Endostatin is an anti-tumor drug that attacks a process called angiogenesis (sometimes also called an Angiogenic Inhibitor). Angiogenesis is the way that a tumor nourishes itself by forming a network of blood vessels. Essentially the tumor sends out signals that summon blood vessels to nourish them. With this nourishment the tumors grow (or metastasize) and eventually kill the patient. Endostatin is designed to disrupt angiogenesis so that tumors are eventually starved and die.Until recently, Endostatin had only been tested on laboratory animals. It succeeded in reducing tumors in mice but had not been tested on humans. Currently Endostatin is being tested in clinical trials on terminally ill cancer patients and not long ago Phase I testing concluded at the M.D. Anderson Cancer Center at the University of Texas. The results were generally positive. Endostatin caused few toxic side effects and caused tumor shrinkage in 8% of the participants.
At this writing, there are only three major clinics were Endostatin clinical trials are being conducted with patients: Dana Farber/Partners Cancer Care in Boston, M.D. Anderson Cancer Center in Houston, and the University of Wisconsin Comprehensive Cancer Center in Madison. So far only phase one trials have been conducted and the sample group has been relatively small. Between the three cancer centers, only a 100 or so terminally ill cancer patients have undergone Endostatin treatment. So unfurtunately there are not many oppurtunities to participate in a clinical trial.
Like all Phase I trials, the trials have mostly been concerned with testing the safety of Endostatin. Nevertheless researchers have also paid close attention to Edostatin's anti-angiogenesis effect. All of the patients in the trial are late stage cancer patients so any slowing of the cancers progression as a result of anti-angiogenesis is regarded by researchers as a very encouraging sign. Therefore they have been pleased to see that between roughly 6-8% of the combined group have shown tumor shrinkage.
Since its earliest trials in laboratory mice, doctors and researchers have seen a great deal of potential in Endostatin as a less toxic alternative to conventional cancer treatments such as chemotherapy and radiotherapy. The clinical trials have thus far shown Endostatin to be a safe drug and the medical community remains hopeful that further testing will not only strengthen this verdict, but show Edostatin to be an effective alternative to conventional treatments.
Researchers believe that Endostatin will be most effective treating fast growing cancers with tumors that rely on a larger number of blood vessels such as mesothelioma, renal cell carcinoma, melanoma and breast cancer.
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Mesothelioma Stages
How Is Malignant Mesothelioma Staged?
Staging is the process of finding out how far the cancer has spread. Staging of mesothelioma is based on imaging studies such as x-rays, CT scans, and MRI scans. The treatment and outlook for patients with mesothelioma largely depends on the stage (extent of spread) of their cancer. Since pleural mesothelioma occurs most frequently and has been studied the most, it is the only mesothelioma for which a staging classification exists.The staging system used in the past for mesothelioma is the Butchart System. This system is based mainly on the extent of the primary tumor mass, and divides mesotheliomas into stages I through IV. Many doctors will still use this system.
Stage I
Mesothelioma is present on one side of the chest only and isn’t growing into the chest wall.
Stage II
Mesothelioma invades the chest wall or involves the esophagus (food passage connecting the throat to the stomach), heart, or has grown into the pleura on the other side of the chest.. The lymph nodes in the chest may also be involved.
Stage III
Mesothelioma has grown through the diaphragm into the peritoneum (lining of the abdominal cavity) or has spread to lymph nodes beyond those in the chest.
Stage IV
Mesothelioma has spread through the bloodstream to other organs (metastases).
Another staging system has recently been developed by the International Mesothelioma Interest Group and adopted by the American Joint Committee on Cancer (AJCC). This is a TNM system, similar to staging systems used for most other cancers. T stands for tumor (its size and how far it has spread to nearby organs), N stands for spread to lymph nodes and M is for metastasis (spread to distant organs). In TNM staging, information about the tumor, lymph nodes, and metastasis is combined in a process called stage grouping to assign a stage described by Roman numerals from I to IV. Major cancer centers are beginning to use this system instead of the Butchart staging because it more accurately depicts the extent of tumor.
Stage I
Mesothelioma involves either the right or left pleura lining the chest. It has only spread to the outer lining of the lung in, at most, a few small spots. It has not yet spread to the lymph nodes.
