Mesothelioma Information-Health Info

Mesothelioma Treatment - Surgery

2006-03-23T08:45:00.000-08:00

Pleural and Peritoneal Mesothelioma Treatment - Surgery
Peritoneal mesothelioma and pleural mesothelioma are relatively rare forms of cancer that are found in people who have been exposed to asbestos. As mesothelioma begins to spread over the surface of the lung it secretes a clear fluid that slowly collapses the chest. Patients then begin to experience shortness of breath and as the tumor grows they also begin to experience chest pain.

In the U.S. there are somewhere between 2,000 and 3,000 new cases of peritoneal and pleural mesothelioma diagnosed each year. It affects the cells in the lining of the lungs (mesothelial cells). There are three types of mesothelioma - epithelial, sarcomatous, and a mixed type. The sarcomatous and mixed types spread quickly, so treatments such as surgery, chemotherapy, and radiation tend to work better on epithelial mesothelioma.

Since mesothelioma cancer spreads quickly, it is important to diagnose and begin mesothelioma treatment as soon as possible.

Mesothelioma Staging System
There is a Staging System used to classify mesothelioma patients and assess the best mesothelioma treatment for their particular stage of cancer:

Stage 1 - the tumor is confined to the lung and has not reached the lymph nodes.
Stage 2 - the tumor moves to the lymph nodes.
Stage 3 - the tumor reaches the abdomen, the heart, or the other side of the chest.
Stage 4 - the cancer makes its way into the bloodstream. This is very rare.
Surgery is usually only possible with Stage 1 and 2 patients.

Surgical Mesothelioma Treatment
There are several types of surgery that can be performed on pleural mesothelioma patients:

The first is called pleurodesis, which involves draining the fluid from the lungs and applying talcum powder or some other material that causes the lung to scar and adhere to the chest wall. This prevents the lung from collapsing when the fluid begins to build up again.
The second type of surgery is called a pleurectomy; in this surgery the chest is opened and the tumor is removed from the lung.
The third type of surgery is called an extrapleural pneumonectomy, and involves the removal of the lung, the diaphragm, and the covering of the heart. The heart covering and diaphragm are then replaced with gortex.
For people diagnosed with the more rare peritoneal mesothelioma, there is one surgical mesothelioma treatment available.

A surgery that removes the lining of the abdomen called a peritonectomy can only be performed in the earliest stages of the peritoneal mesothelioma. This is a risky procedure for mesothelioma treatment involving the removal of all, or a large portion of the peritoneum to rid the body of cancer tissue.
Following surgery, the patient will undergo chemotherapy and then radiation therapy mesothelioma treatment in an attempt to destroy any remaining cancer cells.

Pleural and Peritoneal Mesothelioma Life Expectancy
Prognosis for malignant mesothelioma is still considered poor, but it is improving. There was a time when mesothelioma patients were not expected to survive for very long. Now, if Stage 1 patients receive prompt and aggressive mesothelioma treatment, approximately 50% of them will live another five years. Stage 2 patients can expect to live another two to four years. Stage 3 patients have a life expectancy of six to eight months and for Stage 4 patients it is even less.

This information is meant to provide a brief overview of mesothelioma surgery. It is important that you consult a physician to discuss treatment specific to your case.

