Introducing The Oncologist of Mesothelioma

Being diagnosed with cancer is not a good day for anyone. Mesothelioma is a particularly bad form. Whether you are diagnosed with this or another version, you will undoubtedly be sent off to a medical specialist known as an oncologist.

Cancer treatment has come a long way. It wasn't that long ago that the "C" word was a death sentence and you were just unlucky if you were diagnosed with it. The interesting thing is the concept has expanded greatly as a health risk, but so has the ability to treat it. It is often suggested that we have found no cure to cancer, but that isn't really true. We have found ways to cure people who suffer from various cancers like Lance Armstrong, but we haven't found a universal cure.

The specialists who deal with all of this are known as oncologists. The title covers everyone from medical scientists who do research on the various forms of cancer to doctors who actually treat patients. If you are diagnosed with Mesothelioma, you are going to be referred to just such a specialist.

What should you look for in an oncologist? Well, there are a couple of things. First and foremost, you want someone who is board certified. The certification is a sign you are dealing with a person who is advanced in their understanding and competency in the field. Given the fact you are dealing with a very serious form of cancer, you don't want to be treated by anyone other than the best.


The second thing to look for is a bit more subtle. How would you feel if you dealt with cancer patients all day? You would lose far more patients than almost any other form of medical professional because cancer is an insidious disease. You would probably become a bit number and cynical after a while. There is nothing unprofessional about this. We are all human beings. Still, you really don't want a doctor who manifests this when you are a patient trying to fight Mesothelioma. You want a fighter and this is often why younger oncologists are an ideal choice. Generalities are dangerous, but they often can be more personally involved in the fight. A doctor who views your fight as their fight is ideal.

The diagnosis of Mesothelioma can be a harsh one. The shining night in your effort to fight the cancer will be an oncologist. Find one you are comfortable with and go to war!

Mesothelioma - Primary Lung Cancer and Secondary Lung Cancer

Cancer is a disease related to the uncontrolled growth of tissue, leading to the accumulation of mass (called a tumor or lesion.) Normal cells in the body divide and grow in an orderly controlled manner. When cells grow uncontrollably and this growth invades other tissues or organs, the growths are called malignant or cancerous. When a mass of tissue, or tumor, is benign, it is relatively stable and does not invade other tissues.

Cells from malignant tumors can break away and travel to other parts of the body, usually through the bloodstream, but also through the lymph system. When these cells find new host organs, these cells can grow into tumors in the new tissue. This spreading process is called metastasis and when a cancer has reached an advanced stage to where the malignant cells are attacking other organs, it is said that the cancer tumors have metastasized. The tumors in new organs are always made up of cells similar to those of the original tumor.

Benign tumors do not metastasize. They can often times be removed through surgery and not re-occur.
Lung Cancer

Lung cancer occurs when lung tissue develops cancerous growths. Primary lung cancer is cancer that originates in the lung tissue. Secondary lung cancer is cancer that spreads, or metastasizes, from other organs.
Primary Lung Cancer

There are several different types of primary lung cancer. These are divided into two main groups:

* Small Cell Lung Cancer
* Non-small Cell Lung Cancer

Pleural mesothelioma is often thought of as a third type of primary lung cancer. However, it is not a lung cancer. Mesothelioma does not develop in the lungs, but in the serous membranes surrounding the lungs. As such, it does not fall into the typical categories of lung cancer. Mesothelioma can also occur in other tissues, in the lining of the abdomen, call peritoneal mesothelioma, and in the lining of the heart, pericardial mesothelioma.
Small Cell Lung Cancer

Small Cell Lung Cancer comprises approximately 20% of the primary types of lung cancer. It is called small cell cancer because the tumor cells are very small, with the cells containing almost exclusively the cell nucleus and nothing more. This type of cancer is also referred to as �oat cell� cancer. Chemotherapy is often suggested for this cancer in the early stages because of the rapid way it which it spreads. Surgery is not a good option to stop the spread early on. This type of cancer is most closely linked to smoking; non smokers rarely have it.
Non-Small Cell Cancer

Non-small cell cancer falls into these categories:

* Squamous cell carcinoma
* Adenocarcinoma
* