human trials of the compound, derived from the herbal medicine known as Devil's Weed.

"Currently, there are two patients and two more are starting shortly," Prof Millward said.

"We will be looking to treat about 18 to 25 patients between now and the second quarter of next year."

Animal and laboratory tests have shown extremely heartening results.

"We're talking about a reduction in tumour size in animals and outright killing of cells in the laboratory," Prof Millward said.

Most existing chemotherapy drugs trigger a self destruct mechanism in cancer cells, but mesothelioma and melanoma cells are largely immune to this kind of therapy.

The new compound works by unlocking a receptor on the cancer cell, invading the cell, then killing it – much like planting an explosive inside the cell.

However, Prof Millward warned cancer patients should not get too excited about the possible new treatment.

"After this phase we will then evaluate all the results and look at if the drug is safe and whether it may be beneficial, and if that's the case we will then go to trials for specific cancers," he said.

"If the next set confirms this is a promising treatment, then it will take several more years of large trials to know if it's going to be a marketable treatment for cancer."

In other cancer news, human trials are expected to start soon for a new drug that was found in animal studies to kill late-stage human prostate cancer cells.

Melbourne-based drug development company Cytopia said its new molecule halted the normal growth cycle of prostate cancer cells, eventually leading to cell death.

The company hoped to start testing the therapy on humans by mid-2004.

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Mesothelioma Surgery Option

Surgery for mesothelioma may be performed for one of two reasons: for palliation (to relieve pain and discomfort caused by the tumor), or to cure. Palliative surgery is typically done in cases where the tumor has already spread beyond the mesothelium and is difficult to completely remove, or in cases where the patient is too ill to tolerate a more extensive operation. Curative surgery is offered when the patient is in otherwise good health and the tumor is thought to be localized and can be completely removed. Unfortunately, microscopic spread of cancer cells into the chest wall and diaphragm are common even when such spread cannot be detected by routine tests. Therefore, given the extent of these operations and their very limited success, the exact role of surgery in treating mesothelioma is often debated.

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Radiation Therapy for Mesothelioma

Radiation therapy utilizes x-rays to kill cancerous cells. External beam radiation therapy uses radiation delivered from outside the body that is focused on the cancer. These treatments are much like an extended diagnostic x-ray. Brachytherapy involves radioactive material being placed directly into the chest or the abdomen at the site of the mesothelioma. Radiation therapy is sometimes used as the main treatment of mesothelioma in some patients, especially those whose general health is too poor to undergo surgery. Adjuvant radiation therapy can be used in addition to surgery to kill small deposits of cancer that cannot be seen and removed during surgery. Palliative radiation therapy can also be used to ease symptoms of mesothelioma such as shortness of breath, pain, bleeding, and difficulty swallowing.

Radiation therapy can have the side affects of fatigue and mild skin suburn like effects. Often these are temporary. Radiation may worsen the side effects of chemotherapy. Chest radiation therapy may cause lung damage and lead to difficulty breathing and shortness of breath. In the abdominal area, radiation therapy may cause nausea, diarrhea, and vomiting . If you are having any of these side effects of radiation therapy, contact your doctor for ways to control these side affects.

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Diagnosing Peritoneal Mesothelioma

The first step in diagnosing peritoneal mesothelioma is a physical exam and patient history. If your doctor does not ask about your work history and potential mesothelioma risk factors, let him or her know about your asbestos exposure. A history of asbestos exposure is an important clue for your physician or diagnostician and neglecting to mention this could delay diagnosis.

Following a physical exam and a patient's description of their symptoms, the next step in diagnosing peritoneal mesothelioma is usually to get some type of imaging of the abdomen. An x-ray, CT (or CAT) scan, or MRI may be performed. Although mesothelioma cannot be definitively diagnosed by visual confirmation, tumors may be visible, or an excess of serous fluid may be seen. The three primary types of peritoneal mesothelioma tumor development seen are:

"Dry-painful"

The most common of peritoneal mesothelioma presentations, one large or several small but similarly located peritoneal masses are seen.

"Wet"

Associated with ascites and swelling, no solid masses but small nodules and plaques are visible in this type of peritoneal mesothelioma.

"Mixed"

A combination of both "wet" and "dry" types of peritoneal mesothelioma.

