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Mesothelioma Care Center - Malignant Mesothelioma

 Did You Know?
During the 20th century, some 30 million tons of asbestos were used in industrial sites, homes, schools, shipyards and commercial buildings in the U.S.

Malignant Mesothelioma is a rare form of cancer that affects the mesothelial cells of the serous membranes in the body. The most common form of mesothelioma, affecting the lining of the lung, is pleural mesothelioma. Malignant Mesothelioma is caused by exposure to asbestos. Mesothelioma cases have increased during the past 20 years in response to the widespread use of asbestos in the past.

Malignant Mesothelioma occurs in the thin layer of tissue that covers the majority of your internal organs (mesothelium). About 3,000 to 4,000 people are diagnosed with mesothelioma in the United States each year. Men are more likely to develop mesothelioma than are women. About 4,000 People die from Mesothelioma every year, the rare cancer caused by asbestos exposure.

• It is estimated that 27.5 million Americans were exposed to asbestos between 1940 and 1979. 
• Mesothelioma has a latency period of 20 to 50 years after the first exposure to asbestos.
• It is estimated that there will be about 250,000 cases of Mesothelioma before 2020.

According to The National Cancer Institute, Malignant Mesothelioma cancer is a disease in which the cancer (malignant) cells are found in the sac lining of the chest (pleura), the abdomen (peritoneum), or the heart (pericardium). Most people diagnosed with mesothelioma cancer have worked on jobs where they breathed asbestos.

Asbestos may cause a variety of diseases, from non-cancerous forms such as asbestosis, to much more serious diseases such as mesothelioma. Workers exposed to asbestos in the 1940s, 50s, 60s, and 70s, are coming down with these diseases decades later due to the long latency period associated with all asbestos disease.

Malignant Mesothelioma - Diagnosis

The diagnosis of malignant mesothelioma begins with a thorough medical history to document the patient's symptoms and any possible asbestos exposure, followed by a complete physical examination. These steps generally are followed by a chest or abdominal X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) scan. The imaging studies allow the physician to assess the size, location and extent of the tumor in the chest or abdomen.

Malignant Mesothelioma takes on three forms:

• Peritoneal mesothelioma, in the peritoneum or membrane surrounding the abdomen. A rare form of peritoneal mesothelioma can also affect the male testicles, because the lining around the scrotum is an extension of the peritoneum.
• Pericardial mesothelioma, in the perdicardium or lining surrounding the heart.
• Pleural mesothelioma, which is the most common form of malignant mesothelioma and affects the lining of the lung cavity.

Malignant Mesothelioma – Mesothelioma Treatment

Here are some of the treatments for malignant mesothelioma that are being evaluated:

• Combination chemotherapy - Different combinations of chemotherapy drugs have been tried with mixed results. A recent study showed some benefit of combining cisplatin (Platinol) and gemcitabine (Gemzar). The researchers used the combination to treat 21 patients with advanced mesothelioma, of whom 47 percent showed a partial response.
• Intracavitary chemotherapy - Instilling chemotherapy drugs directly into the pleural or peritoneal space is being researched because of its advantage over traditional chemotherapy. Because the drug is instilled directly into the cavity, much greater doses can be given to patients without causing severe side effects. Some studies have shown this therapy to result in control of effusions and reduced tumor size.
• Brachytherapy (intracavitary radiation therapy) - In this treatment, a radioactive substance is placed directly into the pleural or peritoneal space.
• Multimodality therapy - Any combination of surgery, radiation therapy and chemotherapy is multimodality therapy. For example, researchers have combined surgery with intracavitary radiation or chemotherapy and then administered radiation or chemotherapy afterward.
• Gene therapy - In this approach, a virus that has been genetically altered is introduced into the tumor. The virus infects the tumor cells and makes them vulnerable to anticancer drugs.
• Immunotherapy - Treatments that stimulate the body's immune system to fight cancer cells are called immunotherapy.
• Photodynamic therapy - In this treatment, drugs that are sensitive to light are taken up by the tumor cells, which are then exposed to light.

Mesothelioma - When to Call a Professional

Call your doctor promptly if you have any of the symptoms of lung cancer, especially if you have worked in an industry with high exposure to asbestos.

Malignant Mesothelioma - Mesothelioma Prognosis

Malignant mesothelioma usually is advanced by the time it is diagnosed and thus has a poor prognosis. On average, the survival time after diagnosis is about one year. However, several factors affect prognosis, including the extent of the tumor and the age and health of the patient. In some cases, survival time can be increased with early detection and aggressive treatment, and improved treatments should be available in the near future.

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Malignant Mesothelioma – Symptoms

Mesothelioma symptoms include shortness of breath due to pleural effusion (fluid between the lung and the chest wall) or chest wall pain, and general symptoms such as :

• weight loss
• abdominal pain
• bowel function problems
• chest wall pain
• weight loss
• pleural effusion, or fluid surrounding the lung
• shortness of breath
• fatigue or anemia
• wheezing, hoarseness, or cough
• blood in the sputum (fluid) coughed up (hemoptysis)

Malignant Mesothelioma symptoms in severe cases:

• blood clots in the veins, which may cause thrombophlebitis
• disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs
• jaundice, or yellowing of the eyes and skin
• low blood sugar level
• pleural effusion
• pulmonary emboli, or blood clots in the arteries of the lungs
• severe ascites

Malignant Mesothelioma – Mesothelioma Drugs

In February 2004, the U. S. Food and Drug Administration (FDA) approved pemetrexed (brand name Alimta) for treatment of mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.

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