Mesothelioma Symptoms Causes and Cure

Welcome

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Welcome to blog about Mesothelioma. This blog deals with mesothelioma awareness regarding its introduction, what it is actually, background, symptoms, causes and reasons, various types and categories, treatment, cure and prevention.

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Asbestos Exposure

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Asbestos exposure is the only known cause for malignant mesothelioma and asbestosis. Asbestos has been mined, processed and used to manufacture goods for over 6000 years. However, the more recent heavy use of asbestos, from the late 1880s to the 1960s, caused laborers to be exposed to it in such quantities that asbestos exposure became a deadly curse.

Thousands of cases of mesothelioma and asbestosis have occurred since the 1930s, and medical specialists expect this epidemic to continue for 20 years. The lag time between initial asbestos exposure and the onset of these deadly diseases is typically 30 to 40 years and has been as long as 60 years.
Inhalation of Asbestos
Inhalation of asbestos dust poses the highest risk during asbestos exposure. The asbestos fibers are so tiny that they are able to bypass the natural filtration system of the human lungs. Once inside the most sensitive areas of the lungs, these fibers become embedded in the lung tissue. The durability and tensile strength of these fibers are why asbestos was so widely used as a fire retardant and as a construction component. However, these same characteristics allow asbestos fibers to stay embedded in lung tissue for many years without being destroyed by the body’s natural defense mechanisms. When mesothelioma erupts in the lung tissue, it is called pleural mesothelioma. Asbestosis also occurs due to the embedding of asbestos fibers in the lungs.

Pleural Mesothelioma
Pleural mesothelioma is the most common type of mesothelioma, and it has occurred in a wide range of different laborers exposed to asbestos. Laborers in the Navy shipyards during and after World War II received heavy doses of asbestos exposure while they used asbestos to insulate piping, boiler rooms and other areas of high heat. In many cases the air was filled with asbestos dust and without proper respiration systems, these workers inhaled the asbestos particles day after day.
Those who mined asbestos were exposed to heavy doses during the mining process. In mining towns, such as Libby, Montana, asbestos dust filled the air in not only the mines and processing facilities, but also in the town square. This asbestos exposure has lead many laborers and towns people to develop asbestos lung cancer.
Construction workers who installed asbestos insulation were also exposed. Asbestos was widely used in car brake linings; therefore, laborers involved in the automotive manufacturing process were placed in work environments where asbestos fibers were inhaled, potentially leading to pleural mesothelioma.
Other Asbestos Exposure
Pericardial and peritoneal mesothelioma are also thought to be caused by asbestos exposure. Pericardial mesothelioma occurs in the lining of the heart and peritoneal mesothelioma occurs in the lining of the abdomen. How the asbestos fibers become imbedded in the lining of these other organs is not well understood. For those laborers who contracted these diseases, food could have become contaminated due to asbestos exposure, leading to asbestos fibers invading the abdominal lining. Asbestos fibers could also have gotten into the blood stream, either through food or inhalation, due to asbestos exposure. Once in the blood stream, these fibers could become lodged virtually anywhere in the body.
Asbestos Removal
The use of asbestos has mainly been halted, and the potential for exposure to asbestos has fallen dramatically. However, a number of older buildings still include insulation and floor/ceiling tiles that contain asbestos. Great care should be taken to limit exposure to asbestos during demolition work in older buildings. Respirators should be used to filter the air, and the demolition areas should be sealed so that asbestos dust is not released from the demolition area. For construction sites, OSHA (Occupational Safety and Health Administration) has established extensive guidelines to protect construction workers involved in the demolition of buildings containing asbestos.
It is also common for floor tile in older homes to contain asbestos. When remodeling, it is recommended that these asbestos floor coverings not be disturbed and the new floor coverings be placed on top of the older ones. For homeowners, several websites provide information outlining safe removal procedures in order to limit asbestos exposure.

Mesothelioma Pain Management

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Malignant mesothelioma is a disease that typically has no symptoms early in the disease process. In many cases, the asbestos exposure that caused the disease could have occurred as many as 30 to 60 years earlier. Mesothelioma starts to develop when asbestos fibers become imbedded in the lung and scar tissue forms around the asbestos fibers. But the patient does not detect the formation of the scar tissue, as it causes no perceptible pain.

