More than 3,000 Americans are diagnosed each year with mesothelioma, a rare kind of cancer that primarily affects the middle layer of the tissues that cover body organs and cavities. And like any other cancer, the development of mesothelioma can take anywhere from 20 to 50 years after exposure to the principal carcinogen. Unfortunately, 4 out of 5 cases of mesothelioma has been directly related to prolonged exposure to asbestos.
Each molecule of asbestos is composed of fibrous crystals which, in turn, are composed of even smaller, microscopic fibrils. In 1977, Stanton and Layard hypothesized that the microscopic fibrils can disrupt mitosis or cellular division. It was hypothesized that the very slim fibers of asbestos can get entangled with the chromosomes in the nucleus of cells leading to a disruption in normal cell division. Because the chromosome has been damaged, the resulting daughter cells carry a dysfunctional chromosome, which gives rise to an entirely new kind of cell: a neoplastic cell. Over time, this neoplastic cell further subdivides into numerous cells until it forms one cancerous mass. This is the birth of mesothelioma.
But why the mesothelium? The mesothelium is a layer of special types of cells that line internal organs and body cavities. The most commonly affected mesothelium are those found in the lining of the lungs (known as the pleura) and the chest wall. In some cases, the lining of the heart and the abdomen are also affected. Seven out of 10 mesothelioma cases occur in the pleura where asbestos can have its immediate effect.
When an individual inhales asbestos-laden air, the microscopic fibrils of asbestos are able to diffuse from the air sacs of the lungs and lodge into the mesothelial lining of the pleura. The millions of asbestos fibrils cause cellular damage primarily at the chromosome level where they alter the conformation of the chromosome. And since the chromosomes contain the genetic material with which to create identical daughter cells, the resulting daughter cells are a bit different from the parent cell. This sets the stage for the development of cancer – in this case, mesothelioma – which takes 2 to 5 decades before any significant clinical manifestations can be identified.
Studies now show that the single most prevalent cause of mesothelioma is asbestos exposure. As such, people who are at increased risk for developing mesothelioma are the following:
Cancers, because they occur at the cellular level gradually increasing in the number of damaged cells, take time to develop. Mesothelioma takes about 2 to 5 decades before signs and symptoms begin to manifest. Unfortunately, by then it will be too late as the cancer will already be in its advanced stages. Nevertheless, the most common indicators of mesothelioma include the following:
These symptoms are not conclusive of mesothelioma since there are many other disease conditions that can bring about such manifestations.
Diagnostic imaging technologies can only point to a possible existence of mesothelioma. Chest x-rays, CT scans, and MRIs can only provide a picture of the existing state of the mass. Additionally, if there is abnormal accumulation of fluid, then this will have to be drawn out from the affected body part. The drained body fluid is then examined for any of the distinguishing characteristics of mesothelioma cells. If mesothelioma is to be confirmed, tissue biopsy is needed. For patients with suspected pleural mesothelioma, a thoracoscopy may be performed. If the mesothelioma is in the abdomen, a laparoscopy can be performed to obtain a tissue sample from the suspected mesothelioma.
Furthermore, mesothelioma may have to be differentiated from other types of cancer such as lung or breast cancer which may have metastasized to the pleura. In such cases immunohistochemistry tests may have to be performed.
The staging of the mesothelioma is also needed which takes into consideration the primary tumor, the node involved, and any metastatic tendencies. Mesotheliomas are typically staged I to IV.
The earlier the mesothelioma is diagnosed, the better the prognosis. Even though there are a variety of treatments, these cannot reverse the course of the cancer. Chemotherapy with cisplatin combined with pemetrexed, folate, and vitamin B12 can improve the prognosis by an average of 3 to 4 months. Surgery and radiation therapy are not considered curative either, although radiation therapy combined with chemotherapy can add a few more months. Newer treatments such as the use of alpha interferons and other immunotherapies are being investigated. Heated intraoperative intraperitoneal chemotherapy has also been performed with varying results on patients with peritoneal mesothelioma.
Generally, the prognosis for mesothelioma is poor with a median survival time of 10 months for pericardial mesothelioma and 12 months for the pleural type of mesothelioma. Nevertheless, there have been cases of remarkable mesothelioma survivors including Stephen Jay Gould, who was diagnosed in 1982, but survived his mesothelioma for another 20 years before succumbing to an entirely different form of cancer.
It is believed that industry knew of the dangers of asbestos as early as the 1920s but chose not to divulge the information to the public. The first lawsuits against manufacturers of asbestos were in 1929. Since then, individuals exposed to asbestos have been filing lawsuits and collecting damages for a variety of asbestos-related health conditions such as mesothelioma. Mesothelioma victims are frequently inundated with advertisements from law firms unfamiliar with asbestos litigation or Louisiana law. It is extremely important to seek legal advice from a competent, Louisiana-based lawyer who specializes in mesothelioma and asbestos-related personal injury cases.
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