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Sunday, November 21, 2010
Asbestos is found naturally in the form of silicate-fiber serpentine (chrysotile) or amfibol (crocidolite, amosite, and anthophyllite).
Characteristics: Highly resistant to high temperature, pressure, and acid, but these properties vary according to the type of asbestos. Janis serpentine can be woven into clothing.
Usage: Many and varied, including asbestos cement, building materials and insulation, retaining brakes, and some fire-resistant equipment.
Metabolism: Stimulate severe and irreversible fibrosis in the body tissues.
Definition, Clinical, Diagnosis and Management of asbestosis
Health Effects
Acute: None.
Chronic: chronic fibrotic lung disease, asbestosis. Pleural plaque formation and perkapuran. Lung cancer (synergistic effect with smoking). Malignant mesotheliomas in the pleura and peritoneum. Skin warts. Carcinoma of the canine (?) And (perhaps too) ovaries.
Health Monitoring: National asbestos in the sputum. Lung function tests, including spirometry and gas ditusi. Serial chest radiographs.
Mesothelioma Cancer, Asbestos and Industrial
Treatment: Stay away from exposure. Management of chronic fibrotic lung disease and malignant disease.
Measurement: Need to determine the number of fibers respirabel by taking samples of air through cellulose acetate filters for microscopic analysis and calculations. Respirabel fiber whose length is defined as fibers longer than 5 pm and have a ratio of length: width of at least 3:1 and a diameter of less than 3 pm. Sampling should be conducted in accordance with the guidelines of HSE (The Health and Safety Executive) note EH10 and MDHS 39 / 3.
Standard control:
HSE control limits:
(A) for asbestos which consist of or contain crocidolite or amosite:
(I) 0.2 fibers / ml air during an average period of 4 hours continuously.
(Ii) is 0.6 fibers / ml air for an average period of 10 minutes continuously.
(B) for asbestos which consists of or contains other types of asbestos but not crocidolite or amosite:
(I) 0.5 fibers / ml air during an average period of 4 hours continuously.
(Ii) 1.5 serabut/m1 average air during a period of 10 minutes continuously. Legal requirements and HSE guidance:
The Control of Asbestos at Work Regulations, SI 1987, No. 2115 as amended by SI, 1988, No. 712.
The Asbestos (Licensing) Regulations, SI 1983, No. 1649.
The Asbestos (prohibitions) Regulations, SI 1985, No. 910.
Asbestos (Vol I) Final Report Advisory Committee (Simpson), HMSO, 1980.
Work with asbestos insulation and asbestos coating Approved Code of Practice and Guidance Note: the revised edition, HSC, 1983.
A guide to Asbestos (Licensing) Regulations HS (R), 19.
EH10 Asbestos-Control Limits, measurement of airborne dust concentrations and the assessment of control measures, (revised 1990).
EH35 Probable asbestos concentrations at construction processes, 1989.
EH36 Work with asbestos cement, 1989.
EH37 Work with asbestos insulation board, 1989.
EH41 Respiratory protective equipment for use against asbestos, 1985.
EH51 enclosures provided for work with asbestos insulation and coatings, 1989.
EH52 Removal techniques for asbestos insulation coatings and insulation, 1989. MDHS 39 / 3 MS 13.
Characteristics: Highly resistant to high temperature, pressure, and acid, but these properties vary according to the type of asbestos. Janis serpentine can be woven into clothing.
Usage: Many and varied, including asbestos cement, building materials and insulation, retaining brakes, and some fire-resistant equipment.
Metabolism: Stimulate severe and irreversible fibrosis in the body tissues.
Definition, Clinical, Diagnosis and Management of asbestosis
Health Effects
Acute: None.
Chronic: chronic fibrotic lung disease, asbestosis. Pleural plaque formation and perkapuran. Lung cancer (synergistic effect with smoking). Malignant mesotheliomas in the pleura and peritoneum. Skin warts. Carcinoma of the canine (?) And (perhaps too) ovaries.
Health Monitoring: National asbestos in the sputum. Lung function tests, including spirometry and gas ditusi. Serial chest radiographs.
Mesothelioma Cancer, Asbestos and Industrial
Treatment: Stay away from exposure. Management of chronic fibrotic lung disease and malignant disease.
Measurement: Need to determine the number of fibers respirabel by taking samples of air through cellulose acetate filters for microscopic analysis and calculations. Respirabel fiber whose length is defined as fibers longer than 5 pm and have a ratio of length: width of at least 3:1 and a diameter of less than 3 pm. Sampling should be conducted in accordance with the guidelines of HSE (The Health and Safety Executive) note EH10 and MDHS 39 / 3.
Standard control:
HSE control limits:
(A) for asbestos which consist of or contain crocidolite or amosite:
(I) 0.2 fibers / ml air during an average period of 4 hours continuously.
(Ii) is 0.6 fibers / ml air for an average period of 10 minutes continuously.
(B) for asbestos which consists of or contains other types of asbestos but not crocidolite or amosite:
(I) 0.5 fibers / ml air during an average period of 4 hours continuously.
(Ii) 1.5 serabut/m1 average air during a period of 10 minutes continuously. Legal requirements and HSE guidance:
The Control of Asbestos at Work Regulations, SI 1987, No. 2115 as amended by SI, 1988, No. 712.
The Asbestos (Licensing) Regulations, SI 1983, No. 1649.
The Asbestos (prohibitions) Regulations, SI 1985, No. 910.
Asbestos (Vol I) Final Report Advisory Committee (Simpson), HMSO, 1980.
Work with asbestos insulation and asbestos coating Approved Code of Practice and Guidance Note: the revised edition, HSC, 1983.
A guide to Asbestos (Licensing) Regulations HS (R), 19.
EH10 Asbestos-Control Limits, measurement of airborne dust concentrations and the assessment of control measures, (revised 1990).
EH35 Probable asbestos concentrations at construction processes, 1989.
EH36 Work with asbestos cement, 1989.
EH37 Work with asbestos insulation board, 1989.
EH41 Respiratory protective equipment for use against asbestos, 1985.
EH51 enclosures provided for work with asbestos insulation and coatings, 1989.
EH52 Removal techniques for asbestos insulation coatings and insulation, 1989. MDHS 39 / 3 MS 13.
Labels: Asbestos and Health work
Saturday, November 20, 2010
The medical term for mesothelioma that develops in the abdomen is peritoneal mesothelioma, a variation of the disease that develops in the peritoneum, which is the layer of tissue lining the abdominal cavity wall. The predominant symptom is swelling of the abdomen, due to the production of abnormal amounts of the peritoneal fluid that is normally present in small amounts. The cancer cells develop in the peritoneum, creating small malignancies spread over the surface of the tissue.