In cases where fluid has accumilated in the abdomen, paracentesis may be performed; a needle is inserted into the peritoneal cavity to drain the excess fluid from the abdomen. Usually, cytologic testing on this ascetic (peritoneal) fluid (where specialists examine the fluid for abnormal cells) is not considered effective to diagnose peritoneal mesothelioma.

The next step in effectively diagnosing peritoneal mesothelioma is the collection of a biopsy. A biopsy is required so that the tissues and cells in question can be examined at a microscopic level. A fine-needle aspiration biopsy is usually performed at first because they are minorly invasive and quite safe. Immunohistochemical staining of the biopsy is regularly performed on collected samples. Sometimes referred to casually as "immunos," these tests use special substances that color proteins and markers that indicate cancerous cells.

Sometimes further testing is required to make a definitive diagnosis, whether because the initial biopsy testing was inconclusive or a fine-needle biopsy could not be taken because of the location of the tumor and/or fluid pockets. If this is the case, the next step performed is often a peritoneoscopy. During this procedure, a local anesthetic is administered and a small incision allows the doctor looks inside the abdomen with a special tool called a peritoneoscope.

During the peritoneoscopy, a larger biopsy sample may be collected for testing. Finally, if more tissue is required for testing, diagnositic surgery or "open" biopsy may be required.

Diagnosing peritoneal mesothelioma is very difficult, and cases of peritoneal mesothelioma misdiagnosed or undiagnosed are unfortunately not uncommon. It is important to share your case history of work experience (especially in shipyards and at construction sites) and asbestos exposure potential with your physicians if you feel mesothelioma is a risk. Asbestos fibres can also be carried into the home on clothing, inadvertently exposing the deadly fibres, and the risk of mesothelioma, to family members.

In addition to determing a diagnosis, many diagnostic test also help determine the stage the cancer is in, providing a better idea of a patient's prognosis. The chance of recovery depends on the size of the cancer, where the cancer is, how far the cancer has spread, how the cancer cells look under the microscope, how the cancer responds to treatment, and the patient's age. Peritoneal mesothelioma is usually diagnosed when it has had time to advance; as with most types of cancer, early diagnosis is an excellent first step in fighting the disease.

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Symptoms of Peritoneal Mesothelioma

Symptoms of peritoneal mesothelioma may include, but are not limited to:

Ascites

Ascites is the abnormal collection of fluid in the abdomen; when it is caused by cancer, it is referred to as malignant ascites. A cancer diagnosis is only made in about 10% of ascites cases, and of that 10%, peritoneal mesotheioma makes up only a very small percentage. Ascites can be quite uncomfortable, causing swelling of the abdomen, weight gain, indigestion, nausia, and swelling of the feet and ankles.

Pain or swelling in the abdomen

Fluid retention usually causes swelling; solid tumor masses may be responsible for pain.

Weight loss

Despite the accumulated fluid, which often increases waist size, a patient's appetite may be aversely affected by peritoneal mesothelioma resulting in weight loss.

Bowel obstruction

A blockage in the small or large intestine is a rare, and often late-occuring, symptom of peritoneal mesothelioma.

Anemia

A reduction in the number of red blood cells to below normal; this forces the heart and other organs to work harder to get oxygen where it's needed.

Fever

Infection is the most common cause of fever in cancer patients, but tumor cells can also produce fever-causing agents. A bowel obstruction may also cause fever.

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How does asbestos cause peritoneal mesothelioma?

Although there's no definitive explanation, it is widely believed that asbestos causes peritoneal mesothelioma in one of two ways. First, asbestos fibers may be ingested, and when in the intestinal tract, the fibers may work themselves into the peritoneal cavity and peritoneum. Second, they may be inhaled and transported through the lymph node system to the peritoneal cavity.

Peritoneal Mesothelioma Symptoms

If you are wondering "do I have peritoneal mesothelioma?" you should seek the guidance of your physician immediately; like many cancers, early detection is very important. Malignant peritoneal mesothelioma symptoms may not appear until 20 to 30 years after the first exposure to asbestos. Symptoms are usually not specific to peritoneal mesothelioma, and most often accompany other, less serious medical issues. This may make diagnosing peritoneal mesothelioma more difficult. If you have a history of asbestos exposure, your should have regular check ups with your doctor and an awareness of peritoneal mesothelioma symptoms.

