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Mesothelioma

Mesothelioma
Other namesMalignant mesothelioma
CT scan showing a left sided mesothelioma with an enlarged mediastinal lymph node
SpecialtyOncology
SymptomsShortness of breath, swollen abdomen, chest wall pain, cough, feeling tired, weight loss[1]
ComplicationsFluid around the lung[1]
Usual onsetGradual onset[2]
Causesc. 40 years after exposure to asbestos[3]
Risk factorsGenetics, possibly, infection with simian virus 40[3][4]
Diagnostic methodMedical imaging, examining fluid produced by the cancer, tissue biopsy[2]
PreventionDecreased asbestos exposure[5]
TreatmentSurgery, radiation therapy, chemotherapy, pleurodesis[6]
PrognosisFive year survival c. 8–12% (US; varies by race)[7]
Frequency60,800 (affected during 2015)[8]
Deaths32,400 (2015)[9]

Mesothelioma is a type of cancer that develops from the thin layer of tissue that covers many of the internal organs (known as the mesothelium).[10] The area most commonly affected is the lining of the lungs and chest wall.[1][3] Less commonly the lining of the abdomen and rarely the sac surrounding the heart,[11] or the sac surrounding each testis may be affected.[1][12] Signs and symptoms of mesothelioma may include shortness of breath due to fluid around the lung, a swollen abdomen, chest wall pain, cough, feeling tired, and weight loss.[1] These symptoms typically come on slowly.[2]

More than 80% of mesothelioma cases are caused by exposure to asbestos.[3] The greater the exposure the greater the risk.[3] As of 2013, about 125 million people worldwide have been exposed to asbestos at work.[13] High rates of disease occur in people who mine asbestos, produce products from asbestos, work with asbestos products, live with asbestos workers, or work in buildings containing asbestos.[3] Asbestos exposure and the onset of cancer are generally separated by about 40 years.[3] Washing the clothing of someone who worked with asbestos also increases the risk.[13] Other risk factors include genetics and infection with the simian virus 40.[3] The diagnosis may be suspected based on chest X-ray and CT scan findings, and is confirmed by either examining fluid produced by the cancer or by a tissue biopsy of the cancer.[2]

Prevention focuses on reducing exposure to asbestos.[5] Treatment often includes surgery, radiation therapy, and chemotherapy.[6] A procedure known as pleurodesis, which involves using substances such as talc to scar together the pleura, may be used to prevent more fluid from building up around the lungs.[6] Chemotherapy often includes the medications cisplatin and pemetrexed.[2] The percentage of people that survive five years following diagnosis is on average 8% in the United States.[7]

In 2015, about 60,800 people had mesothelioma, and 32,000 died from the disease.[8][9] Rates of mesothelioma vary in different areas of the world.[3] Rates are higher in Australia, the United Kingdom, and lower in Japan.[3] It occurs in about 3,000 people per year in the United States.[14] It occurs more often in males than females.[3] Rates of disease have increased since the 1950s.[3] Diagnosis typically occurs after the age of 65 and most deaths occur around 70 years old.[3] The disease was rare before the commercial use of asbestos.[3]

  1. ^ a b c d e "Malignant Mesothelioma Treatment – Patient Version (PDQ®)". NCI. September 4, 2015. Archived from the original on 5 April 2016. Retrieved 3 April 2016.
  2. ^ a b c d e Kondola S, Manners D, Nowak AK (June 2016). "Malignant pleural mesothelioma: an update on diagnosis and treatment options". Therapeutic Advances in Respiratory Disease. 10 (3): 275–288. doi:10.1177/1753465816628800. PMC 5933604. PMID 26873306.
  3. ^ a b c d e f g h i j k l m n Robinson BM (November 2012). "Malignant pleural mesothelioma: an epidemiological perspective". Annals of Cardiothoracic Surgery. 1 (4): 491–496. doi:10.3978/j.issn.2225-319X.2012.11.04. PMC 3741803. PMID 23977542.
  4. ^ Vilchez RA, Butel JS (July 2004). "Emergent human pathogen simian virus 40 and its role in cancer". Clinical Microbiology Reviews. 17 (3): 495–508. doi:10.1128/CMR.17.3.495-508.2004. PMC 452549. PMID 15258090.
  5. ^ a b Whittemore AS (2006). Cancer epidemiology and prevention (3rd ed.). Oxford: Oxford University Press. p. 669. ISBN 978-0-19-974797-9.
  6. ^ a b c "Malignant Mesothelioma Treatment – Patient Version (PDQ®)". NCI. September 4, 2015. Archived from the original on 5 April 2016. Retrieved 3 April 2016.
  7. ^ a b "Age-Adjusted SEER Incidence and U.S. Death Rates and 5-Year Relative Survival (Percent) By Primary Cancer Site, Sex and Time Period" (PDF). NCI. Archived (PDF) from the original on 6 September 2015. Retrieved 3 April 2016.
  8. ^ a b Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease and Injury Incidence and Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  9. ^ a b Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality and Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  10. ^ "Malignant Mesothelioma – Patient Version". NCI. January 1980. Archived from the original on 6 April 2016. Retrieved 3 April 2016.
  11. ^ Sardar MR, Kuntz C, Patel T, Saeed W, Gnall E, Imaizumi S, et al. (2012). "Primary pericardial mesothelioma unique case and literature review". Texas Heart Institute Journal. 39 (2): 261–264. PMC 3384041. PMID 22740748.
  12. ^ Panou V, Vyberg M, Weinreich UM, Meristoudis C, Falkmer UG, Røe OD (June 2015). "The established and future biomarkers of malignant pleural mesothelioma". Cancer Treatment Reviews. 41 (6): 486–495. doi:10.1016/j.ctrv.2015.05.001. PMID 25979846.
  13. ^ a b Gulati M, Redlich CA (March 2015). "Asbestosis and environmental causes of usual interstitial pneumonia". Current Opinion in Pulmonary Medicine. 21 (2): 193–200. doi:10.1097/MCP.0000000000000144. PMC 4472384. PMID 25621562.
  14. ^ "What are the key statistics about malignant mesothelioma?". American Cancer Society. 2016-02-17. Archived from the original on 8 April 2016. Retrieved 3 April 2016.

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