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Mesothelioma Overview

Mesothelioma is an aggressive cancer caused almost exclusively by exposure to asbestos. People diagnosed with this disease and their families may be eligible to file lawsuits for compensation.

Hidden Dangers of Asbestos

This rare cancer most commonly affects the lining of the chest and lungs (pleural mesothelioma) or the lining of the abdomen (peritoneal mesothelioma). In the vast majority of cases, workplace exposure to asbestos — a toxic mineral — triggers development of the disease.

By the late 1980s, safety concerns prompted a drastic decline in the once-widespread use of asbestos, yet approximately 3,000 new cases of mesothelioma are diagnosed in the United States each year. Exposure that occurred decades ago continues to injure victims because the disease can take between 20 and 50 years to develop. Asbestos exposure can also cause other serious illnesses, such as lung cancer and asbestosis.

Asbestos has a natural ability to resist heat, flame, electricity and corrosion, which lent itself to a variety of commercial and industrial uses. Manufacturers incorporated the material into thousands of products, including pipes, furnaces, textiles, brake linings and a multitude of building materials.

temperature gauge

Workers across dozens of industries faced perilous clouds of asbestos dust during nearly every phase of production. The risk for mesothelioma is greatest for those who handled or processed raw asbestos daily, especially miners and factory workers. Shipyard workers and Navy veterans also faced substantial health risks from asbestos products, which were used aboard ships built from the 1920s to the 1970s.

illustration of cloud

Despite the availability of safer alternatives with the same fire-resistant properties as asbestos, most companies still preferred to use asbestos for its affordability. Manufacturers and others in the asbestos industry knew about the serious health risks of asbestos for decades, yet never publicized the dangers. This dishonesty and blatant disregard of public health have cost companies billions of dollars in asbestos lawsuits and settlements and have driven nearly 100 companies into bankruptcy.

cash illustration

How Does Asbestos Cause Mesothelioma?

The pervasive use of asbestos in commercial, industrial and household settings in the 20th century has, to some degree, exposed nearly every person in the world to the airborne carcinogen. While the overall risk of asbestos exposure is usually minimal, heavy and repeated exposure -- once typical in occupational settings -- is far more dangerous.

When a person inhales asbestos, microscopic fibers can travel to the ends of small airways and become lodged in the lining of the lungs. Over time, this can cause scarring and genetic changes that lead to pleural mesothelioma. If the fibers are coughed up and swallowed, or ingested with contaminated drinking water, the fibers can penetrate the lining of the abdomen and cause peritoneal mesothelioma.

Mesothelioma Symptoms

The rarity of mesothelioma makes it a challenging cancer for doctors to diagnose. Unless patients immediately reveal a history of asbestos exposure, doctors may confuse mesothelioma symptoms with those of more common and far less serious diseases.

Most patients with mesothelioma first see a doctor because of painful or troublesome symptoms, such as shortness of breath or a cough.

Other mesothelioma symptoms include:
Pain in the side of the chest, lower back or abdomen Hoarseness
Difficulty swallowing Fever
Weight loss Nausea

Diagnosis of Mesothelioma

Unfortunately, mesothelioma rarely causes symptoms early on. Many patients with mesothelioma ignore the symptoms at first, mistaking them for minor problems. It’s fairly common for mesothelioma patients to experience symptoms for several months before diagnosis.

In the first step of diagnosis, doctors perform a physical exam and ask about medical and occupational histories. The doctor may also perform pulmonary function tests (PFTs) to determine how well the lungs are working. If the doctor’s questions and exams suggest mesothelioma, the diagnosis needs to be confirmed with other tests, including imaging scans, biopsies or blood tests.

Doctors typically perform chest X-rays first. If the results show an abnormal growth, which may indicate the presence of a mesothelioma tumor, the doctor will likely order other scans. More detailed imaging scans for detecting mesothelioma include the computed tomography (CT) scan, magnetic resonance imaging (MRI) scan or the positron emission tomography (PET) scan.

Even with positive imaging scan results, doctors cannot make a diagnosis without testing a tissue sample. This process is known as a biopsy. There are several biopsy techniques, but all serve the same purpose: They allow doctors to remove samples of tissue or fluids to inspect. A medical specialist called a pathologist looks at the samples under a microscope to determine if the patient has cancer. Biopsy results can reveal the presence of cancer, its type and other information that will be crucial for treatment.

Mesothelioma Staging

After analyzing the results of physical exams, imaging tests, biopsies and other tests, doctors assign the cancer a stage that describes how far it has spread. Knowing the cancer’s stage helps doctors determine which treatments will be most effective.

Doctors stage pleural mesothelioma with a formal system called the International Mesothelioma Interest Group (IMIG) system. There is no formal staging system for peritoneal mesothelioma. The IMIG system uses Roman numerals to divide the cancer into four stages, ranging from I to IV. More advanced cancers have a higher stage.

Doctors consider several factors when determining the stage of a patient’s mesothelioma, including:
The size and location of the primary tumor
Whether cancer has spread to nearby lymph nodes
Whether cancer has spread to other parts of the body (metastasis)

With this information, doctors can decide which treatment options will provide the greatest benefit. In addition to the stage of the cancer, doctors also consider the cellular subtype of mesothelioma and overall health of the patient when selecting a course of treatment.