The abnormal cells cause the development of excess fluid, which acts as a conduit for malignant cells into adjacent tissues including the lymph systems and eventually nearby organs in the abdominal cavity. Because symptomatic behavior occurs after the disease has matured to a degree the treatment options most patients face are for a cancer that has already moved through the early stages. Peritoneal mesothelioma is generally a diffuse form of cancer made up of a layer of small tumors; on infrequent occasions it will manifest as a single growth of greater mass.
Symptoms of Abdominal Mesothelioma
Physical manifestations that begin to develop as the disease develops are similar to more common abdominal afflictions, which is why diagnosing abdominal mesothelioma can be a process of elimination. Annual diagnoses of the disease in the United States are no more than 500 occurrences per year. Those developing symptoms include:
- Abdominal Swelling
- Abdominal Pain
- Weight Loss
- Nausea
- Gastrointestinal Disturbance
- Fatigue
Abdominial Mesothelioma Diagnosis
There are instances of "dry" peritoneal mesothelioma where the development of excess fluid is not present. In those instances a single tumor may develop which can be seen in a CT scan. The diffuse small tumors normally associated with the disease can also be seen on a CT scan but require further diagnostic steps to determine whether they are in fact tumors or simply cystic growths. A sample of the abdominal fluid can be withdrawn using a procedure called paracentesis for diagnostic purposes, but even then the evidence of cancerous cells is not sufficient. A biopsy is required, most often performed through the naval with the assistance of a laparoscope.
Treatment Options for Abdominal Mesothelioma
If cancerous tissue is located the options for treatment depend on the stage to which the disease has advanced. If it has metastasized to organs within the body then palliative care is likely the only option. If the malignancy is sufficiently contained to be "debulked," the malignant peritoneal tissue may be removed along with growths that have developed in lymph nodes and adjacent surfaces such as the small bowel. Surgical resection is the preferred choice for patients who are healthy enough to recover from major surgical intervention.
The most successful post-surgical treatment has proven to be intraperitoneal chemotherapy that applies chemotherapy medications directly to afflicted areas within the abdominal cavity. The most common medication for this purpose is cisplatin, which is often heated before application. The most responsive cellular form of mesothelioma to this type of treatment is epithelioid; biphasic and sarcomatoid cells are not effectively reduced either by this type of chemotherapy or generalized chemotherapy.
Labels: Abdominal Mesothelioma
Friday, November 19, 2010
There are two types of cells associated with malignant mesothelioma: epithelioid and sarcomatoid. Mesothelioma develops from one of these two types of cells, or develops as biphasic mesothelioma which is a combination of the two. Epithelial mesothelioma defined by its malignant epithelioid cells, occurs in up to sixty percent of all cases of the disease. Sarcomatoid is relatively rare, occurring in less than ten percent of all cases. Epithelial is by far the most common cellular form of mesothelioma.
The epithelial cancer cells that develop with mesothelioma are the most responsive to the treatments currently available for mesothelioma. Patients with this form of the disease have longer average survival times than those who develop biphasic mesothelioma or those who have sarcomatoid cells associated with their cancer; these are more resistant to treatment than epithelial cells and faster growing.
Epithelial cells are common to connective tissue, such as is found in the inner surface of the lungs as well as in the mesothelium. It is a common type of cell and in its malignant form can be quite similar in the case of mesothelioma and adenocarcinoma, which can be a type of lung tumor. The confusion over these similar epithelial cells can often lead to misdiagnosis.
Epithelial Mesothelioma Symptoms
Epithelial malignant mesothelioma can affect different areas of the body. Mesothelioma is cancer to any of the tissues that surround internal organs. Sixty percent of epithelial malignant mesothelioma occurs in the pleural tissues of the lungs. This develops almost exclusively as a result of asbestos inhalation. The symptoms of epithelial malignant mesothelioma that affect the lungs include:
- Shortness of breath
- Persistent cough
- Pain in the chest
- Viral pneumonia symptoms
Many patients are asymptomatic. The right lung is affected sixty percent of the time, the left lung thirty five percent, and both lungs are affected in five percent of epithelial malignant mesothelioma cases.
Epithelial malignant mesothelioma is also common in the peritoneum of the abdomen. This is caused by the ingestion of asbestos that enters the air. Patients with this type of mesothelioma may also remain asymptomatic for years and years, though the following symptoms may be present: weight loss, nausea, effusion (fluid build-up) in the stomach, bowel difficulties, foot swelling and anemia. Malignant mesothelioma can also affect the reproductive organs, the heart, and other major organs.
Epithelial Mesothelioma Prognosis
A person who has been exposed to asbestos for one or two months has the potential to develop epithelial malignant mesothelioma or other asbestos related illnesses up to fifty years later. Mesothelioma has a long latency period. Once diagnosed the prognosis is often bleak. The average patient has a year left to live after they discover their condition.
Risk of Epithelial Malignant Mesothelioma
People who are at risk for developing epithelial malignant mesothelioma include employees who work with asbestos containing materials. Construction workers are particularly at risk, though professionals in the building, shipyard, railroad, and automobile industries as well as people with custodial duties may also be at risk. People who were exposed to asbestos as long ago at the 1940s may still be at risk for contracting this life threatening cancer.
Treatment for Epithelial Mesothelioma
For years mesothelioma treatment has consisted of a combination of surgery and chemotherapy, and often radiotherapy as well, with limited results. The average survival time after diagnosis for this disease hasn't moved much beyond one year. Today however there are some surgeons getting impressive results with cases that have the epithelial characteristic. The technique includes aggressive surgery for both pleural and peritoneal mesothelioma. In the case of pleural mesothelioma, the malignancy of the lung lining and the most common form of the disease, the surgeon has a few choices. The most common are the pleurectomy, which is resection of the pleura – the membrane that encases the lungs and on which the mesothelioma tumors form.
The most aggressive approach is the extrapleural pneumonectomy, which involves removing the pleural membrane and the lung on the affected side of the body. Many surgeons feel that epithelial mesothelioma is the only type that is appropriate for this approach because the epithelial cells will respond to chemotherapy whereas the sarcomatoid cells are more difficult to impact. One study of 120 such procedures revealed a survival rate of 65% at two years for epithelial mesothelioma and 20% at two years for sarcomatoid or biphasic patients.
Multimodality Therapy for Epithelial Mesothelioma
In addition to aggressive surgery the newer therapy regimens utilize hyperthermic intrapleural or intraperitoneal chemotherapy, which involves putting chemotherapy medication directly on the tissue to be impacted during surgery and by using a shunt or tube during postoperative therapy. This approach generally utilizes pemetrexed and cisplatin, two medications that have proven to work with epithelial cells. Directed radiotherapy and occasionally photodynamic therapy is also applied in these cases, and the results – with epithelial mesothelioma – have been impressive.
