Mesothelioma

Mesothelioma is a cancer of the mesothelium, the thin tissue that covers the lungs, heart, and other internal organs. Nearly all cases of this fatal disease are caused by exposure to asbestos. Often, the cancer takes decades to appear and, when it does, it has already reached Stage 3 or 4, making it especially difficult to treat.

Therefore, most victims of mesothelioma face a grim prognosis. Most typically survive 12 to 18 months from the time of diagnosis. Treatments, both conventional and experimental, may extend the life of mesothelioma patients, but there is no cure at this time.

Common Treatment Options

The following are the most common treatment options for pleural mesothelioma, cancer of the lining of the lung:

• Extrapleural pneumonectomy (EPP) – The most aggressive type of mesothelioma surgery, EPP involves the removal of the lung along with its coverings and the associated coverings of the heart and diaphragm. It is followed by chemotherapy and radiation. It is reserved only for the healthiest of patients and involves much risk and a very long recovery period.

• Pleurectomy/decortication – This is surgery to remove the lining of the lung and, hence, the cancer cells found in the lining. In this type of procedure, the lung itself is preserved. Pleurectomy is usually followed by chemotherapy. This surgery is an option for patients whose limited heart and lung function prevent them from undergoing EPP.

• Chemotherapy/Radiation – Patients who are not candidates for any type of surgery may benefit from chemotherapy and radiation to shrink the tumor. These treatments are often used for “palliative” purposes as well, helping to lessen some of the very uncomfortable symptoms of the disease.

Surgery, chemotherapy, and radiation are also used to treat peritoneal (abdominal) mesothelioma, and pericardial (heart) mesothelioma.

Maintenance Therapy

During the late years of the 20th century, researchers and oncologists spent time and dollars researching the effects of Interferon Alpha on malignant mesothelioma tumors. Often, the Interferon was combined with cisplatin in the clinical trials made available to those with pleural mesothelioma. (Cisplatin is a common platinum-based chemo drug still used in the treatment of the disease, but now often combined with Alimta©, the only drug specifically approved by the FDA for the treatment of the disease.)

Author DeeDee Moore notes in her book, Dealing with Mesothelioma Cancer, that these interferon trials did indeed extend the lives of some meso patients.

“Treatment regimens involving immunotherapy have yielded variable results,” she explained. “Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.”

More recently, however, Interferon Alpha has taken on the role of a maintenance drug. At a conference for the Society of Thoracic Surgeons in 2006, Dr. Robert Cameron – a leading expert on the treatment of mesothelioma – presented proof that Interferon Alpha as “maintenance therapy” showed promise. Cameron noted that the median survival of patients receiving interferon alpha after undergoing pleurectomy with decortication followed by surgery was 37 months. Therefore, Cameron and his colleagues at UCLA concluded that interferon alpha, as a maintenance therapy, does indeed have a survival benefit.

Continuing Research

Malignant mesothelioma remains one of the most frustrating forms of cancer for researchers and for oncologists who face victims of the disease each day. It is highly recognized that none of the current treatments will provide a cure for the disease but it is the hope of researchers that continued research and more clinical trials will be integral in the discovery of drugs or therapies that will prolong the lives of sufferers of asbestos-caused cancer. Only time will tell.

Mesothelioma victims – Ask any oncologist to list the most-difficult-to-treat cancers and there’s no doubt that mesothelioma will be on the top of most – if not all – of their lists. It’s a frustrating disease that has doctors wringing their hands and wishing they could do more.

So, what makes mesothelioma such a hard disease to treat and why is the possibility for a positive prognosis rare? Is there any chance that the mortality rate might change in the years ahead?

Mesothelioma Latency Period

The answer to the first part of the question has to do with the particulars of the disease and how it manifests itself. Literally, mesothelioma can “hide” in the body for decades – sometimes as long as 50 years – before it appears.

