What is mesothelioma?
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What is mesothelioma?
For many people, and their families, a diagnosis of mesothelioma is an unwelcome introduction to a disease they may never have heard of and they will want to find out everything they can about the disease. We address a number of our clients' most common questions here but, for more information we would recommend visiting Mesothelioma UK website who we are proud to support as members of their legal panel.
What is mesothelioma?
Exposure to asbestos is thought to be responsible for over 90% of mesothelioma cases. It has been suggested that there may be other rare causes of mesothelioma but they are probably not fully understood at the moment. It is well established that mesothelioma is not caused by smoking tobacco.
Asbestos is a fibrous mineral. When the tiny asbestos fibres become airborne then they can be inhaled and ingested. The fibres may remain dormant in the body for many years. It is thought that it usually takes between 30—40 years from when asbestos exposure took place for any symptoms to come to light although it can take more or less than 30-40 years in some cases. Asbestos fibres can cause genetic mutations to cells in the body that leads to the growth of cancer.
Mesothelioma is associated with occupational asbestos exposure and traditionally affects people who have worked in heavy industries such as shipbuilding, power stations and the construction industry. These are examples of cases that we have dealt with over the years from people from a diverse range of occupations and backgrounds.
However, mesothelioma can also be caused by very low levels of asbestos.
There have been reported cases of people contracting mesothelioma from contact with family members who worked with asbestos, through washing clothes contaminated with asbestos and by children playing around asbestos factories and areas where asbestos waste was dumped.
What are the types of mesothelioma?
The two main types of mesothelioma are pleural mesothelioma and peritoneal mesothelioma. Rarely, mesothelioma can arise in other areas such as the pericardium (the lining around the heart) and the testicles.
Pleural mesothelioma is the more common type of the disease. The pleura is a lining of the chest wall that consists of two layers called the visceral (inner) layer and the parietal (outer) layer. The space between the two layers is called the pleural space and contains a small amount of fluid that lubricates the two layers and allows them to slide comfortably over each other when we breathe in and out. A tumour can grow on the pleura which will form a solid coating around the lung and may cause breathing to become restricted and painful.
Peritoneal mesothelioma is less common than pleural mesothelioma. The peritoneum is the lining of the abdomen which again consists of two layers and helps to protect organs. It produces fluid which helps the abdominal organs to move smoothly against each other as we move around.
Peritoneal mesothelioma causes the peritoneum to thicken and stop working properly. Because pleural mesothelioma is more common than peritoneal mesothelioma and can spread to the abdomen, it may be necessary to clarify whether or not pleural mesothelioma is the primary cancer.
Different cell types of mesothelioma
As well as mesothelioma being found in different parts of the body, there are different cell types of mesothelioma. These can be identified by looking at the cancerous cells under a microscope.
There are three different cell types of mesothelioma: epithelioid mesothelioma, sarcomatoid mesothelioma and biphasic mesothelioma.
Epithelioid mesothelioma is the most common type and tends to grow more slowly than the others, so may respond better to treatments. When viewed under a microscope the cells appear relatively uniform and are cube shaped.
Sacrcomatoid is less common than epithelioid mesothelioma and can be more aggressive. The cells are less uniform and oval in appearance.
Biphasic mesothelioma is a mixture of the two other types and contains both types of cells.
What are the symptoms of mesothelioma?
Mesothelioma predominantly occurs in the pleura (the lining of the lungs). In relation to pleural mesothelioma, often the first major sign that something may be wrong is when fluid builds up in the pleural space. This is known as a pleural effusion and the build up of fluid can restrict the ability of the lung to expand as you breathe and can cause breathlessness and chest pain. A pleural effusion may be found after a chest x-ray has been carried out.
A surgical procedure known as pleural drainage or aspiration may be carried out to drain away the fluid which will make it easier to breathe and may relieve chest pain. This often provides very rapid relief but sometimes the relief is only short-lived as the effusion can recur.
