How Is Mesothelioma Related to Asbestos?
Asbestos exposure can be blamed for almost all of the 3,000-plus cases of malignant mesothelioma diagnosed every year in the U.S.[1] Most asbestos exposure occurred in the workplace.[2]
Companies used asbestos until the government began regulating it in the 1970s. Workers more likely to have been exposed include industrial workers, sailors, shipyard workers, construction laborers, skilled tradespeople, and miners, among others.
Asbestos exposure is now declining and occurs much less often than it did in the past, thanks to the decrease in its use.[3] But anyone with a history of asbestos exposure can still get a diagnosis of mesothelioma today. This cancer has a long latency period, not appearing for decades after exposure.
What Else Causes Mesothelioma?
Asbestos is the primary cause of mesothelioma, but other factors may also contribute to a diagnosis. In rare cases, a patient may receive a mesothelioma diagnosis with no known exposure to asbestos. Some of the other potential causes or contributing factors include:
- Genetics and family history
- Exposure to radiation from past cancer treatment
- The SV40 virus
- Exposure to a mineral similar to asbestos, called erionite
Which Jobs Have the Highest Risk of Asbestos Exposure?
Many employers in the past exposed workers to asbestos. Some of the workplaces that created the biggest risk of exposure included:
- Factories manufacturing asbestos products
- Building and construction companies
- Automotive repair shops
- Shipping companies, shipyards, and other maritime companies
- Oil refineries and power plants
- Railroads
- Steel manufacturers
- Mining companies
Asbestos use is now much more limited, but some workers are still at risk of encountering old asbestos materials. Currently, workers in the construction trades face the greatest risk of asbestos exposure.
What Are the Types of Malignant Mesothelioma?
Malignant mesothelioma is a cancer of the cells of the mesothelium. The mesothelium is a thin, double layer of tissue lining the chest cavity, abdominal cavity, and heart.[4]
- Pleural mesothelioma is the most common type. It develops in the pleural tissue around the lungs.
- Peritoneal mesothelioma, which develops in the abdomen, is less common.
- One of the rarest types occurs in the tissue around the heart and is called pericardial mesothelioma.
Pleural Mesothelioma
- More than three-quarters of cases of mesothelioma are pleural.[5]
- Exposure to asbestos is usually through inhalation of the fibers into the airways.
- Inhaled asbestos fibers lodge in the pleural tissue and cause damage.
- Symptoms include difficulty breathing, chest pains, coughing, and shortness of breath.
Pericardial Mesothelioma
- This extremely rare form of mesothelioma accounts for just 1% of all cases.
- The primary tumor develops in the pericardium around the heart.
- Treating a cancer so close to the heart is extremely difficult.
- Symptoms include chest pain, difficulty breathing, heart palpitations, fatigue, and coughing.
Peritoneal Mesothelioma
- Peritoneal mesothelioma accounts for less than 20% of all cases.[5]
- It occurs in the peritoneum in the abdominal cavity.
- Symptoms include abdominal pain, swelling or tenderness, and constipation or diarrhea.
- Peritoneal mesothelioma may be misdiagnosed as colitis or irritable bowel syndrome.
Mesothelioma types can also be categorized by the type of cells in the tumor.[6]
- Epithelioid: This is the most common type and has the best prognosis and life expectancy.
- Sarcomatoid: Less common and more aggressive than the epithelioid type, these cells grow and spread rapidly. The prognosis is worse.
- Biphasic or Mixed: This type is a mix of epithelioid and sarcomatoid cells.
What Are the Symptoms of Mesothelioma?
Most patients with mesothelioma experience no symptoms or mild symptoms for many years.[2] The early symptoms are similar to those of more common illnesses.
Only when mesothelioma tumors grow larger and begin to spread do symptoms worsen.[4]
The later stages of mesothelioma cause symptoms more typical of other types of cancer: weight loss, fatigue, fever, and persistent pain, swelling, or feelings of fullness in peritoneal mesothelioma.
How Is Malignant Mesothelioma Diagnosed?
Physical Examination
The first step is a physical examination, usually by a patient’s regular physician. This helps rule out more common conditions.
A doctor examines the patient and tests for certain conditions while also taking a medical history.
In addition to characteristic symptoms, it is important to discuss the possibility of past asbestos exposure.
Imaging Scans
Next, patients undergo one or more imaging scans.[7] An X-ray can rule out pneumonia and other non-cancerous lung diseases.
MRIs and CT scans provide a more detailed look at soft tissues. These scans can help doctors find areas of abnormal tissue that may be cancerous.
Biopsy
If an image shows abnormal tissue that could be malignant, the next step is a biopsy to determine if the tissue is malignant. [7]
To perform a biopsy, a doctor takes a sample of cells from the area of abnormal tissue. A pathologist examines the cells under a microscope to look for signs of malignancy and to identify the cancer type.
