Common Mesothelioma Questions & Answers

Whether it is you or a loved one who has been given a mesothelioma diagnosis, the same common set of questions often pop into our minds. These are mesothelioma issues we've covered often on this blog, but they are so important, so critical, that they are worth revisiting from time to time. Covering the basics of mesothelioma is at the core of what we are trying to do in our effort to connect patients and families with critical information. As with any illness, you will learn a lot as you meet with doctors, but it is important to do your own research as well. Here are some common mesothelioma questions we've heard asked over the years by newly diagnosed patients:

What exactly is mesothelioma?
Mesothelioma is a rare form of cancer that attacks the mesothelium and is caused from exposure to airborne asbestos particles being inhaled and injested. Mesothelioma typically infects the pleura (lungs) or peritoneum (abdomen). The asbestos cancer forms around the lining of the organs. When infected by asbestos fibers, the cells of the mesothelium become abnormal and begin to divide at a rapid rate often causing malignant cells to develop and spread.

What causes mesothelioma?
Mesothelioma can be attributed to exposure to asbestos. Due to the long latency period of the disease, the asbestos exposure most often occurs decades prior to diagnosis, between 30-40 years prior in many cases. Many diagnosed with mesothelioma were exposed to asbestos in the workplace; however, the dangers of this exposure were also taken home to family members. Even low levels of exposure can lead to the development of mesothelioma. In addition, there are environmental exposures from deteriorating buildings and old asbestos construction materials to natural occurring asbestos in the earth being disturbed.

How is mesothelioma diagnosed?
If you have already received a mesothelioma diagnosis, then it may be a little less common to ask this question, but many family members and individuals in search of a second opinion are interested in understanding how mesothelioma is diagnosed. The symptoms of mesothelioma are similar to those of asbestosis, a non-cancerous yet life threatening inflammation of the lungs caused by exposure to asbestos, and lung cancer, making it difficult to identify. A complete patient history is required to determine a mesothelioma diagnosis including any exposure to asbestos. Of course, a physical examination is conducted as well as x-rays of the chest and abdominal area. A CT scan, MRI and biopsy are most often used to make a mesothelioma diagnosis.

What are the mesothelioma treatment options?
The treatment of mesothelioma varies from case to case. Factors that influence treatment options for mesothelioma include the location of the asbestos cancer, how far the cancer has developed, and the age and health of the individual diagnosed. Treatment options include surgery to remove the cells, radiation therapy, and chemotherapy. The National Cancer Institute sponsors clinical trails to advance the treatment options for mesothelioma. Unfortunately, there currently is no cure for mesothelioma.

The toughest question, one of the first questions any normal person thinks of, is that of life expectancy. This must be determined on an individual basis. Like treatment, it depends greatly on the type of tumor (pleural mesothelioma or peritoneal mesothelioma), the stage of the disease, and the overall health of the patient.

Catonsville Pushing State of Maryland to Put Asbestos Rules In Place

Residents of Catonsville want bigger answers from the state of Maryland regarding asbestos hazards as a natural rock formation appeared in the middle of a construction site. Neighbors are not only worried about their health, but are growing even more concerned about state and county regulations regarding the rocks removal.

Why such a fuss about a rock? As it turns out this rock is asbestos. Exposure to airborne asbestos can lead to illnesses such as asbestosis, lung cancer, and mesothelioma, a terminal cancer, and the construction company working on the site was crushing the rock, sending asbestos into the air.

Enterprise homes, the company performing the crushing, immediately stopped operations and willingly tested nearby homes for asbestos, but it is the State’s failures that have residents really upset. It is under question to many residents if the state of Maryland has adopted the Asbestos Hazard Emergency Response Act that would deal with situations such as these. AHERA has multiple requirements, including inspecting known asbestos-containing materials every three years, maintaining up-to-date asbestos management plans and training custodial staff in handling the mineral. Many residents believe there are no county or state regulations to deal with asbestos exposure, but that federal standards should have been followed. The Maryland Department of the Environment expressed in a Hometown Annapolis article, that there is not a need to mandate asbestos handling guidelines for companies like Enterprise, when they are willing to cooperate and make efforts to remedy the situation.