As the fibrous scar tissue accumulates in large quantities and the cancerous tumors start to grow in the mesothelium, large amounts of fluid start to gather. This fluid causes much of the pain associated with mesothelioma. Chest pain due to pressure and pain during cough are directly caused by the fluid accumulation.
The growth of the tumors can also cause pain as the tumors push against the nerves and other organs. It is important that if the mesothelioma patient experiences this pain, then the doctor should be advised. There is absolutely no need to endure pain when there are remedies available to make the patient more comfortable.
Certain cancer treatments may help to relieve the pain if the tumors are removed or progression slowed. Also, the fluid can be drained to help eliminate the pressure caused by the accumulation. And there are specific pain management tools apart from the direct treatment for the cancerous tumors. The patient should ask the doctor about directly treating the pain.

Mesothelioma Treatments

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Mesothelioma treatments have thus far been unable to limit the spread of the deadly cancer. Treatments for mesothelioma are divided into two categories; traditional mesothelioma treatments and new mesothelioma treatments.
Traditional mesothelioma treatments are the same as those used to treat most other cancers, and include:
Surgery
Chemotherapy
Radiation therapy (radiotherapy)

Traditional mesothelioma treatments are often used in conjunction with one another in effort to provide the most thorough and effective method of treatment. For example, trimodality therapy combines all three traditional methods of treatment, where chemotherapy is administered first with the aim of slowing the growth of malignant mesothelioma. Chemotherapy treatments are followed by surgery designed to physically remove a mesothelioma tumor mass (extrapleural pneumonectomy is often performed as part of trimodality therapy). Postoperative radiation therapy is used for the final step, to target any lingering mesothelioma cells. Although trimodality therapy has been unable to eradicate malignant mesothelioma, it has proven to be effective in significantly prolonging patients’ survival time by as much as five years (the average post-diagnosis survival time is one to two years).
New mesothelioma treatments have been researched and developed with the hope of succeeding where traditional methods have not. Mesothelioma researchers are optimistic that new mesothelioma treatment modalities will eventually prove to be successful, though they have yet to yield results that are any better than traditional methods.

New treatments for mesothelioma include:
Development of new chemotherapy agents
Intensity modulated radiation therapy (IMRT)
Photodynamic therapy (PDT)
Immunotherapy
Gene therapy
The progression of mesothelioma, as with other cancerous diseases, is typically broken into stages, with the treatment options based on the stage of the disease. The commonly used staging for mesothelioma is the Brigham staging system and it is described as follows.
Stages of Mesothelioma
Stage 1 occurs when the tumor lies completely within the capsule of the pleura, without swollen lymph nodes (adenopathy).
Stage 2 has the characteristics of Stage 1, where the tumor has spread and there is presence of adenopathy. But in Stage 2 the boundaries of the tumor allow for a resection (removal of the tumor) without cutting into other organs.
Stage 3 includes extension of the disease into the chest wall or into the heart, through the diaphragm or peritoneum, or outside the pleura to involve the lymph nodes.
Stage 4 occurs when the cancer has formed in distant organs through metastases.
Treatment options for the management of malignant mesothelioma include:
chemotherapy
surgery
radiation
multimodality treatment
However, none of the treatment strategies have been shown to be particularly effective against the disease.

Diagnosis of Mesothelioma

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Malignant mesothelioma detection, like other cancers, can be accomplished with imaging equipment, such as x-ray machines. But once detected, mesothelioma diagnosis is difficult for a number of reasons. First, there is a very extended time period between the exposure to asbestos and the onset of the disease, sometimes as long as 50 to 60 years. Patients would often not think to tell their doctors about working in an asbestos-related job many years earlier.