Labels: Epithelial Mesothelioma
Thursday, November 18, 2010
The mesothelium is a membrane of tissue that is found throughout the chest and abdominal cavities, where it surrounds organs providing a protective layer. The pericardial mesothelium, also known as the pericardium, surrounds the heart. It is one of four areas of the mesothelium where asbestos caused cancer, or mesothelioma, has been known to occur. Pericardial mesothelioma is the development of malignant tumors on the tissue sac surrounding the heart.
Pericardial mesothelioma is the least common form of the disease. Five percent or less of mesothelioma cases are pericardial – this with a disease for which there are only about 3,000 new diagnoses in the U.S. every year. Part of the reason for its relative infrequency is the process through which mesothelioma develops.
The only known cause for malignant mesothelioma is asbestos. Specifically, the disease is caused when microscopic asbestos fibers lodge in the mesothelium tissue and eventually cause the development of inflammation and abnormal cells. The most common method by which asbestos fibers enter the body is through inhalation, which is why the most common form of the disease is pleural mesothelioma – a malignancy that develops in the outer lining of the lungs. How asbestos fibers travel to the pericardial mesothelium is not entirely clear. Speculation centers on the movement of these tiny fibers through the lymphatic system or through the cardiovascular system itself.
Impact of Asbestos Fibers on the Pericardium
Once asbestos fibers are lodged in the membranes surrounding the heart, they cannot be eliminated by the body. In fact, the body is incapable of shedding asbestos fibers naturally from any portion of the body. These fibers then begin to cause changes in the pericardial membrane, slowly over an extended period of time. As with other types of mesothelioma, the asbestos fibers cause thickening of the tissue layer which can result in chest pains similar to those affiliated with cardiovascular problems. Because heart disease is so common, pericardial mesothelioma may go undetected for some time due to a misdirected diagnosis.
The thickening of the pericardium often puts pressure on the four chambers of the heart, causing not only chest pain but restricted cardiovascular function. The result is often severe shortness of breath, a condition also associated with congestive heart failure. Another reported side effect is the occurrence of venal thrombosis, or clotting in the arteries – a dangerous occurrence in the major blood vessels attached to the heart.
While the exact nature of these changes is not completely understood, thickening of the pericardium eventually can lead to uncontrolled growth of cells in the pericardial layers, causing malignant mesothelioma tumors to form. As malignant cells grow in the pericardium, excess fluid develops in the area putting further pressure on the heart within the mesothelium sac.
Symptoms of Pericardial Mesothelioma
The rarity of pericardial mesothelioma has made it difficult for specialists to determine a specific set of common symptoms. The following symptoms often indicate a cardiac condition, but further tests are required to confirm a diagnosis of pericardial mesothelioma.
- Chest pain
- Irregular heartbeat
- Heart palpitations
- Shortness of breath
One of the unique features of mesothelioma in general is its extremely long latency period. The disease usually does not manifest itself for at least twenty years after the asbestos exposure has occurred, and often may not appear for forty years or more. People whose active work careers occurred from 1945 through 1980 and encountered asbestos are developing the disease in their retirement years, when heart ailments also usually manifest themselves.
Pericardial Mesothelioma Diagnosis
Diagnosis of pericardial mesothelioma is problematic, as the nature of these symptoms is relatively non-specific, in that they can appear as a result of several other cardiac conditions. Diagnosis will involve reviewing an individual's medical history as well as assessing their current medical condition.
Chest x-rays, a CT scan or an MRI scan may all be used to diagnose pericardial mesothelioma. However, to confirm the diagnosis and to determine whether the point of original of the cancer is the pericardium or another area, a biopsy must be performed. This involves removal of fluid or tissue from the pericardial area, and testing of this tissue or fluid for the presence of malignant mesothelioma cells. As with other forms of mesothelioma, medical imaging is usually inconclusive. Pericardial mesothelioma may take the form of a single tumor formed in conjunction with the effusion process – the accumulation of fluid – or it may take the form of a thickened and hardened mass involving the entire pericardial sac.
Treatment of Pericardial Mesothelioma
This form of mesothelioma differs from pleural or peritoneal mesothelioma because of the sensitivity of its location. As pericardial mesothelioma develops it directly impacts the function of the heart, to the point where emergency surgery can be necessary simply to relieve the pressure on the center of the cardiovascular system. An overly constricted heart can go into functional failure. Other forms of mesothelioma develop lethal characteristics more along the pattern of traditional cancer.
Unfortunately for most people who are diagnosed with pericardial mesothelioma, by the time symptoms of the disease appear, the cancer has progressed to a stage where conventional treatments are largely ineffective for anything other than providing temporary relief of symptoms. The difficulty of diagnosing pericardial mesothelioma at an early stage means that the long-term prognosis for most people with the disease is very poor. Survival time can range from mere weeks to fifteen months, but the average period is six months.
In rare cases, the disease may be diagnosed early enough that surgical procedures may provide some benefit. If pericardial tumors are small and have not spread to the lungs, chest wall or lymph nodes, radical surgery may successfully remove most cancerous tissue; however, such surgery is very risky due to the proximity of the heart.
For most people with pericardial mesothelioma, palliative treatment is the only option. This may include a procedure called fine needle aspiration, which removes excess fluid from the pericardium to relive pressure on the heart. Radiation therapy may be used to kill cancer cells and reduce the size of tumors, but this procedure is dangerous, as the heart and lungs themselves may be damaged. There have been reports of successful treatment using specific chemotherapy protocols with multiple drugs.
Labels: Pericardial mesothelioma
Wednesday, November 17, 2010
Peritoneal mesothelioma is a relatively rare form of malignant mesothelioma, making up twenty to twenty five percent of diagnosed mesothelioma cases. This type of mesothelioma affects the cells of the peritoneal mesothelium, also known as the peritoneum, which is the membrane lining the abdominal cavity wall. In this area of the body the mesothelium membrane also supports and protects organs in the abdomen. The peritoneum is made up of two layers, called the visceral and parietal layers. The parietal layer is an outer layer that covers the abdominal cavity, while the visceral layer covers internal organs and the intestinal tract.
All types of mesothelioma are caused by the presence of microscopic asbestos fibers which most often enter the human body by inhalation. These fibers are given off by deteriorating or torn asbestos material, they can float in a dust cloud for a long period, and they are unnoticed when inhaled. That is how they enter the lungs and cause pleural mesothelioma in the lung lining. It is less clear how these fibers make their way to the abdominal cavity.
It is possible that they are ingested in some fashion and work their way through the intestinal system just as they pass through the lungs to the outer layer. It has also been suggested that they pass through the body via the lymphatic system. In any case, when they become embedded in the peritoneum they can cause an assortment of symptoms and eventually cause the development of abnormal, malignant cells.
Impact of Asbestos Fibers on the Peritoneum
One of the most common symptoms of peritoneal mesothelioma is ascites, or the accumulation of excess fluid in the abdominal cavity. This symptom can be assigned to a number of more common conditions, from liver disease to intestinal problems. Just as with pleural mesothelioma, the nature of the symptoms can be misleading. One study cited a mean period of 122 days from the presentation of symptoms to diagnosis.