Construction at the site in Catonsville has resumed, although the asbestos rock is no longer being crushed. Neighbors are left to deal with dust and residue from the site on their homes and in their yards. Although they are being told the residue has been tested and does not contain asbestos, many are still uncertain. There is no doubt that resident’s hope that state and local jurisdiction will come up with an action plan to deal with similar situations in the future.

North Carolina Community Concerned About Former Asbestos Mill

Residents of Davidson, NC are faced with a difficult community decision as a Raleigh developer approaches the Westside neighborhood with hopes to build a commercial or residential development on the former Metrolina Warehouse LLC site. Concerns have been raised as the site was formerly the Linden Cotton Mill and, before that, it was an asbestos mill.

GreenHawk, the Raleigh developers, have opened talks with the community through several neighborhood meetings. Most residents have expressed concerns regarding asbestos, which is still buried under a portion of the site from its previous use as an asbestos mill. It has been noted that the previous owner of the site encapsulated the asbestos according to federal environmental standards and it had been certified as safe. Yet many residents retell stories of illnesses and deaths of family and friends from what they believed to be exposure to asbestos.

Many residents have rallied together and distributed fliers regarding the dangers of asbestos exposure from the proposed development, should GreenHawk decide to remove the asbestos currently on site. This flier notes, “The inhalation of asbestos fibers can cause serious diseases of the lungs and other organs that may not appear until years after the exposure occurs.” This fact is very true, as exposure to airborne asbestos is known to cause mesothelioma, or asbestos cancer that can remain latent for many years and in many cases is terminal.

GreenHawk has been very responsive to the community concerns and have brought in many environmental specialists to speak with residents about the asbestos issue. GreenHawk currently leans toward the removal of the asbestos materials by a licensed asbestos abatement company and under the watchful eye of the EPA. Residents, however, are divided. Some residents express their desire to just leave the asbestos where it is, buried, where it can’t get into the air and do more damage. However, there is no guarantee that developing on the site would not compromise the integrity of the existing encapsulation.

The town residents and GreenHawk plan to arrange several more neighborhood meetings regarding the issue before any steps towards development are taken. Although they had not been contacted for previous meetings, town officials have been notified and plan to be part of further discussions.

Honoring Our Veterans

Today we are proud to honor the United States veterans throughout the world. We are forever proud of the men and women who have served America. It is important to honor them this Veterans Day and everyday, as they have continuously risked their lives to protect ours. At SimmonsCooper we also remember the many military veterans that have lost their lives to lung cancer and mesothelioma due to asbestos exposure. We have been honored to represent veterans throughout the U.S., and today we honor them and the families they left behind.

How are Biopsies Performed and Which One is Right for Me?

In the book 100 Questions and Answers About Mesothelioma the authors ask the following: "How are biopsies performed and which one is right for me?" In my years of working with people that have been diagnosed with mesothelioma, when reviewing their medical records I find that often majority of the time fluid obtained from a thoracentesis or paracentesis is inconclusive for a mesothelioma diagnosis.

While the removal of the fluid provides relief it is very difficult to secure a firm diagnosis of mesothelioma. Why? Because sometimes the abnormal cells are so slight that they are impossible to tell apart from benign, reactive mesothelial cells or other large cells that contain waste or foreign bodies. And, if no abnormal or malignant cells are found in the fluid the patient is often misdiagnosed.

Problems arise when the procedure does not yield sufficient cells to perform the special staining required to diagnose mesothelioma. Extracted fluid that is very thick tends to contain more cells making evaluation by way of immunohistochemical (IHC) or special staining easier to secure a diagnosis of mesothelioma.

The procedure to obtain fluid for cytological analysis requires a local anesthesia and a special needle to drain the fluid. This procedure can normally be performed in the doctor’s office.

A pleural biopsy consists of fluid and a small amount of tissue from the pleura. If the immunohistochemical staining (sometimes referred to as immunos) comes back as inconclusive, then more evasive procedures may be required to confirm a diagnosis. Your doctor may perform a thoracoscopy (a lighted scope with or without a camera). This involves making a small incision in your chest wall and placing a thin tube, called a thoracoscope, into your chest. This enables your physician to look inside your chest and obtain tissue samples. Not only can this procedure obtain tissue samples necessary to confirm a mesothelioma diagnosis it can also help your doctor determine the amount and whereabouts of the disease helping him to formulate a treatment plan.