Second, the typical symptoms of mesothelioma, shortness of breath and coughing, are also symptoms of many other types of lung problems, both cancerous and non-cancerous. Thus, just because a person has these symptoms, it does not in any way provide a mesothelioma diagnosis.
Third, many types of tumors can exist in the serous cavities that are not mesothelioma. These other types of tumors can be non cancerous, or benign, that originate in the tissues of the serous membranes, other than the mesothelium. Or they can be tumors that have migrated from other organs with cancerous growths due to metastases.
Mesothelioma and Imaging Technologies
X-rays and other types of imaging technologies can be used to detect tumors or effusion (build up of fluid) in the body, including mesothelioma detection. A growth in the chest cavity will show up in an X-ray or MRI analysis. But these devices cannot directly determine the type of cancer or provide a mesothelioma diagnosis. They cannot determine whether the tumor is mesothelioma or originates from some other source.

Positron emission tomography (PET) is a type of diagnostic imaging scan that is used for malignant mesothelioma detection. PET scans use the emission of positrons (tiny particles that are emitted from radioactive substances) for the purpose of radiation detection.
Some medical professionals are of the impression that PET scans are the most effective method through which to definitively verify a case of mesothelioma. While they believe that standard imaging techniques like x-rays and MRIs should continue to play a role in diagnosing the disease, it is felt that positron emission tomography is becoming an increasingly valuable tool in the staging and typing of the latent asbestos cancer.
Diagnostic Surgery – Biopsy
To provide a mesothelioma diagnosis, a biopsy is needed. This biopsy then undergoes what is called diagnostic histopathology. Histopathology is a technique where the cells from the tumor are viewed under a high-powered microscope, or electron microscopy. Electron microscopy is considered the gold standard for evaluating tumor material from a biopsy. It is a highly advanced microscope that allows viewing of the tiniest elements of cell tissue.
For mesothelioma diagnosis, a pathologist (a doctor who specializes in disease detection) places the tumor cells in the electron microscope and then views the structure of the individual cells. The mesothelioma cells have a specific shape and pattern, and this allows them to be identified by a very keen pathologist. But mesothelioma cells also look similar to other types of cancer cells, such as adenocarcinoma cells, and this can make the pathologist's job very difficult. Even with the electron microscope, the different types of mesothelioma cells can be hard to recognize. The three types of cells are epithelioid mesothelioma cancer cells, which are tubular in shape, sarcomatoid mesothelioma cancer cells, which are oval and irregularly shaped, and biphasic mesothelioma cancer cells, which are a combination of shapes. These cells can be confused with other types of cancer cells.
New Methods For Mesothelioma Detection
Due to this diagnostic confusion, much research is underway to find new methods for diagnosis. One method is to evaluate the types of compounds generated by the mesothelioma cancer cells. This is called histochemistry. Histochemical reactions have long been used to distinguish between mesothelial and other types of tumor cells. For example, mesothelial cells are known to produce specific types of carbohydrate compounds. Unfortunately, other types of cells in the body also produce these compounds.
Immunochemistry is also being used to detect mesothelioma. This area of study evaluates the presence of antibodies in the body. Certain types of antibodies are known to be associated with certain types of cancer. But mesothelial cells have no specific types of antibodies that can provide a "positive" marker. Consequently, immunochemistry allows the doctor to "eliminate" the other cancers, but does not indicate the presence of mesothelioma. These techniques offer insight into the disease and may help eliminate other diseases, but none can directly detect mesothelioma.
New Blood Tests for Mesothelioma Detection
SMR Protein: Recently, because of the difficulty in diagnosing malignant mesothelioma, research has concentrated on finding new ways to detect the presence of the disease. Researchers in Australia have found that a certain protein, called SMR or Soluble Mesothelin Related protein, is elevated in patients with mesothelioma. These researchers have suggested that a test for the presence of SMR in the blood could represent a useful marker for the diagnosis and disease progression. They feel that such a diagnosis tool could lead to earlier detection, and thus more effective treatment.
One of the most striking findings of their research was that several asbestos-exposed persons who tested positive for SMR were diagnosed with mesothelioma within three years. They suggested that evaluation of SMR may help to identify persons at risk for this deadly disease. Also, they found that SMR levels increase as mesothelioma progresses, suggesting that SMR evaluation could be used to track the progression of the disease and the effectiveness of treatment
Osteopontin Glycoprotein: In an effort to produce the first early-detection test to screen for malignant mesothelioma, researchers at Wayne State University have been studying the possible link between mesothelioma development and levels of a glycoprotein called osteopontin. Early clinical study findings of 190 patients have demonstrated a link between high levels of osteopontin and the development of malignant pleural mesothelioma.
Although the results are being viewed as preliminary, there is a great deal of excitement surrounding the potential of a blood test capable of screening for mesothelioma in its earliest stages. While there is no known cure for malignant mesothelioma, research is ongoing and certain successes have already been realized in terms of extending survival time beyond the one to two year post-diagnosis average. It is hoped that if mesothelioma specialists have more time through which to conduct treatment on a lesser developed form of the asbestos cancer, the greater a patient’s chance at potential survival.
Despite the fact that the preliminary results of the osteopontin blood test clinical trial have been met with some controversy, the National Cancer Institute (NCI) continues to sponsor additional study.
Tell Your Doctor About Asbestos Exposure
If you or a loved one has been exposed to asbestos, even if it was in the distant past, it is very important that you inform your doctor. One reason why mesothelioma is such a deadly disease is that it is detected late in the disease process. If your doctor knows of the exposure, he or she may be more aware of your symptoms or other health issues that could be used for early detection.

