Mesothelioma: Causes, Symptoms,Treatment Options

There are four types of mesothelioma: peritoneal, pericardial, pleural, and testicular.
Peritoneal mesothelioma is a cancer of the lining of the abdominal cavity, also referred to as the peritoneum. This form of mesothelioma makes up about one-fifth of the mesothelioma cases each year and is often refered to as abdominal mesothelioma. This cancer is directly caused by inhaling or unknowingly ingesting asbestos fibers in the air. Peritoneal mesothelioma can spread from the lungs or pleura in mesothelioma patients, also.
Pericardial mesothelioma is the rarest form of malignant mesothelioma, making up just 1/10 of all cases. It affects the pericardium – the lining that protects the heart. The cancer is caused by breathing asbestos fibers, which are absorbed by the body and travel in the blood. When the affected blood is pumped through the heart, the asbestos becomes trapped there. Mesothelioma from the lungs and the abdomen can also spread to the heart in mesothelioma patients.
The third type of mesothelioma, pleural mesothelioma, is the most common. It occurs in the pleura, the lining of the lungs and is often called lung mesothelioma. Pleural mesothelioma makes up around 70% of all mesothelioma cases. It’s caused by inhaling asbestos fibers. The disease might take as long as 40 or 50 years after asbestos exposure to show up. The asbestos causes the delicate, pliable lining to thicken and harden, often leading to cancer. This cancer is aggressive and deadly and can quickly spread to the heart, the chest wall, and the abdominal cavity.
Testicular mesothelioma is extremely rare. in fact, fewer than 100 cases have been reported. This type of mesothelioma causes lumps in the testicles, which may or may not be painful or tender. Testicular mesothelioma is most likely due to asbestos particles traveling through the blood stream to the testicles. Testicular mesothelioma patients make up just a small percentage of all mesothelioma patients.

 The only known cause of mesothelioma is asbestos. The asbestos could have been inhaled, or the tiny particles could have been accidentally swallowed. Asbestos is a mineral with long, thin strands of crystals. It has a number of uses in manufacturing and has been used since ancient times.
The ancient Greeks, Romans, Persians, and Chinese used asbestos to weave into cloth to make it fire retardant. Even then , however, some Greeks realized the inherent danger in the mineral. Strabo, a Greek geographer, recognized that slaves who handled asbestos regularly suffered from lung damage.
With the rise of the Industrial Revolution, asbestos became more widely used. In nineteenth-century America, it was used as a flameproof form of insulation. By the middle of the twentieth century, asbestos was being widely used in the production of gaskets, ceiling insulation, pipe insulation, flooring, roofing, bricks, concrete, drywall, joint compound, clutch discs, brake pads and shoes, and siding. During World War II, millions of pounds of asbestos were used in ship building.
Workers in plants and shipyards that handled asbestos or were around it breathed in the tiny particles or ingested them, not knowing the danger involved. Years later, many of these men were diagnosed with mesothelioma. In the U.S., the ship building industry alone has been or will be responsible for more than 100,000 asbestos-related deaths.

People especially at risk for developing mesothelioma include men who were regularly exposed to large amount of asbestos, especially in the case of plumbers, electricians, shipyard workers, pipefitters, boilermakers, and construction workers.
Unfortunately, it wasn't just the male workers who ended up as mesothelioma patients. Many female family members of these male workers have also developed the cancer - through second-hand exposure. The men would bring the dangerous particles home on their clothing, and the household members would breathe them in.
Also, entire communities near asbestos mines and factories have been negatively impacted. For example, hundreds of people have died as a result of mesothelioma in a Montana town in which an asbestos mine was located.
Though the disease usually takes years - even decades - to develop, some recent cases of mesothelioma have been responsible for relatively quick deaths. After the 2001 destruction of the World Trade Center, several clean-up workers contracted the disease from being exposed to large amounts of asbestos. A few of these mesothelioma patients have already died from the cancer.