Stage II
Mesothelioma involves either the right or left pleura lining the chest and has spread from the lining of the chest into 1) the outer lining of the lung or 2) the diaphragm or 3) into the lung itself.
Stage III
Mesothelioma involves either the right or left pleura lining the chest and has spread into 1) the first layer of the chest wall, or 2) the fatty part of the mediastinum, or 3) a single place in the chest wall or 4) the outer covering layer of the heart or 5) lymph nodes anywhere in the same side of the chest.
Stage IV
Mesothelioma involves either the right or left pleura lining the chest and has spread 1) into the chest wall, either muscle or ribs, or 2) through the diaphragm, or 3) into any organ contained in the mediastinum (esophagus, trachea, thymus, blood vessels), or 4) into the spine, or 5) across to the pleura on the other side of the chest, or 6) through the heart lining or into the heart itself, or 7) into the brachial plexus (nerves leading to the arm), or 8) into lymph nodes outside that side of the chest, or 9) spread to other organs through the bloodstream.
Experts recommend that this staging system should be used instead of the original Butchart staging system.
Read more...
Staging is the process of finding out how far the cancer has spread. Staging of mesothelioma is based on imaging studies such as x-rays, CT scans, and MRI scans. The treatment and outlook for patients with mesothelioma largely depends on the stage (extent of spread) of their cancer. Since pleural mesothelioma occurs most frequently and has been studied the most, it is the only mesothelioma for which a staging classification exists.The staging system used in the past for mesothelioma is the Butchart System. This system is based mainly on the extent of the primary tumor mass, and divides mesotheliomas into stages I through IV. Many doctors will still use this system.
Stage I
Mesothelioma is present on one side of the chest only and isn’t growing into the chest wall.
Stage II
Mesothelioma invades the chest wall or involves the esophagus (food passage connecting the throat to the stomach), heart, or has grown into the pleura on the other side of the chest.. The lymph nodes in the chest may also be involved.
Stage III
Mesothelioma has grown through the diaphragm into the peritoneum (lining of the abdominal cavity) or has spread to lymph nodes beyond those in the chest.
Stage IV
Mesothelioma has spread through the bloodstream to other organs (metastases).
Another staging system has recently been developed by the International Mesothelioma Interest Group and adopted by the American Joint Committee on Cancer (AJCC). This is a TNM system, similar to staging systems used for most other cancers. T stands for tumor (its size and how far it has spread to nearby organs), N stands for spread to lymph nodes and M is for metastasis (spread to distant organs). In TNM staging, information about the tumor, lymph nodes, and metastasis is combined in a process called stage grouping to assign a stage described by Roman numerals from I to IV. Major cancer centers are beginning to use this system instead of the Butchart staging because it more accurately depicts the extent of tumor.
Stage I
Mesothelioma involves either the right or left pleura lining the chest. It has only spread to the outer lining of the lung in, at most, a few small spots. It has not yet spread to the lymph nodes.
Stage II
Mesothelioma involves either the right or left pleura lining the chest and has spread from the lining of the chest into 1) the outer lining of the lung or 2) the diaphragm or 3) into the lung itself.
Stage III
Mesothelioma involves either the right or left pleura lining the chest and has spread into 1) the first layer of the chest wall, or 2) the fatty part of the mediastinum, or 3) a single place in the chest wall or 4) the outer covering layer of the heart or 5) lymph nodes anywhere in the same side of the chest.
Stage IV
Mesothelioma involves either the right or left pleura lining the chest and has spread 1) into the chest wall, either muscle or ribs, or 2) through the diaphragm, or 3) into any organ contained in the mediastinum (esophagus, trachea, thymus, blood vessels), or 4) into the spine, or 5) across to the pleura on the other side of the chest, or 6) through the heart lining or into the heart itself, or 7) into the brachial plexus (nerves leading to the arm), or 8) into lymph nodes outside that side of the chest, or 9) spread to other organs through the bloodstream.
Experts recommend that this staging system should be used instead of the original Butchart staging system.
Read more...
Mesothelioma Legal Options:
AM I ENTITLED TO FILE A LAWSUIT IF I THINK I HAVE BEEN AFFECTED BY ASBESTOS?
