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Mesothelioma

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Do you know what Mesothelioma is? Almost everyone who develops mesothelioma has been in contact with asbestos.  esothelioma is a type of cancer that grows in the lining of the lungs or abdomen, and it can take many decades for the cancer to appear. The main symptoms are chest pains or breathlessness.


Working with asbestos is the major risk factor for mesothelioma. In the United States, asbestos is the major cause of malignant mesothelioma and has been considered "indisputably" associated with the development of mesothelioma. Indeed, the relationship between asbestos and mesothelioma is so strong that many consider mesothelioma a “signal” or “sentinel” tumor. A history of asbestos exposure exists in most cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite. Some studies suggest that simian virus 40 (SV40) may act as a cofactor in the development of mesothelioma. This has been confirmed in animal studies, but studies in humans are inconclusive.

Asbestos was known in antiquity, but it was not mined and widely used commercially until the late 19th century. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the official position of the U.S. Occupational Safety and Health Administration (OSHA) and the U.S. EPA is that protections and "permissible exposure limits" required by U.S. regulations, while adequate to prevent most asbestos-related non-malignant disease, they are not adequate to prevent or protect against asbestos-related cancers such as mesothelioma. Likewise, the British Government's Health and Safety Executive (HSE) states formally that any threshold for mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE assumes that no such "safe" threshold exists. Others have noted as well that there is no evidence of a threshold level below which there is no risk of mesothelioma. There appears to be a linear, dose-response relationship, with increasing dose producing increasing disease. Nevertheless, mesothelioma may be related to brief, low level or indirect exposures to asbestos. The dose necessary for effect appears to be lower for asbestos-induced mesothelioma than for pulmonary asbestosis or lung cancer. Again, there is no known safe level of exposure to asbestos as it relates to increased risk of mesothelioma.

The duration of exposure to asbestos causing mesothelioma can be short. For example, cases of mesothelioma have been documented with only 1–3 months of exposure. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

Latency, the time from first exposure to manifestation of disease, is prolonged in the case of mesothelioma. It is virtually never less than fifteen years and peaks at 30–40 years. In a review of occupationally related mesothelioma cases, the median latency was 32 years. Based upon the data from Peto et al., the risk of mesothelioma appears to increase to the third or fourth power from first exposure.

People who have worked with asbestos or material containing asbestos - for example, insulation engineers, shipyard workers, maintenance workers and building workers - can be affected by mesothelioma. But workers in many other industries may have also been exposed to asbestos, but not remember being exposed to it, so they may be asked for a thorough work history. People who have come into contact with asbestos from washing contaminated clothing,or living near asbestos factories may also develop mesothelioma.

There is no cure for mesothelioma at the moment, although there are treatments available that can help to control the symptoms and improve quality of life. The kind of treatment offered will depend on individual circumstances and how advanced the cancer is.

Every person diagnosed with mesothelioma will need support and help. Many may find it hard to accept their diagnosis, while others will feel angry and bitter, as may their relatives and friends. It is important that anyone diagnosed with mesothelioma has access both to information about their illness and treatment and to emotional support, including someone to talk to when they feel ready.

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