Frequently Asked Questions

2006-03-23T08:43:00.000-08:00

Malignant Mesothelioma Frequently Asked Questions
What Causes Malignant Mesothelioma Cancer?
Malignant Mesothelioma is a very rare cancer that is most often caused by exposure to microscopic asbestos fibers that embed themselves into the lungs and abdomen.
What are the types of mesothelioma?
Pleural mesothelioma and peritoneal mesothelioma are the two most common types of malignant mesothelioma cancer. The pleural sac, or mesothelium, is a membrane that surrounds the lungs giving them room to expand and contract as you breath. Asbestos fibers are absorbed into the pleura and over time cancer begins to develop.
The peritoneum is similar to the pleural mesothelium except it lines the abdominal cavity. The mesothelioma cancer victim ingests asbestos fibers and cancer eventually develops in the stomach.
Is malignant mesothelioma curable?
At this time malignant mesothelioma is not a curable disease. However, increased medical technology has prolonged the life in many mesothelioma cases. Your best defense against the progression of malignant mesothelioma cancer is early diagnosis; consult with your doctor if you know you have been exposed to asbestos.
What are the available treatments for mesothelioma cancer?
Several mesothelioma cancer treatment options are available depending on how far the disease has progressed. Chemotherapy, surgery and radiation treatment have all been used to help slow the progression of mesothelioma cases. Read more about mesothelioma treatment.
Are there clinical trials for new treatments for mesothelioma?
Yes. Your best bet to find information about clinical trials would be to contact medical schools in your area. If there are no malignant mesothelioma clinical trials at that university they should be able to refer you to one that is offering programs testing new treatment for your or a loved one's mesothelioma case.
What about legal action and mesothelioma attorneys?
Litigation by mesothelioma attorneys on behalf of asbestos exposure victims has increased steadily for the past twenty years. Mesothelioma is a cancer that can progress silently, and may remain dormant for many years. Thus, many who worked with asbestos products years ago are now beginning to discover their illness and retain mesothelioma attorneys to represent their case. Many companies that mined or produced products with asbestos knew that asbestos is a carcinogen and chose not to inform the men and women that worked with asbestos of this fact. A qualified mesothelioma attorney may be able to establish proof of asbestos exposure and hold these companies financially responsible for their negligence.
If you or a family member is suffering from mesothelioma it is important to speak with a qualified mesothelioma attorney about compensation for suffering and medical expenses.
How can I find a mesothelioma attorney?
You can find three qualified mesothelioma law firms in our site by clicking on mesothelioma attorneys, and choosing one of the firms listed. Each firm has experience with asbestos litigation on behalf of malignant mesothelioma cancer patients.

Mesotheliona Clinical Trials

2006-03-23T08:39:00.000-08:00

Mesotheliona Clinical Trials

In order to one day find a mesothelioma
cure, doctors engage in clinical trials where they test new
mesothelioma drugs to determine the if they are effective.

Mesothelioma clinical trials follow a plan of very strict scientific
guidelines, which is called a protocol. The protocol explains everything
that will happen in the study. It must be approved by review boards
made up of health care professionals and other qualified people
before the study can enroll patients.

When a potential mesothelioma drug is first identified, preclinical
studies, which are conducted in a laboratory setting, help to find
out whether the drug is safe to test in humans. During this stage,
the drug is usually studied in animals to answer questions about
how a drug works and how the body changes and disposes of it. Humans
do not participate in preclinical studies. There are four possible
phases of cancer clinical trials in humans, each designed to answer
different questions about the treatment being studies.

In Phase I mesothelioma clinical trials, doctors are primarily
studying the safety of giving mesothelioma drugs to humans, while
also looking for the best way to give a medication (for example,
as a pill, an injection, or an infusion). They will usually study
how the mesothelioma drug is eliminated from the body in humans.
Also, doctors are trying to find the right doses for further testing.
They carefully watch for any side effects. Phase I study drugs are
usually given to small groups of humans. During this phase, for
drugs used to treat mesothelioma cancer, investigators may be able
to find out which tumors a treatment works best in.

In Phase II mesothelioma clinical trials, the mesothelioma
drug is studies in a larger group. The primary purpose of these
studies is to see how well the drug or treatment shrinks tumors
in patients with specific types of cancer. The investigator will
watch closely for side effects and will also watch how the disease
responds to the treatment.

In Phase III mesothelioma clinical trials, the new cancer
treatment is generally compared to a standard existing treatment.
Patients are usually randomly assigned (that is, a process similar
to flipping a coin is used to determine which treatment the patient
receives) to receive either a standard treatment or the new treatment.
During the trial, patients may or may not be told which treatment
they are getting but are told what to expect and what to watch for.
Occasionally, even the doctor will not know which treatment each
patient is getting so that he or she can remain unbiased about how
the disease is responding to the treatment. (This is uncommon in
cancer clinical trials). Phase III studies are designed to ensure
that any side effects that patients experience are identified treated
according to local standards of care.

Phase IV mesothelioma clinical trials study a drug that has already
been approved by the Food and Drug Administration. Drug companies
often sponsor these trials to study even more uses of drugs already
available.

