Mesothelioma

How common is mesothelioma?

The incidence of mesothelioma has been increasing in recent years. In the United States, approximately 2,000 new cases of mesothelioma are diagnosed each year.

Who are more likely to get mesothelioma?

The vast majority of mesothelioma is associated with asbestos exposure. Workers in an environment where asbestos fibres are present have an increased incidence of mesothelioma, with occupational exposure to asbestos fibres accounting for 70-80% of all cases of mesothelioma. Smoking alone as a risk factor has not been found to increase the incidence of mesothelioma, but the combination of smoking and occupational exposure to asbestos increases the likelihood of developing cancer in the respiratory tract in general. The greater the exposure, the greater the risk, and it is striking that it can take up to 40 years from exposure to asbestos to a diagnosis of mesothelioma. Not only the severity but also the frequency of exposure plays a very important role. In other words, the more asbestos-laden the working environment and the more years one works in this environment, the greater the risk of developing mesothelioma.

Are there any symptoms indicative of mesothelioma?

The symptoms presented are not specific to mesothelioma and often occur in the context of other diseases. The most common symptom of mesothelioma is dyspnoea due to pleural effusion (presence of fluid in the chest). There may also be thoracalgia, coughing and easy fatigue. In cases where the peritoneum is affected by mesothelioma, abdominal distension due to ascites (accumulation of fluid in the abdomen), abdominal pain, loss of appetite and weight loss may occur.

What tests does a patient with suspected mesothelioma undergo?

If mesothelioma is suspected, a chest X-ray will show the presence of pleural effusion. A chest CT scan will then provide more precise information on the size of the pleural effusion, on tumour-like lesions in the pleura (their extent and location) and on further pathological findings in the lung parenchyma or lymph nodes. Additional abdomen CT scanning will be required to stage the disease.

How is mesothelioma diagnosed?

The diagnosis of mesothelioma is made by cytological examination of pleural fluid obtained by paracentesis or by pleural biopsy through thoracoscopy.

What are the treatments available today?

Treatment of mesothelioma depends on the location, stage of the disease, age and general condition of the patient. Treatment options include surgery, chemotherapy and radiotherapy or a combination of such. Chemotherapy is the most commonly used treatment for mesothelioma and recently immunotherapy has been used. Radiotherapy is usually used in combination with surgical treatment and/or chemotherapy, and most often palliatively in cases of pain due to chest wall involvement.