Mesothelioma is a rare and aggressive cancer caused almost exclusively by exposure to toxic asbestos fibers. An estimated 3,000 patients are diagnosed annually in the United States.

Pleural mesothelioma, the most common form of the cancer, accounts for almost 75 percent of cases. It begins in the pleura, a thin membrane that surrounds the lungs. When tumors form, it typically leads to serious respiratory distress.

There is no definitive cure for pleural mesothelioma, although recent therapeutic advances and an aggressive, multidisciplinary approach to treatment have allowed some patients to survive and thrive three, four, five or more years beyond their initial prognosis.

The typical prognosis, though, is still just 6 to 18 months.

Diagnosis Is Difficult

A major hurdle in treatment stems from an inability to diagnose mesothelioma in the early stages when it can be more effectively treated.

The length latency period (20 to 50 years) between first exposure to asbestos and actual diagnosis is why it is typically found during a person’s senior years.

The majority of pleural mesothelioma cases stem from occupational exposure when microscopic asbestos fibers are unknowingly inhaled or ingested.

The fibers become lodged in the pleura and cause irritation, chronic inflammation, scarring and genetic damage that slowly develops into the deadly cancer. One of the symptoms is a fluid buildup between the lungs and the membrane, making it increasingly difficult to breath.

Even as mesothelioma advances, diagnosis is difficult. Early symptoms, such as shortness of breath, dry hacking cough and chest discomfort, often mirror those of less serious problems.

The rarity of the cancer also means many doctors never see it and struggle to recognize mesothelioma until it has metastasized throughout the thoracic cavity. Other doctors will misdiagnose early symptoms as the flu or pneumonia and bypass the extensive testing that a diagnosis requires.

The diagnostic process typically involves:

• Chest X-rays
• Blood tests
• CT and PET imaging scans
• Thoracoscopy (a type of tissue biopsy)

Even after a multitude of tests, it’s not unusual for an oncologist still to confuse it with lung cancer, which is treated differently.

“This isn’t lung cancer,” said Dr. Abraham Lebenthal, thoracic surgeon and mesothelioma specialist at Brigham and Women’s Hospital in Boston. “To understand the subtleties of mesothelioma, you need an expert.”

Pleural Mesothelioma in Indiana

The state of Indiana ranks 21st in the country when it comes to mesothelioma deaths. Many of the cases were attributed to Indiana’s numerous manufacturing industries that once used an abundance of asbestos-containing materials.

Treatment

Pleural mesothelioma is best treated — and also best diagnosed — at a specialty center that deals with it regularly.

The most effective treatment approach is multimodal treatment, which combines two or more of the traditional treatments such as chemotherapy, surgery and radiation. Patients also benefit from a multidisciplinary approach, involving a team of experienced specialists.

While aggressive surgery has proven effective, less than half of those diagnosed are surgical candidates. If the cancer already has metastasized, which is often the case, the best treatment is palliative care.

There also are complementary therapies that include an integrative approach, which attempts to treat the whole person beyond the disease. The goal with integrative medicine is improving the quality of life.

The Pleural Mesothelioma Center is available to provide information and support for anyone needing help with this disease. The free services include locating mesothelioma specialists, providing financial help and answering any questions you might have.

Sources

Indiana Department of Environmental Management. (n.d.). Asbestos. 

U.S. Centers for Disease Control and Prevention. (1985). HHE Report No. HETA-84-151-1544, Nuturn Corporation, New Castle, Indiana. 

Centers for Disease Control and Prevention, National Center for Health Statistics. (2015, January). Underlying Cause of Death 1999-2013 on CDC WONDER Online Database.