Clinical Trials: Mesothelioma

California

Duarte; City of Hope National Medical Center

A Double-Blind Placebo Controlled Randomized Phase II of Gemcitabine & Cisplatin With Or Without the VEGF Inhibitor Bevacizumab in Patients with Malignant Mesothelioma

San Diego; Sharp Clinical Oncology Research

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Colorado

Aurora; Research Center

ALIMTA Plus Gemcitabine (Gemzar) for Patients with Malignant Pleural or Peritoneal Mesothelioma who have not had previous chemotherapy

Aurora; University of Colorado Cancer Center

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Florida

Miami; Oncology / Hematology Group of South Florida

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Tampa; Research Center

ALIMTA Plus Gemcitabine (Gemzar) for Patients with Malignant Pleural or Peritoneal Mesothelioma who have not had previous chemotherapy

Illinois

Chicago; Research Center

ALIMTA Plus Gemcitabine (Gemzar) for Patients with Malignant Pleural or Peritoneal Mesothelioma who have not had previous chemotherapy

Chicago; University of Chicago Medical Center, Section of Hematology / Oncology

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Indiana

South Bend; Northern Indiana Cancer Research Consortium

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Maryland

Baltimore; Research Center

ALIMTA Plus Gemcitabine (Gemzar) for Patients with Malignant Pleural or Peritoneal Mesothelioma who have not had previous chemotherapy

Massachusetts

Boston; Research Center

ALIMTA Plus Gemcitabine (Gemzar) for Patients with Malignant Pleural or Peritoneal Mesothelioma who have not had previous chemotherapy

Michigan

Grand Rapids; Spectrum Health, Cook Research Department

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

New Jersey

Somerville; Somerset Medical Center

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

New Mexico

Albuquerque; Research Center

ALIMTA Plus Gemcitabine (Gemzar) for Patients with Malignant Pleural or Peritoneal Mesothelioma who have not had previous chemotherapy

New York

New York; Columbia-Presbyterian Medical Center

ALIMTA Plus Gemcitabine as Front-Line Chemotherapy for Patients with Malignant Pleural or Peritoneal Mesothelioma. A phase II Clinical Trial.

New York; Columbia-Presbyterian Medical Center

Open - Label Study of Alimta (pemetrexed) Combination with Cisplatin for Chemonaive Patients with Malignant Pleural Mesothelioma.

New York; Research Center

ALIMTA Plus Gemcitabine (Gemzar) for Patients with Malignant Pleural or Peritoneal Mesothelioma who have not had previous chemotherapy

New York; Columbia Presbyterian Medical Center

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

New York; Columbia University Medical Center

A phase II, open-label, non-randomized, multicenter, single agent study of intravenous sdx-102 for the treatment of patients with MTAP - deficient cancers.

New York; Columbia-Presbyterian Medical Center

Phase II trial of combined resection, intraperitoneal chemotherapy, and whole abdominal radiation for treatment of peritoneal mesothelioma.

New York; Columbia-Presbyterian Medical Center

Phase II trial of perioperative gemcitabine and cisplatin chemotherapy in resected pleural mesothelioma

New York; Biomedical Research Alliance of New York

Cancer in the Lungs- Caused by exposure to asbestos

Oklahoma

Tulsa; Southwestern Regional Medical Center

Open-Label Study of ALIMTA (pemetrexed) and Cisplatin in chemonaive patients with malignant Pleural Mesothelioma.

Texas

Austin; Lone Star Oncology Consultants, PA

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Houston; S. R. Burzynski Clinic

Phase II Study Of Antineoplastons A10 And AS2-1 In Patients With Mesothelioma

Wisconsin

Madison; Research Center

ALIMTA Plus Gemcitabine (Gemzar) for Patients with Malignant Pleural or Peritoneal Mesothelioma who have not had previous chemotherapy

International

D-14109 Berlin, Germany; Pneumologie II, Zentralklinik Emil von Bering

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

D-21075 Hamburg, Germany; Allgemeines Krankenhaus Harburg

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

D-22927 Grosshansdorf, Germany; Krankenhaus Grosshansdorf, Zentrum fur Pneumologie und Thoraxchirurgie, Pneumo.- Onkolog. Abteilung

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

D-81675 Munchen, Germany; TU Munchen, Klinikum Rechts der Isar, Med. Klinik Hamatologie und Onkologie

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

D-82131 Gauting, Germany; Asklepios Fachkliniken, Zentrum fur Pneumologie und Thoraxchirurgie

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Alessandria, Italy; Azienda Osped. Nazion Antonio e Biagio e Cesare Arrigo, Divisione di Pneumologia

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Genova, Italy; Struttura Semplice di Pneumotisiologia, Ospedale San Marino

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Pavia, Italy; IRCCS - Policlinico San Matteo, Clinica Malattie dell Apparato Respiratorio

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Pavia, Italy; IRCCS - Policlinico San Matteo, Divisione di Pneumologia

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Venezia, Italy; Ospedale Civile di Venezia, Unita Operativa Oncologia Medica

ONCONASE ® plus doxorubicin vs. doxorubicin for patients with Malignant Pleural or Peritoneal Mesothelioma who have had no more than one prior chemotherapy regimen.