Though there have been some exceptions to this long latency period (particularly among 9-11 first responders who were exposed to excessive amounts of asbestos all at one time), those who’ve worked in professions that include steel workers, oil refinery employers, pipefitters, plumbers, electricians, welders, and insulators have often been surprised to learn of the presence of mesothelioma years and years after they’ve been exposed.

Misdiagnosis of Symptoms

Because of this lengthy latency period, when symptoms do arise, no one is thinking about asbestos and cancer. Consider the symptoms of mesothelioma, which include:

• Coughing
• Chest pain
• Shortness of breath
• Fatigue

These symptoms can apply to dozens of common ailments, from heart problems to bronchitis. That means more time is often lost before a correct diagnosis is made and treatment is further delayed. Often, by now, the cancer has reached stage 3 or 4.

Researchers have been working on tests that identify the biomarkers of mesothelioma in order to diagnose the disease earlier. For example, blood tests like the FDA-approved MESOMARK© assay scan an individual’s blood for soluble mesothelin-related peptide, a sure sign that the disease could be present or developing.

Determining a Prognosis

Once a diagnosis is made, doctors rely on these factors to determine a prognosis.

• Type of mesothelioma – pleural, pericardial, peritoneal, or testicular. This is determined by using imaging and biopsies
• The size of the tumor
• The location of the tumor and whether or not it can be treated surgically (is “resectable”)
• Which symptoms are present and the extent of those symptoms
• Whether the disease has spread to other areas of the body (metastases)
• The overall health of the individual – Many victims of the disease are older and already have a host of other medical problems with which they contend.

Survival Rates

Survival rates for cancers of all types are usually measured by something called the 5-year survival rate. This is based on the number of people who are still alive five years after their diagnosis. This number is very low for meso patients. The American Cancer Society put it at about 5% to 10%. It’s not a very encouraging statistic.

While those who are diagnosed at a younger age do tend to live longer, the numbers are still grim, especially because the disease – in many cases – could have been avoided if employers had been more diligent about protecting their workers from asbestos exposure. Researchers continue to work hard towards developing new treatments for the disease, but there are still miles to go before the road ahead looks brighter.

Are you a car guy…or girl? Many Americans are gaga over their automobiles. Some collect them. Others make a habit of buying old ones and rebuilding or repairing them so that they’re good as new.

For some individuals, every weekend is spent working on those cars until everything is just right and they can show off that masterpiece to their family and friends.

Or maybe you make your living as an auto mechanic. There are tens of thousands of certified mechanics in the United States, standing ready to service some of the 235 million or so cars and trucks on America’s roadways.

It’s a profession that Americans couldn’t do without, and most people will tell you that it’s super helpful to have a mechanic you can trust to work on your car(s).

Working as a mechanic comes with some risks, though the job is certainly not as dangerous as being perhaps a firefighter, an electrician, or even a pipefitter, right? Not necessarily. Anyone who works on an old car or on a car that contains parts not recently manufactured in the U.S. might be putting themselves at risk for asbestos exposure because of auto parts containing asbestos.

Consider the inside of a car. Many of the elements found under the hood and elsewhere in a car’s mechanical system create friction in order to function properly. That means heat is generated.

So, for decades, manufacturers of these so-called friction parts used asbestos in their products so as to avoid the chance for fires to develop.

Car-related items that may have contained asbestos include:

• Hood liners
• Brake pads
• Brake linings
• Brake blocks
• Clutch facings
• Transmission parts
• Gaskets
• Heat seals
• Valve rings
• Packing materials

Just as with other asbestos items, if the asbestos in the above-mentioned parts is not disturbed, a problem is not likely. But because mechanics and DIYers generally perform tasks that involve moving and removing components, filing, drilling, etc., dust is generated and asbestos inhalation can become a problem, especially when a car manufactured prior to about 1975 is involved.

It is these older autos that represent the highest risk to the person doing the repairs.

