Malignant mesothelioma is a rare form of cancer, in which cancer cells are found in the sac lining the chest, the lining of the abdominal cavity or the lining around the heart.
Most people with malignant mesothelioma have worked on jobs where they breathed asbestos. Others have been exposed to asbestos in a household environment, often unaware. There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing of asbestos workers. An exposure of as little as one or two months can result in mesothelioma 30 or 40 years later.
People exposed in the 1940s, 50s, 60s and 70s are now being diagnosed with mesothelioma because of the long latency period of asbestos disease.
Malignant mesothelioma stages are divided into two groups: localized and advanced disease. In localized malignant mesothelioma (Stage I) cancer is found in the lining of the chest wall and may also be found in the lining of the lung, the lining of the diaphragm, or the lining of the sac that covers the heart on the same side of the chest. Advanced malignant mesothelioma includes Stage II, Stage III and Stage IV.
- Stage II-cancer is found in the lining of the chest wall and the lymph nodes on the same side of the chest. Cancer may also be found in the lining of the lung, the lining of the diaphragm, or the lining of the sac that covers the heart on the same side of the chest.
- Stage III-cancer has spread to any of the following areas: the chest wall, the mediastinum, the heart, beyond the diaphragm and the peritoneum. Cancer may have also spread to lymph nodes on the other side of the chest or outside the chest.
- Stage IV-cancer has spread to distant organs or tissues.
Traditionally malignant mesothelioma is treated with multi-modality therapy including surgery, radiation therapy and chemotherapy. The procedures listed below are performed for “curative intent.” The goal is removal of disease, with the knowledge that microscopic disease will most likely remain. For this reason many patients are given chemotherapy and/or radiation therapy after surgery to remove any cancer cells that remain.
For Pleural Mesothelioma:
- Pleurectomy/decortication is usually performed on patients with early stage disease (Stage I and selected Stage II), and attempts to remove all gross tumor. If it is found that all tumor cannot be removed without removing the lung, a pneumonectomy (removal of lung) may be performed at the same time.
- Extrapleural pneumonectomy surgery is an option for a “select few.” Early-stage malignant pleural mesothelioma patients with respectable cancer formation (capable of being removed) are the best candidates for extrapleural pneumonectomy surgery.