Information on Mesothelioma

There have been several lawsuits recently regarding cases of Mesothelioma. The following is a breif description of what it is and the legal issues surrounding it. Mesothelioma is an uncommon form of cancer and is usually associated with previous exposure to asbestos. In this disease, malignant cancer cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura, or the outer lining of the lungs and chest cavity. Mesothelioma may also occur in the peritoneum, which is the lining of the abdominal cavity, or the pericardium, a sac that surrounds the heart.

This site is designed to give you information with respect to symptoms and diagnosis of the disease and offer several links and other resources of help from mesothelioma lawyers and attorneys to help you with your claims to general information with respect to lung cancer.

 Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. These symptoms may be caused by mesothelioma or by other, less serious conditions.

 Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of occupational exposure to asbestos may increase clinical suspicion for mesothelioma. A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).

Treatment of mesothelioma using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation. The clinical behavior of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favors local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.
Surgery. Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing with a 5 year survival rate of less than 10%. It is most useful for palliation.

Radiation. Although the tumor is highly resistant to radiotherapy and chemotherapy, these regimens are sometimes used to relieve symptoms arising from tumour metastases such as obstruction of a major blood vessel.
Chemotherapy. In February 2004, the Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma.

Immunotherapy. Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer). Mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.

Heated Intraoperative Intraperitoneal Chemotherapy. A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute[5]. The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.

This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells. 

Legal Issues: In the United States, the average mesothelioma-related settlement was $1 million; for cases that go to trial awards averaged $6 million, according to a study by the RAND Corporation. Only a small fraction of the thousands of asbestos-related lawsuits in the United States every year are related to mesothelioma. In 2004, a bill in the United States Senate aimed an asbestos litigation reform failed to reach a floor vote. In January of 2005, Senate Judiciary Committee Chairman Arlen Specter announced he would again try to pass an asbestos litigation reform bill. A separate bill introduced on March 17, 2005, the Fairness in Asbestos Injury Resolution Act of 2005 (FAIR act of 2005), seeks to ensure a set amount of compensation dependent on the symptoms of the victim. The range is from Medical Monitoring for victims with Asbestosis or Pleural Disease to $35,000 for victims with Mixed Disease With Impairment all the way to over $1,000,000 for Mesothelioma victims and nonsmoking Lung Cancer victims. FAIR act of 2005, full text.