What Is Malignant Mesothelioma?

No, malignant mesothelioma cannot be inherited, and it is not contagious. However, family members could have been exposed to asbestos secondhand (known as take-home asbestos) when those who worked with the material accidentally brought fibers home on clothing or uniforms. Secondhand exposure to asbestos can cause mesothelioma.

Benign (or noncancerous) tumors can develop in the mesothelium tissue lining. However, these tumors are not the result of asbestos exposure, and they can be removed with a positive prognosis for the patient. Unfortunately, though, the large majority of mesothelioma cases are malignant. Benign cases are extremely rare.

Malignant Mesothelioma is not easily diagnosed, further complicating treatment of a disease that is fast-spreading and resilient.

One of the first things patients experience is a dry cough and/or shortness of breath caused by a pleural effusion. Shortness of breath is experienced because the effusion (water around the lung) is pushing on the lung, making it difficult to breathe. Most patients presented with these symptoms receive initial treatment but the symptoms tend not to go away, or they may go away but only for a short amount of time.

When symptoms reappear after a few months, the cancer may already be advanced stage. Certain factors—such as a young patient, the absence of lung masses, or lack of a clear reason why the patient has a pleural effusion—are highly suspicious and warrant a more aggressive diagnosis. The earlier mesothelioma is diagnosed, the more varied the treatment options and the better the patient prognosis in most cases.

Most hospitals perform a thoracentesis (drainage of the lung with a needle), but 50 percent of these tests return a negative result. A more aggressive diagnostic approach is therefore recommended, such as a biopsy or a pleuroscopy (camera-assisted biopsy). Diagnostic imaging techniques (i.e. X-rays, CT scans, and MRI) may assist with diagnosis but only a tissue sample can unequivocally diagnose mesothelioma.

Benign tumors, if not removed, are usually carefully monitored for changes that may indicate they have turned cancerous. For people who have had a benign mesothelioma tumor removed, there is a risk that the tumor could come back as cancer.

In some cases, doctors may be able to remove a malignant tumor and attempt to kill off any remaining cancer cells with chemotherapy and radiation. However, even if the surgery and treatment are successful, that does not mean a patient is “cured.” The tumor can come back. Particularly in the case of mesothelioma, complete eradication of the cancer is not possible.

Editor’s Note: This question was posed to Dr. DaSilva in the live Q&A. The answer is adapted in part from his response.

Neither treatment fits all patients in all circumstances, because every patient and every mesothelioma case is different.

There are passionate advocates of extrapleural pneumonectomy (EPP) and passionate advocates of pleurectomy/decortication (P/D). Given patient selection appropriate to the disease stage and the best treatment for that patient, there isn’t any significant difference in terms of overall survival outcome.

For example, a young patient with early stage mesothelioma and good pulmonary function could benefit from extrapleural pneumonectomy, whereas an elderly patient with poor pulmonary function might not do as well with EPP. Again, it’s all about selecting the right patient for the operation.

Your treatment specialist can discuss with you which surgical procedure, if any, is appropriate for your disease stage, overall health and performance status. Also keep in mind that there are surgical options in addition to EPP and P/D that might be more appropriate for you.

Unfortunately, there is no cure for malignant mesothelioma. However, there are many palliative treatments available that can help ease a patient’s pain and possibly extend his or her life expectancy. In addition, researchers are always exploring new drugs and treatment options that provide hope for a cure in the future.

Many families find themselves overwhelmed by the cost of mesothelioma treatment and the challenges of caring for a loved one full time. You should not have to worry about how you can afford legal help, too.

A good malignant mesothelioma attorney will provide a free initial consultation on your case. You should also not be charged anything to get started on your claim. Instead, the attorney should be willing to handle your case on a contingency fee basis, which means you don’t pay anything until the attorney recovers compensation for you.

Mesothelioma is a rare cancer that is caused when a person inhales or ingests asbestos fibers. It develops in the mesothelium, which is a tissue membrane that lines the chest cavity, abdominal cavity, lungs, and other internal organs. Because the disease’s only known cause is asbestos, mesothelioma is sometimes called the asbestos cancer.