You can only file a law suit if you have definitely been affected by asbestos, which means seeking medical assistance and getting a diagnosis of mesothelioma as soon as possible. Once your diagnosis has been confirmed by your doctor, you should then seek legal assistance as soon as possible to file your lawsuit for compensation. Your lawyer will need to have details of your diagnosis in order to put together your law suit.
WHO WILL I BE SUING?This all depends on your situation and where, when and how you were exposed to asbestos. You may have been exposed by your employer many years ago; your exposure may have been the result of a faulty product that contains asbestos; or you may have been exposed through contact with someone that worked with asbestos. Your lawyer will advise you on the best route to take with your compensation claim.
CAN DOCTORS BE SUED FOR NOT DIAGNOSING THE DISEASE QUICKLY ENOUGH?
Although cases have been filed for medical negligence, this is a tricky area. Because the disease takes so long to properly manifest, it is often at quite a late stage by the time you seek medical assistance and a diagnosis is made. Furthermore, the symptoms of mesothelioma are very non-specific which means that they could be associated with a number of other common diseases. If your doctor is not aware of your connection with asbestos, there is a good chance that he or she will test and treat your for a number of other diseases before testing for mesothelioma. To avoid this happening, you should always make your doctor aware that you have been exposed to asbestos, as this will give him the information he needs to make an informed diagnosis and prescribe early treatment.
WHAT DOES THE COMPENSATION COVER?
The compensation you receive is to cover a number of things. Firstly, you may have run up enormous medical bills getting tests and treatment for your illness. Secondly, you have every right to be compensated for the pain and suffering you have experienced as well as the mental anguish and grief suffered by yourself and your family. And thirdly, your family has a right to be financially secure after you have gone, and the companies responsible for your terminal illness should be liable to pay for this financial security.
IS MY LAWSUIT GUARANTEED TO BE SUCCESSFUL?
There are no guarantees, but providing you find a lawyer as soon as possible (within the time limits set by your state) and you are able to help your lawyer put a good case together by providing the necessary information a quickly as possible, then you stand a good chance.
WILL A LAWYER CHARGE MUCH FOR HIS SERVICES?
The good news is that most mesothelioma lawyers will not charge any up front fees at all. Even if they have to hire an investigator to do some research to help your case, they normally foot the bill for this. These lawyers work on a contingency fee, which means that the only money they take is from your compensation payout if and when you are successful. No compensation for you means no fee for the lawyer. If you do get compensation, the lawyer does take a cut as his fee – normally around 35%.
WHAT IF I HAVE MISSED THE DEADLINE WITHIN WHICH I CAN FILE A CLAIM?
You must always seek legal advice within the statutes of limitation as according to your state, as this will maximise your chances of a successful lawsuit. However, if for any reason you have missed the deadline, there is no harm in contacting a lawyer anyway to see whether there is anything that can be done. Your lawyer may have an idea of how to get around this, but a missed deadline normally means that your chances of success are slim.
Read more...
You can only file a law suit if you have definitely been affected by asbestos, which means seeking medical assistance and getting a diagnosis of mesothelioma as soon as possible. Once your diagnosis has been confirmed by your doctor, you should then seek legal assistance as soon as possible to file your lawsuit for compensation. Your lawyer will need to have details of your diagnosis in order to put together your law suit.
WHO WILL I BE SUING?This all depends on your situation and where, when and how you were exposed to asbestos. You may have been exposed by your employer many years ago; your exposure may have been the result of a faulty product that contains asbestos; or you may have been exposed through contact with someone that worked with asbestos. Your lawyer will advise you on the best route to take with your compensation claim.
CAN DOCTORS BE SUED FOR NOT DIAGNOSING THE DISEASE QUICKLY ENOUGH?
Although cases have been filed for medical negligence, this is a tricky area. Because the disease takes so long to properly manifest, it is often at quite a late stage by the time you seek medical assistance and a diagnosis is made. Furthermore, the symptoms of mesothelioma are very non-specific which means that they could be associated with a number of other common diseases. If your doctor is not aware of your connection with asbestos, there is a good chance that he or she will test and treat your for a number of other diseases before testing for mesothelioma. To avoid this happening, you should always make your doctor aware that you have been exposed to asbestos, as this will give him the information he needs to make an informed diagnosis and prescribe early treatment.