There are a few types of biopsies:[8]
- A fluid biopsy removes fluid from between the pleural or peritoneal tissue layers. This is not the most definitive way to diagnose cancer.
- A needle biopsy is more accurate. Doctors insert a long needle into the area to remove a small sample of tissue.
- If the needle sample is inconclusive or the abnormal tissue is too difficult to reach, doctors may need to perform a surgical biopsy to remove tissue and cells.
The Stages of Mesothelioma
A complete cancer diagnosis includes staging.[8] Mesothelioma is staged from one through four. One is the earliest stage with the least progression of the disease. Four is the most advanced stage with significant progression.
Specialists stage cancer based on the size of the tumor, the number of lymph nodes involved, and if the cancer has spread to other organs. The stage helps doctors create the best treatment plan and gives the patient a more detailed prognosis.
Stage I
Stage I mesothelioma patients have the best chance of long-term survival. Few patients receive a diagnosis at this early stage because symptoms are often non-existent or mild, including coughing, fever, chest pain, breathing difficulties, and general fatigue. Early patients have several treatment options, including aggressive surgery. They have the best overall prognosis.[5]
Stage III
By stage III, the cancer has spread more extensively throughout the chest cavity or abdomen, depending on the type. Treatment may shift to palliative care. Extending survival time is difficult but possible. Symptoms include severe chest pain, weight loss, night sweats, coughing, fatigue, and other uncomfortable symptoms.[5]
Can Mesothelioma Be Cured if Caught Early?
Early-stage mesothelioma has the best prognosis, but there is no cure for mesothelioma. This doesn’t mean people don’t survive it. Researchers and specialists continue to develop better ways to manage the disease, resulting in longer life expectancy and improved quality of life for patients.
No single treatment cures mesothelioma, but some patients achieve remission with the right combination of therapies and other factors. Multimodal treatment in early-stage patients provides the best chance for remission.
Emerging and innovative treatments like gene therapy, immunotherapy, vaccine therapy, and others are changing the game for mesothelioma patients, even if none represent a definitive cure.
What Are the Options for Mesothelioma Treatment?
Treatment plans for mesothelioma vary depending on the needs, limitations, and preferences of each patient. Treatment also depends on the type and stage of the cancer.[9] Mesothelioma is aggressive and spreads fast. Diagnosis usually comes in the later stages, which limits treatment options.
Typical treatment plans are multimodal, including two or more strategies. The standard options are surgery, chemotherapy, and radiation therapy.
Palliative care is an important aspect of mesothelioma treatment. It includes hospice and end-of-life care but also treatments and therapies to improve the quality of life for patients at any stage.
Palliative care providers enrich and strengthen the care provided by an oncologist and surgeon. They are experts in pain and symptom management and can help support important decision-making and patients’ goals. Patients with advanced cancers who are not eligible for surgery or chemotherapy need more palliative care services.[10]
Surgical Treatment
The goal of surgical treatment for mesothelioma is to remove as much of the cancerous tissue as possible.
Treatment plans often combine surgery with chemotherapy and radiation to eliminate cancer cells that the surgeon could not remove or to shrink tumors ahead of surgery.[7]
Not all patients are eligible for surgery. Surgery may extend life expectancy, or in rare cases, lead to remission.
Some surgical procedures relieve symptoms and are a part of palliative care.
Chemotherapy
Chemotherapy uses drugs that target and destroy fast-growing cancer cells to shrink tumors.
Chemotherapy is the most common treatment for mesothelioma patients.
An exciting and effective new treatment for peritoneal mesothelioma uses a heated solution of chemotherapy drugs circulated in the abdominal cavity.[9]
Radiation Therapy
Radiation therapy uses high-energy beams of particles to destroy tumors and cancer cells.
Radiation is traditionally delivered externally by aiming the beam at the tumor site.[9]
To minimize damage to healthy tissues and to target tumors more directly, some patients may receive internal radiation therapy.
Some patients benefit from adding complementary and alternative therapies to a traditional treatment plan.
Examples include acupuncture, gentle massage, exercise, yoga, aromatherapy, and consultation from an oncology dietitian. These may help manage symptoms and side effects of living with mesothelioma: pain, anxiety, fatigue, and others.[9]
What Is the Prognosis for Mesothelioma Patients?
A patient’s prognosis depends on the average life expectancy for each stage of the cancer. Typical life expectancy by stage is based on the experiences of past patients.[11]
Other factors influence prognosis:[8]
- Patients with early-stage mesothelioma have a better prognosis than those in the later stages.
- The type of mesothelioma, by cell and location, impacts prognosis. Those with peritoneal disease generally have better survival rates than pleural mesothelioma, for instance.
- Age and overall health affect outcomes. Younger, healthier patients have a better prognosis.
- When surgery is still a treatment option, patients who choose a more aggressive procedure generally have a better prognosis.
How Does Someone Die from Mesothelioma?