Mesothelioma Treatment Options

Because mesothelioma is such an uncommon cancer, few doctors and oncologists have experience treating it. For the best treatment results, it is crucial that patients seek a mesothelioma specialist who has extensive experience treating the disease. Numerous treatment centers throughout the United States provide a team of experts that specialize in mesothelioma treatment, including Brigham and Women’s Hospital in Boston and Memorial Sloan-Kettering Cancer Center in New York.

Several types of treatments are available to patients with mesothelioma. Because no single course of treatment works best for everyone, mesothelioma specialists create individual treatment plans for each patient. When planning treatment, doctors consider the patient’s cancer stage, mesothelioma subtype, overall health and ability to perform daily activities.

The standard therapies for mesothelioma include surgery, chemotherapy and radiation therapy. Medical experts also explore new treatment options in research studies called clinical trials. Most patients are encouraged to apply for clinical trials if they meet the requirements.

Surgery

Doctors perform mesothelioma surgery in an attempt to cure the cancer or to relieve painful symptoms. While not every patient will qualify for curative surgery, other surgical treatments may improve survival. With a technique called cytoreductive surgery, for example, doctors can extend survival by removing as much of the cancerous growth as possible.

In one common surgery for pleural mesothelioma called pleurectomy, surgeons remove the part of the pleura that contains the mesothelioma. Another surgical option for mesothelioma patients is extrapleural pneumonectomy, in which surgeons remove an entire lung, part of the lining of the chest, the diaphragm and sometimes the lining of the heart. Because there is no conclusive evidence that shows which surgery is better, doctors consider many factors before recommending a procedure.

surgery room

Chemotherapy

Chemotherapy uses drugs, either in the form of tablets or intravenous injections, to kill mesothelioma cancer cells and prolong survival. Doctors often deliver this treatment option before surgery to shrink tumors (neoadjuvant chemotherapy) or after surgery to prevent the cancer from returning (adjuvant chemotherapy). They may also offer chemotherapy on its own or in combination with other treatments, such as radiotherapy.

Doctors administer chemotherapy in cycles that may involve a single drug or several drugs given simultaneously. For patients with pleural mesothelioma, doctors typically prescribe a drug combination of Alimta and cisplatin for first-line treatment. Doctors may deliver chemotherapy drugs directly into the abdomens of peritoneal mesothelioma patients before or after surgery. When choosing a chemotherapy treatment plan, doctors consider the type of mesothelioma, its location and extent of spread, and the patient’s age and overall health.

chemotherapy IV

Radiation Therapy

Radiation therapy kills cancer cells using targeted, high-energy rays. Doctors sometimes perform this treatment after surgery (adjuvant radiation therapy) to kill areas of cancer that were too small to detect and remove during surgery. Because radiation therapy can reduce the size of tumors, the treatment can also help alleviate bothersome symptoms caused by local cancer spread, such as pain, difficulty swallowing and shortness of breath.

While radiation therapy is helpful for preventing the return of pleural mesothelioma after surgery, doctors use it less frequently for peritoneal mesothelioma treatment because of the potential side effects. Most mesothelioma patients receive external beam radiation therapy (EBRT), which uses a machine outside of the body to deliver the radiation. Before treatment, a special doctor called a radiation oncologist will use imaging scan results to shape the beams of radiation and determine the proper dose.

radiation treatment
Factors Associated with a Better Prognosis
Early stage cancer
Epithelial subtype
Good health and performance status
Younger age
Female patient
No chest pain
No significant weight loss
Normal levels of red blood cells, white blood cells and blood platelets

Mesothelioma Survival Rates

Because mesothelioma is highly aggressive and doctors rarely diagnose patients before the cancer has reached an advanced stage and spread, survival is typically poor. According to medical literature, the average survival time for mesothelioma patients ranges from four to 18 months. When discussing the prognosis (survival outlook) of patients with pleural or peritoneal mesothelioma, doctors typically tell patients they have about a year to live.

However, it’s important to understand that survival statistics are drawn from past clinical trials that combine the results of a large number of patients. Each person’s cancer is unique, and generalized survival rates do not reflect the survival benefits of important factors that affect prognosis. Further, the statistics fail to consider which treatments the patients received, or the fact that response to treatment can vary. Some patients survive much longer than the typical prognosis.

Mesothelioma Lawsuits

Starting in the 1960s, workers, consumers and families began filing thousands of mesothelioma lawsuits against companies that manufactured asbestos-containing products or permitted their installation. Time and again, juries have found that asbestos companies acted “with malice” by covering up the dangers of asbestos. By failing to adequately protect workers, these companies contributed to an epidemic of asbestos-related disease that was preventable.

People diagnosed with mesothelioma and other asbestos-related diseases have a legal right to take asbestos companies to court for their negligence. Filing an asbestos lawsuit provides patients and their loved ones the opportunity to receive fair compensation for pain and suffering, medical bills, lost wages and funeral expenses. Lawsuits sometimes lead to an award by means of a favorable jury verdict, but are more commonly resolved with an out-of-court settlement.

Some patients file claims with an asbestos bankruptcy trust established by a company that is no longer in business. Family members who lost a loved one to mesothelioma may choose to file a wrongful death lawsuit. Veterans who were exposed to asbestos while serving in the Navy or another branch of the military can file a lawsuit against manufacturers as well as a claim with the U.S. Department of Veteran Affairs to apply for Veterans Affairs (VA) disability benefits.

Free Case Review

Exposure to asbestos can cause mesothelioma and a variety of other medical issues. If you or your loved ones suffered from lung cancer or other asbestos-related complications, you may have legal options. Tell us about your experience and we will provide you with a free case review.

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