Lawyer description
Mesothelioma is a form of cancer
that is almost always caused by previous exposure to
asbestos. In this disease, malignant cells develop in
the mesothelium, a protective lining that covers most of
the body's internal organs. Its most common site is the
pleura (outer lining of the lungs and chest cavity), but
it may also occur in the peritoneum (the lining of the
abdominal cavity) or the pericardium (a sac that
surrounds the heart).
Most people who develop mesothelioma have worked on jobs
where they inhaled asbestos particles, or have been
exposed to asbestos dust and fibre in other ways, such
as by washing the clothes of a family member who worked
with asbestos, or by home renovation using asbestos
cement products. There is no association between
mesothelioma and smoking.
Signs and symptoms
Symptoms of mesothelioma may not appear until 20 to 50
years after exposure to asbestos. Shortness of breath,
cough, and pain in the chest due to an accumulation of
fluid in the pleural space are often symptoms of pleural
mesothelioma.
Symptoms of peritoneal mesothelioma include weight loss
and cachexia, abdominal swelling and pain due to ascites
(a buildup of fluid in the abdominal cavity). Other
symptoms of peritoneal mesothelioma may include bowel
obstruction, blood clotting abnormalities, anemia, and
fever. If the cancer has spread beyond the mesothelium
to other parts of the body, symptoms may include pain,
trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by mesothelioma or by
other, less serious conditions.
Mesothelioma that affects the pleura can cause these
signs and symptoms:
chest wall pain
pleural effusion, or fluid surrounding the lung
shortness of breath
wheezing, hoarseness, or cough
In severe cases, the person may have many tumor masses.
The individual may develop a pneumothorax, or collapse
of the lung. The disease may metastasize, or spread, to
other parts of the body.
Tumors that affect the abdominal cavity often do not
cause symptoms until they are at a late stage. Symptoms
include:
abdominal pain
ascites, or an abnormal buildup of fluid in the abdomen
a mass in the abdomen
problems with bowel function
weight loss
In severe cases of the disease, the following signs and
symptoms may be present:
blood clots in the veins, which may cause
thrombophlebitis
disseminated intravascular coagulation, a disorder
causing severe bleeding in many body organs
jaundice, or yellowing of the eyes and skin
low blood sugar level
pleural effusion
pulmonary emboli, or blood clots in the arteries of the
lungs
severe ascites
A mesothelioma does not usually spread to the bone,
brain, or adrenal glands. Pleural tumors are usually
found only on one side of the lungs.
Diagnosis
Diagnosing mesothelioma is often difficult, because the
symptoms are similar to those of a number of other
conditions. Diagnosis begins with a review of the
patient's medical history. A history of exposure to
asbestos may increase clinical suspicion for
mesothelioma. A physical examination is performed,
followed by chest X-ray and often lung function tests.
The X-ray may reveal pleural thickening commonly seen
after asbestos exposure and increases suspicion of
mesothelioma. A CT (or CAT) scan or an MRI is usually
performed. If a large amount of fluid is present,
abnormal cells may be detected by cytology if this fluid
is aspirated with a syringe. For pleural fluid this is
done by a pleural tap or chest drain, in ascites with an
paracentesis or ascitic drain and in a pericardial
effusion with pericardiocentesis. While absence of
malignant cells on cytology does not completely exclude
mesothelioma, it makes it much more unlikely, especially
if an alternative diagnosis can be made (e.g.
tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as
suspicious, a biopsy is needed to confirm a diagnosis of
mesothelioma. A doctor removes a sample of tissue for
examination under a microscope by a histopathologist. A
biopsy may be done in different ways, depending on where
the abnormal area is located. If the cancer is in the
chest, the doctor may perform a thoracoscopy. In this
procedure, the doctor makes a small cut through the
chest wall and puts a thin, lighted tube called a
thoracoscope into the chest between two ribs.
Thoracoscopy allows the doctor to look inside the chest
and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform
a laparoscopy. To obtain tissue for examination, the
doctor makes a small opening in the abdomen and inserts
a special instrument into the abdominal cavity. If these
procedures do not yield enough tissue, more extensive
diagnostic surgery may be necessary.
Prevention & Expectations
What can be done to prevent the disease? Since the
1970s, the Environmental Protection Agency and the
Occupational Safety and Health Administration have
regulated the asbestos industry in the U.S. In the past,
asbestos was used as a fire retardant and an insulator.
Other products are now used in its place. The
controversy involving exposure to different forms of
asbestos continues.
There are two major types of asbestos called chrysotile
and amphibole. It is thought that the amphibole form of
asbestos is to blame for causing mesothelioma. However,
asbestos is still being removed even if it is the
chrysotile variety. Removal is taking place in schools
and other public buildings throughout the U.S. The hope
is that these measures will greatly reduce the
occurrence of this cancer.
What are the long-term effects of the disease? A
mesothelioma is a highly aggressive tumor that is
generally deadly. Current treatment of malignant
mesothelioma is designed to make the person with cancer
comfortable. Long-term survival cannot usually be
expected.
What are the risks to others? Mesothelioma is not
contagious and cannot be passed from one person to
another. The exposure to the asbestos that caused the
cancer occurred many years to several decades before the
disease appeared. People who live with asbestos workers
have a higher risk of getting this cancer.
Legal issues
The first lawsuits against asbestos manufacturers were
in 1929. Since then, many lawsuits have been filed
against asbestos manufacturers and employers, for
neglecting to implement safety measures after the link
between asbestos, asbestosis and mesothelioma became
known (some reports seem to place this as early as
1898). The liability resulting from the sheer number of
lawsuits and people affected has reached billions of
dollars. The amounts and method of allocating
compensation have been the source of many court cases,
and government attempts at resolution of existing and
future cases. |
