Prevent Mesothelioma

Mesothelioma

Definition

Malignant mesothelioma (me-zo-thee-le-O-muh) is a rare cancer that occurs in the thin layer of tissue that covers the majority of your internal organs (mesothelium).

Doctors divide mesothelioma into different types based on what part of the mesothelium is affected, including:

• Pleural malignant mesothelioma, which affects the tissue that surrounds the lungs and is the most common form of mesothelioma.
• Peritoneal mesothelioma, which occurs in the tissue in your abdomen.
• Pericardial mesothelioma, which affects the tissue surrounding the heart.
• Mesothelioma of the tunica vaginalis, which occurs in the lining around the testicles.

Between 2,000 and 3,000 people are diagnosed with mesothelioma in the United States each year, according to the American Cancer Society.

Symptoms

Signs and symptoms of mesothelioma vary depending on where the cancer occurs.

Pleural mesothelioma signs and symptoms may include:

• Shortness of breath
• Painful breathing (pleurisy)
• Painful coughing
• Chest pain under the rib cage
• Unusual lumps of tissue under the skin on your chest
• Unexplained weight loss
• Dry (nonproductive) cough

Peritoneal mesothelioma signs and symptoms may include:

• Abdominal pain
• Abdominal swelling
• A change in your bowel habits, such as more frequent diarrhea or constipation
• Lumps of tissue in the abdomen
• Unexplained weight loss

Other forms of mesothelioma 
Signs and symptoms of pericardial mesothelioma and mesothelioma of the tunica vaginalis are unclear. These forms are so rare that not much information is available. Pericardial mesothelioma signs and symptoms may include difficulty breathing or chest pains. Mesothelioma of the tunica vaginalis may be first detected as a mass on a testicle.

When to see a doctor 
See your doctor if you have signs and symptoms that may indicate mesothelioma. Signs and symptoms of mesothelioma aren't specific to this disease and, due to the rarity of mesothelioma, are more likely to be related to other conditions. If any persistent signs and symptoms seem unusual or bothersome to you, ask your doctor to evaluate them.

Causes

In general, cancer begins when a series of genetic mutations occur within a cell, causing the cell to grow and multiply out of control, when healthy cells would normally die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can break off from an initial tumor to spread elsewhere in the body (metastasize).

It isn't clear what causes the initial genetic mutations that lead to mesothelioma, though researchers have identified factors that may increase the risk. It's likely that cancers form because of an interaction between many factors, such as inherited conditions, your environment, your health conditions and your lifestyle choices.

Benign pleural mesothelioma 
A form of noncancerous (benign) tumor that can occur in the chest is sometimes called benign mesothelioma. However, this name is misleading. Benign mesothelioma doesn't begin in the same cells where the cancerous forms of mesothelioma begin. And, in a minority of cases, benign mesothelioma can be very aggressive, despite the term "benign." For this reason, some doctors now refer this tumor as solitary fibrous tumor.

Solitary fibrous tumor usually doesn't cause signs and symptoms. Most cases are inadvertently discovered during tests and procedures for other conditions. It isn't clear what causes solitary fibrous tumors, but they aren't linked to asbestos exposure. Treatment for solitary fibrous tumor typically includes surgery.

Risk factors

Asbestos exposure: The primary risk factor for mesothelioma 
Asbestos is a mineral that's found naturally in the environment. Asbestos fibers are strong and resistant to heat, making them useful in a wide variety of applications, such as in insulation, cement, brakes, shingles, flooring and many other products. People who work around asbestos fibers are thought to have the greatest risk of mesothelioma.

When asbestos is broken up, such as during the mining process or when removing asbestos insulation, dust may be created. If the dust is inhaled or swallowed, the asbestos fibers may settle in the lungs or in the stomach, where they can cause irritation that may lead to mesothelioma, though how exactly this happens isn't understood.

Mesothelioma risk is believed to be increased in people who are exposed to high levels of asbestos, in people who are exposed to asbestos over a long period of time and in people exposed to asbestos at a young age. It can take 30 to 40 years or more for mesothelioma to develop as a result of asbestos exposure.

Some people with years of asbestos exposure never develop mesothelioma. And yet, others with very brief exposure develop the disease. This indicates that other factors may be involved in determining whether someone gets mesothelioma or doesn't. For instance, you could inherit a predisposition to cancer or some other condition could increase your risk.

Possible risk factors 
Factors that may increase the risk of mesothelioma include:

• Personal history of asbestos exposure. If you've been directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.
• Living with someone who works with asbestos. People who are exposed to asbestos may carry the fibers home on their skin and clothing. These stray fibers can put others in the home at risk of mesothelioma. People who work with asbestos should shower and change clothes before leaving work.
• Smoking. Risk of mesothelioma is increased greatly in smokers who are exposed to asbestos.
• SV40. Some research indicates a link between mesothelioma and simian virus 40 (SV40), a virus originally found in monkeys. Millions of people may have been exposed to SV40 when receiving polio vaccinations between 1955 and 1963, because the vaccine was developed using monkey cells. Once it was discovered that SV40 was linked to certain cancers, the virus was removed from the polio vaccine. Whether SV40 increases the risk of mesothelioma is a point of debate, and more research is needed.
• Radiation. Some research links mesothelioma to the radioactive substance thorium dioxide, which was used along with X-rays to diagnose various health conditions from the 1920s to the 1950s. Thorium dioxide was later found to cause cancer and is no longer used.
• Family history. A family history of mesothelioma may increase your risk of mesothelioma, but more research is needed to understand this theory.

Complications

Complications from spreading cancer 
As pleural mesothelioma spreads in the chest, it puts pressure on the structures in that area. This can cause complications, such as:

• Difficulty breathing
• Chest pain
• Difficulty swallowing
• Swelling caused by pressure on the large vein that leads from your upper body to your heart (superior vena cava syndrome)
• Pain caused by pressure on the nerves and spinal cord
• Accumulation of fluid in the chest (pleural effusion), which can compress the lung nearby and make breathing difficult

Death 
Mesothelioma that progresses can lead to death. People who die of mesothelioma usually die from related complications, such as lung failure, heart problems, stroke and other causes.

Preparing for your appointment

You're likely to start by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a doctor who specializes in lung diseases (pulmonologist) or abdominal problems (gastroenterologist).

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes. If you're worried about mesothelioma, make a list of all your occupations, even those you had for only a few months.
• Make a list of all medications, as well as any vitamins or supplements, that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For mesothelioma, some basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?
• What are other possible causes for my symptoms or condition?
• What kinds of tests do I need?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist? What will it cost, and will my insurance cover seeing a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend?
• What will determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor 
Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time to cover other points you want to address. Your doctor may ask:

• When did you first begin experiencing symptoms?
• Have your symptoms been continuous, or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Do your symptoms affect your ability to work?

What you can do in the meantime 
Try to avoid anything that worsens your signs and symptoms. For instance, if you're experiencing shortness of breath, try to take it easy until you can meet with your doctor.

For more http://www.mayoclinic.com/print/mesothelioma/DS00779/DSECTION=all&METHOD=print