Mesothelioma is a cancer of the cells that make up the lining around the outside of the lungs and inside of the ribs (pleura), or around the abdominal organs (peritoneum).
The only known cause of mesothelioma in the U.S. is previous exposure to asbestos fibers. Asbestos manufacturers knew about the hazards of asbestos seventy years ago - but they kept this knowledge to themselves. The first warnings to workers exposed to asbestos were given in the mid-1960s, and they were terribly inadequate. Even today, workers are not always told they are working around asbestos and are at risk for asbestos disease.
Do these:
Seek out the best and most up-to-date information.
Seek out the best medical care.
Early screening for mesothelioma diagnosis.
Stay in close contact with your doctor.
Consider whether or not you want to bring a lawsuit because of this asbestos-related injury.
Remember that resources are available to you through community and medical support groups, asbestos victims' organizations, your place of worship, as well as your family and friends.
Do you want more information about mesothelioma?
Please explore our website or contact us to request additional information
Pleural Mesothelioma
Pleural mesothelioma is of two kinds: (1) diffuse and malignant (cancerous), and (2) localized and benign (non-cancerous.)
Benign mesotheliomas can often be removed surgically, are generally not life-threatening, and are not usually related to asbestos exposure. Malignant mesotheliomas, however, are very serious. Fortunately, they are rare - about two thousand people are diagnosed with mesothelioma in the U.S. each year.
The remainder of this section is about diffuse malignant pleural mesothelioma.
Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. Its only known cause in the U.S. is previous exposure to asbestos fibers, including chrysotile, amosite or crocidolite. This exposure is likely to have happened twenty or more years before the disease becomes evident, since it takes many years for the disease to "incubate." It is the most common type of mesothelioma, accounting for about 75% of all cases.
Mesothelioma is sometimes diagnosed by coincidence, before there are any symptoms. For instance, tumors have been discovered through routine chest x-rays. However, when symptoms occur, they may include shortness of breath, weakness, weight loss, loss of appetite, chest pains, lower back pains, persistent coughing, difficulty in swallowing, alone or in combination. An initial medical examination often shows a pleural effusion, which means an accumulation of fluid in the pleural space - the area between the lungs and the chest wall.
The first step in detecting pleural mesothelioma is, typically, a chest x-ray or CT scan. This is often followed by a bronchoscopy, using a viewing scope to look inside the lungs.
The actual diagnosis usually requires obtaining a piece of tissue through a biopsy. This could be a needle biopsy, an open biopsy, or through a tube with a camera (thoracoscopy or chest scope.) If an abnormality is seen through the camera then a tissue sample can be taken at the same time, using the same tube. This is a hospital procedure that requires anesthesia, but is not usually painful. The tissue sample is tested by a pathologist.
Fluid build-up from the pleural effusion can generally be seen on a chest x-ray and heard during a physical examination, but a firm diagnosis of mesothelioma can only be made through a biopsy and pathological testing. This is important because there are also benign pleural effusions and other tumors that have a similar appearance to mesothelioma. Diagnosing mesothelioma can be quite difficult; it requires special lab stains, and much experience in understanding them.
The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle. With the lungs restricted, they get smaller and less functional, and breathing becomes more difficult. At first a person with mesothelioma may be breathless only when he or she exercises, but as lung function drops, he or she can become short of breath even while resting.
The tumor spreads by direct invasion of surrounding tissue. As it spreads inward it can compress the lungs. As the tumor spreads outward it can invade the chest wall and ribs, and this can be extremely painful.
Current medical science does not know exactly how and why, at a cellular level, asbestos fibers cause mesothelial cells to become abnormal (malignant or cancerous.) Thus it is not known whether only one fiber causes the tumor or whether it takes many fibers. It seems that asbestos fibers in the pleura can start a tumor as well as promote its growth; the tumor does not depend on any other processes for its development.
There is as yet no known cure for malignant mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment. The Firm has represented many clients who lived for five to ten years after diagnosis, most of them in good health for a majority of those years. Some mesothelioma victims succumb within a few months; the average survival time is about a year.
The treatment options for people with mesothelioma have improved significantly, especially for those whose cancer is diagnosed early and treated vigorously. Many people are treated with a combination of therapies, sometimes known as multimodal therapy.
Specific types of treatment include:
Chemotherapy and other drug-based therapies
Radiation therapy
Surgery and
Intra-operative photodynamic therapy.
There are also experimental treatments like gene therapy and immunotherapy, angiogenesis inhibitors, and clinical trials for various new treatments and combinations of treatments.
