Mesothelioma is a cancer caused by exposure to asbestos. Over time,
many people have been unwittingly exposed to the deadly fibres as a
result of their work, or by living alongside someone who works in an
environment which contains asbestos.
Once the fibres are inhaled, or ingested, they can lodge themselves
in internal body tissue where they cause
damage and may lead to
asbestos-related diseases. Mesothelioma is possibly the most severe form
of disease associated with asbestos.
It can take a long time for mesothelioma to develop – at least ten to fifteen years and sometimes even as many as forty years.
Can I make a claim?
For a while, employers were not aware of the dangers of asbestos, but
it quickly became apparent that workers needed protecting. If an
employer failed to provide adequate training or protection for their
employees they can be held liable for compensation if a worker suffers
an industrial disease such as mesothelioma.
If you would like more information about mesothelioma symptoms or any
other aspect of the disease, including making a compensation claim,
please call our lawyers FREE on 0800 0891331.
Thompsons Solicitors in Scotland has an excellent track record in
tracing the liable parties, and their insurers, even if the firm has
ceased trading. Contact us today using our online claim forms, or simply
leave your details and we will call you back.
Types of mesothelioma
There are three different types of Mesothelioma: Pleural Mesothelioma, Peritoneal Mesothelioma and Pericardial Mesothelioma.
Pleural Mesothelioma is the most common type and is caused by
inhaling asbestos fibres into the lungs. A tumour then forms on the
lining (pleura) of the lungs, which makes breathing difficult and
painful.
Peritoneal Mesothelioma is less common and is caused by
inhaled fibres which are coughed up out of the lungs and then swallowed
down into the stomach. A tumour then develops on the lining of the
abdomen (peritoneum) which prevents it from working properly to
lubricate the organs inside the abdomen.
Pericardial Mesothelioma is the least common form of the
disease. Patients suffering from this type of mesothelioma develop a
tumour on the membranes lining the heart and this prevents the heart
from working properly to pump blood around the body.
Mesothelioma in the chest (pleural mesothelioma)
Pleural mesothelioma starts in the pleura. The pleura is the two layers
of thin membrane that surround the lungs and line the chest wall. The
inner layer is attached to the lungs and the outer layer lines the chest
wall and diaphragm. Between the two layers is the pleural cavity. This
cavity is almost empty. The two layers of pleura slide against each
other. They're moist so that lungs can move smoothly against the chest
wall as you breathe.
Sometimes mesothelioma can spread into the area around the heart (pericardium).
Mesothelioma in the abdomen (peritoneal mesothelioma)
Peritoneal mesothelioma starts in the peritoneum. This is the sheet of
tissue covering and lining the internal organs in the abdomen. This
sheet helps to protect the organs and allows them to move around within
the abdomen. The peritoneum makes a fluid that helps to keep the
abdominal organs moving freely and smoothly as we move around.
Causes of mesothelioma
Asbestos exposure
Mesothelioma is very strongly linked with asbestos exposure. Almost
everyone diagnosed with mesothelioma was exposed to asbestos.
Asbestos is a mineral rock made up of masses of tiny fibres. For many
decades, asbestos was mined and widely used in building materials and
for insulation, fireproofing and sound absorption. It was used to
insulate buildings, ships, car parts, household appliances and power
stations.
There are three types of asbestos - blue, brown and white. All are
linked to mesothelioma although blue and brown are more commomly linked.
The health hazards of asbestos have become clear in recent decades.
Asbestos has been banned in Australia since 2004 and it is now illegal
here to store, mine, import, sell, install or reuse any products
containing asbestos. Any asbestos products already in place are allowed.
However, great care needs to be taken if anything known to contain
asbestos is to be disturbed or pulled down. There are strict regulations
associated with removal and disposal of asbestos for areas greater than
10m2. See our ‘Services and information' section.
Most people are at low risk of asbestos exposure and mesothelioma.
People who've been exposed to asbestos in their jobs are at greater
risk. Such jobs include:
- mining or milling asbestos
- manufacture and repair of goods using raw asbestos fibres, such as brake linings
- use of products containing asbestos, like in building and construction,
- heating, shipyards, power stations, boiler making, gas fittings and plumbing
- alteration, repair or demolition of buildings or other structures containing asbestos.
It may take over 20 years after exposure for any disease caused by
asbestos to become evident (it can take up to and over 50 years).
However, most workers exposed to asbestos won't develop an asbestos-related disease.
Why is asbestos dangerous?
When asbestos is disturbed, it forms a dust made up of tiny fibres. This
can easily be breathed in and cause serious health problems, notably:
- pleural plaque
- asbestosis
- diffuse pleural thickening
- benign pleural effusion
- lung cancer
- mesothelioma.
When asbestos is disturbed it sends out fibres into the air that can be
inhaled by anyone nearby. Workers in mining and construction, plumbers,
carpenters and auto mechanics have been at risk of exposure to asbestos.
It can also affect family members of workers who brought home asbestos fibres on their clothing and shoes from their work site.
It is not clear how asbestos fibres get into the peritoneal cavity. It
is unlikely that they come through the wall of the gut. However, they
may come in through the diaphragm. When asbestos fibres are taken into
the body, cells react in an abnormal way. This may result in
inflammation and scarring causing pleural plaque or diffuse pleural
thickening. Or it may alter the DNA of the cells and result in the cells
becoming malignant.
How common is mesothelioma?
Mesothelioma is a rare type of cancer but it is affecting more people.
Australia has one of the highest rates of mesothelioma in the world.
This is related to the high rate of asbestos use in mining,
construction, manufacturing and home renovations over many years. In
2007 (the most recent data available), nearly 600 people were diagnosed
with mesothelioma in Australia. Of these new cases, 81% were men.
In Victoria about 160 people are diagnosed each year. These figures are
likely to change. Experts believe the number of people diagnosed with
asbestos-related diseases will not peak until 2020. Since 1980 there
have been about 13,000 new cases of mesothelioma in Australia.
Symptoms
In its early stages mesothelioma (pleural and peritoneal) may not cause
many symptoms. It is only later, when the cancer moves into the
underlying tissues or causes fluid to leak into the cavity in the chest
or abdomen, that symptoms appear.
Symptoms of pleural mesothelioma
The cancer causes cells in the pleura to produce fluid, called a pleural
effusion. The fluid builds up between the two layers of pleura and
presses on the lungs. This can cause:
- shortness of breath
- a persistent dry cough
- pain, which is often described as a heaviness or dull aching in the
shoulder, arm, chest wall and upper abdomen. Some people describe it as
like having pulled a muscle; others describe it as a sharp, stabbing or
even ‘burning' pain
- difficulty swallowing, a hoarse voice or coughing up sputum or blood - these are rare symptoms.
As the cancer progresses, it can grow into the lung, lymph nodes, chest wall, ribs, brain and liver, causing other symptoms.
Symptoms of peritoneal mesothelioma
Mesothelioma in the peritoneum (‘peritoneal mesothelioma') causes:
- abdominal pain
- swollen abdomen
- poor appetite
- nausea and vomiting
- fever
- bowel or urinary problems.
Symptoms of advanced stage disease
Advanced stage cancer usually means cancer that has spread from where it
began to other parts of the body. You may hear doctors call this
‘metastatic', ‘progressive' or ‘secondary' cancer. Most people diagnosed
with mesothelioma have advanced cancer, although at the time they are diagnosed they may not yet have symptoms of advanced cancer.
As well as the symptoms described above, other symptoms that may appear at this stage include:
- severe weight loss
- fatigue
- fever
- sweating
- confusion due to chemical imbalances in the body or spread of the
- cancer to the brain
- lumps under the skin.
All symptoms discussed in this section can be caused by other, less
serious diseases. However, if you or someone close to you has any of
them (especially if you know you have been exposed to asbestos) you
should see your doctor. If necessary they can do further tests to find
the cause of your problems.
If you've been exposed to asbestos in the past and develop
shortness of breath, chest pain or other symptoms (pain, cough, weight
loss), see your GP and ask for a referral for a chest x-ray or other
tests they think may be necessary. Tell the doctor you've been exposed
to asbestos. If any abnormalities show up on your x-ray or you remain
unwell you should see a respiratory specialist.
Mesothelioma Causes
Contact with asbestos is the leading cause of
mesothelioma cancer, as nearly every patient diagnosed with this
aggressive cancer came in contact with it at some point. Mesothelioma
caused by asbestos exposure commonly occurs occupationally,
environmentally or as a result of secondhand exposure.
Mesothelioma — a cancer that most commonly attacks the lungs and abdomen
— was profoundly rare until industrial and commercial companies
expanded the use of asbestos during the 20th century. After spending
decades investigating the disease and its causes, medical researchers
identified one primary culprit: Exposure to asbestos.
Medical research studies gradually pointed to the fact that breathing in
minuscule asbestos fibers starts a chain of physical and metabolic
events that lead to the development of several types of cancers or an
incurable breathing disorder called asbestosis.
In March 2009, the International Agency for Research on Cancer
reconfirmed that asbestos exposure is the leading cause for mesothelioma
and all forms of asbestos cause the disease.
What are the Most Common Mesothelioma Symptoms?
Asbestosis and mesothelioma symptoms, unfortunately,
mirror many other types of lung-related diseases. Symptoms can be
different based on the type of cancer and can be vague and mild even as
the disease progresses into a later stage. Early signs can be so slight
that they are mistaken as normal aches and pains or symptoms of other
illnesses, making asbestos-related cancer hard to detect.
Early Mesothelioma Symptoms Are Hard to Detect
Many patients don't understand the early symptoms of
mesothelioma. They only seek medical advice when symptoms intensify,
which is why much of the mesothelioma research today involves finding
better ways to secure an earlier diagnosis, when it can be treated more
effectively. There is considerable support for early screening for those
with prolonged, occupational exposure to asbestos.
Mesothelioma Symptoms Are Often Misdiagnosed
For physicians who are not trained to deal with these
diseases, mesothelioma doesn't come to mind when trying to link warning
signs to a disease. Consider, for instance, how often doctors hear that a
patient is tired all the time. People with mesothelioma have been
misdiagnosed initially with things like pneumonia, bronchial infection
and COPD.
Pleural Mesothelioma Symptoms
Pleural
mesothelioma is caused by inhaling asbestos fibers, which become trapped
in the lining of the lungs, known as the pleura. These microscopic
fibers cause irritation and inflammation in the pleura. This
inflammation causes thickening in the layers of the pleura and the
buildup of fluid around the lungs (pleural effusion). The buildup of
fluid and thickening of the lining surrounding the lungs prevents the
lung from fully expanding. This causes chest discomfort and painful
breathing.
Pleural Mesothelioma Symptoms (Stages 1 & 2)
Patients in
the early stages of pleural mesothelioma do not exhibit many symptoms.
Those that do show are not specific to the disease. Symptoms common in
the early stages of this disease are:
- Shortness of breath (dyspnea)
- Chest pain
- Persistent coughing
- Pleural effusions (fluid buildup)
- Fever
- Fatigue
- Weight loss
- Body aches
These are similar to symptoms of various other disorders, such as
pneumonia, common cold, asthma, influenza, and Chronic Obstructive
Pulmonary Disease (COPD). Pleural effusions and inflammation in the
lining of the lungs are the main source of discomfort associated with
mesothelioma, but are also linked to pneumonia and COPD.
Up to 25 percent of patients have symptoms like dyspnea and chest pain for approximately 6 months before seeing a doctor.
Pleural thickening is another result of pleural mesothelioma that is
common in other diseases. This is caused by the scarring of the pleura.
It causes a loss of elasticity in the lungs, which is essential for the
lung to expand for normal breathing.
Pleural thickening can also be caused by tuberculosis, pleurisy, and
empyema (infection in the lung that causes a buildup of pus in the
pleura). However, in mesothelioma, this is specifically caused by
scarring of the pleura due to asbestos.
Pleural Mesothelioma Symptoms (Stages 3 & 4)
Late
stages of pleural mesothelioma have more specific symptoms, but also
include symptoms from the earlier stages. In stages 3 and 4, symptoms
still include difficulty breathing, chest pains, and coughing, but these
symptoms may be more severe.
Symptoms specific to pleural mesothelioma begin to emerge in these
stages. This is when most patients are diagnosed. These symptoms may
include:
- Fever and/or night sweats
- Shortness of breath (dyspnea)
- Painful breathing
- Fatigue
- Anemia
- Persistent pain in the chest or rib region
- Persistent coughing
- Coughing up blood (hemoptysis)
- Difficulty swallowing (dysphagia)
- Pleural effusions
During these stages, treatment may be used to relieve pain and
discomfort associated with various symptoms. For example, doctors may
drain pleural effusions to reduce chest pain and make breathing easier.
Pericardial Mesothelioma Symptoms
Pericardial
mesothelioma makes up less than 1 percent of mesothelioma cases, and
the exact origin of the disease is unknown. Symptoms associated with
pericardial mesothelioma are:
- Chest pain
- Pericardial thickening
- Irregular heartbeats
- Pericardial bleeding
- Dyspnea (difficulty breathing)
- Pericardial effusion (fluid buildup)
Misdiagnosis of pericardial mesothelioma is common because the
symptoms associated with the cancer are so general. The most common
misdiagnoses for pericardial mesothelioma are pericarditis (inflammation
of the pericardium) and myocarditis (inflammation of the heart).
Symptoms of Mesothelioma
Presenting symptoms of pleural mesothelioma can be as nondescript as a
chest pain, slight fatigue, or a shortness of breath during physical
activity. Symptoms often mirror signs of less serious respiratory issues
and are hardly unusual for a senior.