Primary and Secondary Lung Cancer

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Cancer is a disease related to the uncontrolled growth of tissue, leading to the accumulation of mass (called a tumor or lesion.) Normal cells in the body divide and grow in an orderly controlled manner. When cells grow uncontrollably and this growth invades other tissues or organs, the growths are called malignant or cancerous. When a mass of tissue, or tumor, is benign, it is relatively stable and does not invade other tissues.

Cells from malignant tumors can break away and travel to other parts of the body, usually through the bloodstream, but also through the lymph system. When these cells find new host organs, these cells can grow into tumors in the new tissue. This spreading process is called metastasis and when a cancer has reached an advanced stage to where the malignant cells are attacking other organs, it is said that the cancer tumors have metastasized. The tumors in new organs are always made up of cells similar to those of the original tumor.
Benign tumors do not metastasize. They can often times be removed through surgery and not re-occur.
Lung Cancer
Lung cancer occurs when lung tissue develops cancerous growths. Primary lung cancer is cancer that originates in the lung tissue. Secondary lung cancer is cancer that spreads, or metastasizes, from other organs.
Primary Lung Cancer
There are several different types of primary lung cancer. These are divided into two main groups:
Small Cell Lung Cancer
Non-small Cell Lung Cancer

Pleural mesothelioma is often thought of as a third type of primary lung cancer. However, it is not a lung cancer. Mesothelioma does not develop in the lungs, but in the serous membranes surrounding the lungs. As such, it does not fall into the typical categories of lung cancer. Mesothelioma can also occur in other tissues, in the lining of the abdomen, call peritoneal mesothelioma, and in the lining of the heart, pericardial mesothelioma.
Small Cell Lung Cancer
Small Cell Lung Cancer comprises approximately 20% of the primary types of lung cancer. It is called small cell cancer because the tumor cells are very small, with the cells containing almost exclusively the cell nucleus and nothing more. This type of cancer is also referred to as “oat cell” cancer. Chemotherapy is often suggested for this cancer in the early stages because of the rapid way it which it spreads. Surgery is not a good option to stop the spread early on. This type of cancer is most closely linked to smoking; non smokers rarely have it.
Non-Small Cell Cancer
Non-small cell cancer falls into these categories:
Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma
Adenosquamous cell carcinoma
Undifferentiated carcinoma
Each category of non-small cell cancer are physiologically similar and they respond to treatment differently than to small cell lung cancer.
Squamous cell carcinoma is a common type of primary lung cancer. This type of cancer is also linked to smoking and it develops from the cells than line the airways in the lungs. Squamous cells are thin, flat cells that look like fish scales. Commonly the tumor growths are located in the center of the lungs near the large airways (bronchi). It is also referred to as epidermoid carcinoma. It comprises approximately 30 to 35% of the non-small cell cancer in the US, affecting men and the elderly most frequently.
Adenocarcinoma, like squamous cell carcinoma, develops from tissues in the lung airways. But, it develops from the glandular secretory tissues. (tissues that produce mucus). It is often found in the outer airway passages, not the main bronchi, like the squamous cell variety. The incidence of this cancer is increasing. It comprises about 40% of the non-small cell lung cancer in the US and is the most common lung cancer among women.
Large cell lung cancer is named after its appearance. The cells look large and unnatural under the microscope. These types of cells grow quite quickly.
Adenosquamous carcinoma are cells that appear flat under the microscope, like the squamous cells, but derive from the glandular secretory cells, like the adenocarcinoma.
Undifferentiated carcinoma includes cancer cells that cannot be identified as one of the other groups. The cells appear abnormal under the microscope and multiply uncontrollably.
Secondary Lung Cancer
Secondary lung cancer is cancer that has spread to the lungs from other organs. Many different types of cancer spread to the lungs, because of its very high blood supply. These include breast cancer and colon cancer.
The type of cancer is very important when it comes to treatment. The different types of cancer cells respond differently to different types of chemotherapy and other therapies. When cancer cells spread from other organs to the lungs, then the lungs have to be treated for the other type of cancer, not lung cancer. This is an important distinction. For example, breast cancer that spreads to the lungs, has to be treated for breast cancer, not lung cancer.