WHAT DOES THE COMPENSATION COVER?
The compensation you receive is to cover a number of things. Firstly, you may have run up enormous medical bills getting tests and treatment for your illness. Secondly, you have every right to be compensated for the pain and suffering you have experienced as well as the mental anguish and grief suffered by yourself and your family. And thirdly, your family has a right to be financially secure after you have gone, and the companies responsible for your terminal illness should be liable to pay for this financial security.
IS MY LAWSUIT GUARANTEED TO BE SUCCESSFUL?
There are no guarantees, but providing you find a lawyer as soon as possible (within the time limits set by your state) and you are able to help your lawyer put a good case together by providing the necessary information a quickly as possible, then you stand a good chance.
WILL A LAWYER CHARGE MUCH FOR HIS SERVICES?
The good news is that most mesothelioma lawyers will not charge any up front fees at all. Even if they have to hire an investigator to do some research to help your case, they normally foot the bill for this. These lawyers work on a contingency fee, which means that the only money they take is from your compensation payout if and when you are successful. No compensation for you means no fee for the lawyer. If you do get compensation, the lawyer does take a cut as his fee – normally around 35%.
WHAT IF I HAVE MISSED THE DEADLINE WITHIN WHICH I CAN FILE A CLAIM?
You must always seek legal advice within the statutes of limitation as according to your state, as this will maximise your chances of a successful lawsuit. However, if for any reason you have missed the deadline, there is no harm in contacting a lawyer anyway to see whether there is anything that can be done. Your lawyer may have an idea of how to get around this, but a missed deadline normally means that your chances of success are slim.
Read more...
Mesothelioma Attorneys
Mesothelioma is a disease that, until recently, was extremely rare. To date, little is know about the condition. However, as the rate of the disease has increased, a new breed of lawyers – those dealing specifically with mesothelioma lawsuits – have stepped in to fight for the rights of victims afflicted with this disease. These lawyers and law firms often deal exclusively with mesothelioma victims and their families who wish to claim compensation from the companies that were responsible for their exposure to asbestos. These mesothelioma lawsuits often result in millions of dollars for the victims when handled by an experienced lawyer or law firm.Those who have been diagnosed with mesothelioma have every right to file a lawsuit. Many of the companies responsible for exposing workers to asbestos were well aware of its dangers and effects, but still saw fit to let their workers continue with little or no protection against the dust and fibers that emanated from this hazardous material. Now, decades later, the effects of this exposure is taking its toll on American workers just as they reach their golden years. These workers are entitled to compensation and justice for their pain, suffering and loss of life. A mesothelioma lawsuit can provide them with such justice.
Today, there are many mesothelioma lawyers to choose from. The number of lawyers and law firms handling these lawsuits is on the rise. Many of these lawyers have dealt with numerous mesothelioma lawsuits and have a good deal of experience and knowledge about the disease. Those looking for a mesothelioma lawyer should chooser someone that has proven experience in the field. Most reputable lawyers will be happy to provide facts and figures on previous cases that they have handled. However, these lawyers often do not provide private information that might be subject to confidentiality. They can, however, provide you with details on how quickly cases were resolved, how much compensation was successfully obtained and how many mesothelioma lawsuits they have dealt with.
It is also worth finding out about the mesothelioma lawsuits that were not successful, and why they were not successful. It may be something as simple as a missed piece of evidence to failure to comply with sensitive timetables associated with such cases. These elements can make the difference between a successful and an unsuccessful lawsuit. By finding out why some lawsuits resulted in no compensation, you may be able to avoid making the same type of mistake.
It is important that you find a good, experienced mesothelioma lawyer as soon as possible after you have been diagnosed with the disease. Most states have a set time limit in which you can file your lawsuit, and it is very important that you not miss that deadline known as a statute of limitations. Otherwise you may find that you are ineligible to make a claim. You also need to give your lawyer as much time as possible to do the necessary research and put together a solid and case against the negligent parties. In short, the earlier you get to a mesothelioma lawyer, the better your chances of success.
