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What is Mesothelioma? The Break Down

Mesothelioma is a condition many of us have heard about, but do not know what it is. It is a rare, aggressive tumor that invades the lining of the lungs, heart, or abdomen. So, what causes mesothelioma? While there are various causes of cancer, exposure to asbestos is the main culprit. 

A diagnosis of mesothelioma is a devastating one. While there are some treatment options for Mesothelioma, the prognosis is grim. It remains an incurable form of cancer. It is vital to be hyperaware of the causes of mesothelioma. That way, you stay informed and know what steps you can take to avoid exposure to certain toxic conditions responsible for the diagnosis. 

What are the types of Mesothelioma? 

There are a certain number of cells that are dedicated to the lining found in the chest, heart, and other internal organs. This lining is known as the mesothelium. The purpose of the mesothelium is to protect the organs by producing fluid so that the organs can move smoothly against each other. The mesothelial tumors usually form in the linings surrounding any of the organs. 

There are four different types of mesothelioma, depending on which internal organ is affected. The symptoms may differ depending on where cancer occurs.

Pleural Mesothelioma: The Lungs

Pleural mesothelioma takes residence in the lining of the lungs. The lining of the lungs is referred to as the pleural. Pleural Mesothelioma attacks the lungs and is the most aggressive and most common type of mesothelioma, affecting 80% of all cases. There are a few signs and symptoms to watch out for:

  • Shortness of breath accompanied by chest pain
  • Dry coughing and noticeable lumps of tissue under the skin of your chest.
  • Unexplained weight loss
  • Fever and fatigue

These symptoms are also similar to lung cancer, and other conditions could be to blame. 

Peritoneal Mesothelioma: The Abdomen 

Peritoneal mesothelioma embeds itself in the lining surrounding the abdomen. It is the second most common form of mesothelioma. This type of mesothelioma still has a poor prognosis like the rest, but in comparison to the other forms, it seems more favorable to the latter. Only 500 cases are diagnosed with peritoneal mesothelioma annually. Asbestos again is the leading cause of peritoneal mesothelioma. The symptoms of peritoneal mesothelioma include:

  • Abdominal pain and swelling
  • Fluid in the abdomen
  • Nausea
  • Unexplained weight loss 

Tunica Vaginalis: Testicular Mesothelioma

There have only ever been 100 documented cases of testicular mesothelioma. It is accountable for less than one percent of all mesothelioma cases. This form of mesothelioma permeates the lining of the testicles. A few symptoms to be aware of include lumps on testicles and scrotal swelling. 

Pericardial Mesothelioma: The Heart

Pericardial Mesothelioma affects the heart and originates in the pericardium, which lines the heart. Less than 50 people are diagnosed per year. Sadly, in most cases, it is not diagnosed until it is discovered in an autopsy. Since it is such a rare form of mesothelioma, the research is limited. Symptoms of pericardial mesothelioma include chest pain, inflammation of the pericardium, fluid in the heart, difficulty breathing, and unexplained weight loss. 

Malignant versus Benign Mesothelioma 

A tumor is either malignant or benign. Malignant mesothelioma is found in the majority of cases. Malignant means that cancer spreads quickly throughout an individual’s body and continues to grow at a rapid rate. This rate of growth limits treatment options and the life expectancy for those diagnosed with a malignant form of mesothelioma carries an average of 12 to 21 months after formal diagnosis.  

Benign mesothelioma is a slow-moving, non-cancerous form of mesothelioma. It is non-invasive and has a low chance of reoccurrence. Usually, a benign type of mesothelioma can be removed surgically. However, it is essential to know that a benign tumor has the potential to turn cancerous, transforming into malignant mesothelioma. 

A medical professional can determine if a tumor is malignant or benign by taking a biopsy of the tissue or fluid and reviewing the cells under a microscope. 

Malignant Mesothelioma: Cancer Cells 

There are three main cell types found in malignant forms of mesothelioma. The cells can be easily identified based on how they look. It is crucial to determine which cell type to implement an appropriate treatment plan and assess life expectancy. Depending on which cell type is found, the medical professional can better create a more effective mode of treatment. The three central cell types of mesothelioma cells include epithelial, sarcomatoid, and biphasic. 

Epithelioid 

Epithelioid cells are the most prevalent mesothelioma cell type found in more than half of diagnosed cases. These cells indicate a more favorable life expectancy than the other two cell types. The life expectancy for epithelioid mesothelioma is one to two years. 

The Epithelioid are slow-moving and have proven to respond well to treatment. Under a microscope, these cells are easily detectable because they form small clusters grouping together. A few notable symptoms of epithelioid mesothelioma include hoarseness, coughing, chest or abdominal pain, fluid build-up in the lungs or abdomen, fever, fatigue, and unexplained weight loss.  

Sarcomatoid: Fibrous 

Sarcomatoid cells are the most troublesome and complicated of the three cancer cells to treat. Sarcomatoid mesothelioma is typically associated with the pleural (lung) and peritoneal (heart) mesothelioma. These cells have a frightening life expectancy of six months. Sarcomatoid mesothelioma is responsible for 10-20 percent of mesothelioma cases.  