Once in the peritoneum, asbestos fibers cause changes in peritoneal cells that cause them to divide without restraint, causing the peritoneal layers to thicken. The growth of cancer cells puts pressure on internal organs, and this pressure is increased by the fluid buildup. The accumulation of pressure can sometimes cause adjacent organs to begin to malfunction, further complicating diagnosis. Intestinal obstruction can occur, as can emergency surgery due to inflammatory lesions. Thrombosis in the veins and hypoglycemia are common symptoms.
Despite the evidence of some sort of highly intrusive affliction, CT scans and radiology exams won't result in a firm diagnosis. A precise diagnosis based on imaging alone is not possible. Peritoneal mesothelioma may consist of a single tumor, diffuse small tumors, or a combination along with benign calcified nodules. It is not a disease that can easily be addressed surgically.
Symptoms of Peritoneal Mesothelioma
The section above discusses many of the more severe symptoms of peritoneal mesothelioma. When a patient is first seen, however, the collection of complaints may include some very common physical conditions that can be attributed to several different ailments. A brief list of common initial symptoms:
- Weight loss
- Fever or night sweats
- Pain or swelling in the abdominal area
- Obstruction of the small or large intestine
- Anemia
- Edema or thrombosis in the legs
Peritoneal Mesothelioma Diagnosis
Once a physician has determined that this rare disease may be involved in the case, diagnostic measures are multifaceted. While the use of imaging equipment cannot produce a complete diagnosis, it can produce evidence of a mass growing on one of the peritoneal mesothelium surfaces, or show an accumulation of small irregularities that may be tumors or plaques.
Biopsy is a common choice at this juncture, often performed along with a laparoscopy in order to allow for more accurate observation of any internal masses. Protein markers found in blood samples that are evidence of one of the two types of mesothelioma cells – epithelial or sarcomatoid – are used in some pathology labs.
Treatment for Peritoneal Mesothelioma
Despite the commonly diffuse nature of peritoneal mesothelioma, surgical resection is still the best option if the disease is at the stage where most or all of the malignant tissue can be removed. In situations where all of the diseased tissue cannot be removed, as much as possible is taken and the procedure is called "debulking." Where possible, "intracavity" chemotherapy is undertaken during the surgical process to more precisely target the malignant areas remaining within the abdomen.
For most patients with peritoneal mesothelioma that has metastasized to one of the nearby organs treatment is palliative, and is designed reduce the rate at which the cancer spreads. If the surgery is relatively successful and the following therapy has some effect the survival time can stretch beyond two years. For partial resections the survival period is far shorter.
In cases where surgery and chemotherapy are not suitable treatment options, palliative treatment is used to provide symptomatic relief; however, such treatments cannot slow the progression of the cancer. These types of treatments are used simply to manage pain and provide relief from symptoms such as the build-up of fluid in the peritoneal cavity.
It is difficult to find survival period figures that reflect the results of a large sample. However the consensus seems to be that post-surgical survival times for peritoneal mesothelioma is better, on the average, than for pleural mesothelioma. A study done in the UK followed seventeen patients over a period from 1998 to 2007 who underwent surgery for resection of peritoneal mesothelioma, followed by a thorough chemotherapy program. Eight of the patients had a partial resection, or debulking, of malignant tissue and eight had a full resection. The average survival period for those with a partial removal of cancerous tissue was one year, while for the patients with a full resection it was 3.7 years. Either figure is well beyond the survival rates for pleural mesothelioma patients.
Labels: Peritoneal Mesothelioma
Tuesday, November 16, 2010
Pleural mesothelioma is a form of cancer that develops in the pleura, or outer lining of the lungs. The mesothelium is a large membrane of tissue that provides a protective surface for several of the body's organs and for both the chest cavity and the abdominal cavity. Pleura is a term for the dual layered mesothelium membrane that surrounds the lungs; the outer layer (the parietal layer) attaches to the chest wall, while the inner layer (the visceral layer) wraps around the lungs. The narrow space between the two is called the pleural area. This particular form of malignant mesothelioma is by far the most common, constituting up to seventy percent of all diagnosed cases of mesothelioma.
The only known cause of mesothelioma is asbestos; specifically, microscopic fibers that find their way into the human body. The most common method for human absorption of asbestos fibers is inhalation, generally inhalation of fibers given off by deteriorating or mangled asbestos products. When these fibers are inhaled the body is incapable of shedding them through any physiological process. The fibers lodge in the lungs and in many cases, work their way through the lungs over time to embed themselves in the pleura, the outer lining of the lungs.
Impact of Asbestos Fibers on the Pleura
These fibers will cause changes to the mesothelium cells that form the pleural membrane over a long period of time. Eventually the cells will begin uncontrolled growth - thickening the pleural walls, causing a buildup of fluid, and eventually leading to the development of mesothelioma cancer in the form of tumors. Often this process can take twenty years or more, which is why mesothelioma is usually diagnosed long after the exposure to asbestos has occurred. Asbestos fibers slowly cause things to go awry in the pleural space, causing a number of symptomatic developments.
As swelling begins to occur in the mesothelium, the space between the outer lung and the chest wall begins to narrow. Normally there is a thin layer of fluid that allows these two surfaces to slide against one another. When the swelling causes the fluid to dissipate, a dry rubbing of the chest wall and the lung surface can occur with every breath, causing acute discomfort.
Developing mesothelioma can also have the opposite effect in the pleural space by causing the development of excess fluid in the area. This condition is a common mesothelioma symptom and is called pleural effusion. Excess fluid in the chest cavity reduces the ability to draw a full breath. One of the early non-surgical treatments for this symptom is drainage of the excess fluid in order to lessen the patient's discomfort. This condition eventually develops in 80% to 95% of all pleural mesothelioma cases; in 60% of those cases it develops on the right side of the chest cavity.
The continued presence of asbestos fibers in the pleural mesothelium can occasionally trigger the development of nodes that sometimes calcify on both the lung lining and the parietal layer lining the chest wall. These nodules are called pleural plaques. They can be indicative of fibrosis in the lungs, leading to the development of asbestosis. They can also be a precursor to the development of malignant mesothelioma cells. Some patients are fortunate and develop pleural plaques without the development of an active disease. In all cases however pleural plaques are assumed to be associated with the presence of asbestos.
Pleural mesothelioma is a "diffuse" form of cancer, meaning that it usually consists of many small tumors spread over the mesothelium membrane, rather than a single large tumor. That makes the disease more difficult to treat with standard chemotherapy and radiologic therapy because there is no single mass to target. In recent years researchers have developed some methods of using chemical intervention to allow for precise targeting of malignant cells in this complex oncological environment.