Mesothelioma Risk Factors

2006-03-23T08:36:00.000-08:00

Most people diagnosed with mesothelioma worked at jobs where they were exposed to asbestos. Exposure for as few as one or two months can lead to mesothelioma 10 to 50 years later. The long latency period means that people exposed to asbestos in the 1950's, 1960's, 1970's and 1980's may now be seeing symptoms and are now being diagnosed with mesothelioma.

Since the late 1800's asbestos has been mined and used commercially in the United States. Initially the risk associated with asbestos was unknown. An increased risk of disease from asbestos was later revealed among workers in the building, construction, shipbuilding, railroad and automotive industries. It's important to realize that any exposure to asbestos increases your chance of developing mesothelioma. (click here for occupations exposed to asbestos)

One risk factor to consider is the concentration of asbestos in the air you breathed; another risk factor is the duration of all exposures. The combination of concentration and duration increases your risk of contracting asbestos related diseases including mesothelioma. Contraction of the disease also depends on a your own susceptibility to asbestos. There is also evidence that family members living with asbestos workers have developed asbestos related diseases by inhaling dust from workers clothes or body.

Causes of Mesothelioma

Asbestos becomes harmful when fibers are released into the air and then inhaled. After fibers are breathed in they travel to the ends of small air passages and reach the pleura which can cause damage to mesothelial cells. If swallowed, the fibers can reach the abdominal cavity which can cause peritoneal mesothelioma.

Types of Mesothelioma

2006-03-23T08:35:00.000-08:00

Mesothelioma is a rare form of cancer in which malignant (cancerous) cells are found in the sac lining the chest or abdomen. Exposure to airborne asbestos particles increases the risk of developing malignant mesothelioma.
The word Mesothelioma (like other cancer names) is derived from mesothelium, a membrane that covers and protects most internal organs of the body. Mesothelium is composed of two layers of cells, one layer surrounds the organ and the second layer forms a sac around it. Lubricating fluid is produced by the Mesothelium and is released between the layers which help moving organs to flow easily against adjacent structures. Organs such as the heart, lungs and stomach that expand and contract rely on this fluid.

Mesothelium is named differently depending on where it is located in the body. The mesothelial tissue covering the lungs and the chest cavity is the pleura. The tissue covering the organs in the abdominal cavity is the peritoneum. The tunica vaginalis testis covers the male internal reproductive organs and the tunica vaginalis testis surrounds the female reproductive organs. Most cases of Mesothelioma begin in the pleura or the peritoneum. When mesothelioma develops in the pleura (known as pleural mesothelioma), the delicate lining thickens and fluid may collect between the two layers of the pleura. The abdomen peritoneal mesothelioma causes thickening of the lining and a collection of fluid in the abdomen, called ascites. Symptoms are associated with the organs that may be affected by mesothelioma.

Mesothelioma has a long latency period and it's important to determine who needs to be examined. This long silent period makes diagnosis difficult and symptoms may sometimes be mistaken for something else. Treatment options are often determined by the stage of mesothelioma of the patient.

Mesothelioma is serious and life-threatening. By the time cancer is diagnosed the patients survival time is usually short. Mesothelioma usually spreads throughout the peritonal or pleural cavity before diagnosis, and complete surgical removal is unlikely. Because of this, the average survival time is only 1 year. If the cancer is found early, approximately 50% of the patients survive 2 years and approximately 20% survive 5 years. Additionally, unlike with other tumors, chemotherapy and radiation therapy are not very effective.

Who Gets Cancer?

2006-03-23T08:29:00.000-08:00

Detailed Guide: Cancer (General Information)
Who Gets Cancer?