Companies that manufactured asbestos-containing auto parts included:

• Raybestos
• Johns Manville
• Owens Corning
• Bendix
• Cooper Industries
• RPM International
• Dana Corporation
• And many others

In addition, the fact that mechanics often work in small, unventilated spaces such as garages, makes the possibility of inhalation of fibers even more likely. This was especially the case decades ago when agencies like OSHA were not involved in making sure working conditions were safe for mechanics and others in similar positions.

Today, mechanics and their employers should be taking precautions to make sure that asbestos inhalation does not occur. Simple steps can help avoid an eventual cancer diagnosis. For example, auto shops should contain a HEPA vacuum system with components that can trap asbestos dust before it escapes.

OSHA also demands the use of low pressure wet cleaning methods when cleaning brakes and clutches, etc. It keeps airborne dust from escaping. Mechanics should never use water hoses or squirt bottles to clean parts and should be aware that items such as generic shop vacs are not sufficient for collecting asbestos fibers.

If you know someone who’s developed asbestosis or mesothelioma from on-the-job exposure as an auto mechanic, it’s important to gather as much information as possible about the contamination and to see an attorney to learn what legal rights accompany this negligent exposure. It may not be too late!

America changed in the 1800s. With the onset of the Industrial Revolution, which historians say began in about 1830 and spread out over the next century or so, production of goods moved from home businesses to factories where machines now aided in the manufacture of countless products that supported the growth of America and would transform the lives of Americans from coast to coast.

With the Industrial Revolution came many new technologies and many new products. Though asbestos, which enjoyed its earliest modern uses in items such as the steam engine, wasn’t a product of the Industrial Revolution – it’s a naturally-occurring mineral – its use did indeed skyrocket during this time. By the mid-20th century, products that contained asbestos numbered in the tens of thousands and were way too numerous to count.

Asbestos in the Home

A list compiled by a government consumer-related agency once noted that some 3,000 “household” products containing asbestos in the years prior to about the mid 1970s. These included items that were handled nearly every day by the homeowner, especially housewives and even children. Even some popular beauty products included asbestos materials.

These items included:

• Hairdryers
• Ironing board pads and covers
• Irons
• Coffee pots
• Toasters
• Crock pots
• Electric blankets
• Portable dish washers and heaters
• Decorative fireplace logs
• Pot holders and oven mitts
• Make-ups and talcum powders
• Potting mixes and pesticides
• Attic insulation
• Shingles and tiles
• And much more!

That means EVERYONE in the house might have been exposed to this toxic “miracle mineral”, from the youngest of children to mom and dad. Though these items no longer contain asbestos, even that long ago exposure could cause an eventual diagnosis of asbestosis or mesothelioma.

Other General Products Containing Asbestos

Those who worked outside the home in a variety of industries were exposed to a bevy of other asbestos-containing products. Shipbuilders, plumbers, pipefitters, construction workers, welders, electricians, insulators, auto mechanics, firefighters, and a long list of other workers encountered such products nearly daily while working in their fields, particularly prior to the 1980s.

Among the products most responsible for causing mesothelioma and other lung-related diseases are:

• Adhesives
• Drywall tape
• Cement
• Insulation
• Gaskets
• Valves
• Textile cloths like firefighter suits, blankets, ropes, stage curtains
• Brake pads
• Clutches
• Hood liners
• Electrical cloth
• Laboratory hoods
• Some plastics and vinyl products
• Mastics
• Ductwork connectors
• And much more

Remember, in its solid intact form, asbestos usually wasn’t dangerous. But any time it became damaged or was cut, sawed, drilled, or manipulated in any way so as to cause fibers to circulate through the air, asbestos became toxic. Inhalation of even the tiniest amount of asbestos, be it from an old hairdryer or something much larger, could have caused tumors to form.

If you believe you were regularly exposed to toxic asbestos products and are now suffering symptoms like chest pains, shortness of breath, coughing, and fatigue, see your doctor and tell him/her about that exposure. The sooner a definitive diagnosis is made, the more options are available for treatment.