Many people are concerned because they do not know exactly where and when they were exposed to asbestos. Some people may have worked in several different places and been exposed to asbestos on numerous occasions. However, your mesothelioma lawyer can help in identifying products that you were exposed to. If necessary, your mesothelioma lawyer will hire the services of a private investigator to find out where the exposure took place. With some research and digging, the lawyer is generally able to pinpoint the company or companies responsible for the exposure.
Again, this can take time and is another reason why it is so important to find a mesothelioma lawyer as soon as possible after the diagnosis of the cancer has been confirmed. Understandably, patients who have just been told that they have mesothelioma will have a great deal on their minds and filing a lawsuit may not be one of their priorities. However, the timely process of selecting a lawyer and filing your lawsuit can make all the difference in securing the future of your family.
Read more...
Today, there are many mesothelioma lawyers to choose from. The number of lawyers and law firms handling these lawsuits is on the rise. Many of these lawyers have dealt with numerous mesothelioma lawsuits and have a good deal of experience and knowledge about the disease. Those looking for a mesothelioma lawyer should chooser someone that has proven experience in the field. Most reputable lawyers will be happy to provide facts and figures on previous cases that they have handled. However, these lawyers often do not provide private information that might be subject to confidentiality. They can, however, provide you with details on how quickly cases were resolved, how much compensation was successfully obtained and how many mesothelioma lawsuits they have dealt with.
It is also worth finding out about the mesothelioma lawsuits that were not successful, and why they were not successful. It may be something as simple as a missed piece of evidence to failure to comply with sensitive timetables associated with such cases. These elements can make the difference between a successful and an unsuccessful lawsuit. By finding out why some lawsuits resulted in no compensation, you may be able to avoid making the same type of mistake.
It is important that you find a good, experienced mesothelioma lawyer as soon as possible after you have been diagnosed with the disease. Most states have a set time limit in which you can file your lawsuit, and it is very important that you not miss that deadline known as a statute of limitations. Otherwise you may find that you are ineligible to make a claim. You also need to give your lawyer as much time as possible to do the necessary research and put together a solid and case against the negligent parties. In short, the earlier you get to a mesothelioma lawyer, the better your chances of success.
Many people are concerned because they do not know exactly where and when they were exposed to asbestos. Some people may have worked in several different places and been exposed to asbestos on numerous occasions. However, your mesothelioma lawyer can help in identifying products that you were exposed to. If necessary, your mesothelioma lawyer will hire the services of a private investigator to find out where the exposure took place. With some research and digging, the lawyer is generally able to pinpoint the company or companies responsible for the exposure.
Again, this can take time and is another reason why it is so important to find a mesothelioma lawyer as soon as possible after the diagnosis of the cancer has been confirmed. Understandably, patients who have just been told that they have mesothelioma will have a great deal on their minds and filing a lawsuit may not be one of their priorities. However, the timely process of selecting a lawyer and filing your lawsuit can make all the difference in securing the future of your family.
Read more...
Cancerous Mesothelioma
Mesothelioma is a type of cancer that can develop in the tissues covering the lungs or the abdomen. It is a cancer of mesothelial cells. These cells cover the outer surface of most of our internal body organs, forming a lining that is called the mesothelium.
About two thirds or three quarters of mesotheliomas occur in the chest (67 to 75%). They start in the two sheets of tissue known as pleural membranes (or pleura) that cover the lungs. The gap between the pleura is called the pleural space. The pleura are fibrous sheets that help to protect the lungs. They also produce a lubricating fluid that helps the pleural membranes to slide over each other easily when the lungs expand and deflate as we breathe. Mesothelioma of the pleura is called pleural mesothelioma.
The sheet of tissue covering the heart (the pericardium) is very close to the pleura. So in some people pleural mesothelioma may also spread into the pericardium. The diagram below shows the pleural membranes thickening due to mesothelioma.
The sheet of tissue covering the organs of the abdomen (tummy) is called the peritoneum. It helps to protect the contents of the abdomen and keep them in place. It also produces a lubricating fluid. The fluid helps the abdominal organs to move smoothly against each other as we move around.
