What is mesothelioma

Hi, I’m a consultant medical oncologist at the Royal Marsden Hospital, and I´m going to explain what is the mesothelioma and the asbestos exposure symptoms .

What is mesothelioma?

Mesothelioma is a cancer of a membrane that lines various organs in the body called the mesothelium. Now the mesothelium is found in various places, mainly in the chest and also in the abdomen, or tummy. The majority of cases that we see as doctors are actually plural mesothelioma. So these are cancers of the lining of the lung.

Usually this tumor, usually caused by asbestos exposure, is really quite silent and it is very difficult to pick it up at a very early stage because it grows silently within the chest cavity. When patients become unwell and they seek medical input it’s usually because they’re feeling short of breath, they’re not able to do things with as much capacity as they could before – going uphill, walking up the stairs, or even just resting and talking to people is becoming more difficult because of breathlessness. Other symptoms that patients can have, other than breathlessness, is weight loss.

In fact weight loss without trying to diet is generally indicative of underlying problems such as cancer, and should be investigated further. Mesothelioma is predominantly seen in patients that have been exposed to asbestos fibers. Nearly 8 or 9 out of 10 patients with a diagnosis of mesothelioma report that they have worked either in an industry which has had asbestos associated with it or have known to have been exposed to asbestos in the past.

Smoking by itself doesn’t cause mesothelioma, but patients that have known that they’ve been exposed to asbestos should not smoke. They should give up smoking if they do because that massively increases the risk of lung cancer because the airways become more damaged because of the smoke.

And often there can be a long lag period between asbestos fibers exposure and the cancer forming. The average lag period that we see is anywhere between 15 to 60 years, with most patients having a lag period around. Some patients who have cared for patients who have been exposed to asbestos and then developed mesothelioma might be at increased risk. This is generally the typical setting of the wife of a man that has worked in the construction industry who has potentially brought his overalls or work shoes or work cap home to be cleaned and the asbestos fibers from such materials can then be in the home environment.

The one thing to emphasize is that mesothelioma does not seem to be hereditary, so you can’t inherit that from your parents. Neither is it infectious, you can’t catch mesothelioma from another patient that has mesothelioma. There are a number of tests that doctors do to make a diagnosis of mesothelioma. Usually a GP will do an examination, will listen to the chest to see whether there is any fluid present or not and then arrange for a chest x-ray to be performed.

Mesothelioma treatment

The mainstay of treatment of mesothelioma is generally with chemotherapy. The aim of this is very much to improve the quality of life of our patients. There’s very good evidence that this can potentially in some patients shrink the cancer and also keep the cancer under control for longer than it would do otherwise, and sometimes that can improve length of life as well.
Other treatments that can be considered include radiotherapy and that can be useful in very specific cases, either to prevent cancer from growing along biopsy sites, or to target a specific area that might be causing pain or discomfort. We’re expecting more cases of mesothelioma over the next few years because of the lag phase between asbestos exposure and the disease becoming clinically manifest. If patients have known they’ve been exposed to asbestos it’s worth them just touching base with their GP so they can just have a general assessment to make sure they’re okay.

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