~Mesothelioma~

What is mesothelioma?
What is malignant mesothelioma?
How to prevent mesothelioma ?
What are the symptoms of mesothelioma?
What causes mesothelioma?


~Asbestos~

Asbestos
Asbestosis
What are symptoms and signs of asbestosis?
What are the types of asbestos fibers?
Does asbestos exposure cause lung cancer?
What is pleural disease?
How is asbestosis treated?

Mesothelioma is a form of cancer that afflicts the tissues lining the body's organs, as well as the spaces in between them. It is one of the more problematic forms of cancer, since symptoms do not often appear until the disease reaches advanced stages. The best way to treat mesothelioma is to prevent its development altogether. That's most effectively accomplished by avoiding exposure to asbestos.

This is a step to prevent the development of mesothelioma

Step1
Avoid contact with asbestos at all costs. Asbestos was once used extensively for a variety of purposes (like insulation and mining), and exposure to it is the number-one leading cause of mesothelioma. It is no longer prevalent in the United States, but there are still areas where it may be present, including old apartment buildings and condemned structures

Step2
Ask an expert to come to your home, place of business or wherever you intend to spend a majority of your time to verify there is no asbestos present. Don't attempt to remove the asbestos yourself, but instead hire someone who is qualified and trained in its removal.

Step3
Do not live with someone who works near asbestos. The fibers of asbestos can be transported via clothing and the skin, making it very easy to spread to other people. Even a few stray fibers are sometimes enough to cause mesothelioma.

Step4
Be aware that people over the age of 65 are more likely to develop mesothelioma, so be sure to receive regular checkups to keep tabs on your health once you approach and pass that age. Your body has had much more time to accumulate exposure to asbestos.




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Most people with malignant mesothelioma have worked on jobs where they breathed asbestos. Usually, this involves men over 40 years of age. Others have been exposed to asbestos in a household environment, often without knowing it. Interestingly, the number of new cases of mesothelioma has been relatively stable since 1983, the same time that the restrictions on asbestos were instituted by the U.S. Occupational Safety and Health Administration (OSHA). In Europe, the number of new cases of mesothelioma continues to rise.

Asbestos is the only known risk factor for malignant mesothelioma, a cancer that affects the tissue lining the lung (pleura) or abdomen (peritoneum). Malignant mesothelioma is not associated with cigarette smoking but is strongly linked with the degree of asbestos exposure. However, 20% to 40% of patients with malignant mesothelioma have no prior asbestos exposure. In malignant mesothelioma, there is a very long duration between exposure and the onset of disease, usually greater than 30 years.

Although exposure to asbestos alone can lead to lung cancer, the risk increases dramatically in smokers of cigarettes or other forms of tobacco.

In nonsmokers who have been exposed to asbestos, the risk of lung cancer is five times that of unexposed workers.
In smokers who have not been exposed to asbestos, the risk of lung cancer is eleven times that of non-smokers.
In heavy smokers with asbestos exposure, the risk of lung cancer is at least 16 times higher than that of unexposed nonsmokers.


Lung cancer in asbestos-exposed and unexposed individuals is similar in both the type of cancer and its signs and symptoms. The link between cigarette smoking, asbestos and cancer of the lung itself does not apply to cancer of the lining of the lung (see malignant mesothelioma section below). Diagnosis and treatment of lung cancer is a complex topic and a pulmonary specialist should be involved in the workup of a suspected lung cancer.

Another type of lung disease that is linked to asbestos exposure involves the lining of the lungs, called the pleura. Harmless disease of the pleura is often the only manifestation of asbestos exposure. There are a number of different changes that can occur in the pleura with asbestos exposure. Pleural plaques (discussed above) may develop from fibers that migrate out to the outside edge of the lungs and cause scarring of the pleura. Pleural "calcification" may occur from calcium deposits in areas of prior damage.