Mesothelioma of the tissues lining the abdominal cavity is known as peritoneal mesothelioma. Between a quarter and a third of mesotheliomas occur in the abdomen (25 to 33%). So it is much less common than pleural mesothelioma. Peritoneal mesothelioma does not usually spread to other parts of the body.
A type of non cancerous (benign) mesothelioma can develop in the lining of the lungs, or in the lining of the reproductive organs. It can occur in either men or women. These non cancerous tumours are very rare.
Mesothelioma is quite a rare cancer, but it is becoming more common. Around 2,400 people are diagnosed with mesothelioma in the UK each year. There are about 5 times as many cases in men as in women. This is probably because many cases have been caused by exposure to asbestos at work. Mesothelioma in the chest (pleural mesothelioma) is much more common than mesothelioma in the abdomen (peritoneal mesothelioma).
We know what causes most cases of pleural mesothelioma. Around 1 in 10 people exposed to asbestos develop mesothelioma in the pleural membranes. Many people with peritoneal mesothelioma have also been exposed to asbestos. We have known of a link between asbestos and lung disease since the beginning of the 18th century. But the link with mesothelioma has only been known since the 1960's. Unfortunately, the number of cases of mesothelioma in the UK each year is expected to rise sharply over the next 20 years because of the heavy use of asbestos in industry from the end of the second world war up until the mid 1970s.
Between 7 and 8 out of every 10 people (70 to 80%) diagnosed with mesothelioma say they have been in contact with asbestos. Your risk is greater if you were exposed to large amounts of it from an early age for a very long period of time. But some people say they have no history of any exposure to asbestos.
Remember that many people who develop mesothelioma due to asbestos exposure may be able to claim compensation. It is important to talk to a lawyer about this as early as possible. Your specialist doctor or nurse may be able to give you some information. Or some of the mesothelioma organisations can help and advise you.
So most cases of mesothelioma occur in men who have worked in manufacturing using asbestos or who have used asbestos products, particularly in construction or engineering. A recent UK study showed that risks are particularly high for metal plate workers (mainly in shipbuilding) and carpenters, and the risk is higher in people exposed to asbestos before the age of 30. This study estimated that 1 out of 17 British carpenters born in the 1940s and employed in carpentry for more than 10 years before the age of 30 would go on to develop mesothelioma. People who worked as plumbers or mechanics also have an increased risk.
Asbestos was widely used in the years after the war (after 1945). Mesothelioma may not develop until 15 to 40 years after you have been exposed to asbestos, which is why we are now seeing an increase in cases. The number of cases is expected to peak around 2020 and then start to go down.
There are three main types of asbestos - blue, brown and white. Blue and brown asbestos are strongly linked with mesothelioma. They have been banned since the late 1980's and cannot be imported into the UK. White asbestos is now also thought to be harmful. The use of all asbestos was banned in 1999 in the UK.
Asbestos is made up of tiny fibres. You can breathe these fibres in when you come into contact with asbestos. The fibres work their way into the pleura, lining the lung. They irritate the pleura and may cause gene changes (mutations) that lead to the growth of cancer. Some of the fibres that have been breathed in can be coughed up and swallowed. This is probably the cause of peritoneal mesothelioma.
If you have been exposed to asbestos, your family may also have been exposed. Asbestos fibres can be carried home on your clothes. Research studies have confirmed that the families of people exposed to asbestos also have a higher risk of developing mesothelioma.
The symptoms of pleural mesothelioma are
Some people have changes in the shape of their fingers and nails called finger clubbing, but this is not common.
The symptoms of peritoneal mesothelioma are
Read more...
About two thirds or three quarters of mesotheliomas occur in the chest (67 to 75%). They start in the two sheets of tissue known as pleural membranes (or pleura) that cover the lungs. The gap between the pleura is called the pleural space. The pleura are fibrous sheets that help to protect the lungs. They also produce a lubricating fluid that helps the pleural membranes to slide over each other easily when the lungs expand and deflate as we breathe. Mesothelioma of the pleura is called pleural mesothelioma.
The sheet of tissue covering the heart (the pericardium) is very close to the pleura. So in some people pleural mesothelioma may also spread into the pericardium. The diagram below shows the pleural membranes thickening due to mesothelioma.
