How Asbestos Exposure Occurs

People who worked for an extended period of time in an environment where asbestos dust was regularly released are at greatest risk for pleural mesothelioma. The body's natural defense mechanisms successfully clear many asbestos fibers, but when asbestos exposure is heavy, these defense systems are overwhelmed. Mucus within the airways traps asbestos fibers and other toxins that are inhaled. These trapped foreign particles are either swallowed or coughed up.

These fibers travel to the lungs and become imbedded in the lung lining, outside of the lungs and inside the ribs. These long, pointed fibers can reach the pleural lining of the chest wall and lung. Once the fibers have penetrated the pleura they injure the mesothelial cells. When these jagged particles settle in the pleura, they cause inflammation. The inflammation, in turn, can lead to dangerous cancerous tumors. In some cases, those who've inhaled asbestos fibers will first develop the less-severe asbestosis, followed by mesothelioma several years later.

Upon diagnosis, patients usually exhibit multiple tumor masses affecting both the visceral (further from the lung) and parietal surfaces (closer to the lung) of the pleura. The parietal surface is more often affected than the visceral surface, and the right lung, due to its larger size, often suffers more damage than the smaller left lung. In addition, more asbestos tends to settle in the lower lungs than the upper lungs.

These tumors often grow quickly in size and can cover the entire lung cavity, making it very difficult to breathe and causing excruciating pain. Also, in the advanced stages of pleural mesothelioma, the cancer may spread to other nearby organs, including the heart, abdomen, and lymph nodes.

The tissue changes leading to mesothelioma occur slowly. The symptoms of mesothelioma generally do not appear for 20 to 30 years after the initial asbestos exposure. A latency period of up to 50 years has been known.

This is a Pleural Mesothelioma Symptoms !!!

Pleural mesothelioma patients display all three types of mesothelioma cancer cells: epithelioid mesothelioma, sarcomatoid mesothelioma and biphasic mesothelioma.

Once trapped in the body, asbestos fibers cause cancerous cells to divide abnormally, resulting in the thickening of the pleural membrane layers and mesothelial cells, causing build-up of fluid (called pleural effusion). The fluid begins to put pressure on the lungs and the respiratory system in general, preventing normal breathing.

Symptoms of pleural mesothelioma are largely caused by these developments and may include the following:

- Persistent dry or raspy cough

- Coughing up blood (hemoptysis)

- Difficulty in swallowing (dysphagia)

- Breathlessness (dyspnea)
Shortness of breath that occurs even when at rest. Along with shortness of breath, patients may suffer from a cough. Rarely, patients may develop hoarsness or cough up blood (hemoptysis).

- Chest pain
Chest pain is often nonspecific, and may sometimes be felt in upper abdomen, shoulder, or arm. Chest pain and breathlessness are the most common, and usually earliest presenting, symptoms of pleural mesothelioma. Persistent pain in the chest or rib area, or painful breathing.

- Pleural effusion
A pleural effusion is the result of too much fluid building up between the parietal and visceral pleura (linings of the chest and lungs, respectively); a pleural effusion may cause chest pain and difficulty breathing (dyspnea), however, many cause no symptoms and are first discovered during the physical examination or seen on a chest x-ray.

- Development of lumps under the skin on the chest

- Night sweats or fever
Less common, but still cited enough to be considerd a symptom of pleural mesothelioma are fever, chills, and night sweats.

- Weight Loss
Unexplained weight loss is cited as a symptom in about a third of pleural mesothelioma cases.

- Fatigue


Pleural Mesothelioma Diagnosis

As with other types of mesothelioma, pleural mesothelioma is difficult to diagnose since symptoms do not typically arise for some time after initial asbestos exposure occurs. Additionally, since the symptoms of pleural mesothelioma are typical of many illnesses, in the early stages of the cancer the symptoms are often mistaken for less threatening diseases such as influenza and pneumonia.

X-rays or CT-Scans are often used to diagnose pleural mesothelioma.
A pleural mesothelioma diagnosis is made partly on the basis of symptoms but additional diagnostic tests are needed to confirm the presence of cancer. Following a medical history review and physical examination, patients must typically undergo imaging tests, such as x-rays or CT scans, to confirm the location of cancer. A patient must also usually endure fluid and tissue tests, also known as biopsies, to confirm the type of cancer involved.

Pleural effusions and peritoneal effusions are experienced by two-thirds of patients. Hemothorax - the collection of blood in the pleural cavity - also is a symptom. To get a diagnosis, doctors use imaging technologies as well as histological analysis and molecular biologic analyses. A pleural smear examines a sample of pleural fluid under the microscope to detect for abnormal organisms. The test is performed when infection of the pleural space is suspected or when an abnormal collection of pleural fluid is noticed by chest X-ray. Sometimes the tumor grows through the diaphragm, making the site of origin difficult to assess.



