Malignant Mesothelioma

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About Malignant Mesothelioma

Malignant mesothelioma is a rare and aggressive form of cancer that strikes just 2,500-3,000 people in the United States each year. The disease, which is always considered terminal, is caused by exposure to asbestos. People with mesothelioma are often shocked by their diagnosis: The condition has a decades-long latency period, with symptoms that often don't appear until forty years after their exposure.

Mesothelioma most frequently appears in the pleural cavity that holds the lungs but can also develop in the peritoneal cavity. Though researchers are working hard to develop safe and effective cures, the prognosis for the disease is extremely poor. Most people with pleural mesothelioma die within a year-and-a-half of diagnosis, while people with peritoneal mesothelioma have slightly longer survival times of up to five years.

Types of Mesothelioma and their Symptoms

Malignant mesothelioma affects an organ known as the mesothelium which is found in four different areas of the body. Most cases affect the mesothelium in either the pleural cavity or the peritoneal cavity.

  • Pleural Mesothelioma – Pleural mesothelioma represents approximately 80% of all mesothelioma diagnoses. It affects the pleural lining of the lungs.

    The symptoms of pleural mesothelioma include shortness of breath, chest pain, coughing, and difficulty swallowing. Many patients experience unexplained weight loss, night sweats or fever, and hoarseness. One of the biggest challenges of a pleural mesothelioma diagnosis is that its symptoms are so similar to those of other, more benign diseases that patients often put off getting a diagnosis, and physicians who are unfamiliar with the disease or unaware of the patient's history of asbestos exposure misdiagnose it. This delay allows the cancer to progress, making treatment more difficult once the disease is eventually identified and confirmed.
  • Peritoneal Mesothelioma – Peritoneal mesothelioma represents approximately 15% of all mesothelioma diagnoses. It affects the lining of the peritoneal cavity, which holds the organs of the digestive system.

    As is true of pleural mesothelioma, peritoneal mesothelioma shares many symptoms with benign gastrointestinal diseases, and this can lead to a delayed diagnosis or misdiagnosis. Symptoms include nausea and or vomiting, abdominal pain, diarrhea or constipation, and swelling of the abdomen. Many patients experience night sweats or fever and unexplained weight loss.
  • Pericardial Mesothelioma – Pericardial mesothelioma represents less than 5% of all mesothelioma diagnoses. It affects the lining of the pericardial cavity, where the heart is found.

    The symptoms of this rare condition include chest pain, irregular heartbeat, fever, and difficulty breathing. Because so few physicians see cases of pericardial mesothelioma, it is easy for it to be mistaken for another, more common heart condition.
  • Testicular Mesothelioma – Testicular mesothelioma represents less than 5% of all mesothelioma diagnoses. It affects the lining of the testes.

    There are very few reported cases of testicular mesothelioma. The most common symptom is a lump on the testicles, which is frequently misdiagnosed as an inguinal hernia.

Diagnosing and Staging Malignant Mesothelioma

As described above, there are many similarities between the symptoms of malignant mesothelioma and other illnesses. Procuring a fast and accurate diagnosis is essential to effective treatment. Depending upon your symptoms, you will likely undergo a variety of tests that include imaging studies, bloodwork, and biopsies. Tests that are frequently ordered include:

  • Chest X-ray
  • CT Scan
  • MRI
  • PET Scan
  • Thoracoscopy
  • Blood Tests

These tests do more than confirm the presence of tumors. They also identify the type of mesothelioma cells that make up the tumors and tell physicians how far your cancer has advanced. This information is essential to your care team's ability to create an individualized treatment plan that will give you the best outcome.

There are three different types of mesothelioma cells; epithelioid, sarcomatoid, and biphasic. Mesothelioma tumors made up of epithelioid cells respond best to treatment and carry the best prognosis, while sarcomatoid cells are more aggressive and spread more easily, making them much more difficult to treat. Biphasic mesothelioma cells share characteristics of both of the other types.

In addition to information about cell type, your physician will use diagnostic tests to assess the stage of your disease. Knowing whether your cancer is localized to the pleura (Stage I), spread to adjacent organs or lymph nodes (Stage II), grown into additional tissues or distant lymph nodes (Stage III), or has metastasized throughout the body (Stage IV) serves as an important guide for how aggressively your mesothelioma should be treated and which protocols are likely to have the greatest impact.

What Does It All Mean?

Unfortunately, mesothelioma is always considered a terminal diagnosis. The prognosis for your particular disease will depend upon where in the body your mesothelioma is, its cell type and stage, and your physical condition and age at the time of your diagnosis. The younger and healthier you are and the earlier the cancer's stage, the more options your physician will be able to provide. Your personal preferences will also play a role, as many patients choose not to pursue aggressive, expensive treatments.