Biphasic: Mixed

Biphasic mesothelioma is when an individual has both epithelial and sarcomatoid cells in the tumors. There are differing prognoses because both of the cells are present. However, the treatment plan is typically based on which cell is the most dominant.  

What are the Statistics surrounding Malignant Mesothelioma? 

According to the American Cancer Society, Mesothelioma initially had an increased presence from the 1970s to the 1990s. Fortunately, since that time, the number of diagnoses has declined. Mesothelioma is rare in the United States, diagnosing roughly 3,000 cases per year. 

The declining rate is most likely due to changes in the workplace that produce extensive exposure to asbestos. The changes observed were mostly in men, due to the nature of work where asbestos is commonly found. Women have not increased and have maintained a steady rate over time. However, outside of the United States, mesothelioma continues to increase. Mesothelioma is typically found in Caucasians and Hispanics. Mesothelioma is found at a lower rate in African Americans and Asian Americans. 

Treatment Options 

The treatment type will depend on which kind of mesothelioma a patient is diagnosed with. The most common modes of treatment are chemotherapy and surgery. There is also an abundance of clinical trials that are studying immunotherapy as a method of treatment.

Research is typically narrow because of the rarity of the condition; however, there are many ongoing clinical trials aimed at increasing the patient’s life expectancy while working towards a cure.  

Main Cause of Mesothelioma: Asbestos 

There are countless potential causes that can lead to mesothelioma, but the most common perpetrator is asbestos. When asbestos fibers are inhaled, they ultimately set into the lining (mesothelium) of the lungs, heart, or abdomen. This causes destructive inflammation that forms the mesophilic tumors. According to a source, asbestos disrupts the mitosis process cell division, causing cellular mutation and damage. Asbestos can also cause the cells within the lining of the organs to remit mutagenic reactive oxygen paired with nitrogen, leading to mutation. 

Mesothelioma does not usually surface for 10 to 50 years when it beings to present symptoms. That fact alone makes it challenging to identify the cause and makes early detection nearly impossible. Many diagnoses of mesothelioma have been linked to the patient’s workplace. It is most common to come in contact with asbestos fibers in the following places of work:

  • Electrical work (buildings & remodels)
  • Auto Repair Shop and Car Dealership
  • Insulation Installation work
  • Shipyards
  • Construction (home remodels, demolition)
  • Plumbing work
  • Mines
  • Firefighting work
  • Oil refineries
  • Railroads
  • Power plants

Remember, this not an exhaustive list of potential occupations at risk for asbestos exposure, but it does list the most commonly affected by the harmful fibers. There is also second-hand exposure to asbestos. This can be lethal to family members regularly coming in contact with materials or clothing that have accumulated asbestos fibers. 

Asbestos has also been found in many household products like paint and planting soils. However, it has recently been discovered at an alarming rate in talcum powder. A new study recently conducted shows that it can cause the rare cancer. Talcum powder has been linked to causing not only mesothelioma but also ovarian cancer.

Asbestos in Talcum Powder

A recent case study published on October 10, 2019, in the Journal of Occupational and Environmental Medicine linked talcum powder to malignant mesothelioma. The research consisted of 33 individual subjects, composed mostly of women who were diagnosed with malignant mesothelioma. More interestingly, only the subjects with the most exposure to asbestos was through the use of talcum powder—virtually eliminating any other cause of mesothelioma. Especially since exposure to asbestos is the main risk factor for developing fatal cancer. 

An article published by Time noted that the authors to study explained, “in particular detail the cases of six individuals, all of whom underwent tissue testing that showed fibers consistent with the type of asbestos found in cosmetic talc, but not in things like building supplies and insulation. Some of these people used products containing talcum powder daily for decades.” 

The authors of this study hope to raise awareness for those who have used talcum powder in the past and those who may continue to do so. She warns consumers that there are no regulations for talcum powder and to consider using a safer alternative.

Since the release of the study, as of October 18, 2019, Johnson and Johnson have announced a voluntary recall of its Baby Powder after the Food and Drug Administration (FDA) discovered “sub-trace levels” of asbestos in a bottle of powder purchased online. An investigation is currently underway to confirm that the bottle was not tampered with in any way. 

Johnson & Johnson recalled lot # #22318RB that was released in the U.S. last year. Johnson & Johnson further recommends anyone with this lot number to discontinue use. 

Mesothelioma and the Future

Malignant Mesothelioma has been a cancer plaguing the world for decades. It is an aggressive form of cancer that affects many people that work in various industries. Asbestos has also found its way into American households where asbestos has been found in cosmetics, paints, certain plastics, and more. It is a lethal form of cancer, and it’s one that should not be taken lightly. Due to the time it takes for the symptoms of mesothelioma to appear (10-50 years), it is hard to determine the real cause while we may be using a product or may be exposed to asbestos now without even realizing it. Being able to recognize the symptoms and being more aware of your surroundings can make a difference in not only your health but the safety and well-being of others. 

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