Treatments that reduce pain and improve lung function, are becoming more successful (although they cannot cure mesothelioma.) Pain control medications have become easier to administer. Debulking is a surgical process of removing a substantial part of the tumor and reducing the pleural thickening; this can provide significant relief. X-ray therapy has also been successfully used to control the tumor and the pain associated with it for a while.
Further Resources
More information about pleural mesothelioma and treatments:
Malignant Pleural Mesothelioma: Update, Current Management, and Newer Therapeutic Strategies, by M. Pistolesi, MD & J. Rusthoven, MD; Chest October 2004; 126(4):1318-1329
National Cancer Institute
University of Pennsylvania/OncoLink
American Cancer Society
Medicine Online
Froedtert Medical College - Thoracic oncology program offers a comprehensive range of treatment options, with special expertise in treament of mesothelioma.
Diagnosis for Malignant Mesothelioma Cancer: Screening
The National Cancer Institute's definition of screening for cancer is the examination or testing of people for early signs of certain type of cancer even though they have no symptons - this is the best way to achieve a diagnosis as early as possible. Early detection and diagnosis is particularly important for people with historical exposure to asbestos due to the latency period (up to 30 years) before which symptoms of malignant mesothelioma cancer may become apparent.
Early Signs of Mesothelioma Aid Diagnosis:
Recognizing early symptoms of malignant mesothelioma may aid in diagnosis. Symptoms include difficulty in breathing (dyspnea) and/or chest pains, fever, nausea or anemia; other signals are hoarseness, difficulty swallowing (dysphagia), or coughing up blood (hemoptysis). For many suffering from pleural mesothelioma, there may be pain in the chest or lower back. Those people with peritoneal mesothelioma may experience an expanding waist size or abdominal pain resulting from the growth of cancer cells in the abdomen.
Since many of these symptoms are also caused by less serious illnesses, it can be difficult to recognize asbestos-related diseases in the early stages. Due to this difficulty of early diagnosis of asbestos cancer and mesothelioma, the best way to determine your health risk is to consult a doctor for an initial examination, which may include a pulmonary function test (PFT) and x-rays.
Screening Methods to Identify Asbestos-Related Disease:
After a preliminary physical examination, the doctor may need to look inside your chest cavity with a thorascope for accurate diagnosis. During this thoracoscopy procedure, a cut will be made in your chest and a small piece of tissue (biopsy) may removed for examination. While you may feel some pressure, there is usually no pain.
Another special tool that may be used is the peritoneoscope, which allows for examination inside your abdomen. This instrument is inserted into an opening made in the abdomen, and a biopsy specimen may also be taken.
If the presence of fluid is indicated by either of these procedures, the doctor may drain it by inserting a needle into the affected area. Removal of chest fluid is called thoracentesis; removal of abdominal fluid is call paracentesis.
Other screening methods for diagnosis of asbestos-related disease include various imaging tests. In addition to X-rays, methods include magnetic resonance imaging (MRI) or positron emission tomography (PET). A more recent and promising screening method is the computed tomography (CT) scan.
Computed Tomagraphy / CT Scan:
Top Deadliest Diseases
Q: What is the deadliest disease in the world?
A: The results of ranking the leading causes of death are subject to the cause categories used. The broader the cause categories used, the more likely they will rank among the top leading causes of death.According to the estimates in The world health report 2004, there were 57 million deaths in the world in 2002. The broad category of all "noncommunicable diseases" killed 33.5 million people; communicable diseases, maternal and perinatal conditions, and nutritional conditions killed 18.3 million people worldwide; and external causes of injuries killed 5.2 million people.When analysing at disaggregated level, the following are the leading causes of death:No.CauseEstimated number of deaths (in millions)
A: The results of ranking the leading causes of death are subject to the cause categories used. The broader the cause categories used, the more likely they will rank among the top leading causes of death.According to the estimates in The world health report 2004, there were 57 million deaths in the world in 2002. The broad category of all "noncommunicable diseases" killed 33.5 million people; communicable diseases, maternal and perinatal conditions, and nutritional conditions killed 18.3 million people worldwide; and external causes of injuries killed 5.2 million people.When analysing at disaggregated level, the following are the leading causes of death:No.CauseEstimated number of deaths (in millions)
- Heart disease
- Cerebrovascular disease
- Lower respiratory infections
- HIV/AIDS
- Chronic obstructive pulmonary disease
- Perinatal conditions
- Diarrhoeal diseases
- Tuberculosis
- Malaria
- Trachea, bronchus, lung cancers
- Road traffic accidents
- Diabetes mellitus
GLAUCOMA: Facts
Glaucoma Facts and Stats
Glaucoma is a very misunderstood disease. Often, people don’t realize the severity or who is affected. We hope the following information is helpful to you.