Over one million people get cancer each year. Approximately one out of every two American men and one out of every three American women will have some type of cancer at some point during their lifetime. Anyone can get cancer at any age; however, about 77% of all cancers are diagnosed in people age of 55 and older. Although cancer occurs in Americans of all racial and ethnic groups, the rate of cancer occurrence (called the incidence rate) varies from group to group.

Today, millions of people are living with cancer or have been cured of the disease. The sooner a cancer is found and the sooner treatment begins, the better a patient's chances are of a cure. That's why early detection of cancer is such an important weapon in the fight against cancer.

What Is Cancer?

2006-03-23T08:26:00.000-08:00

Detailed Guide:
What Is Cancer?

Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells.

Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide more rapidly until the person becomes an adult. After that, cells in most parts of the body divide only to replace worn-out or dying cells and to repair injuries.

Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to form new abnormal cells.

Cancer cells develop because of damage to DNA. This substance is in every cell and directs all activities. Most of the time when DNA becomes damaged the body is able to repair it. In cancer cells, the damaged DNA is not repaired. People can inherit damaged DNA, which accounts for inherited cancers. More often, though, a person's DNA becomes damaged by exposure to something in the environment, like smoking.

Cancer usually forms as a tumor. Some cancers, like leukemia, do not form tumors. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow.

Often, cancer cells travel to other parts of the body where they begin to grow and replace normal tissue. This process is called metastasis. Regardless of where a cancer may spread, however, it is always named for the place it began. For instance, breast cancer that spreads to the liver is still called breast cancer, not liver cancer.

Not all tumors are cancerous. Benign (noncancerous) tumors do not spread (metastasize) to other parts of the body and, with very rare exceptions, are not life threatening.

Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That is why people with cancer need treatment that is aimed at their particular kind of cancer.

Cancer is the second leading cause of death in the United States. Half of all men and one third of all women in the United States will develop cancer during their lifetimes. Today, millions of people are living with cancer or have had cancer. The risk of developing most types of cancer can be reduced by changes in a person's lifestyle, for example, by quitting smoking and eating a better diet. The sooner a cancer is found and treatment begins, the better are the chances for living for many years.

LEADING CANCER LINKS

2006-03-23T08:25:00.000-08:00

Listed below are links to other cancer resources on the Internet that have information about mesothelioma.

American Cancer Society

National Cancer Institute

University of Pennsylvania’s Oncolink

Mayo Clinic

Intellihealth

American Institute for Cancer Research - www.aicr.org

American Thoracic Society - www.thoracic.org

Canadian Cancer Society - www.cancer.ca

ChemoCare - www.chemocare.com

Mesothelioma Aid - www.mesothelioma-aid.org

Sometimes people with serious illnesses would like to speak with others in the same situation. The following organizations attempt to match people with similar situations looking for mutual support.

Anderson Network (cancer)
Phone : 1-800-345-6324 (Toll Free)
Website: www.mdanderson.org/andersonnetwork
The Anderson Network, part of The University of Texas M. D. Anderson Center in Houston has a database of 700 cancer survivors.

Cancer Hope Network (cancer)
Phone: 1-877-HOPENET (Toll Free)
Website: www.cancerhopenet.org
Cancer Hope Network has a database of 325 patients representing 45 cancers.

Med Help Int'l Patient Network (all illnesses)
www.medhelp.org/network.htm

Books
Libby, Montana: Asbestos and the Deadly Silence of an American Corporation by Andrea Peacock - This book just came out on Libby, Montana, the asbestos coverup; we'll tell you more about it after we've read it.

Fatal Deception: How Big Business is Still Killing Us with Asbestos
by Michael Bowker - This book should be of interest to anyone affected by an asbestos-related illness. It chronicles the fight for justice in Libby, Montana, site of the most lethal environmental disaster in U.S. history. It tells in great detail of the callous disregard of the W. R. Grace Company, both for the protection of its workers (and literally, the town of Libby), from the deadly effects of asbestos fibers, and in the far-reaching coverup that followed. Also mentioned, are concerns about a possible coverup by the EPA and the government at the site of the World Trade Center in New York, and the fact that asbestos is still an ingredient in thousands of products in the U.S. – one of the few nations that has still not placed a ban on its use.

Mesothelioma Journal

2006-03-23T08:22:00.000-08:00

Extended surgical staging for potentially resectable malignant pleural mesothelioma.
SOURCE: Ann Thorac Surg. 2005 Dec;80(6):1988-92.

