INTRODUCTION: Mesothelioma is a kind of cancer that is most always brought on by previous exposure to asbestos. Nearly all people who develop it have worked on jobs where they inhaled asbestos particles or dust, or they have been exposed to asbestos dust and fibre in other ways, such as by washing the garments of a member of the family who worked with asbestos.

It is a very serious disease with an average survival time of only 1 to 2 yrs after diagnosis. Unlike lung cancer, there is no correlation between mesothelioma and smoking. The disease happens more often in males than in females and risk rises with age, but this disease can appear in both men and women at any age. It is also known to occur in people who are genetically pre-disposed to it.

SYMPTOMS: The disease may not appear until 20 - 50 years after exposure to asbestos. Diagnosing it can be hard, because the symptoms are similar to those of a number of other diseases. The signs of mesothelioma include shortness of breath due to pleural effusion (fluid between the lungs and the chest wall) or a painful chest wall , and more general symptoms such as loss of weight.

Signs of mesothelioma may also include abdominal pain, ascites, or an unusual buildup of fluid in the abdomenal mass in the abdomen, bowel function problems. Other signs of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and high body temperature.

If the disease has spread beyond the mesothelium to other areas of the body, signs may include pain, having trouble swallowing, or swelling of the neck or face.

In severe cases of the disease, the following signs and symptoms may be present: blood clots in the veins, which may cause thrombophlebitis, disseminated intravascular coagulation, a disorder causing severe bleeding in many body organs, jaundice, or yellowing of the eyes and skin, low blood sugar level, pleural effusion, pulmonary emboli, or blood clots in the arteries of the lungs, severe ascites. These symptoms may be caused by mesothelioma or by other, less serious conditions.

TREATMENT: There are several kinds of treatment plans available: Radiation, Surgery, and chemotherapy including recently approved drugs. Despite treatment with chemotherapy, radiation therapy or surgery, the disease comes with a poor prognosis. For persons with localized disease, and who can tolerate a radical surgery, radiation is given most often post-operatively as a consolidative treatment.

Although the disease is normally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to ease symptoms arising from tumor growth, such as blockage of a major blood vessel. In February 2004, the United States FDA approved pemetrexed (brand name Alimta) for treatment of cancerous pleural mesothelioma.

CONCLUSION: Mesothelioma is a kind of cancer that is most often caused by previous exposure to asbestos. If it affects the pleura it can cause these signs and symptoms: pain in the chest wall, pleural effusion, or fluid surrounding the lungs, shortness of breath, fatigue or anemia, wheezing, hoarseness or cough, blood in the sputum (fluid) coughed up (hemoptysis).

It is described as localized if the condition is found only on the membrane surface where it started. Screening tests might diagnose mesothelioma earlier than conventional methods thus increasing the survival prospects for patients.

The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibres from the lung are transported to the abdomen and associated organs via the lymphatic system.

It has been said that in humans, transport of fibres to the pleura is essential to the pathogenesis of the disease.

Experimental evidence suggests that asbestos acts as a total and complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion.

Although reported incidence rates have increased in the past 20 years, the disease is still a relatively rare cancer. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades.

Between 1973 and 1984, there has been a threefold rise in the diagnosis of pleural mesothelioma in Caucasian men. From 1980 to the late 1990s, the death rate from mesothelioma in the U.S. increased from 2,000 per year to 3,000, with men 4 times more likely to acquire the malignancy than women. These rates may not be accurate, since it is possible that many cases are mis-diagnosed as adenocarcinoma of the lung, which is difficult to separate from mesothelioma.

Working with asbestos is the major risk factor for mesothelioma. However, the disease has been reported in some individuals without any known exposure to asbestos. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

Smoking modern cigarettes does not appear to increase the risk of developing the disease. The Kent brand of cigarettes used asbestos in its filters for the first few years of production in the 1950s and some cases of mesothelioma have resulted.