Fluid may accumulate around the lung. This fluid collection, called an effusion, can be the first sign of asbestos-related disease. Often, these fluid collections have no associated symptoms, resolve on their own, and recur sporadically. However, some patients may experience pain or bleeding around their lungs. "Diffuse pleural thickening," which means a generalized thickening of the lining of the lung, can occur as well. The thickened pleura may form a peel of scar tissue and even affect the lung's ability to expand. This condition may cause a significant shortness of breath. Diffuse pleural thickening is considered a later-onset consequence of repeated fluid accumulations.

Patients with asbestosis, like others with chronic lung disease, are at a higher risk of serious infection, low oxygen levels in the blood, and heart failure. These patients also may not recover as quickly from viral and bacterial infections. In addition, they may be at increased risk for certain fungal and unusual infections that take advantage of diseased or scarred lung tissue. The medical management of these patients should focus special attention on preventing and rapidly treating these infections. Flu and pneumococcal vaccinations are a part of routine care for these patients. There is, however, no treatment or cure for asbestosis. In particular, steroid and immune-based therapies have not been shown to benefit these patients.

Other key elements in treating patients with asbestosis are smoking cessation, early detection of worsening disease or cancer, and avoidance of further exposure to asbestos. Supplemental oxygen during exercise or at rest (depending on the need) may be provided to improve daily function.

The clinical symptoms usually include slowly progressing shortness of breath and cough, often 20 to 40 years after exposure to asbestos. Breathlessness advances throughout the disease, even without further asbestos inhalation. In the absence of cigarette smoking, sputum (mucus coughed up from the lungs) production and wheezing are uncommon. The exception is workers who have been exposed to very high concentrations of asbestos fibers. Those workers may also develop symptoms as soon as 10 years after exposure. Other indications of asbestosis include abnormal lung sounds on examination, changes in the ends of the fingers and toes ("clubbing"), a blue tinge to the fingers or lips ("cyanosis"), and failure of the right side of the heart ("cor pulmonale").

There are two major groups of fibers, the amphiboles and chrysotile fibers. Chrysotile (white asbestos), also called "Serpentine" fibers, are long and curled. The amphiboles, long straight fibers (including actinolite, amosite, anthrophyllite, crocidolite, and tremolite) are much more likely to cause cancer of the lining of the lung (Mesothelioma) and scarring of the lining of the lung (pleural fibrosis). Either group of fibers can cause disease of the lung, such as asbestosis.

The risk of developing asbestos-related lung cancer varies between fiber types. Studies of groups of patients exposed chrysotile fibers show only a moderate increase in risk. On the other hand, exposure to amphibole fibers or to both types of fibers increases the risk of lung cancer by two fold. Although the Occupational Safety and Health Administration (OSHA) has a standard for workplace exposure to asbestos (0.2 fibers/milliliter of air), there is debate over what constitutes a safe level of exposure. While some believe asbestos-related disease is a "threshold phenomenon," which requires a certain level of exposure for disease to occur, others believe there is no safe level of asbestos.

In most buildings, asbestos does not become airborne. However, surfaces that are damaged or disturbed can cause asbestos to become inhalable. High concentrations can occur after cutting, sanding, or remodeling asbestos- containing materials.

Reducing asbestos exposure involves either the removal or sealing of asbestos-containing materials. Inexperienced attempts to remove asbestos can release dangerous levels of the fibers.

what does fiber size have to do with asbestos-related lung disease?

Depending on their shape and size, asbestos fibers deposit in different areas of the lung. Fibers less than 3 mm easily move into the lung tissue and the lining surrounding the lung (pleura). Long fibers, greater than 5 mm (1/5 inch), cannot be completely broken down by scavenger cells (macrophages) and remain in the lung tissue. These asbestos fibers can cause inflammation. Substances damaging to the lungs are then released by the cells of inflammation that are responding to the foreign asbestos material. The persistence of these long fibers in the lung tissue and the resulting inflammation seem to initiate the process of cancer formation.

As inflammation and damage to tissue around the asbestos fibers continues, the resulting scarring can extend from the small airways to the larger airways and the tiny air sacs (alveoli) at the end of the airways. Some of these fibers can move to the surface of the lung where they form plaques (white-gray regions of scarred tissue) in the tissue lining of the lung (pleura). In severe cases of asbestosis, scarring of both the lung and its lining tissue can occur.