Mesothelioma

Mesothelioma is a rare type of cancer that can develop decades after exposure to asbestos. Asbestos is a mineral that was once widely used due to its fire resistant and insulating properties, but is no longer mined, milled or manufactured in Australia because of the health risks. All uses in new products are now banned in Australia and no asbestos products may be imported. Strict precautions also govern the removal and disposal of asbestos and asbestos-containing materials.
Mesothelioma usually starts in the outer membrane of the lungs (pleura) but can also occur in the membrane lining of the abdominal cavity (peritoneum). Uncommonly, the heart or reproductive organs may be affected. Mesothelioma cannot be cured. Treatment aims to prolong life and keep the person as comfortable as possible.

Symptoms - lungs

he lungs are wrapped in a thin membrane called the visceral pleura. The chest wall is similarly lined (parietal pleura). These two membranes touch and slide across each other while we breathe, lubricated by a slick of fluid.
Mesothelioma usually develops in only one lung. The tumour tends to grow across the lung until the entire organ is encased. Sometimes cancer cells migrate to lymph nodes and other areas of the body (such as the unaffected lung) via the lymphatic system. Mesothelioma causes the pleura to make more fluid than necessary, which presses on the lung (pleural effusion). Symptoms include:
* Breathlessness
* Dry cough
* Pain.

Symptoms - peritoneum

About 10 per cent of mesothelioma cases involve the peritoneum. The peritoneum is a membrane that forms the lining of the abdominal and the pelvic cavities. Swallowed asbestos fibres can move through the stomach wall and cause mesothelioma to develop in the peritoneum. Symptoms of peritoneal mesothelioma include:
* Painful abdomen
* Swollen abdomen
* High temperature
* Nausea and vomiting
* Bowel problems
* Urinary problems.

Symptoms - later stages

Symptoms in the later stages of the disease include:
* Sudden and unexplained weight loss
* Spitting up sputum
* Spitting up blood
* Swallowing problems
* Hoarseness.

High risk groups

The primary risk factor for mesothelioma is asbestos exposure. The disease is rarely seen in young people. Since mesothelioma can take as long as 40 years to develop, the incidence tends to rise following middle age. High risk groups include anyone who has worked with asbestos - in jobs such as asbestos mining, milling, manufacture or in the construction, power and shipbuilding industries - and their close family or household members: for example, those who washed their work clothes.

Diagnosis methods

Diagnosis of mesothelioma may include:
* Medical history including history of asbestos exposure
* Physical examination
* Blood tests
* Chest x-rays
* CT scans
* MRI
* Drainage and laboratory analysis of the pleural fluid
* Tissue sample (biopsy) to help differentiate mesothelioma from another condition known as 'benign asbestos related pleural disease'.

Treatment options

Depending on the type of mesothelioma, the stage of disease and the person's preference, treatment options can include:
* Pleurectomy - surgery to remove the affected tissue. The affected lung may also be removed in whole or in part. Usually only small tumours are treated with surgery. Life span may be prolonged for a few months or years.
* Phototherapy - sometimes used during pleurectomy. Stray cancer cells within the chest are highlighted with special dye and killed by laser.
* Pleurodesis - a special powder is inserted between the pleural layers to cause inflammation that stops production of excess fluid. It is performed using a slender instrument (endoscope) inserted into the chest.
* Peritoneal surgery - to remove tumours in the abdominal cavity. Bowel symptoms can often improve following this procedure.
* Chemotherapy - cancer-killing drugs that can shrink the cancer and ease symptoms. Chemotherapy is often recommended if the cancer has returned following other treatment, or if other treatments are inappropriate.
* Radiotherapy - x-ray treatment to kill cancer cells. Only small areas can be treated or else the healthy cells of the lungs, heart and liver may be damaged. Radiotherapy is often used to ease pain and breathlessness.

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