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Peritoneal Mesothelioma (Abdominal Mesothelioma)

Malignant peritoneal mesothelioma is an extremely rare cancer. Only 100 to 500 cases are diagnosed in the US each year, making up less than 30% of all mesothelioma cases.

Peritoneal mesothelioma is a cancer affecting the abdominal lining, or peritoneum (paira-tin-e-um), which is why is is sometimes referred to as abdominal mesothelioma. This membrane supports and covers the organs of the abdomen.

The peritoneum is made of two parts, the visceral and parietal peritoneum. The visceral peritoneum covers the internal organs and makes up most of the outer layer of the intestinal tract. Covering the abdominal cavity is the parietal peritoneum.

Cells in these linings secrete a fluid which allows organs to move against one another. For instance, as the intestines move food through the body. The cells of the mesothelium are designed to create fluid, but the cancer can cause them to overproduce, creating a build up of excess fluid in the abdominal cavity.

Because pleural mesothelioma is more common and often spreads to the peritoneal cavity, it is important to determine if pleural mesothelioma is the primary cancer.

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Diagnosing Pleural Mesothelioma

A physical exam and patient history will likely be your doctor's first step in diagnosing pleural mesothelioma. Past exposure to asbestos is a strong risk factor for pleural mesothelioma and the longer and more seriously you were exposed to asbestos, the greater your risk. If your doctor does not ask about your work history and potential mesothelioma risk factors, let him or her know about your asbestos exposure.

The next step is usually an x-ray of the chest. Pleural effusions, masses, and scarring may be seen on x-rays. Because x-rays are less sensitive than newer imaging techniques, an abnormal finding on an x-ray will likely prompt your physician to order further imaging through a CT or CAT scan or MRI. This will likely provide a better idea of the size, location, and invasiveness of the mass, but not a definitive diagnosis, nor a complete picture of if the mesothelioma has metastized into the lymph system.

Once a suspicious mass or fluid has been spotted, your doctor will probably order a thoracentesis and/or biopsy be performed.

Thoracentesis is a minimilarly invasive procedure where fluid is removed from the pleural space. As many as 95% of patients with pleural mesothelioma have pleural effusions, or excess fluid collection in the pleural space. Thoracentesis (or thoracocentesis) is generally an outpatient procedure and usually requires only local anesthestic. A hollow needle or catheter is interted into the chest to drain the accumuated fluid.

Generally the first biopsy, or tissue collection, performed is a fine-needle aspiration biopsy. Using a thin, hollow needle, cells from the suspcious mass are extracted. Like the thoracentesis, it is not as invasive as many surgical procedures and can help avoid the need for diagnostic surgery.

The collected fluid and/or biopsy tissue will then be sent for analysis by pathologist and/or cytologists. These specialists will look for signs of cancerous cells in the samples. Immunohistochemistry is the chemical staining of these samples to better identify abnormal cells. "Immunos," as these tests are sometimes called, are an important form of testing and are usually recommended.

If a definitive diagnosis has still not been reached, more invasive testing may be required. Your doctor may perform a thoracoscopy; this involves inserting a lighted scope, sometimes with a camera on it, into the chest for a closer look. If suspicious masses are seen, the doctor may cut out a sample of tissue to be examined for maligant cells.

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Symptoms of Pleural Mesothelioma

Symptoms of pleural mesothelioma may include, but are not limited to:

Breathlessness (dyspnea)

Along with shortness of breath, patients may suffer from a cough. Rarely, patients may develop hoarsness or cough up blood (hemoptysis).

Chest pain

Chest pain is often nonspecific, and may sometimes be felt in upper abdomen, shoulder, or arm. Chest pain and breathlessness are the most common, and usually earliest presenting, symptoms of pleural mesothelioma

Weight Loss

Unexplained weight loss is cited as a symptom in about a third of pleural mesothelioma cases.

Pleural effusion

A pleural effusion is the result of too much fluid building up between the parietal and visceral pleura (linings of the chest and lungs, respectively); a pleural effusion may cause chest pain and difficulty breathing (dyspnea), however, many cause no symptoms and are first discovered during the physical examination or seen on a chest x-ray.