Rice DC, Erasmus JJ, Stevens CW, Vaporciyan AA, Wu JS, Tsao AS, Walsh GL, Swisher SG, Hofstetter WL, Ordonez NG, Smythe WR.
Department of Thoracic and Cardiovascular Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.

BACKGROUND: Extrapleural pneumonectomy for malignant pleural mesothelioma (MPM) is a high-risk procedure, and patients require careful preoperative staging to exclude advanced disease. Computed tomography, magnetic resonance imaging, and positron emission tomography are useful staging modalities, but do not reliably identify contralateral mediastinal involvement or transdiaphragmatic invasion. We evaluated the role of extended surgical staging procedures, which generally includes a combination of laparoscopy, peritoneal lavage, and mediastinoscopy, to more precisely stage patients with MPM.

METHODS: One hundred eighteen patients with MPM, deemed clinically and radiologically resectable, underwent extended surgical staging. Mediastinoscopy was performed in 111 patients, laparoscopy in 109 patients, and peritoneal lavage in 78 patients.

RESULTS: Ten (9.2%) patients had gross evidence of transdiaphragmatic or peritoneal involvement. Peritoneal lavage was positive for metastatic MPM in 2 (2.6%) patients, neither of whom had obvious transdiaphragmatic invasion. Ipsilateral mediastinal nodes contained metastatic tumor in 10 of 62 (16.1%) patients. Contralateral nodes were positive in 4 of 111 (3.6%) patients. Of the patients who underwent biopsy of both ipsilateral and contralateral mediastinal nodes, and who had complete pathologic staging after extrapleural pneumonectomy (n = 46), 14 (30.4%) had N2-positive nodes. Only 5 of these patients were correctly identified by mediastinoscopy (sensitivity 36%, accuracy 80%). Extended surgical staging identified 16 (13.6%) patients who had contralateral nodal involvement, transdiaphragmatic invasion, or positive peritoneal cytology.

CONCLUSIONS: Extended surgical staging defines an important subset of patients with unresectable MPM not identified by imaging. Because of the potential morbidity associated with extrapleural pneumonectomy, we advocate that extended surgical staging be performed in all patients with MPM before resection.

Mesothelioma Online Websites

2006-03-23T08:18:00.000-08:00

Mesothelioma Collect Millions of Dollars
As seen on television. Mesothelioma lawsuit and compensation information. We can help you collect the compensation that you are entitled to. Free advice nationwide.
www.mesothelioma-lawsuits-asbestos.com

Mesothelioma Help
Leading mesothelioma Web site. Comprehensive information on symptoms and treatment, clinical trials, for those who suffer from mesothelioma. Recommended by doctors.
www.mesotheliomaweb.org

Mesothelioma Help and Legal Options
Diagnosed with Mesothelioma? Free Patients book. Know your legal rights. Our experienced Mesothelioma lawyers team has helped hundreds of Mesothelioma victims recover millions. Nationwide.
www.mesotheliomaoptions.com

Mesothelioma - Free Info Packet
Find mesothelioma information online and a more thorough mesothelioma packet available for free. Get as many answers as possible quickly and easily.
mesothelioma-lung-cancer.org

Mesothelioma Lawyers
Millions of dollars for mesothelioma victims. 28 yrs of experience. We can help you collect now.
mesotheliomaattorney.com

Mesothelioma Information
Mesothelioma is a cancer that is unique to those who have been exposed to asbestos. Information about mesothelioma from lawyers who specialize in asbestos litigation.
www.mesotheliomafyi.com

Mesothelioma Treatment Update
Medical treatment information and legal representation for mesothelioma, lung cancer, asbestosis and pleural disease victims caused by asbestos exposure.
www.mesothelioma.com

Mesothelioma Treatment: Payment Help
Mesothelioma diagnosis? Comprehensive web site on drug treatments and offers payment assistance to patients. Nationwide service.
www.mesothelioma-cancer-treatment.com

Mesothelioma Empowerment
An up-to-date survey of medical abstracts, doctor referrals and mesothelioma patient profiles.
www.mesothel.com

Mesothelioma Lawyers
The mesothelioma lawyers at the Law Offices of Peter G. Angelos, PC, have over 20 years experience in representing and mesothelioma cancer lawsuits.
www.asbestosattorneys.net