Pleural mesothelioma cancer
may take decades to develop after exposure to asbestos, but it attacks
quickly once taking hold. The microscopic asbestos fibers that are
inhaled can lodge in the thin lining around the lungs and trigger
physiological cellular changes that lead to this rare but aggressive
cancer.
Many people with pleural mesothelioma are unaware of their own
condition for months or even years because initial symptoms are often
mistaken for less threatening illnesses. Any history of asbestos exposure,
or even suspected asbestos exposure, should be discussed with a
physician, who can refer a patient to a specialist right away. An early
diagnosis is critical to survival because it can lead to more effective
therapy options.
Symptoms Can Be Confusing
Most symptoms of pleural mesothelioma involve the respiratory system
and often are misdiagnosed because most medical professionals rarely see
this disease. It's estimated that more than 2,000 people in the United
States are diagnosed annually with this cancer. By comparison, an
estimated 150,000 Americans are diagnosed with lung cancer each year.
Initial symptoms of pleural mesothelioma often are confused with
pneumonia or asthma or another respiratory ailment. Even a specialist
will need considerable time — in addition to results of various, complex
tests — to provide a definitive diagnosis.
According to a 2011 study of 221 pleural mesothelioma patients, many
reported similar symptoms in the early stages, often before it was
diagnosed.
They included:
- 79 percent experienced shortness of breath
- 64 percent suffered chest pain
- 36 percent had a chronic cough
- 90 percent presented with pleural effusions (excess fluid around lungs)
- 30 percent experienced significant weight loss
If any of these symptoms appear, and there is a history of asbestos exposure, it is important to see a specialist.
Many patients diagnosed in stage I have no symptoms and the cancer is
accidentally detected through routine X-ray or other tests. In this
early stage, the tumor burden is relatively minimal and may not cause
any noticeable symptoms. The two most common presenting symptoms of
pleural mesothelioma are shortness of breath and chest pain. These
symptoms usually develop as a result of pleural effusion or tumors
pressing against the lung and chest wall, which can happen in in stages I
through III.
In stage II, as tumors spread beyond the pleural lung lining and into
the lung and diaphragm, pain may increase and may be felt in the
shoulder or upper abdomen in addition to the chest. Difficulty breathing
and coughing may arise or worse at this stage.
During stage III, tumors spread more thoroughly throughout the chest,
placing pressure on the lungs and chest wall. These physical changes
can lead to an increase in pain and difficulty breathing, dry cough,
tightness in the chest, fatigue and weight loss.
By stage IV, tumors have spread throughout the chest and rarely
spread to distant locations. The degree of tumor burden in the chest can
severely worsen pulmonary symptoms like shortness of breath. Others
symptoms may include lumps of tissue under the skin on the chest, pain
in the lower back, fever and night sweats. Some patients experience a
hoarse voice and difficulty swallowing. At this stage, patients often
need help breathing and require continuous oxygen.
Recognizing Symptoms
Because a pleural mesothelioma diagnosis is often not made until
after the cancer has spread, the prognosis can be grim. The process of
recognizing the symptoms and turning them into a definitive diagnosis so
treatment can begin usually involves multiple procedures with different
medical professionals and often takes several months.
During the diagnostic process,
a patient may see a pulmonologist, a radiologist, a pathologist and a
surgeon, as well as an oncologist and a primary care physician. Patients
might also then opt for a second opinion. Early symptoms could lead to
imaging tests that include X-rays, an MRI, CT scans and PET scans. If
one of the scans reveals an irregularity, a biopsy is needed to confirm
the presence of mesothelioma. Although it can take 10 to 50 years after
exposure to asbestos before cancer develops and symptoms appear, the
survival time after symptoms are diagnosed can be short. The majority of
patients are given a prognosis of six to 18 months to live.
Early diagnostic methods, more awareness and improved treatments
have allowed some patients to live well beyond their initial prognosis.
The most important thing is to find a specialist who understands the
disease and understands all the intricacies and treatment options.
"It's important to have someone who is comfortable with the disease,"
said Hedy Kindler, M.D., director of the mesothelioma program at the
University of Chicago Medical Center. "You need a quarterback who
understands all the options."
- Cassandro, R., Montrasio, S., & Espsito, V. (2008).
Natural history of human pleural mesothelioma. In A. Baldi (Ed.),
Mesothelioma from bench side to clinic (pp. 337-345). New York, NY: Nova
Science Publishers, Inc.
- Kindler, H (2012, February). University of Chicago Medical Center, Phone interview with Hedy Kindler, M.D.
- Moore, A., Parker, J., Wiggins, J. (2008). Malignant Mesothelioma. Orphanet Journal of Rare Diseases. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652430/?tool=pubmed
- Alexander, R. (2011, October). University of Maryland. Phone interview with Richard Alexander, M.D.