Mesothelioma is a rare cancer that affects the mesothelium. The mesothelium is a sac that covers and protects some internal organs. In most cases, the cancer begins in the pleura (membrane around the lungs and lining the wall inside the chest) or peritoneum (membrane lining the abdominal cavity). About 3000 new cases are diagnosed in the United States each year. More men than women get this illness, and risks increase with age.
Working with asbestos is the major risk factor. However, it can occur in some people without any asbestos exposure. The combination of smoking and asbestos exposure increases the risk.
Symptoms may not appear until 30 to 50 years after asbestos exposure. Symptoms of pleural mesothelioma include short-ness of breath and chest pain. Signs and symptoms of perito-neal mesothelioma include weight loss, abdominal pain and swelling, bowel obstruction, blood clotting abnormalities, anemia, and fever.
If cancer spreads to other body parts, pain, trouble swallow-ing, or neck or face swelling may occur.
Diagnosing this illness is often hard, because symptoms are similar to those of other conditions. The health care provider will check the medical history (especially history of asbestos exposure), do a physical examination, and order x-rays, lung function tests, computed tomography (CT), or magnetic reso-nance imaging (MRI).
A biopsy is needed to confirm the diagnosis. In a biopsy, a surgeon removes a sample of tissue for study with a microscope.
The doctor may, in rare cases, do thoracoscopy if suspecting cancer in the chest. The doctor makes a small cut through the chest and puts in a thin, lighted tube (thoracoscope) to look inside.
The doctor may, in rare cases, do peritoneoscopy if suspecting cancer in the abdomen (belly). In this case, a similar instrument, called a peritoneoscope, is used.
The health care provider will also want to learn the stage of the disease, or how far it has spread. Knowing the stage helps the health care provider plan treatment. Mesothelioma can be localized (found only on the membrane) or advanced (spread to lymph nodes, lungs, chest wall, or abdominal organs).
Treatment depends on the cancer’s location and stage and your age and general health.
Surgery, radiation therapy, and chemotherapy are some-times combined. The doctor may remove part of the lining of the chest or abdomen and some tissue around it. Radiation therapy involves using high-energy x-rays to kill cancer. Radiation may come from a machine or from putting materials that produce radiation where cancer cells are found. Chemotherapy uses drugs to kill cancer cells. Most drugs are injected into a vein (intravenous, or IV).
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