The condition develops when asbestos fibers become lodged in the lining of the body's lungs. However, fibers can also collect in the lining of the heart (pericardium) or abdominal cavity (peritoneum). Over time, the fiber can cause significant biological damage to organs and sets the stage for the development of malignant (cancerous) mesothelioma.
Who Is at Risk for Mesothelioma?
Asbestos is a natural mineral found in the environment. However, manufacturers used the strong asbestos fibers decades ago in manufacturing products including flooring, shingles, brake pads and insulation because of its resistance to heat. During the mining process, the asbestos fibers are broken up, causing dust to escape into the air. This also occurs when removing insulation made with asbestos fibers. If the dust is swallowed or inhaled, the fibers of the asbestos mineral material can settle in the stomach, lungs, or heart pericardium and cause significant irritation that eventually results in mesothelioma.
Doctors do not understand how the exposure to asbestos fibers takes two to four decades for mesothelioma to develop. This is because summoned the jewels who were exposed for years to the fibers never developed the disease, while some who were exposed only once or for short-term developed the condition. The most common associated mesothelioma risk factors include:
- Familial History – If a child, sibling or parent develop mesothelioma, the patient likely has an increased potential risk of developing the disease.
- Living Arrangements – Individuals who live with the person who works with asbestos fibers have an increased potential risk of developing the disease themselves. This is because they are likely exposed to stray fibers brought into the home for many years that are brought into the house on clothing and skin.
- Personal History – Individuals that have been exposed to asbestos fibers at home or at work have a slightly increased risk of developing mesothelioma compared to those who breathe fibers in a work environment.
Mesothelioma, like all cancers, begins when normal cells develop genetic mutations caused by numerous factors. The genetic mutations alter the cell's DNA causing the normal lifecycle of the cell to become abnormal, leading to the disease. This type of cancer, like all forms, begins to develop because the abnormal cell continually reproduces and never dies off, which then causes cancer masses to form.
Individuals most at risk for developing the disease are those with inherited conditions, live in specific harmful environments, make dangerous lifestyle choices, or are experiencing other health conditions.
Many of the common symptoms associated with Mesothelioma vary greatly between patients. These Include:
- Pleural Mesothelioma – This form of cancer affects lung tissue and can cause significant symptoms including painful coughing, chest pain behind the ribs, unexplained weight loss and unusual lumps of tissue that occur under the skin.
- Peritoneal Mesothelioma – This type of cancer affects abdominal tissue and can cause abdominal swelling, pain, unexplained weight loss, and lumps of tissue that can be felt in the abdomen.
- Pericardial Mesothelioma – This type of cancer affects the tissue that surrounds the heart (pericardium) and can cause significant symptoms including chest pains and difficulty in breathing.
- Tunica Vaginalis Mesothelioma – This form of cancer affects the tissue around the testicles that is first identified as a mass or swelling appearing on the testicle.
Many of the symptoms associated with mesothelioma cancer are not specific to its condition. This means doctors may wrongly diagnose the condition without further evaluation including a comprehensive personal history that reveals the patient was exposed to asbestos fibers.
To accurately diagnose mesothelioma, the doctor will perform a comprehensive physical examination to look for unusual signs including lumps and swollen areas. Usually, the doctor will recommend imaging scans including CT (computerized tomography) scans and chest x-rays to look for abnormalities in the abdomen and chest. Based on test results, the doctor may also recommend further testing including a biopsy that might involve:
- Fine Needle Aspiration – Portions of tissue or fluid is removed by the doctor using a small thin needle that is inserted into the abdomen or chest.
- Thoracoscopy – This procedure allows the doctor to view inside the chest by making one or more small incisions through the skin between the ribs. A tiny video camera tube is inserted through the opening in the chest cavity to allow the surgeon to excise (remove) small tissue samples for testing.
- Laparoscopy – During this procedure, the doctor can view the interior of the abdomen by making a small incision in the abdominal wall and inserting a tiny video camera and specialized surgical tools to remove small portions of tissue that can be examined under a microscope.
- Thoracotomy – The surgical procedure requires the chest to be open between the ribs so the surgeon can look for any indicators of the disease and remove tissue samples for testing.
- Laparotomy – The surgical procedure opens the abdomen so the surgeon can look for any signs of the disease and remove tissue samples for testing.
Once the tissue sample has been analyzed and evaluated under a microscope, a pathologist can identify abnormal mesothelioma tumors and where the cells have developed in the body. The stage of the disease will determine an effective treatment plan.
The type of treatment the doctor will recommend or prescribe depends on how much the mesothelioma has progressed and if the disease has spread in the body. Unfortunately, this type of disease is highly aggressive and sometimes a cure is not always possible. In its advanced stage, it might not be possible to remove the cancerous mass. When this occurs, the doctor will likely prescribe palliative treatment to minimize discomfort during the final stages of the disease.Typical options for treating mesothelioma include:
- Surgery – The surgical procedures can decrease fluid buildup, remove damaged tissues in the abdomen or lungs, remove debulking where the surgery removed as much of the affected tissue as possible, and surgical removal of the lung and surrounding tissue when necessary.
- Chemotherapy – Using chemicals to destroy cancer cells, this procedure allows the chemicals to move throughout the body that will slow the progression or shrink the mass of mesothelioma mass that cannot be removed through surgical procedures.
- Radiation Therapy – Using high-energy x-ray beams, radiation therapy can destroy cancer cells in specific spots or areas in the body. Sometimes, radiation therapy is used conjunctively with or after chemotherapy treatments to help promote remission or a cure.
Clinical trials are available for mesothelioma in patients who meet the criteria for participation. Being involved in a clinical trial in no way guarantees a successful outcome. Current treatments include targeted therapy, biological therapy, and gene therapy.