In the early stages, mesothelioma often has no symptoms or warning signs. Once mesothelioma symptoms are noticeable, the cancer may be in the late stages.
Symptoms for all four forms of mesothelioma might include:
· Fatigue
· Night sweats
· Fever
· A dry, unproductive cough
· Coughing up blood
· Weight loss for no apparent reason
· Difficult or painful swallowing
· Chest or rib pain
· Shortness of breath
· Anemia
· Change in bowel habits
· Nausea
· Vomiting
· Abdominal pain or swelling
· Heart palpitations
· Arrhythmia
· Difficulty breathing
-low back pain
- difficulty sleeping
· Lumps under the skin of the abdomen, chest, or testicles

If mesothelioma is present, a doctor will most likely be able to make a definitive diagnosis shortly after the patient is experiencing symptoms. Diagnostic tools might include:
· Patient history
· Chest x-ray
· PET scan
· CT scan
· MRI
· Thoracoscopy
· Needle aspiration
· Bronchoscopy
· Laparoscopy
· mediastinoscopy

Currently, there is no cure for mesothelioma. There are, however, several treatment options available for mesothelioma patients, including surgery, chemotherapy, and radiation.
Surgery: The cancerous cells and growths of mesothelioma might be successfully removed from the mesothelioma patient with surgery if the cancer is in stage I and stage II. If surgery cannot remove all the cancer, the procedure might still be beneficial in relieving pain. It can also be used as an important diagnostic tool.
Radiotherapy: Radiation therapy is also used for mesothelioma patients. Often, it follows surgery. Radiation is often used to relieve painful symptoms in mesothelioma patients and to inhibit the spread of the cancer for a short term. With external beam radiation, tumors are flooded with radioactive beams in order to kill the abnormal cells.
Brachytherapy: With brachytherapy radiation, radioactive rods or seeds are placed directly into the tumor so that healthy cells are not damaged. Brachytherapy results in fewer side effects than does traditional radiation therapy in mesothelioma patients.
Chemotherapy: Chemotherapy treatment often follows surgery. Chemicals given to the mesothelioma patient, often intravenously, inhibit cancer cells from dividing and multiplying. Unfortunately, the chemicals cannot distinguish between cancer cells and normal cells, so unpleasant side effects often occur. A new type of chemotherapy, referred to as heated chemotherapy, is an option for peritoneal mesothelioma treatment. With this therapy, the chemicals are focused directly into the peritoneum.

With all the new studies and mesothelioma research being conducted, a cure for mesothelioma could be just around the corner. New drugs and mesothelioma treatment options are either available now or are in the clinical trial process. One could very well result in a miracle for mesothelioma patients.
Gene Therapy: With this therapy, a virus is introduced into the mesothelioma patient that causes cancer cells, at their DNA level, to produce a special protein that causes their death. After this procedure, the patient is treated with chemotherapy that damages only the abnormal cells and is not harmful to healthy cells. Currently, this form of therapy is available only through clinical trials, but the results are promising.
Active and Passive Immunotherapy: With this type of treatment, the mesothelioma patient’s immune system is manipulated to destroy cancer cells. With the active type, mesothelioma cells are removed and made into a vaccine-like substance. When the treated cells are reintroduced into the mesothelioma patient, the immune system recognizes them as a harmful invader and takes protective measures. With the passive form of immunotherapy, the patient’s immune system is made stronger to improve the battle against the cancerous cells.
Photodynamic Therapy: If the mesothelioma is restricted to the pleura, this form of therapy might be effective for mesothelioma patients. It uses powerful laser light to kill cancer cells that have been exposed to an IV solution that makes them ultra-sensitive to the light energy. Possible side effects include skin and eye sensitivity, vomiting, nausea, and a metallic taste in the mouth.
New clinical trials for mesothelioma option treatment now being conducted or recruited for:
· Study of pemetrexed with or without Cisplatin for peritoneal mesothelioma treatment and pleural mesothelioma treatment
· Doxorubicin with or without P-30 protein for all types of mesothelioma
· Combination therapy with or without Bevacizumab in the treatment of all tyoes of mesothelioma
· Gemcitabine and Epirubicin to treat all types of mesothelioma
· Combination chemotherapy before surgery for pleural mesothelioma
· Antineoplastin therapy for patients with advanced mesothelioma
· Experimental Drug SS1(dsFv)-PE38
· Pemetrexed disodium and Gemcitabine
· Study of Decitabine in preventing the growth of tumours
· Radiofrequency ablation
· Study of gene induction with Decitabine infusion
· Phase III study of Suberoylanilide Hydroxamid Acid in advanced pleural mesothelioma
· Phase II study of oral Milataxil for malignant mesothelioma