Mesothelioma Symptoms

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Mesothelioma symptoms are not specific to the disease, that is, many of the mesothelioma symptoms are the same for other medical problems. Also, most studies show that mesothelioma can occur as much as 30 to 40 years after exposure to asbestos. Thus, when a mesothelioma symptom occurs, many mesothelioma patients do not know that the symptoms they experience are related to something that happened much earlier in their lives. In reality, only a short time period of asbestos exposure, as little as a few months, can create the conditions for a disease that erupts much later in life.

Mesothelioma affects the lining of various cavities in the body. Over time, the growth of the cancerous tumors causes these tissues to expand and gather fluid. The presence of excess fluid is typically what causes the symptoms to occur. The symptoms of the disease will also depend on the location of the tumors.
Pleural Mesothelioma Symptoms
For pleural mesothelioma, which is in the lining surrounding the lung, shortness of breath, chest pain and a persistent cough are common symptoms. Unfortunately, these symptoms are also very common for a number of other ailments, including pneumonia. The most common presenting symptom is localized chest pain, but this may not occur until the disease is well advanced. Coughing and weight loss are not uncommon. Some patients show virtually no symptoms.
Peritoneal Mesothelioma Symptoms
Peritoneal mesothelioma is a cancer of the abdomen lining. Symptoms include swelling or a mass in the abdomen, weight loss and abdominal pain. Also, bowel obstruction and blood clots have been known to occur. Fever is sometimes present.

Pericardial Mesothelioma Symptoms
The lining of the heart is called the pericardium. Pericardial mesothelioma affects this heart lining, causing fluid to gather. Symptoms include chest pain, cough, irregular heart beating and irregular breathing patterns. Many of these symptoms would manifest themselves when patients exert themselves, even with minimal exertion. This type of mesothelioma is the most rare.
With any cancer, the earlier the disease can be detected, the better the prognosis for a treatment that halts the progression.

Diseases of the Lungs and Mesothelium

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Mesothelioma is a rare disorder and is often misdiagnosed. It is a disease that derives directly from the mesothelial cells in the serous membranes. But it is not uncommon for other growths to appear in the mesothelium, both cancerous and non cancerous.

Tumors of the mesothelium can be benign (non-cancerous) or cancerous. A malignant tumor of the mesothelium is called malignant mesothelioma, but because most mesothelial tumors are cancerous, the disease is often simply called mesothelioma.
Benign Tumors
Although uncommon, the mesothelium of certain female and male reproductive organs may develop a benign tumor called an adenomatoid tumor. In men, the tumor starts in the area where the sperm is carried from the testicles and in women it starts in the fallopian tubes. Another type of benign tumor that starts in the female reproductive organs is called a benign cystic mesothelioma.
A type of benign tumor that used to be called benign fibrous mesothelioma can form in the pleura around the lungs. It is now known that this type of tumor starts in the tissues under the mesothelium and therefore is not a type of mesothelioma. It is typically not cancerous, but can progress to cancer in some cases. A similar disease that forms in the peritoneum is called a fibrous tumor of the peritoneum. These types of tumors are often removed surgically, and no other treatment is needed.

