Asbestos Exposure

Founder's Spotlight: Mesothelioma

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What is Mesothelioma?

Malignant mesothelioma is a rare, aggressive cancer that affects the cells of the mesothelium tissue that lines several body cavities and most often affects the lungs, abdomen and heart.

There are four types of Mesothelioma:

• Pleural
• Peritoneal
• Pericardial
• Testicular

The most common types are pleural and peritoneal and they represent approximately 95% of all mesothelioma diagnoses. Pleural is the most commonly occurring form and it attacks the lining of the lungs. Peritoneal is the second most common and it develops in the peritoneal membrane that lines the cavity of the abdomen. Testicular mesothelioma is very rare and only a few hundred patients have been diagnosed with this form of mesothelioma.

Mesothelioma: The Straight Facts

Q: How many patients are diagnosed with some type of mesothelioma annually?

A: Approximately 3,000.

Q: What is the primary cause of mesothelioma?

A: Asbestos exposure is the sole cause of mesothelioma.

Q: How long does it take for patients to develop the disease after they have been exposed to asbestos?

A: It takes approximately 20-40 years for the disease to manifest.

Q: What is the average age of someone diagnosed with mesothelioma?

A: The average age for pleural mesothelioma is 69 and the average age for peritoneal is 51.

Q: Which gender gets diagnosed with mesothelioma most frequently?

A: Men represent 80% of all mesothelioma cases since males are more likely to have worked in occupations where asbestos exposure is prevalent.

Q: Which race gets diagnosed with mesothelioma most frequently?

A: Predominately, mesothelioma patients are Caucasian. 

Q: What is the prognosis?

A: Prognosis depends heavily on the type of mesothelioma. The average life expectancy for patients is approximately 12-22 months after the initial diagnosis. There are those patients who have exceeded the average and have lived for approximately five years or more after they were diagnosed.

Forms of Mesothelioma: The Details

Pleural: This is the most common form and it affects the protective lining of the lungs, known as the pleural. This form of mesothelioma is caused by the inhalation of asbestos fibers into the lungs. Once asbestos is in the lung tissue it can cause the manifestation of lung cancer. If asbestos is absorbed into the pleural lining, that is when pleural mesothelioma is developed.

Peritoneal: This second most common type of mesothelioma develops in the lining of the abdomen known as the peritoneum. Peritoneal mesothelioma is caused by the ingestion of asbestos. In the preliminary stages of the disease, peritoneal mesothelioma typically does not expand beyond the peritoneal cavity that contains the abdominal organs. In later stages, the infected cells can spread to the lymph nodes and the blood.

Pericardial: This type of mesothelioma represents about 1% of all diagnosis. It affects the lining of the heart known as the pericardium. Pericardial is very rare, difficult to detect and usually has a bleak prognosis.

 Symptoms of Mesothelioma

It’s important to keep in mind that symptoms will vary depending on the type of mesothelioma and the patient. The symptoms highlighted encompass the ones that other patients have reported experiencing.

Pleural symptoms include:

• Shortness of breath
• Chest pain (specifically when taking deep breaths)
• Fever
• Persistent cough
• Difficulties with swallowing
• Fatigue
• Low levels of oxygen
• Fever

Peritoneal symptoms include:

• Nausea
• Unintentional weight loss
• Anemia
• Blood clots
• Loss of appetite
• Fever

Pericardial symptoms include:

• Chest pain
• Persistent cough
• Heart palpitations/arrhythmia
• Shortness of breath

Survival Rates

The prognosis varies for everyone. However, there are influencing factors that can significantly impact the hypothesis of how many years a patient may have remaining.

Elements affecting life expectancy include:

• Type of mesothelioma: Research has found that those with pleural mesothelioma have a slightly better prognosis than those diagnosed with peritoneal mesothelioma. It is important to remember that new and more effective treatments are being developed regularly and can contribute to a better prognosis in all types of mesothelioma.
• Malignant vs. benign mesothelioma: Malignant mesothelioma is a very vigorous cancer and the symptoms don’t usually manifest until stages three or four. A diagnosis of malignant mesothelioma is a direct result of asbestos exposure and has a very high mortality rate. Benign mesothelioma is not cancerous and is not a result of asbestos exposure. The benign version is highly treatable and rarer than malignant mesothelioma. Successful treatment and full recoveries are often experienced with benign mesothelioma patients.
• Stage: An early discovery and diagnosis can play a significant role in the life expectancy of the patient. Often in stage one and two, there will be very little spreading if any at all. Additionally, treatments are proven to be more successful in these stages. However, with stages three and four, spreading has often occurred which can make treatment more challenging and less effective.
• Cell type: There are three different mesothelioma cell types– epithelioid, sarcomatoid and biphasic. Biphasic is a mix of epitheloid and sarcomatoid cells. Those patients with epithelioid cells have the best prognosis than those with the other two cell types.
• Sex: More men are diagnosed with mesothelioma that women. This is largely due to occupational differences and the risk of exposure to asbestos. The life expectancy for female patients is approximately six months longer than men.
• Age: Generally, older patients are usually in poorer health than younger patients. Because of this, older patients have a poorer prognosis than younger patients. The older a patient is, the less favorable the prognosis.