For many patients, mesothelioma is a terminal cancer. This is a distressing fact to face, both for the patient and their loved ones. It may help to have a better understanding of what to expect.
Talk to your medical team and consider joining support groups for terminal cancer to get more information. Symptoms worsen as the disease progresses. You may experience more fatigue, increased pain, confusion, loss of appetite, and difficulty breathing.
It’s important to consider palliative care in the late stages of mesothelioma. It may be terminal, but the right treatments and therapies can make you more comfortable and improve your quality of life for the time you have left.
How Do I Find the Best Doctor?
See your general practitioner first to rule out more common illnesses. Don’t be afraid to get a second opinion if you feel your doctor is not taking your concerns seriously, especially if you know you have been exposed to asbestos.
If you receive a mesothelioma diagnosis, find a specialist as soon as possible. This is a rare type of cancer that even many oncologists have never encountered. A mesothelioma specialist can provide the best care and treatment options as part of a multi-disciplinary team.
How Do I Find the Best Treatment Facility?
Many specialists in mesothelioma work as part of multi-disciplinary teams at cancer treatment centers. These facilities include units or departments with teams that focus entirely on mesothelioma diagnosis, treatment, and research.
A good place to start your search is at the National Cancer Institute (NCI).[12] The NCI lists several facilities throughout the country as Designated Cancer Centers. Several of these employ mesothelioma specialists.
Are There Clinical Trials for Mesothelioma?
- Approved Protocol
- Investigator Selection
- Approval Process
- Patient Recruitment & Participation
- Data Entered & Reviewed
- Statistical Analysis
- Presentation & Publication Report
- Data Field & Registration Obtained
NCI Cancer Centers and other mesothelioma specialty treatment facilities often give patients access to clinical trials.[13]
Clinical trials study experimental medications, therapies, and procedures. They give patients the opportunity to try new treatments, not yet available to everyone.
For aggressive cancers like mesothelioma, with limited options for a cure, clinical trials can be a ray of hope for patients. Your specialist can help you determine if you are eligible for any trials.
What Are My Options to Pay for Mesothelioma Treatment?
Treatment costs for mesothelioma skyrocket quickly. Take advantage of any resources available, including legal actions for compensation.
If your health insurance coverage is limited, consider other resources:
- Funding from nonprofit advocacy groups and charities
- Disability or workers’ compensation insurance
- Veterans benefits
- Lawsuits against companies that made asbestos products
- Claims to trust funds set up by companies that exposed workers
What Is the Mesothelioma Trust Fund?
Mesothelioma or asbestos trust funds are financial resources for people who get sick after being exposed to asbestos on the job. These funds were established by companies responsible for asbestos injuries to workers and their families.[14]
You may qualify for compensation from an established trust fund even if you aren’t sure where you were exposed to asbestos. For most people, it was on the job.
Getting Benefits for Veterans with Mesothelioma
Mesothelioma patients who experienced asbestos exposure while serving in the United States military may receive compensation and free healthcare.[15]
Veterans are at the greatest risk of developing mesothelioma because of the heavy use of asbestos in barracks, equipment, vehicles, and ships.
Asbestos use in the military peaked between 1935 and 1975. The U.S. Navy used more asbestos than any other branch.[16]
Applying for VA benefits can be complicated and confusing. Rely on an experienced attorney for guidance. You may also be able to file a lawsuit against the manufacturers of the asbestos-containing materials you used during your time in the military.
How Do I Find the Best Mesothelioma Lawyer?
Immediate treatment should be your top priority after receiving a mesothelioma diagnosis. But you may also need legal assistance.
You have a right to seek compensation through legal means if exposed to asbestos.
A lawyer experienced with asbestos cases can help you determine your rights and what legal steps you can take to seek compensation.
Look for an attorney or law firm with experience in handling asbestos cases and a proven track record of securing compensation for victims. Be sure you feel comfortable working with the lawyer you choose and that they will devote time and effort to your case.
Can’t Afford a Lawyer?
Most people undergoing expensive mesothelioma treatments aren’t able to pay attorney fees. This is why reputable, experienced lawyers in asbestos cases never charge anything up front.
They work on a contingency basis. This means that you pay nothing at all until your lawyer wins your case. Your lawyer then takes an agreed-upon percentage of your compensation.
Be sure to do your research on fees before retaining legal help. Lawyer fees vary.
Will I Go to Trial?
Most mesothelioma lawsuits end in settlements and never go to trial. Your attorney will investigate your case, provide proof of your injuries to the defense, and help negotiate a settlement amount on your behalf.
Only if an agreement cannot be reached by both sides will your case go to trial.
It is rare to have to go to court for mesothelioma. However, if you are too ill to go, your lawyer can make accommodations. For example, some plaintiffs have given their testimony via video from the comfort of their homes. Your legal team does most of the hard work in a trial.
Frequently Asked Questions