Asbestos refers to a group of six fibrous minerals that occur naturally in the environment. These minerals have been used in many industrial and household products over the years. Asbestos is considered a dangerous carcinogen, which means it is a cause of cancer. Mesothelioma is a type of cancer caused by asbestos exposure.

No. Cigarette smoking has no known causative effect on pleural mesothelioma. However, if you are a smoker, one of the best things you can do for your health now is to stop smoking.

Researchers have found that people who continue to smoke after a cancer diagnosis may have more pain than patients who have never smoked. In addition, the American Society of Clinical Oncology reports that smoking may reduce the effectiveness of cancer treatment.

Patients who continue to smoke and undergo surgery may have an increased risk of heart and lung complications, including increased problems from general anesthesia. Smoking is also known to impede wound healing and may increase the risk of wound infection.

Pleural effusion is the accumulation of fluid around the lungs. When the fluid contains cancer cells, it is known as malignant pleural effusion.

Fluid buildup restricts the natural movement of the lung, resulting in shortness of breath, a feeling of tightness in the chest, and pain. Pleural effusion is not a disease; it is a complication of an underlying disorder.

Most pleural mesothelioma patients have pleural effusion. To treat the buildup of fluid, a procedure called thoracentesis is performed. This must be done before further treatment can be administered. Draining fluid from the pleural cavity usually provides immediate relief of unpleasant symptoms.

Malignant mesothelioma can develop 15 to 60 years after a person was exposed to asbestos. Most people came into contact with asbestos on the job, such as at factories, shipyards, construction sites, and industrial facilities. However, others have been diagnosed with malignant mesothelioma after secondhand exposure to asbestos, such as from coming into contact with the dangerous material when it was carried home on loved one’s uniforms.

Yes. An accurate staging of your disease is needed to determine your prognosis and most effective treatment(s).

The treatment options are typically based on the extent of the cancer, which is determined by staging.  A localized cancer would be identified as Stage 1, for example, and can involve a surgically removable tumor.  Once the cancer cells have spread beyond that original location, and a higher stage level is designated, the mesothelioma is considered advanced and surgery is often no longer an option.

The most popular staging system used for pleural mesothelioma is the TNM System developed by the International Mesothelioma Interest Group. The letters TNM stand for Tumor, lymph Node, and Metastasis. This system is similar to the staging systems used for other cancers and can be summarized as follows:

• Stage I. In Stage I mesothelioma, one side of the chest’s pleural lining (the pleura) has tumors. The cancer has spread to the outer lining of the lungs, but it is minimal. Cancer has not spread to the lymph nodes.
• Stage II. Stage II mesothelioma is characterized by tumors on one side of the pleura. Tumors have spread to the outer lung lining, the diaphragm, or the lung itself.
• Stage III. In Stage III mesothelioma one side of the pleura has tumors, and tumors have spread to the first layer of the chest wall, a single spot in the chest wall, the chest’s fatty parts, the heart’s outer layer, or any lymph nodes on the same side of the chest as the primary cancer.
• Stage IV. Stage IV mesothelioma is found on one side of the pleura in addition to any of the following areas: the pleura on the other side of the chest, the chest wall, chest organs or any other organs in the body, the diaphragm, blood vessels, the spine, the nerves leading to the arm, or the lymph nodes on the opposite side of the primary cancer site.

Although the stage of the cancer is important in determining a patient’s prognosis, additional factors are also important when assessing life expectancy. The patient’s age at disease diagnosis, status as a smoker or non-smoker, mesothelioma type, the length of time between asbestos exposure and the onset of symptoms, a patient’s overall health, and other factors all play a role in patient outlook.

Malignant mesothelioma can develop 15 to 60 years after a person was exposed to asbestos. Because the latency period for the disease is so long, many people do not immediately connect their symptoms to their asbestos exposure. However, it is important for anyone who has been exposed to asbestos to tell the doctor immediately if he or she is experiencing any symptoms indicating lung disease.

People may confuse malignant mesothelioma with lung cancer. However, these are two separate types of cancer. Lung cancer is a carcinoma that affects the lung itself. Mesothelioma is a cancer that attacks the mesothelium tissue that lines the lungs, chest cavity, and other organs in the body. Exposure to asbestos can cause both types of cancer, but it is the only known cause of malignant mesothelioma.