The sheet of tissue covering the organs of the abdomen (tummy) is called the peritoneum. It helps to protect the contents of the abdomen and keep them in place. It also produces a lubricating fluid. The fluid helps the abdominal organs to move smoothly against each other as we move around.
Mesothelioma of the tissues lining the abdominal cavity is known as peritoneal mesothelioma. Between a quarter and a third of mesotheliomas occur in the abdomen (25 to 33%). So it is much less common than pleural mesothelioma. Peritoneal mesothelioma does not usually spread to other parts of the body.
A type of non cancerous (benign) mesothelioma can develop in the lining of the lungs, or in the lining of the reproductive organs. It can occur in either men or women. These non cancerous tumours are very rare.
Mesothelioma is quite a rare cancer, but it is becoming more common. Around 2,400 people are diagnosed with mesothelioma in the UK each year. There are about 5 times as many cases in men as in women. This is probably because many cases have been caused by exposure to asbestos at work. Mesothelioma in the chest (pleural mesothelioma) is much more common than mesothelioma in the abdomen (peritoneal mesothelioma).
We know what causes most cases of pleural mesothelioma. Around 1 in 10 people exposed to asbestos develop mesothelioma in the pleural membranes. Many people with peritoneal mesothelioma have also been exposed to asbestos. We have known of a link between asbestos and lung disease since the beginning of the 18th century. But the link with mesothelioma has only been known since the 1960's. Unfortunately, the number of cases of mesothelioma in the UK each year is expected to rise sharply over the next 20 years because of the heavy use of asbestos in industry from the end of the second world war up until the mid 1970s.
Between 7 and 8 out of every 10 people (70 to 80%) diagnosed with mesothelioma say they have been in contact with asbestos. Your risk is greater if you were exposed to large amounts of it from an early age for a very long period of time. But some people say they have no history of any exposure to asbestos.
Remember that many people who develop mesothelioma due to asbestos exposure may be able to claim compensation. It is important to talk to a lawyer about this as early as possible. Your specialist doctor or nurse may be able to give you some information. Or some of the mesothelioma organisations can help and advise you.
So most cases of mesothelioma occur in men who have worked in manufacturing using asbestos or who have used asbestos products, particularly in construction or engineering. A recent UK study showed that risks are particularly high for metal plate workers (mainly in shipbuilding) and carpenters, and the risk is higher in people exposed to asbestos before the age of 30. This study estimated that 1 out of 17 British carpenters born in the 1940s and employed in carpentry for more than 10 years before the age of 30 would go on to develop mesothelioma. People who worked as plumbers or mechanics also have an increased risk.
Asbestos was widely used in the years after the war (after 1945). Mesothelioma may not develop until 15 to 40 years after you have been exposed to asbestos, which is why we are now seeing an increase in cases. The number of cases is expected to peak around 2020 and then start to go down.
There are three main types of asbestos - blue, brown and white. Blue and brown asbestos are strongly linked with mesothelioma. They have been banned since the late 1980's and cannot be imported into the UK. White asbestos is now also thought to be harmful. The use of all asbestos was banned in 1999 in the UK.
Asbestos is made up of tiny fibres. You can breathe these fibres in when you come into contact with asbestos. The fibres work their way into the pleura, lining the lung. They irritate the pleura and may cause gene changes (mutations) that lead to the growth of cancer. Some of the fibres that have been breathed in can be coughed up and swallowed. This is probably the cause of peritoneal mesothelioma.
If you have been exposed to asbestos, your family may also have been exposed. Asbestos fibres can be carried home on your clothes. Research studies have confirmed that the families of people exposed to asbestos also have a higher risk of developing mesothelioma.
The symptoms of pleural mesothelioma are
- Pain in the lower back or the side of the chest
- A persistent cough
- Shortness of breath
- A hoarse or husky voice
- Losing more than 10% of your weight when not dieting
- Sweating and high temperatures
- Difficulty swallowing
Some people have changes in the shape of their fingers and nails called finger clubbing, but this is not common.
The symptoms of peritoneal mesothelioma are
- Pain in the abdomen (tummy)
- Swelling in the abdomen
- Feeling or being sick
- Poor appetite
- Losing more than 10% of your weight when not dieting
- Diarrhoea or constipation
Read more...