Four Key Facts About Glaucoma.
Glaucoma is a leading cause of blindness
Glaucoma can cause blindness if it is left untreated. And unfortunately approximately 10% of people with glaucoma who receive proper treatment still experience loss of vision.
There is no cure (yet) for glaucoma
Glaucoma is not curable, and vision lost cannot be regained. With medication and/or surgery, it is possible to halt further loss of vision. Since glaucoma is a chronic condition, it must be monitored for life.
Glaucoma is a very misunderstood disease. Often, people don’t realize the severity or who is affected. We hope the following information is helpful to you.
Four Key Facts About Glaucoma.
Glaucoma is a leading cause of blindness
Glaucoma can cause blindness if it is left untreated. And unfortunately approximately 10% of people with glaucoma who receive proper treatment still experience loss of vision.
There is no cure (yet) for glaucoma
Glaucoma is not curable, and vision lost cannot be regained. With medication and/or surgery, it is possible to halt further loss of vision. Since glaucoma is a chronic condition, it must be monitored for life.
Diagnosis is the first step to preserving your vision.
Everyone is at risk for glaucomaEveryone is at risk for glaucoma from babies to senior citizens. Yes, older people are at a higher risk for glaucoma but babies can be born with glaucoma (approximately 1 out of every 10,000 babies born in the United States).
Young adults can get glaucoma, too. African-Americans in particular are susceptible at a younger age.
There may be no symptoms to warn youWith open angle glaucoma, the most common form, there are virtually no symptoms. Usually, no pain is associated with increased eye pressure.
Vision loss begins with peripheral or side vision. You may compensate for this unconsciously by turning your head to the side, and may not notice anything until significant vision is lost. The best way to protect your sight from glaucoma is to get tested. If you have glaucoma, treatment can begin immediately.
Some Statistics About GlaucomaSources are listed at the bottom of this page.
It is estimated that over 3 million Americans have glaucoma but only half of those know they have it. (1)
Approximately 120,000 are blind from glaucoma, accounting for 9% to 12% of all cases of blindness in the U.S. (2)
About 2% of the population ages 40-50 and 8% over 70 have elevated IOP.
Glaucoma is the second leading cause of blindness in the world, according to the World Health Organization.
Glaucoma is the leading cause of blindness among African-Americans. (2)
Glaucoma is 6 to 8 times more common in African-Americans than Caucasians. (3)
African-Americans ages 45-65 are 14 to 17 times more likely to go blind from glaucoma than Caucasians with glaucoma in the same age group.
The most common form, Open Angle Glaucoma, accounts for 19% of all blindness among African-Americans compared to 6% in Caucasians. (4)
Other high-risk groups include: people over 60, family members of those already diagnosed, diabetics, and people who are severely nearsighted.
Estimates put the total number of suspected cases of glaucoma at around 65 million worldwide. (5)
Public Awareness and AttitudesA survey done for GRF by ICR, Inc. in Media, PA, found that:
74% of over 1,000 people interviewed said they have their eyes examined at least every two years. 61% of those (less than half of all adult Americans) are receiving a dilated eye exam (the best and most effective way to detect glaucoma). 16.1% of African-Americans were unfamiliar with glaucoma. 8.8% of Caucasians do not know anything about glaucoma. A Research To Prevent Blindness Survey found that:
Blindness ranked third (after cancer and heart disease) as people’s major fear. 20% of people knew that glaucoma was related to elevated pressure within the eye. Most of them mistakenly thought people could tell if they had glaucoma due to symptoms, or that it was easily cured, or that it did not lead to blindness. 50% had heard of glaucoma, but weren’t sure what it was. 30% had never heard of glaucoma.
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Diagnostic Tests
Early detection, through regular and complete eye exams, is the key to protecting your vision from damage caused by glaucoma.
It is important to have your eyes examined regularly. Your eyes should be tested at:
ages 35 and 40
age 40 to age 60, get tested every two to four years
after age 60, every one to two years
Anyone with high risk factors, should be tested every year or two after age 35.
It is important to have your eyes examined regularly. Your eyes should be tested at:
ages 35 and 40
age 40 to age 60, get tested every two to four years
after age 60, every one to two years
Anyone with high risk factors, should be tested every year or two after age 35.
Four Common Tests for Glaucoma
Regular glaucoma check-ups include two routine eye tests: tonometry and ophthalmoscopy.