Malignant Tumors
The most common form of malignant tumors in the mesothelium are metastatic tumors. That is, the tumors start in another part of the body and then the cancer metastasizes and spreads to the mesothelium. The ratio is between 7: 1 to 20: 1 for the occurrence of these types of tumors versus a mesothelioma. Mesothelioma derives directly from the mesothelial cells and does not migrate into the mesothelium from other organs.
The most common metastatic tumors that grow in the pleura derive from, in descending order:
breast
lung
ovary
stomach
large intestine
pancreas
thyroid
kidney
For the pericardial tumors from metastases, the most common originating organs are lung, breast and thyroid. In the peritoneum, the ovary, stomach, large intestine, pancreas and breast are the most common sources of metastatic tumors.

Mesothelioma Cancer Cells Types

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Malignant mesothelioma is generally divided into three histological categories, or types of cells: epithelioid, sarcomatoid and biphasic mesothelioma. Within each of these mesothelioma cancer cell types, subtypes exist. Many mesothelioma patients display more than one cell type.

The diagnosis of mesothelioma cannot be specifically by lung x-rays or other types of imaging, because many different types of cancer can be present in the lungs. The images show only that a tumor may be present, but does not provide an indication of whether the tumor is mesothelioma. A biopsy must be performed where the mesothelioma cancer cell types are used to distinguish mesothelioma from other types of cancer, such as lung cancer.
Epithelioid Mesothelioma Cancer
Epithelioid mesothelioma is the most common cell type, constituting approximately 50% to 70% of all malignant mesothelioma. These cells are relatively uniform in shape and have a tubular pattern with a distinct cell nucleus. The individual cells are shaped like cubes or multi-sided boxes.
Because of the similarity between adenocarcinoma and mesothelioma cancer cells, they are often confused and mesothelioma can be misdiagnosed. Inspection of the cancer cells under high-powered microscopes and identification of unique characteristics of the chemical properties of the cells can help make the proper diagnosis. Learn more about epithelioid mesothelioma cancer.

Sarcomatoid Mesothelioma Cancer
Sarcomatoid mesothelioma is the least common type of mesothelioma cancer cell and accounts for approximately 10% to 15% of malignant mesothelioma. These cells typically have more of an oval, irregular shape and the nucleus of each cell is not as visible with a microscope as the epithelioid mesothelioma cancer cells. Because of the similarity of appearance, the sarcomatoid cancer cells can also easily be confused with the more typical sarcoma cancer cells. Learn more about sarcomatoid mesothelioma cancer.
Biphasic Mesothelioma Cancer
Approximately 20% to 40% of the mesothelioma cancer cells fall into the biphasic category, which is combination of the sarcomatoid and epithelioid types. The biphasic type can occur with the two types of cells intermixed continuously throughout the tumor, or with them in specific groupings. Transitional areas between the two cell types are often present. Learn more about biphasic mesothelioma cancer.
Prognosis Based on Cell Type
The mesothelioma cancer cell type does affect the prognosis. A study conducted on 167 patients showed that patients had the following mean survival times:
epithelioid
8.5 months
sarcomatoid
7 months
biphasic
6 months
Treatment options are very similar for patients with the different cell types.

Mesothelioma Trials

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Mesothelioma is a relatively rare form of cancer linked to chronic asbestos exposure. There has been a sharp decline in asbestos exposure since the 1970s when asbestos use was halted for most applications. However, the incubation period for mesothelioma from initial exposure to asbestos to the onset of the disease varies from 20 to 50 years. As such, deaths related to this disease have risen recently and are expected to continue rising until the year 2020. This anticipated increase in incidence of mesothelioma has spurred considerable interest in clinical trials to develop better treatments for the deadly disease.

