Mesothelioma is a rare and aggressive cancer caused almost exclusively by exposure to toxic asbestos fibers. Approximately 3,000 patients are diagnosed each year in the United States.
Pleural mesothelioma, the most common form of cancer, accounts for nearly 75% of cases. It begins in the pleura, a thin membrane that surrounds the lungs. The formation of tumors usually causes severe respiratory distress.
There is no definitive treatment for pleural mesothelioma, although recent therapeutic advances and an aggressive multidisciplinary therapeutic approach have allowed some patients to survive and thrive three, four, five years or more after their initial prognosis.
The typical prognosis, however, is still just 6 to 18 months old.
The diagnosis is difficult
A major barrier to treatment stems from the inability to diagnose mesothelioma at an early stage, while it can be treated more effectively.
The latency period (20 to 50 years) between the first exposure to asbestos and the actual diagnosis is the reason why it is usually found during the life of an elderly person.
The majority of cases of pleural mesothelioma result from occupational exposure when microscopic fibers of asbestos are inhaled or ingested without their knowledge.
The fibers lodge in the pleura and cause irritation, chronic inflammation, scars and genetic damage that slowly develop into deadly cancer. One of the symptoms is an accumulation of fluid between the lungs and the membrane, which makes it more and more difficult to breathe.
Even if mesothelioma progresses, diagnosis is difficult. The first symptoms, such as shortness of breath, dry cough and chest discomfort, often reflect those of less severe problems.
The scarcity of cancer also means that many doctors never see it and have trouble recognizing mesothelioma until it metastasizes into the chest cavity. Other doctors will poorly diagnose the early symptoms of influenza or pneumonia and circumvent the many tests required by the diagnosis.
The diagnostic process usually involves:
- Chest x-ray
- Blood tests
- Computed tomography and PET
- Thoracoscopy (type of tissue biopsy)
- Even after a multitude of tests, it is not unusual for an oncologist to confuse it with lung cancer, which is treated differently.
"It's not lung cancer," said Dr. Abraham Lebenthal, a thoracic surgeon and mesothelioma specialist at Brigham and Women's Hospital in Boston. "To understand the subtleties of mesothelioma, you need an expert."
Pleural mesothelioma in Indiana
The state of Indiana ranks 21st in the country in terms of mesothelioma deaths. A large number of cases have been attributed to Indiana's many manufacturing industries, which once used a large amount of asbestos-containing materials.
Pleural mesothelioma is better treated - and also better diagnosed - in a specialized center that treats it regularly.
The most effective therapeutic approach is multimodal therapy, which combines two or more of the traditional treatments such as chemotherapy, surgery and radiotherapy. Patients also benefit from a multidisciplinary approach, calling on a team of experienced specialists.
Although aggressive surgery has proven effective, less than half of those diagnosed are candidates for surgery. If the cancer has already metastasized, which is often the case, the best treatment is that of palliative care.
There are also complementary therapies that include an integrative approach, which attempts to treat the whole person beyond the illness. The goal of integrative medicine is to improve the quality of life.
The pleural mesothelioma center is available to provide information and support to anyone needing help to fight this disease. Free services include localization of mesothelioma specialists, financial assistance and answers to your questions.
Department of Environmental Management of Indiana. (North Dakota.). Asbestos.
US Centers for Disease Control and Prevention. (1985). HHE Report No. HETA-84-151-1