Mesothelioma Summary

Mesothelioma is a rare cancer, but the number of people it affects is increasing. There are over 1,700 new cases in the UK each year. It is much more common in men than in women.

Mesothelioma occurs in the pleura (the membranes surrounding the lungs) or, more rarely, in the peritoneum (the membrane lining the abdomen). The cancer tends to spread locally. It is often quite advanced at the time of diagnosis.

Risk factors for Mesothelioma

Asbestos
Exposure to asbestos is the main risk factor for mesothelioma. Around 8 out of 10 people with mesothelioma have been exposed to asbestos. It can take fifteen to forty years following asbestos exposure for mesothelioma to develop.
Changes in the pleura occur when people breathe in asbestos fibres. These may penetrate the lining of the lung. Mesothelioma of the abdominal lining may result from coughing up and swallowing inhaled asbestos fibres.

In the past, asbestos was used widely in the building industry, the ship building industry and in the manufacture of household appliances. It is an effective insulating material because it does not conduct heat well and is resistant to melting or burning.

Family members of people exposed to asbestos also run a higher risk of developing mesothelioma. This is because workers can carry asbestos fibres into the home on their clothes.

Many people who develop mesothelioma because of exposure to asbestos may be eligible for compensation. They should discuss this with their doctor.

Other chemicals
A naturally occurring mineral called zeolite, which is found in Turkey, may cause some cases of mesothelioma.

Radiation
Mesothelioma may develop following exposure to radiation from a substance called thorium dioxide, which was used to create X-rays of blood vessels until 1955.

Other lung diseases
Mesothelioma is more common in people who have had serious lung diseases such as tuberculosis.

Prevention

Thanks to very strict regulations on asbestos, the main cause of mesothelioma, it is likely that this type of cancer will become increasingly rare. For now, the number of cases is still increasing because of the delay between exposure to asbestos and the development of the disease. People whose work involves demolition of old buildings and structures should make sure that proper health and safety measures are in place.

Screening

People who may have been exposed to asbestos at work should ask their doctor about the possibility of regular check-ups, which usually includes an annual X-ray.

Signs and symptoms

Mesothelioma does not generally cause symptoms in the early stages. Symptoms of mesothelioma in the lining of the lung can include:

pain in the lower back or the side of the chest

a persistent cough

shortness of breath

hoarseness (a 'husky' voice)

unexplained weight loss

sweating

difficulty swallowing.

Symptoms of mesothelioma in the abdominal lining may include:

abdominal pain

swelling in the abdomen

nausea and vomiting

loss of appetite

unexplained weight loss

change in bowel habits

These signs and symptoms usually indicate problems other than cancer. However, people who have been exposed to asbestos or notice any symptoms should see their doctor.

Detection

Initially the doctor will ask questions about medical history, and carry out a physical examination. The doctor or, after referral, a specialist may want to do further tests, which can include :

Fluid drainage
Many people with mesothelioma have fluid around their lungs or in their abdominal cavity. The test uses a needle to extract this fluid. A specialist can then analyse it in the laboratory to see if any cancer cells are present.

Thoracoscopy

Since mesothelioma can affect the lungs and the abdomen, doctors may also carry out some of the tests commonly used to detect lung or stomach cancer, such as:

Chest X-ray or abdominal X-ray

CT scan

Bronchoscopy

Mediastinoscopy

Laparoscopy

Treatment

Possible treatments include:

Surgery
If the cancer is in its early stages, doctors may be able to remove it surgically. The doctors might also use surgery to relieve symptoms such as pain and the accumulation of fluid.

Radiotherapy
Doctors usually use radiotherapy to control symptoms such as fluid collection or pain.

Chemotherapy
Doctors may use chemotherapy after surgery or on its own. They can also use it to relieve symptoms caused by the cancer, such as pain.

Supportive care
Some people may be too ill to tolerate intense chemotherapy, radiotherapy, or surgery. Supportive treatment will aim to control and manage some of the effects and symptoms that the cancer causes, such as pain, breathing problems, weight loss and other symptoms.

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