Mesothelioma Clinical Trials
Until recently, clinical trials for mesothelioma were difficult to conduct. The disease had a rapid onset and progression, leading to a relatively short survival period in which to conduct clinical trials. Also, there was a lack of basic understanding about the clinical biology of the disease and how the disease changed during progression.
Specific clinical measures were difficult to obtain in order to demonstrate the response to treatment. Recently, as part of the Alimta clinical trial, researchers developed new metrics that included factors other than just pleural thickening or abnormal breathing capability. A number of new clinical trials are now underway, many of them using these new measurement techniques. Hopefully these trials will lead to ways to stop or reverse the progression of mesothelioma.
Mesothelioma Trial Phases
Clinical trials for evaluating mesothelioma treatments are broken into four parts or phases. These Phases are described below (Source FDA).

Phase IResearchers evaluate a drug or treatment in a small group of people/patients (20 to 80) for the first time to evaluate a drug’s safety, determine the appropriate dosage range and identify side effects.
Phase IIResearchers treat a larger group of people/patients to determine if the drug treatment is effective and safe for the dosage levels determined in Phase I.
Phase IIIResearchers administer the drug or treatment to a large group of people/patients to confirm the effectiveness of the drug and evaluate the drug’s side effects. In this phase, the drug under evaluation will be compared to commonly used treatments. Additionally, researchers use Phase III trials to determine the proper protocol for the use of the drug when it is released for routine treatment.
Phase IVResearchers perform follow-up studies from Phase III, primarily to obtain information that can be used when marketing the drug, such as drug risks, benefits and optimum use.

Background and History

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The history of mesothelioma started in the early 1900s. Mesothelioma history, just as in the discoveries of other major diseases, has a combination of science, politics, medical research and courage. Mesothelioma is a deadly disease that affects the lining of several organs in the body, most commonly the lungs. It is now known that asbestos exposure is the primary cause for this disease; however, for more than 100 years of asbestos mining and production, the link between asbestos and mesothelioma remained obscured.

Lung Disease and Asbestos
In the early 1900s workers at asbestos factories in Britain were experiencing an alarmingly high incidence rate of lung disease. The first reported case of asbestosis in a British asbestos worker occurred in 1906. By the late 1920s, the lung disease problems associated with asbestos mining and production were becoming well known, so much so that the British government commissioned a study in 1930. The study results showed that asbestosis was an occupational disease and was associated with asbestos exposure.
Mesothelioma and Asbestos
The link between lung cancer and asbestos was slower to emerge. While many asbestos workers were dying of lung cancer in the 1930s and 1940s, there was also high growth rate of tobacco use and a high incidence of tuberculosis. Unless an autopsy was performed, it was difficult to determine the exact type of lung cancer that caused death. During this time period, it appears that the asbestos industry officials made little effort to establish the link between asbestos and mesothelioma, even though considerable evidence suggested this link.

The South African Asbestos Mines
After World War II, asbestos mining in South Africa was growing rapidly. South Africa had plenty of cheap labor, and new technology was making asbestos mining much more efficient. Although a well known South African medical researcher noted in 1928 that asbestos exposure could cause danger, he attributed the dangers to asbestos processing, not mining. (South Africa did little processing of asbestos at that time.)
In 1948, South Africa commissioned the first chest and infectious disease hospital in the area of the asbestos mines. The hospital's first medical superintendent, Chris Sleggs, was the first physician anywhere in the world to see a significant number of malignant mesothelioma cases. He noted the presence of atypical cases of lung disease in the wards. Most cases of tuberculosis recovered with treatment, but a few of the cases appeared to be resistant to the drugs. He began to investigate.
Chris Wagner, a medical researcher, became aware of the atypical lung disease in the mid 1950s. He started a research project to better understand the occupational hazards associated with the asbestos mining. Due to the efforts of Drs. Sleggs and Wagner, along with a third researcher, Ian Webster, by the late 1950s, the connection between mesothelioma and asbestos was well documented.
In 1959, these three researchers attended an international conference in Johannesburg, South Africa. They presented papers, based on their research, showing the connection between mesothelioma and asbestos. After the conference, they combined their data and submitted it to a prestigious British medical journal. Their data showed that of the 33 cases of pleural mesothelioma investigated by them, 32 had proven exposure to asbestos mining.