Pleural Mesothelioma Symptoms
Mesothelioma symptoms can be misleading, as they resemble symptoms associated with more common afflictions such as asthma, allergies, cardiovascular problems, pneumonia and even tuberculosis. Because of a twenty to forty year latency period for the disease, mesothelioma patients are generally in their sixties or older and often may be expected to be exhibiting respiratory difficulties that come with age and, perhaps, smoking. There is an inherent irony in the fact that the disease is sufficiently rare that it is often not considered by diagnosing physicians until other possibilities are eliminated. Nevertheless because asbestos was so pervasive in the mid twentieth century tens of thousands of American workers have developed it and often died without a proper diagnosis.
Some of the common symptoms for pleural mesothelioma:
- A persistent cough that is harsh and dry
- Shortness of breath
- Painful inhalation
- Chest pain
- Weight loss
- Fever or night sweats
- Persistent fatigue
Often the type of chest pain associated with either "wet" or "dry" pleural effusion help to differentiate from pain associated with cardiovascular problems or with more common respiratory ailments. Pain in the anterior chest wall associated with difficulty inhaling is characteristic of pleural effusion combined with cancerous invasion of the tissue lining the chest wall, the parietal pleura.
Pleural Mesothelioma Diagnosis
Diagnosis procedures for chest-related symptoms often begin with a chest X-ray. These images may show the thickening of the pleural wall, an initial indication of cell malfunction in the pleural membrane. An MRI or CT scan may confirm the presence of fluid in the pleural area, which can be taken as a primary indicator of mesothelioma.
The search for malignant cells often begins with extraction of some of the excess fluid in the pleural area. Often this procedure is accompanied by a biopsy that extracts a small tissue sample from the pleural mesothelium. In recent years, Australian researchers have discovered a protein "marker' associated with the presence of malignant pleural mesothelioma that has proven to be present in 84% of the clinical test cases. That marker can be found with a simple blood test.
Treatment for Pleural Mesothelioma
Unfortunately, pleural mesothelioma is usually diagnosed only after it has been active in the body for a long period, giving mesothelioma patients a low probability of receiving a good pleural mesothelioma prognosis. The disease is always fatal; the question is how long the patient's life after diagnosis can be prolonged. One of the most important benchmarks for reasonably successful treatment is "respectability." If the cancerous tissue is sufficiently contained that it can be removed surgically, the survival period can be extended substantially. Often this type of surgery includes removal of a lung lobe in order to insure against the cancer spreading through the lung. With or without surgery, treatment usually includes both chemotherapy and radiotherapy.
There has been a good deal of research on mesothelioma treatment, with the specific goal of extending the life expectancy for victims of the disease. While the disease can be slowed, it cannot be stopped. Today, the use of new medications in chemotherapy and with the use of radiation treatment during surgery life expectancy is being extended slowly, with small steps.
Labels: Pleural Mesothelioma
Monday, November 15, 2010
Malignant mesothelioma is a lethal cancer that affects the lining of the lung, chest cavity, or abdominal cavity. The only known cause for mesothelioma, malignant and benign, is exposure to asbestos. It is the presence of microscopic asbestos fibers within the body that cause mesothelioma. The disease develops in the mesothelium, membrane found throughout the body that serves as a covering and protective surface for several of the body's internal organs, as well as lining for the chest cavity and the abdominal cavity. Cancer that develops in the mesothelium is called mesothelioma. Benign mesothelioma is usually a soft tumor that develops on either the membrane lining the chest cavity wall or on the abdominal cavity wall. It does not develop as a diffuse cancer, like malignant mesothelioma often does, and is relatively rare. Benign mesothelioma accounts for about 10% of all diagnosed mesothelioma cases.
Three Types of Malignant Mesothelioma
Pleural Mesothelioma develops in the section of the mesothelium that provides the outer lining of the lungs and that lines the chest cavity wall. This section of the mesothelium is called the pleura; the area between the two membranes is called the pleural space or pleural cavity. This form of the disease is by far the most common, constituting seventy percent or more of all diagnosed cases of malignant mesothelioma. The reason this form of the disease is predominant is that the asbestos fibers that cause it most often are internalized by breathing. They are tough microscopic fibers that can be inhaled unknowingly in any location where an old or torn asbestos product may release them; they are invisible and light enough to float on a cloud of dust.
Peritoneal Mesothelioma is located in the membrane that lines the wall of the abdominal cavity. This form of the disease accounts for fifteen to twenty percent of all diagnoses. It begins by thickening and inflaming the peritoneal mesothelium, or peritoneum, which often causes the development of excess fluid in the area. Pressure develops on the intestines and other nearby organs, resulting in a number of symptoms that are often read as intestinal blockage, kidney problems, or liver disease.
Pericardial Mesothelioma is the most unusual diagnosis, occurring in five percent or less of all malignant mesothelioma cases. This portion of the mesothelium forms a sac around the heart. When the disease becomes active it causes the membrane – known as the pericardium – to thicken, harden and put pressure on the heart. The result is often heart palpitations, arrhythmia, chest pain that is commonly associated with heart disease, and if the pericardium becomes too thick, heart failure.
Cell Types of Malignant Mesothelioma
Mesothelioma is also broken down into cell types; there are two distinct types of cancer cells that may be part of this malignancy. Epithelioid mesothelioma is caused by epithelial cells; about 50% to 60% of mesothelioma cancers are of this type. It tends to have a better prognosis than the other types. Sarcomatoid or fibrous cells cause 10% to 20% of malignant mesotheliomas. These cases are much more difficult to treat effectively. The third possibility is biphasic mesothelioma, which includes both types of cells. They make up about 30% to 40% of all cases.
Malignant Mesothelioma Risk
The most common cause of malignant mesothelioma is asbestos exposure. Workers in the steel, mining, plumbing, milling, insulation, and power generation industries, among hundreds of others who handle or manufacture asbestos products, are at the highest risk of developing malignant mesothelioma. Asbestos exposure in the workplace has resulted in tens of thousands of mesothelioma cases over the past half century, as asbestos was a widely used component of industrial, manufacturing and construction products.
While the risks of the disease increase depending on the frequency and intensity of asbestos exposure, there have been a number of malignant mesothelioma cases among people who have had only one or two months of exposure. One of the unusual aspects of the disease is the extraordinarily long period of latency that usually accompanies it. Mesothelioma symptoms generally begin to manifest themselves twenty to fifty years after the hazardous asbestos exposure has occurred. That means the average mesothelioma patient is well over fifty years old and in many cases retired. And, in too many cases, mesothelioma victims are also inflicted with some of the medical frailties that accompany old age, making diagnosis of this rare disease more difficult.
Asbestos fibers are sharp and easily cling to various surfaces such as hair, skin, clothes, and shoes of workers who may track the toxic fibers into their homes subjecting innocent family members to serious illnesses and disease. They may be contained in dust collected on clothing during the course of a workday. Family members of those who are regularly exposed asbestos brought into the home also are at risk of developing malignant mesothelioma.