Patients who prefer not to treat their disease generally live no more than six months from the time of their diagnosis, and sometimes mesothelioma claims their life in a matter of weeks. With treatment, pleural mesothelioma patients have a prognosis of 15 to 22 months, and peritoneal mesothelioma patients have a prognosis of between three and seven years.

Treatment Options

The treatment options that are available for your mesothelioma vary depending on where in the body it is located and how far the tumors have spread within your body.

  • Pleural Mesothelioma – Patients with pleural mesothelioma may be eligible for one of two different surgical procedures to remove as much of the cancer as possible. These two options are extrapleural pneumonectomy and pleurectomy and decortication.

    Pleural mesothelioma patients may also be offered a combination of chemotherapy, radiation therapy, immunotherapy, photodynamic therapy, gene therapy, and tumor-treating fields. The availability of each of these protocols and their application may depend upon where you are receiving care, as many community hospitals do not have access to the same state-of-the-art treatment as is available in larger academic hospitals and specialized cancer treatment centers.
  • Peritoneal Mesothelioma – Physicians have found that a combination of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is extremely effective in the treatment of peritoneal mesothelioma. This procedure involves the surgical removal of as much malignant tissue as possible, followed by directly applying a heated chemotherapy solution to the surgical site. This exposes any microscopic cancer cells missed by the surgery to a far greater concentration of chemotherapy than can be administered systemically, and avoids many of chemotherapy's adverse side effects.

    Mesothelioma patients who choose not to undergo treatment or who are not eligible can derive significant benefits from palliative treatments meant to make them more comfortable and preserve their quality of life. This can range from surgery, chemotherapy, and radiation to pain management. Physicians are also able to offer relief from some of the disease's most uncomfortable symptoms through processes that drain excess fluid from the chest cavity or lungs.

Paying for Mesothelioma Treatment

Newly diagnosed mesothelioma patients have many concerns. They want to understand their disease and how they got it, and they want to know what is going to happen to them and their family. Another worry is about the cost of their disease. Even those with robust health insurance face significant expenses at the same time that their health is preventing them from continuing to earn an income or when they've already retired and have limited means.

Faced with the potential for catastrophic financial burdens, some consider foregoing treatment, but there are other options. Because mesothelioma is so frequently a result of a company or employer's negligence in warning against the dangers of asbestos or providing appropriate protection, compensation is available through workers' compensation, mesothelioma lawsuits, and asbestos bankruptcy trusts. The attorneys at Danziger & De Llano can help.

How Do People Get Mesothelioma

Mesothelioma is caused by exposure to asbestos, a mineral that was widely used in industrial settings up to the last quarter of the 20th century. Asbestos has historically been highly valued for its strength and its ability to resist heat and flame. It is a fibrous material that is easily broken down, and that is where its dangers lie: When asbestos is damaged its microscopic fibers become airborne and are easily inhaled or ingested. Once asbestos fibers enter the body, their needle-like ends can become embedded in the cells of the mesothelium, leading to cell death and eventual mutation into deadly tumors.

After centuries of suspicion about early deaths and lung problems in people who worked with asbestos, scientists confirmed that the mineral was highly carcinogenic. This news came as a shock to millions of people who had worked with asbestos-containing products throughout their careers, but it was not a surprise to the companies that mined, manufactured, or sold those products. Many had commissioned their own studies of the material and most had been aware of the risks it posed. All of them chose to keep the information to themselves because the material was inexpensive and it was profitable to continue using it. Their silence resulted in countless illnesses and deaths.

Most people who have been diagnosed with malignant mesothelioma were exposed to asbestos in their workplace. They may have worked in factories or construction, as plumbers or electricians. Many victims are veterans of America's military who were exposed during their years of service, while others are housewives and daughters who laundered family members' work clothes when they returned home each night covered in asbestos dust.

In recent years, a new type of mesothelioma patient has been identified: People who were exposed to asbestos that contaminated the talc in popular talcum powder products, including Johnson & Johnson's Baby Powder.

Scientists have not yet identified the exact mechanism that leads to the development of mesothelioma, but they believe that the body's inflammatory reaction to a foreign body has something to do with it. Though mesothelioma is the deadliest outcome of asbestos exposure, the mineral has also been linked to lung cancer, asbestosis, ovarian cancer, and other illnesses.

Contact Danziger & De Llano

A mesothelioma diagnosis will leave you angry, anxious and overwhelmed. It's easy to feel alone and afraid of the future. The attorneys at Danziger & De Llano can help.

We have been answering questions and representing asbestos victims for decades. We have the answers to all of your questions and are ready to provide you with options that best suit your situation and your goals. We can connect you with the best physicians for your condition and help you get the compensation that will alleviate your financial concerns and help you move forward with greater comfort and confidence for your family's future.

Call us today.