Causes of Mesothelioma

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Asbestos exposure is by far one of the most common causes of mesothelioma. Over 50% of the patients have a history of asbestos exposure. This exposure could occur while directly handling the fibrous material, or it could occur through just environmental exposure.
There are numerous documented cases where patients contracted the disease due to living close to the asbestos mines or by coming in contact with asbestos when some of the fibers became airborne. Persons most commonly afflicted include shipyard workers, construction workers, automobile mechanics (particularly those working on brake linings), insulation workers, pipe and heater installation and flooring workers and roofers.

Also, for those who have had asbestos exposure and who smoke, the risk becomes exaggerated. Studies show that asbestos workers who also smoke are 55 times more likely to die of mesothelioma than nonsmokers without asbestos exposure.
Erionite
Erionite is a mineral that has a long, thin rod-like amphiboles structure. Exposure to this mineral has been associated with increased incidence of mesothelioma. Erionite exposure has a high mortality rate due to mesothelioma in Anatolia, Turkey.
Exposure to asbestos is the primary cause for malignant mesothelioma in most patients. If you or a loved one has been exposed to asbestos, then you are at risk. There is no minimum level of exposure that is deemed safe. Insure that during your routine health care, you advise your doctor of previous asbestos exposure, particularly if you experience any chest pressure, shortness of breath, chest pain or coughing. While these symptoms do not indicate the presence of the disease, they are the most common symptoms and should be further investigated if you have had asbestos exposure.

An Introduction to Mesothelioma

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Malignant mesothelioma is a rare form of cancer that affects the mesothelial cells of the serous membranes in the body. The most common form of mesothelioma, affecting the lining of the lung, is pleural mesothelioma. Two to three thousand new cases of malignant mesothelioma are diagnosed each year.

The mission of All About Malignant Mesothelioma is to provide a one-stop resource for comprehensive, up-to-date mesothelioma information. We cover the full scope of malignant mesothelioma issues including background, history, risk factors, diagnosis, and treatment. Please recommend the site to someone who may benefit from mesothelioma information.
Introduction to Malignant Mesothelioma
Malignant mesothelioma affects the lining or membranes of certain large cavities in the body. These cavities, called the serous cavities, house certain major organs in the body including the heart, lungs, abdomen and others. The membranes that surround these cavities are called the serous membranes. They serve to protect these major organs from the friction and abrasion that occur as the organs move against each other during typical daily functioning, such as breathing and heart beating. The serous membranes derive from specialized cells called mesothelial cells. These cells form to create the mesothelium, which is the major tissue layer of the serous membranes. Cancer that occurs in the mesothelium tissue is called mesothelioma.

Malignant mesothelioma takes on three forms:
Peritoneal mesothelioma, in the peritoneum or membrane surrounding the abdomen. A rare form of peritoneal mesothelioma can also affect the male testicles, because the lining around the scrotum is an extension of the peritoneum.
Pericardial mesothelioma, in the perdicardium or lining surrounding the heart.
Pleural mesothelioma, which is the most common form of malignant mesothelioma and affects the lining of the lung cavity.
All mesotheliomas are now considered to be malignant, or cancerous. They start as a localized tumor and spread rapidly to include most of the surrounding tissues and organs. Originally, fibrous cists and other non-cancerous growths that appeared in the serous membranes were thought to be mesotheliomas and were termed "benign fibrous mesothelioma" and "multicystic mesothelioma." These conditions are now known not to originate in the mesothelial cells, but other cells within the serous membranes. These conditions are typically localized, non-cancerous and do not spread rapidly.
Etiology of Malignant Mesothelioma
Most cases of malignant mesothelioma are associated with a previous exposure to fibrous minerals, of which asbestos is the most important. There is now indisputable evidence of the role of these fibers in the development of this disease. This has been demonstrated in animal experiments and many other experiments. Not everyone who is exposed to asbestos fibers has developed malignant mesothelioma, suggesting that other factors may also be involved.
Although malignant mesothelioma is rare, it is a serious, deadly disease. It is often in the advanced stages when it is detected, so the outlook for the patients is not as good as it is for the cancers that are detected earlier. The average survival time after detection is 1 to 2 years. This survival time also depends on the type of mesothelioma.