Every 4 mesothelioma cases, 1 case goes unreported
The latest statistic presented by the Cary, North Carolina-based, government journal Environmental Health Perspectives (EHP) regarding mesothelioma cancer, which affects the protective lining of the lungs, heart, chest and abdomen, states that for every four to five cases reported worldwide, at least one case goes unreported. This is the first study to offer a global estimate of unreported mesothelioma cases. The collective experience of countries with available data on asbestos disease was used to generate the estimation.Malignant mesothelioma is caused almost exclusively by prolonged exposure to asbestos. People are generally exposed to asbestos by inhaling microscopic, carcinogenic fibers released whenever asbestos is disturbed. These fibers collect and fester in the lungs, explaining why the mesothelioma most commonly occurs in the lining of the lungs.
The EHP study used mesothelioma deaths as a proxy mesothelioma cases because mesothelioma patients usually die shortly after diagnosis and in many countries deathsto be more uniformly and accurately reported than diagnoses. The scientists studied the correlation between country-level asbestos use from 1920 to 1970 and mesothelioma deaths reported between 1994 and 2008. Out of the 56 countries included in the study, there were approximately 174,300 mesothelioma deaths from 1994-2008.
Cumulative asbestos use in 89 countries, from 1920 to 1970, totaled over 65 million metric tons. The United States, Russia, United Kingdom, Germany, and Japan were the leaders in production and exportation. They were also some of the first countries to adopt the ban on asbestos use in the 1980′s.
The study found that a country’s cumulative use of asbestos in prior decades can reliably predict the number of recent mesothelioma deaths in the countries reporting mortality data. It is estimated that an additional 38,900 cases may have occurred in the 33 countries not providing mesothelioma data over the same 15-year period.
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The EHP study used mesothelioma deaths as a proxy mesothelioma cases because mesothelioma patients usually die shortly after diagnosis and in many countries deathsto be more uniformly and accurately reported than diagnoses. The scientists studied the correlation between country-level asbestos use from 1920 to 1970 and mesothelioma deaths reported between 1994 and 2008. Out of the 56 countries included in the study, there were approximately 174,300 mesothelioma deaths from 1994-2008.
Cumulative asbestos use in 89 countries, from 1920 to 1970, totaled over 65 million metric tons. The United States, Russia, United Kingdom, Germany, and Japan were the leaders in production and exportation. They were also some of the first countries to adopt the ban on asbestos use in the 1980′s.
The study found that a country’s cumulative use of asbestos in prior decades can reliably predict the number of recent mesothelioma deaths in the countries reporting mortality data. It is estimated that an additional 38,900 cases may have occurred in the 33 countries not providing mesothelioma data over the same 15-year period.
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Malignant Mesothelioma
Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart, the pericardium (a sac that surrounds the heart) or tunica vaginalis.Most people who develop mesothelioma have worked on jobs where they inhaled asbestos and glass particles, or they have been exposed to asbestos dust and fiber in other ways. It has also been suggested that washing the clothes of a family member who worked with asbestos or glass can put a person at risk for developing mesothelioma. Unlike lung cancer, there is no association between mesothelioma and smoking, but smoking greatly increases the risk of other asbestos-induced cancers. Those who have been exposed to asbestos often utilize attorneys to collect damages for asbestos-related disease, including mesothelioma. Compensation via asbestos funds or lawsuits is an important issue in mesothelioma (see asbestos and the law).
The prognosis for malignant mesothelioma remains disappointing, although there have been some modest improvements in prognosis from newer chemotherapies and multimodality treatments. Treatment of malignant mesothelioma at earlier stages has a better prognosis, but cures are exceedingly rare. Clinical behavior of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favors local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease. The histological subtype and the patient's age and health status also help predict prognosis.
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to mesothelioma, radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel. Radiation therapy when given alone with curative intent has never been shown to improve survival from mesothelioma. The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Chemotherapy is the only treatment for mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery.This trial was the first to report a survival advantage from chemotherapy in malignant pleural mesothelioma, showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the group of patients treated with cisplatin in the combination with pemetrexed and who also received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give.
Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, or vinorelbine on its own, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin.
In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.
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