As the tumour progresses further symptoms may develop. These may include:
- A persistent cough or wheezing
- A hoarse voice
- Tiredness and fatigue
- Loss of appetite and weight loss
- Difficulty in swallowing food
- Nausea and vomiting
- Bloody sputum
- Unexplained fever and sweating
- Recurring chest infections
- Abdominal pain. This may be particularly associated with peritoneal (stomach) mesothelioma.
In the latter stages of the illness symptoms may progress, so it is important to seek medical advice to make sure that treatments are made available. Various treatments may be offered to help to treat and palliate the symptoms and make sure that the sufferer is kept as comfortable and free of pain as possible.
How is mesothelioma diagnosed?
Visiting a GP
Your GP might refer you to a hospital for a chest x-ray or sometimes, directly to a specialist lung doctor (a respiratory physician).
Seeing specialist doctors at the hospital
The CT scan pictures will be looked at by a doctor called a radiologist who specialises in reporting on x-rays and scans. The radiologist will write a report and send this to the specialist doctor who originally asked for the scan to be carried out. Sometimes a CT scan will be used when a biopsy is carried out.
Pleural or peritoneal fluid
Analysis of the fluid (known as cytology) may not always lead to the detection of mesothelioma cells and typically in the majority of cases, a biopsy will be carried out.
A biopsy with a scan/fluid drainage
However, mesothelioma can be a difficult illness to diagnose. It may be difficult for the pathologist to decide if the cells or tissue are a type of mesothelioma or not. The cells can look similar to other types of cancer such as lung cancer in the case of pleural mesothelioma. Therefore, it is often necessary for you to undergo a surgical biopsy.
Thoracoscopy/video assisted thoracoscopic surgery (VATS)
An ultrasound or CT scan may be used to position the needle correctly. The doctor will then take a sample from the pleura. This procedure may require a short stay in hospital for the patient.
To assist in reaching a diagnosis hospitals have teams of experts called multi-disciplinary teams (MDT’s). They consist of specialist health professionals with different areas of expertise who regularly meet to discuss whether they believe the diagnosis is correct, the stage of the disease and possible treatments.
The system that is used in the UK for pleural mesothelioma is the International Mesothelioma Interest Group (IMIG) staging system with stage 4 being the most advanced stage and stage 1 the least advanced.
What treatments are available?
This will depend on a number of factors including your general fitness, any pre-existing health conditions, the type of mesothelioma and the stage your illness is at.
It is not the intention of this website to offer a comprehensive guide about available treatment options and this is something that should be discussed with your treating doctors. More information is available from the charity Mesothelioma UK, who we work closely with
What treatments do the NHS provide?
This can vary based on your individual circumstances. Pleural effusions (build-up of fluid in the lung) are commonly drained to alleviate symptoms and doctors will attempt a procedure to insert surgical talc to try to prevent the build up of fluid.
It is common for those with mesothelioma to be treated with palliative chemotherapy in an effort to stabilise the disease. Radiotherapy and surgery may also be considered.
Are clinical trials available?
Some types of treatments may be offered as part of a clinical trial. The results of trials can help to improve treatment in the future, but their availability varies considerably. The most up to date information can be found on the Mesothelioma UK clinical trials page.
How can Leigh Day help fund treatment in the private sector?
As a result of research some “second line” treatments that have seen promising results in trials are available privately in the UK.
Immunotherapy is an emerging form of treatment for mesothelioma. Immunotherapy trials are ongoing and may be available. Alternatively, immunotherapy treatment can be provided in the private sector, although it be can extremely expensive.
Leigh Day are experts in bringing successful claims when compensation for the cost of immunotherapy has been recovered from defendants as part of successful claims.
How do I make a claim for mesothelioma?
They’ll listen to your case with a free consultation and assess the strength of your claim, advising you on the best next steps to take.
How long do I have to bring mesothelioma claim?
For asbestos claims after death, the three year period typically runs from the date of death.
In all circumstances, it’s advisable to seek legal advice as soon as possible. Sometimes it’s possible to ask the court to let your claim proceed despite the fact that it is over three years since you were diagnosed. Leigh Day has experience bringing cases ‘out of time’.
Leigh Day is proud to be a member of the Mesothelioma UK legal panel