1.Tonometry
Ttest he tonometry measures the inner pressure of the eye. Usually drops are used to numb the eye. Then the doctor or technician will use a special device that measures the eye’s pressure.
2.Ophthalmoscopy
Ophthalmoscopy is used to examine the inside of the eye, especially the optic nerve. In a darkened room, the doctor will magnify your eye by using an ophthalmoscope (an instrument with a small light on the end). This helps the doctor look at the shape and color of the optic nerve.
If the pressure in the eye is not in the normal range, or if the optic nerve looks unusual, then one or two special glaucoma tests will be done. These two tests are called perimetry and gonioscopy.
Perimetry
The perimetry test is also called a visual field test. During this test, you will be asked to look straight ahead and then indicate when a moving light passes your peripheral (or side) vision. This helps draw a “map” of your vision.
3.Gonioscopy
Gonioscopy is a painless eye test that checks if the angle where the iris meets the cornea is open or closed, showing if either open angle or closed angle glaucoma is present.
Optic Nerve Computer Imaging
In recent years three new techniques of optic nerve imaging have become widely available. These are scanning laser polarimetry (GDx), confocal laser ophthalmoscopy (Heidelberg Retinal Tomography or HRT II), and optical coherence tomography (OCT).
The GDx machine does not actually image the optic nerve but rather it measures the thickness of the nerve fiber layer on the retinal surface just before the fibers pass over the optic nerve margin to form the optic nerve. The HRT II scans the retinal surface and optic nerve with a laser. It then constructs a topographic (3-D) image of the optic nerve including a contour outline of the optic cup. The nerve fiber layer thickness is also measured. The OCT instrument utilizes a technique called optical coherence tomography which creates images by use of special beams of light. The OCT machine can create a contour map of the optic nerve, optic cup and measure the retinal nerve fiber thickness. Over time all three of these machines can detect loss of optic nerve fibers.
4.Your intraocular eye pressure
(IOP) is important to determining your risk for glaucoma. If you have high IOP, careful management of your eye pressure with medications can help prevent vision loss. Recent discoveries about the cornea, the clear part of the eye’s protective covering, are showing that corneal thickness is an important factor in accurately diagnosing eye pressure. In response to these findings, the Glaucoma Research Foundation has put together this brief guide to help you understand how your corneal thickness affects your risk for glaucoma, and what you can do to make sure your diagnosis is accurate.
Corneal Thickness
In 2002, the five-year report of the Ocular Hypertension Study (OHTS) was released. The study’s goal was to determine if early intervention with pressure lowering medications could reduce the number of ocular hypertensive (OHT) patients that develop glaucoma. During the study, a critical discovery was made regarding corneal thickness and its role in intraocular eye pressure and glaucoma development.
Why is Corneal Thickness Important?
Corneal thickness is important because it can mask an accurate reading of eye pressure, causing doctors to treat you for a condition that may not really exist or to treat you unnecessarily when are normal. Actual IOP may be underestimated in patients with thinner CCT, and overestimated in patients with thicker CCT. This may be important to your diagnosis; some people originally diagnosed with normal tension glaucoma may in fact be more accurately treated as having regular glaucoma; others diagnosed with ocular hypertension may be better treated as normal based on accurate CCT measurement. In light of this discovery, it is important to have your eyes checked regularly and to make sure your doctor takes your CCT into account for diagnosis.
A Thin Cornea—The Danger of Misreading Eye Pressure
Many times, patients with thin corneas (less than 555 µm) show artificially low IOP readings. This is dangerous because if your actual IOP is higher than your reading shows, you may be at risk for developing glaucoma and your doctor may not know it. Left untreated, high IOP can lead to glaucoma and vision loss. It is important that your doctor have an accurate IOP reading to diagnose your risk and decide upon a treatment plan.
A Thicker Cornea May Mean Less Reason to Worry About Glaucoma
Those patients with thicker CCT may show a higher reading of IOP than actually exists. This means their eye pressure is lower than thought, a lower IOP means that risk for developing glaucoma is lowered. However, it is still important to have regular eye exams to monitor eye pressure and stay aware of changes.
Pachymetry—A Simple Test to Determine Corneal Thickness
A pachymetry test is a simple, quick, painless test to measure the thickness of your cornea. With this measurement, your doctor can better understand your IOP reading, and develop a treatment plan that is right for your condition. The procedure takes only about a minute to measure both eyes.
Related Articles
What is Glaucoma?
Are You at Risk For Glaucoma?
Anatomy of the Eye
Glaucoma Facts and Stats
The Importance of Corneal Thickness
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