Symptoms of Malignant Mesothelioma
Pleural mesothelioma being the most common form of the disease, the symptoms most often seen involve the chest. Those may include chest pain, a dry cough, shortness of breath and difficulty with physical exertion. Beyond these physical symptoms are the medical causes. Pleural effusion, a condition that causes the accumulation of fluid in the pleural space, is seen in a majority of pleural mesothelioma cases. Thickening of the pleura is brought on by inflammation and the development of small tumors across the membrane's surface.
Peritoneal mesothelioma is characterized by a swollen abdomen and abdominal pain, usually caused by a buildup of fluid. Bowel obstruction, edema in the legs, and thrombosis in the legs are also seen with this version of malignant mesothelioma. Anemia and loss of appetite may occur.
Pericardial mesothelioma causes chest pain similar to that felt with cardiovascular disease. It can also cause thrombosis in the veins and arteries around the heart, as well as the palpitations and arrhythmia mentioned above. Like pleural mesothelioma it will cause shortness of breath and lack of physical stamina. For all of these forms of malignant mesothelioma, fatigue, sweating, weight loss and difficulty sleeping may also become physical difficulties.
Malignant Mesothelioma Treatment
The nature of the treatment received by mesothelioma patients is directed by the degree to which the disease has advanced. That question is analyzed by medical personnel through the process of staging, a formal protocol that provides a series of benchmarks for the malignancy, the degree to which it has spread, its location(s) within the body and the types of malignant cells that make up the tumor development.
The key question for mesothelioma treatment is whether or not there is a surgical option to remove some or all of the malignant tissue. If the staging diagnosis determines that surgery is feasible, a resection procedure will remove the malignant portion of the mesothelium, or as much as can be removed, and often adjacent tissue that is diseased or threatened as well. With pleural mesothelioma, for example surgical intervention often involves a partial pneumonectomy, which means removing a portion of the lung next to the malignant mesothelium tissue. Surgery to remove portions of the peritoneum in the case of peritoneal mesothelioma may also involve removing portions of the stomach.
In cases where surgical intervention is warranted and performed, a program of chemotherapy combined with radiotherapy usually follows. Depending on the location of the malignancy and whether or not malignant tissue remains in the body, the chemotherapy may be administered via the standard intravenous method or may be applied directly to the targeted tissue during surgery. The two drugs that the FDA has approved for the treatment of mesothelioma are pemetrexed and cisplatin, usually used in combination because they attack different weaknesses in cancer cells.
Techniques have been developed to minimize the damage that radiation therapy does to healthy cells near the malignant areas being targeted, but limiting healthy cell damage remains an issue for both chemotherapy treatment and radiation. Sometimes radiotherapy is used during the course of surgery so that physicians can target precisely the diseased tissue remaining in the body while it is still exposed on the operating table.
Photodynamic therapy has been developed to allow for the targeting of radiological cancer treatment as well. Still in experimental stages, photodynamic therapy essentially uses photosensitive medications that are injected into the patient and activated by light when they reach the appropriate area to be treated. This promising technique is under study in several clinical trials, as is immunotherapy – another method of attacking cancer cells with specific molecules.
Mesothelioma Staging
There are three or more sets of guidelines for the staging of malignant mesothelioma cases. The most common is the TNM system, an acronym that references tumors, nodes and metastases. TNM is used to stage lung cancer, ovarian cancer and other types of the disease, and has been approved as a standard by the American Joint Committee on Cancer, an organization that counts the National Cancer Institute among its founding members.
Currently pleural mesothelioma is the only form of the disease that has a formal staging structure. It is the most common form of a relatively rare disease; accordingly physicians assess the spread of cancer in peritoneal mesothelioma or pericardial mesothelioma based on less form analyses of the presence of malignancy.
Briefly, the four TNM stages are as follows:
Stage I: Mesothelioma is present in the pleura covering either the right or left lung. It may have spread to the pericardium or the diaphragm or lung on the same side of the body. There is no evidence of cancer in the lymph nodes.
Stage II: Mesothelioma meets all of the conditions of stage I with the additional spread to lymph nodes near the malignant tissue in the pleura and on the same side of the body.
Stage III: Mesothelioma has advanced into the chest wall, the heart, the esophagus or possibly the ribs on the same side of the body as the original pleural malignancy. There may or may not be lymph node involvement.
Stage IV: Mesothelioma has moved to the opposite side of the body, impacting the pleura on the other lung as well as the opposite lung itself, and possibly extending to organs in the abdominal cavity. Metastases have occurred in several areas.
Malignant Mesothelioma Prognosis
Surgery to resect malignant tissue is generally a viable choice with stages one and two, and often with stage three. In the latter case, it depends on the location of the extended malignancy. In stage two and stage three cases, the surgery may involve only a partial removal of malignant tissue, a process referred to as "debulking." In all cases, a regimen of chemotherapy and usually radiotherapy follows the surgical procedure.
In cases where surgery has been performed and an aggressive chemotherapy program undertaken, the prognosis for mesothelioma patients who are otherwise healthy patients may extend to eighteen months or beyond. If the cancer was at stage one or stage two, the outlook for a reasonable survival period can be encouraging. Unfortunately, the median survival period for mesothelioma patients in general hovers at around one year. Some studies have shown the figure to be thirteen months; others closer to eleven months or less. But the value of a surgical intervention followed by chemotherapy seems to be well established; while most gains are in months some are in years.
Mesothelioma Clinical Trials
There is an excellent database of current clinical trials underway for mesothelioma treatment at the National Institutes of Health (NIH) website ClinicalTrials.gov. Most of them evolve around the use of various chemotherapy drugs in combination with one another. The two drugs that have proven to impact mesothelioma tumors with some success are pemetrexed and cisplatin; these are the only two approved by the FDA for mesothelioma treatment.
The drugs are effective against some forms of mesothelioma malignant cells and less so against others; effective with pleural mesothelioma, perhaps, but ineffective with the pericardium. The point is that these two drugs have proven the ability to successfully kill some of the cancer cells some of the time and so many of the clinical trials involve using other cancer chemotherapy drugs in conjunction with pemetrexed, cisplatin, or both.
All of the chemotherapy drugs used in mesothelioma clinical trials such as these have been approved for treatment of other types of tumors. For example some drugs such as Bortezomib act by stopping blood flow to a tumor, and by killing certain enzymes that allow malignant cells to proliferate. There is currently a clinical study using this drug in conjunction with cisplatin to test the success with malignant mesothelioma tumors.
Onconase is a drug that impacts the RNA in some cancer cells, causing them to die. Clinical trials using this chemotherapy drug in conjunction with other drugs that starve tumors by choking off blood supply or that somehow suppress the ability of malignant cells to multiply are underway in several locations. Some of these trials are sponsored by the National Cancer Institute, some are generated in foreign medical centers, and some are undertaken by cancer centers in the U.S. with the assistance of grants from the NIH.