 Pleural: The life expectancy of pleural patients heavily depends on the stage of the disease at the time of diagnosis.

Peritoneal: Patients with peritoneal mesothelioma often have higher survival rates than those with pericardial or pleural types. On average, patients live approximately 12 months after diagnosis. However, recent studies have shown that some patients have lived up to 5 years after receiving different treatments including cytoreduction with HIPEC. Typically, the average survival time after receiving this treatment is approximately 30-90 months.

Pericardial: Most patients with this heart-centered form of mesothelioma live an average of 6 months after their initial diagnosis. There are different treatments available that may extend life expectancy and improve quality of life.

Mesothelioma Cell Varieties

The form and stage of mesothelioma are the most critical factors medical professionals evaluate when determining the best treatment for their patients. Doctors may determine how vigorous the chosen treatment procedure may be based on the type of mesothelioma cells present. 

Epithelioid (about 50-70% of all cases): This is the most common variety of the mesothelioma cells. Patients with this cell variety typically have the best prognosis.

Biphasic (about 20-35% of cases): This variety is composed of both epithelioid and sarcomatiod. The prognosis is better for patients that have more epithelioid cells that sarcomatoid.

Sarcomatoid (about 5-10% of all cases): These cells are rarer than epithelioid and they spread much faster. There are not as many medical treatment options so the prognosis is much bleaker for patients who have sarcomaotid cells as opposed to epithelioid.

Treatment Options 

Surgery, chemotherapy, and radiation therapies are standard procedures used to treat mesothelioma. Doctors often use more than one of these procedures and there are additional methods that may be beneficial to patients depending on the type and stage.

Pleural treatments include:

• Extra Pleural Pneumonectomy (EPP) surgery: In EPP, the surgeon removes the infected lung, lining and some of the diaphragm. This surgery is used to eliminate as many tumors as possible.
• Pleurectomy/ Decortication surgery: The surgeon performing this procedure removes the lining around the lung but leaves the lung and other surrounding organs intact.
• Thoracentesis: A needle is inserted into the lining to drain fluid that helps patients that suffer with shortness of breath and the pain and discomfort that accompanies it. 

Peritoneal treatments include:

• Cytoreductive surgery: Tumors are surgically removed from the abdominal lining of patients during this procedure.
• Hyperthermic Intraperitoneal Chemotherapy (HIPEC): HIPEC is generally performed after cytoreductive surgery. This heated chemotherapy technique is also used to treat other forms of cancer including ovarian and colon. HIPEC flushes the abdominal area with the goal of removing any infected cells that were not removed during cytoreductive surgery.

Pericardial treatments include:

• Pericardiectomy: This procedure involves the surgeon removing the lining around the heart. It is up to the surgeon’s discretion as to how much of the lining to remove. The goal is to extract the mass and any associated cells.
• Pericardiocentesis: The goal of this technique is to remove fluid build-up from around the patient’s heart. Patients who have had this procedure often report relief from the pressure that builds in the chest due to the presence of excessive fluid.
• Percutaneous Balloon Pericardiotomy: After a pericardiectomy, patients may suffer the build-up of fluid. To relieve this, the surgeon inserts a balloon between the layers of the lining to remove as much fluid as possible. 

How Do I Prepare Myself and My Family for the Journey Ahead?

If the prognosis is less than ideal for the patient, it is time to understand their desires for how they would like to be treated during and after their life’s journey. The Five Wishes Living Will gives the patient control and enables them to pass from this life with dignity and with the knowledge that their loved ones understand their final requests. Five Wishes gives mesothelioma patients an avenue to communicate the things that matter:

1. The kind of medical treatment they would like or not like
2. How comfortable they want to be
3. How they want to be treated
4. Who can make decisions for them when they are no longer able
5. What they want their family to know and understand

1-800-LAW-FIRM is offering this free resource for mesothelioma patients and their families. Complete the form on the sidebar or call 1-800-LAW-FIRM to request your free copy.