Night sweats

Less common, but still cited enough to be considerd a symptom of pleural mesothelioma are fever, chills, and night sweats.

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Pleural Mesothelioma Symptoms

"Do I have pleural mesothelioma?" If you have been asking yourself this question, chances are you have a history of asbestos exposure.

Pleural mesothelioma's symptoms are not specific, and may indicate other, less serious, conditions. However, if you know you have a history of asbestos exposure, it is wise to be proactive regarding your health care choices and observant of potential symptoms of pleural mesothelioma. Have regular check ups with your physician and make sure he or she is aware of your concerns and your history of asbestos exposure.

Pleural mesothelioma is a dose-dependent disease, meaning that the longer and more heavily your exposure to asbestos, the greater the chance you have of developing pleural mesothelioma (or another type of mesothelioma). This dose-dependence can also affect how quickly you are diagnosed with pleural mesothelioma, although the disease is known for its long latency periods of 10, 20, even as many as 40 years from exposure to disease progression.

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What Is Pleural Mesothelioma ?

Malignant pleural mesothelioma is the most common type of mesothelioma, making up over two-thirds of all cases. Pleural mesothelioma affects the lining of the lung and chest cavity known as the pleura.

The pleura is made up of the parietal and visceral pleura. The parietal pleura lines the chest wall and diaphragm while the visceral pleura lines the lungs. Fluid between these two membranes allows them to slip against one another as the lungs expand and contract.

Asbestos fibers work their way into the smallest passageways of the lungs and then into the pleura. Once there, an unknown chemical reaction causes cancerous cell development. As the cells begin to divide abnormally, the pleural lining thickens and excess fluid may accumulate.

Pleural thickening gradually contracts the breathing space, causing shortness of breath—often the first symptom for pleural mesothelioma. The fluid, once carefully measured to allow smooth movement between the lungs and other organs, now causes increased pressure, further hindering breathing. This excess fluid is often seen on X-rays, and is referred to as a pleural effusion.

Pleural mesothelioma, like all kinds of mesothelioma, can be difficult to diagnose or easily misdiagnosed. If you are aware of prior asbestos exposure, it is important to inform your physician so that mesothelioma symptoms can be correctly identified.

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What is Mesothelioma?

In the United Kingdom almost 2000 people a year are diagnosed with mesothelioma. It is also known as ‘diffuse’ or ‘malignant’ mesothelioma. Mesothelioma is a form of cancer that affects the Mesothelium, which is a thin membrane that lines the inner surface of the chest wall where it is known as the pleura, and abdomen, where it is known as the peritoneum. It also surrounds the organs found within these cavities for example the heart, lung and intestines. It is far more common to have mesothelioma in the chest than in the abdomen, there is approximately 1 case of peritoneal mesothelioma to every 12 cases of pleural mesothelioma. Picture Source - http://medicina.bloguje.cz/img/pleura%5B1%5D.jpg

Pleural Mesothelioma

The pleural lining has two layers: the visceral (inner) layer is next to the lung and the parietal (outer) layer lines the chest wall. The pleura produces fluid that lubricates the space between the two layers, this allows the two layers to slide comfortably over each other as we breathe in and out. Pleural mesothelioma causes the pleura to thicken. This thickening of the pleura might begin to press onto the lungs or attach itself to the inside of the chest wall. In either case the expansion of the lung becomes progressively restricted by the tumour. Fluid, sometimes several litres, can collect between the two layers of the pleura; this affects the lungs ability to expand and causes the person to feel breathless. This is known as a pleural effusion. Picture Source - www.mesotheliomacenter.org

Peritoneal Mesothelioma

The peritoneum also has two layers the inner (visceral) layer which is next to the abdominal organs and the outer (parietal) layer which lines the abdominal wall. Peritoneal mesothelioma causes the peritoneum to thicken and fluid to collect in the abdomen. This collection of fluid is called ascites and causes the abdomen to swell. Because pleural mesothelioma is more common and often spreads to the peritoneal cavity, it is sometimes necessary to determine if pleural mesothelioma is the primary cancer. Picture source - www.mesotheliomacenter.org

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