There are also trials underway attempting to establish effective methods of using photodynamic therapy to target diseased cells, along with other methods that are meant to protect the healthy cells surrounding tumors. Destroying healthy cells has always been an issue with chemotherapy and radiotherapy; today researchers are using new technology and molecular knowledge to try and find healthier ways to treat post-operative malignant mesothelioma.
Labels: Malignant Mesothelioma
Saturday, November 13, 2010
Mesothelioma has become a household word to tens of thousands of U.S. citizens. It is a form of cancer associated with asbestos, and with the mesothelioma lawsuits that forced many asbestos companies into bankruptcy. Asbestos was an enormously popular material for construction products and insulation for industrial plants, commercial buildings and homes. By 1985 it was a proven carcinogen, after more than fifty years of suspicion from the medical community and denials from asbestos companies.
The Asbestos – Mesothelioma Link
Unlike most cancer, mesothelioma is almost always caused by just one source: asbestos exposure. The National Cancer Institute reports that up to 80% of all mesothelioma cases are caused by asbestos exposure. However additional causes of the disease are just guesses and include such exotic factors as exposure to a mineral in Turkey called zeolite and previous infection with the Simian monkey virus. Exposure to radiation may make the development of mesothelioma more likely.
For most of the twentieth century, asbestos was heavily used in the manufacture of all types of insulation, flooring, ceiling tiles, pipe fittings, plaster, caulking, roofing, and other construction products. Any industrial facility or power plant (including naval engine rooms) that generated heat probably had pipes, tanks and other fixtures insulated with asbestos. Some sort of asbestos product was at virtually all construction job sites up to 1985 or so.
Asbestos is a fibrous material that when disturbed, emits fibers into the air which can be inhaled by any nearby worker: a miner, a construction worker, a ship’s crewman working around the ship’s pipes and boilers, plumbers, carpenters, auto mechanics, workers in the oil business, in power plants, in chemical plants – the list goes on. The list also includes family members of workers that brought home asbestos fibers on their clothing and shoes from the job site.
Types of Mesothelioma
Mesothelioma is not just lung cancer. It begins in the lining of the chest or abdominal cavities and can impact the organs contained in or near those places: lungs, heart, reproductive organs. The mesothelium is a tissue lining for cavities in the upper body. In the pleural area, the area around the lungs, it is a double tissue with the inner portion (the visceral layer) lining the lungs themselves and the outer portion (the parietal layer) lining the chest wall.
There are three types of mesothelioma: as with the pleural area the disease can impact the lining around the heart and in the abdominal cavity. Mesothelioma is a condition of uncontrolled cell growth that causes the mesothelium layers to thicken and often results in fluid accumulating between the two layers. These cancer cells can be either malignant or benign.
Pleural Mesothelioma
Pleural mesothelioma impacts the lining of the chest cavity around the lungs. When both the inner and outer membrane layers (the mesothelium) thicken and retain fluid in the area between, pressure is put on the lungs and shortness of breath develops. Other symptoms of pleural mesothelioma include a persistent cough, chest pain, hoarseness and perhaps trouble swallowing. The more general symptoms for mesothelioma are fever, weight loss and fatigue, which explains why the initial appearance of mesothelioma symptoms are often misdiagnosed as pneumonia or some other common pulmonary problem.
Pleural mesothelioma is by far the most common form of the disease, accounting for about 75% of all cases. It is, however, a disease of the membranes surrounding the lungs. If the rogue cells are malignant and pass into the lungs, the lung cancer that results is secondary to mesothelioma. Nevertheless, lung cancer that develops as a result of mesothelioma is often referred to as asbestos lung cancer or mesothelioma lung cancer.
Pericardial Mesothelioma
Pericardial mesothelioma impacts the membrane that surrounds the heart. This form of the disease is the rarest: less that 10% mesothelioma diagnoses are for the pericardial variant. One of the issues with pericardial mesothelioma is that medical researchers are unsure how asbestos fibers get into the tissue around the heart. In the case of pleural mesothelioma they are inhaled. How they migrate to the pericardial area is something of a mystery. One theory holds that they break up into smaller pieces after inhalation and somehow are carried to the pericardial area in the bloodstream.
In any case, the impact of asbestos fibers on the pericardial mesothelium is the same as in the pleural area. They cause inflammation which eventually leads to the uncontrolled growth of cells – cancerous cells. As the membrane thickens, fluid buildup occurs and pressure is put on the heart. The symptoms can include an irregular heartbeat and little or no stamina, along with chest pain. Because these characteristics are also symptomatic of heart disease, the diagnosis for mesothelioma is often overlooked initially.
Peritoneal Mesothelioma
This form of the disease impacts the membrane that lines the abdominal cavity, the peritoneum. It is also unclear how this form of the disease develops. The theory for pericardial mesothelioma that tiny asbestos fibers travel through the bloodstream is also applicable for the peritoneal variety. It is also quite possible that asbestos fibers work their way to the abdominal wall through the digestive tract and that they are introduced to the body through eating or drinking.
Asbestos fibers travel through the air like dust and pollen. They could certainly find their way to consumable items on a jobsite. Regardless of the source, the impact of asbestos on the peritoneal membrane is the same. Over time they act as an irritant which results in prolonged inflammation, eventually leading to the development of uncontrolled cancerous cell growth.
Fifteen to twenty percent of all mesothelioma cases are peritoneal. The fact that it is more common than pericardial mesothelioma would suggest that the causal theory based on ingestion makes sense. Lung cancer can also be a secondary development of peritoneal mesothelioma; in addition one of the rare forms of peritoneal mesothelioma can impact the testicles. The membrane within the scrotum is an extension of the peritoneal mesothelium.
Symptoms of peritoneal mesothelioma usually begin with abdominal pain as the fluid buildup caused by the mesothelioma cells begins to impact the abdominal cavity. It can also be accompanied by shortness of breath and a cough, although these symptoms are less common. What peritoneal mesothelioma does share with other types of the disease is a lag of some months between manifestation of the symptoms and a diagnosis.
Years Between Asbestos Exposure and Mesothelioma
Mesothelioma is difficult to diagnose and there are a number of reasons for it. One is that the symptoms mimic those of much more common diseases. Another is that mesothelioma cancer itself does not result in tumor development; that occurs only after the disease has fully developed and metastasized into a nearby organ. But perhaps the most difficult factor is the reality that it takes years and often decades for those asbestos fibers to do their work.
In the case of pleural mesothelioma, the fibers are inhaled and slowly work their way through the lung wall into the mesothelium as the body tries to rid itself of this irritant. Once lodged in the membrane around the lungs, the fibers slowly create a situation where they trigger the development of malformed cancerous cells that begin the process of thickening the membranes which in turn begins the fluid accumulation process.