Top left, A: posterior-anterior chest radiograph in a patient with malignant pleural mesothelioma demonstrating significant right-sided pleural effusion and diffuse pleural thickening associated with marked volume loss of the right hemithorax. No definite pleural plaques are seen. Top right, B: CT image from a patient with a right-sided pleural mesothelioma, illustrating complete encasement of the ipsilateral lung with a thick rind of tumor, neoplastic invasion of the interlobar fissures, small residual pleural effusion, and marked unilateral volume loss. Center, C: MRI with transaxial, sagittal, and coronal views from a patient with a right-sided pleural mesothelioma. MRI may be most beneficial in the determination of chest wall, mediastinal, and diaphragmatic invasion. Bottom, D: PET scan with 18-FDG in the same patient as in center panel (C) with transaxial, sagittal, and coronal views. 18-FDG PET scanning in mesothelioma can aid in tumor staging, localization of biopsy sites, and distinguishing between pleural fibrosis and active malignant tissue. (resource : chest journal)

malignant pleural mesothelioma treatments

Have you been suffering from constant coughs and chest pains lately? Or are you beginning to have difficulty breathing? Then you should go and see your doctor right away. You might be suffering from the symptoms of malignant pleural mesothelioma. Unfortunately, by the time the symptoms do appear there is little chance that this cancer can be fully cured.

Still, there are 3 ways by which the spread of this cancer can be slowed down. Here is a short explanation of these 3 ways:

* Chemotherapy. This method of treatment is commonly used for most kinds of cancer. While it cannot remove the cancer from your body, it will prevent the cancer from growing and spreading, to a certain degree. This treatment must be done continuously. It is quite painful and expensive, but it is effective in prolonging one’s life.

* Radiotherapy. In this treatment, radiation is used to prevent the spread of cancer cells in one’s chest wall. While this will not cure your cancer, it will prevent other possible health hazards such as the blocking of a blood vessel. This method also goes a long way in relieving the painful symptoms of pleural mesothelioma.

* Surgical Removal. In this method, the certain parts of your body infected by the cancer will be removed in order to prevent it from spreading throughout your body. This is the most effective means of treating the cancer, but it can only be done during early stages of the cancer—before it spreads throughout your body.

You can choose to undergo one or more of these treatments for cancer depending on how much the disease has spread. It is important to keep in mind that none of these treatments have been proven to stop the cancer completely. The disease was just discovered recently, so the cure should arrive sometime soon.

Keep in mind that these treatments are very expensive. And you shouldn’t even be the one paying for the medical bills you will incur. Instead it should be your employer shouldering the bills for you. It is your employer’s responsibility to ensure that the workplace is safe for all his employees.

Unfortunately, most owners of asbestos factories don’t care to keep the workplace safe. If your employer refuses to give you compensation then you should hire a lawyer to help you with your case. He has already caused your death. The least he can do is help you prolong your life. Take steps in treating your malignant pleural mesothelioma now!!!

Malignant Pleural Mesothelioma

Although the insulating properties of asbestos have been known for millennia, the link between asbestos exposure and mesothelioma was not recognized until 1960, when it was first described in South African asbestos miners. The incidence of mesothelioma parallels asbestos usage with a latency of 20 to 40+ years; thus, patient numbers are declining in the United States but rising in the developing world. Radiation, genetics, and possibly simian virus 40 are less common causes. Diagnosis can be challenging, since the results of pleural fluid cytology testing are often negative despite repeated sampling.

No staging system adequately predicts prognosis in the unresected patient. Newly described biomarkers, including soluble mesothelin-related peptide, megakaryocyte potentiation factor, and osteopontin, may predict which asbestos-exposed individuals will develop mesothelioma, and may prove useful in assessing response to treatment. Since surgery cannot eradicate all residual microscopic disease, a multimodality approach is encouraged. 

Metaanalysis suggests that pleurectomy/decortication may achieve outcomes similar to those of extrapleural penumonectomy. The standard first-line chemotherapy for unresectable disease is pemetrexed plus cisplatin. This combination improves response, survival, time to progression, pulmonary function, and disease-related symptoms. Carboplatin is often substituted, with similar results. Other active agents include raltitrexed, gemcitabine, and vinorelbine. Novel agents in clinical trials include inhibitors of the epidermal growth factor receptor, vascular endothelial growth factor, mesothelin, and histone deacetylases. Although disappointing results of early trials did not confirm promising preclinical data, recent studies have suggested that some novel agents may be effective. As we learn more about mesothelioma biology, molecularly targeted agents may become treatment options. 

About 2,500 Americans will be given a diagnosis of malignant mesothelioma this year. Though once viewed with a nearly universal nihilism, recent advances have changed this outlook considerably. This review will provide a brief overview of recent progress that has been made in the diagnosis and treatment of this disease.