If, through radiological observation, there appears to be more solid tumor than fluid, then your doctor will recommend an open biopsy. The incision is determined by the size of the thickened pleura and should be done by a thoracic surgeon with knowledge of mesothelioma. Normally a tissue sample measuring from 1 to 1½ inches in diameter is harvested to provide the pathologist adequate tissue to make a diagnosis.

You should follow your doctor’s advice on which procedure should be used for your diagnosis as he is the best one to determine your physical ability to undergo these diagnostic procedures.

Everyday - even this very minute - dedicated researchers are diligently working to advance our ability to diagnose mesothelioma through immunohistochemical staining and other special procedures less evasive in hopes that early detection may aide in the treatment of mesothelioma patients.

Lynn Collins has been helping mesothelioma patients and families for over 10 years. In this exclusive series she examines the book 100 Questions and Answers About Mesothelioma" by Harvey I. Pass, MD, Laura Roy, RN, and Susan Vento.

Greater Research for Environmental Asbestos Exposure

For years mesothelioma concerns have been focused on the occupational environment, for those exposed to asbestos materials in the workplace and the people these workers were in daily contact with outside of the workplace. Only recently have researchers started to focus on asbestos fibers in the general environment and they are finding that asbestos is affecting more than just workers exposed to airborne asbestos.

Asbestos is a known carcinogen and is recognized for contributing to mesothelioma, a cancer affecting the pleural and peritoneal linings of internal organs and asbestos lung cancer. Mesothelioma is distinct in the cancer family as it originates from no other factor than exposure to asbestos materials. As it was once believed this exposure was only happening in the workplace, it is now becoming apparent that there are risks of exposure in our general environment. An individual can be exposed to asbestos when living with asbestos workers, has regular exposure to soiled work clothes from an asbestos worker, environmental exposure in neighborhoods of industrial sources, and passive exposure from buildings containing asbestos materials.

New research is being conducted to determine the effects of environmental asbestos exposure. With the help of the Mesothelioma Database, researchers have been able to study the geographical impact of environmental asbestos exposure. This research will help to determine the effects of airborne asbestos on people living close to industrial sources and naturally occurring asbestos mines and moving outward geographically to determine how much of a risk the asbestos is to residents of the next town. This risk mapping will expand mesothelioma diagnosis abilities and hopefully, allow for quicker mesothelioma treatment options.

Kentucky Demolition Raises Community Asbestos Concerns

As highlighted on KYPost.com, the Kentucky Department of Environmental Protection has issued a public advisory regarding asbestos contamination of demolition materials being shredded and then offered to the public as free mulch.

Although it is a requirement of the Division of Air Quality that businesses sample for asbestos before performing any demolition project, this demolition project was not reported to the DAQ. The demolition site was located just within city limits and close to a public highway. The building being demolished and containing asbestos materials was once the Independent Tobacco Warehouse.

According to the post, a grinder was used to shred any remaining demolition material, including old roofing that commonly contains asbestos, and make it into mulch, as a large portion of the material was old wood. The Department of Environmental Protection responded to a complaint about the demolition piles and an air quality sample was taken. It was this sample which indicated that indeed there was asbestos in the free “mulch” piles.

Exposure to airborne asbestos can cause severe lung irritation and even asbestos cancers. A common asbestos cancer caused by exposure to airborne asbestos is mesothelioma. Mesothelioma affects the lining of internal organs like the lungs and stomach and often remains dormant for many years before diagnosis.

The scariest part of this type of asbestos exposure is that it is impossible to track which residents picked up this asbestos laden “free mulch” and took it back to their homes or businesses for use. Nor is there a way to calculate the number of adults or children who may have been exposed during the demolition itself either, as particles were obviously airborne during the shredding and demolition process as well. The post did not mention if workers performing the demolition were properly protected from exposure.

The Department of Environmental Protection immediately alerted the mayor of the town and Emergency Management Services of the asbestos contamination. The Independent Tobacco Warehouse and the company responsible for the site demolition were also cited for their violations.