The result is a remarkably lengthy period of latency for the disease. By the time the symptoms appear – the shortness of breath, fatigue and fever – many years will have elapsed since the asbestos exposure. The patient may be a Navy veteran that spent four years on a ship three decades ago. The asbestos exposure will be long forgotten and the symptoms mirror indications of other more common diseases. The fact that mesothelioma is most often shrouded in a lengthy latency period means that it usually isn’t diagnosed until it has had time to fully develop as a malignant threat. The common latency period for mesothelioma is twenty to fifty years and twenty to thirty years for asbestosis.
Developing Mesothelioma Treatment Options
If mesothelioma is in an early stage it can be treated with surgery in combination with radiotherapy and chemotherapy. For pleural mesothelioma a pleurectomy – removing the diseased pleura – or an extrapleural pneumonectomy, which removes a lung in addition – are the two likely options. Peritoneal mesothelioma, when treated surgically, involves removal of the peritoneum in addition to adjacent malignant tissue.
Whether or not surgery is viable chemotherapy and radiotherapy are employed to slow or halt the disease. Efforts generally focus on slowing or stopping the growth of the cancerous cells. There are a number of approaches to this concept. One chemotherapy drug called cisplatin that is used for mesothelioma treatment has at its core molecules of platinum, which has proven to damage the DNA in certain types of cancer cells, resulting in their inability to reproduce. This sort of targeted chemotherapy does less damage to surrounding healthy cells than some more general formulations of anti-cancer cell agents.
Another chemotherapy drug approved by the FDA for mesothelioma treatment is pemetrexed, a medication that targets enzymes vital to certain types of cancer cells. This is another successful approach to narrowing the focus of chemotherapy and limiting collateral damage; however some mesothelioma cancer cells have shown resistance to pemetrexed. For that reason, mesothelioma clinical trials have recently been completed that utilize cisplatin and pemetrexed in combination. The result was a significant extension of survival time for many of the participants. Radiotherapy remains an adjunct form of mesothelioma treatment used to target certain types of malignant cells. It is also used to treat symptoms such as pleural effusion which can have a debilitating effect on the patient.
Early Diagnosis: the Key to Mesothelioma Survival
Practitioners working on mesothelioma cancer are faced with the difficult combination of a disease that is usually fully developed when diagnosed and that is a diffuse spread of cancer cells that are not gathered in the form of a tumor, often creating a situation where surgery isn’t a viable option. In addition, its initial symptoms are often readily assumed to be the result of some more common problem such as a pulmonary illness or heart problems.
In order to achieve some pattern of early diagnosis, people who know they have been exposed to asbestos must consult with their doctors and seek some preliminary tests to ensure that there are no signs of the disease. CT and MRI scans can today detect thickening of the mesothelium membrane in some cases. If diagnosis can be made before the physical symptoms appear, the doctor may have some chance of bringing growth of the cell mass to a halt before it is too late.
Mesothelioma in the Courts
The toxic nature of asbestos has been evident to some since the 1930s. By 1985 enough people had become sick from asbestos exposure that the relationship between asbestos and mesothelioma was incontrovertibly established. For years, asbestos companies and industrial giants that manufactured products using asbestos denied the health problems associated with it.
By the end of the 1990s the courts had ruled that people who suffered from an asbestos-related disease were entitled to liability compensation from asbestos companies who mined the material and corporations that used it to make consumer and construction products. The result has been over one hundred bankruptcies and the establishment of several trusts holding billions of dollars to compensate people who can prove personal damage or damage to a deceased family member as the result of asbestos exposure.
Asbestos is the Cause of Many Illnesses
While the lethal nature of mesothelioma cancer has drawn a lot of the attention given to asbestos toxicity, there are several other afflictions that can be attributed to the material. One of the most common and most harmful is asbestosis. This disease is the result of scarred lung tissue that has been damaged by asbestos fibers. It is a permanent, progressive, restrictive lung illness also known as pulmonary fibrosis. Asbestosis causes shortness of breath, reduced lung capacity and chest pain.
The most common affect of asbestos exposure is pleural plaques. These are smooth, raised strips of fibrous tissue that develop on the pleura. One third to one half of individuals with significant asbestos exposure will develop this condition. They are not pre-malignant and are not believed to lead to further health problems. They will calcify however, and show up on X-rays as an indication of asbestos exposure. Pleural thickening can also be a benign condition that is caused by the presence of asbestos fibers, leading to chest pain and possible pleural effusion.
Mesothelioma Treatment Research
Historically the treatment of mesothelioma has been palliative. However if the disease is diagnosed early enough, pleural or peritoneal surgery is possible. An important part of this decision making process, along with the stage of the cancer, is the health of the patient. But oncologists have gotten more aggressive in recent years about performing partial resections on mesothelioma malignancy and using powerful forms of chemotherapy to treat it. In virtually all cases radiotherapy and chemotherapy are recommended for both post-operative and non-surgical treatment.
The use of targeted chemotherapy is an example of how researchers are approaching mesothelioma today along with a number of other cancer types. Cells that can be programmed to attack or compromise cancer cells and then introduced into the afflicted area have become a common strategy for cancer treatment. Methods of targeting radiotherapy have also been introduced, in order to minimize the destruction of healthy cells adjacent to cancerous cells.
In general, researchers are looking for combinations of radiotherapy and chemotherapy that work best with certain types of mesothelioma cells (there are two) and in certain stages of the disease. Because there are so many late stage diagnoses, palliative care is still an important component of mesothelioma research. The National Cancer Institute sponsors many clinical trials for mesothelioma treatment, with nearly one hundred under way as of June 2010.
Doctors and Lawyers
Asbestos has affected the health of tens of thousands of people that we are aware of; there is a massive additional population of individuals who were never diagnosed or were exposed and died at a time when asbestos-related industries were in the throes of professional denial.
The courts have slowly come to the realization that this has been a national tragedy of sorts and that there is a large class of people who worked around asbestos, and their families that also suffered as a result, who are entitled to compensation. Asbestos companies have been forced to take financial responsibility to a degree uncommon in product liability law. Today there are trust funds established by these companies that hold billions of dollars to pay for claims against those companies for lives damaged or ruined by asbestos.
There are still many thousands of asbestos and mesothelioma claims to be filed because of the fact that mesothelioma has such a long latency period. Workers who were exposed to asbestos products on the job site daily during the 1970s may only now be showing the symptoms of asbestos toxicity. If you or a family member may be one of those individuals, it is important to both your health and your financial well being to confirm any potential asbestos health problems with your doctor.
If your physician detects asbestos damage, a mesothelioma lawyer with expertise in the field can obtain fiscal damages for you. If you’d like to discuss this possibility, fill out our simple form or give us a call and we’ll put you in touch with an experienced professional who can talk you through the details of your case and go over your options. There will be no financial obligation on your part; that will fall to the asbestos companies if yours is a viable case.
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