Mesothelioma Basic Facts
Get the facts about Mesothelioma and asbestos exposure disease. Legal help and information about this rare cancer. National help for all patients.
www.mesothelioma-center.com

Mesothelioma Information Newsletter
Information about mesothelioma cancer, treatment options, asbestos exposure issues, asbestos cancer and other asbestos diseases, litigation resources, and current research.
www.mesothelioma-facts.com

Mesothelioma? Millions for Your Family
Get justice. Millions of dollars may be available for you and your family. Asbestos cancer kills thousands of workers. Get justice. National law firm.
www.mesothelioma-corporate-lawsuits.com

Mesothelioma Information
If you or someone you know have been diagnosed with Mesothelioma or suffer due to asbestos exposure, then find out the facts about your legal rights by requesting free.
www.cancer-mesothelioma.org

Mesothelioma: U. of Maryland Med. Center
Information on mesothelioma and other asbestos-related diseases. This includes types, testing and the treatment options, from the University of Maryland Medical Center in Baltimore.
www.umm.edu

Mesothelioma - Martin & Jones
Offers information on asbestosis and mesothelioma.
www.asbestos-mesothelioma-lawyers.com

Mesothelioma: Questions and Answers

2006-03-23T08:16:00.000-08:00

What is Mesothelioma?

Mesothelioma is the term used to describe a cancerous tumor that involves the mesothelial cells of an organ. Mesothelial cells are cells that form a protective lining over the lungs, heart and abdominal organs. The most common type of mesothelioma is pleural mesothelioma. The pleura is a thin membrane found between the lungs and the chest cavity. It provides a lubricated surface so that the lungs do not rub and chafe against the chest walls.

What causes it?

Virtually all cases of mesothelioma are related to inhaling of asbestos fibers. There are about 3,000 cases per year (mostly men over the age of 40) and there will be about 300,000 cases before 2030. Mesothelioma usually spreads rapidly through the mesothelial cells to the heart and abdominal organs. The life span is typically 24 months after diagnosis, but it depends on what stage the cancer is detected, the health of the patient and other factors.

Although asbestos exposure causes mesothelioma, it has a latency period after exposure that could last 15 to 50 years. This means that someone who worked in a factory with asbestos 40 years ago could be developing mesothelioma now. Anyone who knows they were exposed to loose asbestos fibers should be tested regularly for mesothelioma.

Diagnosis of Mesothelioma

The onset of mesothelioma symptoms usually takes a long time. The first symptom is often a constant chest pain. This pain is later accompanies by difficulty breathing due to an accumulation of fluid in the chest. Other symptoms include coughing, fever and weight loss. Mesothelioma can be diagnosed by your doctor with a chest CT-scan.

What Needs to Happen?

After a positive mesothelioma diagnosis, your doctor will discuss the available treatment options. Many newer treatments promise to improve patients quality of life and add several years of life. What may not be explained the that the disease is not a random act of nature, but the result of a dangerous product that was used despite evidence of the harm it would cause. Companies have had to pay workers billions of dollars to compensate them and their families for this wanton disregard of human life and safety.

Will there be a lawsuit?

Most people are reluctant to take legal action. However, Mesothelioma presents a nearly 100% certainty that someone or a company is at fault. If the person's work history can be traced, the likelihood is that a very large settlement awaits the victim. Your attorney can explain the details, but most claims settle out of court very quickly, unlike many other types of cases.

How much will I get?

The amount of the settlements varies greatly, but usually start at half million to several million. The award is based on many factors such as the amount of funds available, the duration and location of the asbestos exposure, the persons overall health. Your attorney will know how to maximize the recovery to get the most compensation for you and your family.

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Mesothelioma Settlement ClaimsMesothelioma is a rare cancer caused by asbestos exposure many years before the cancer develops. If you or a loved one has been diagnosed with Mesothelioma, pleural, lung or asbestos cancer you may be entitled to collect Millions of Dollars from negligent companies.
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Are you eligible for compensation through a Lawsuit? If you are a victim of Mesothelioma, your eligibility for a multimillion dollar award will depend on several issues:a) Statute of Limitationsb) Asbestos Exposure Can Be Shownc) Responsible Partiesa) Statute of LimitationsIf you would like more information about Mesothelioma settlements, please fill out the information below for a no-cost assessment of your rights to a Multi Million dollar compensation package.

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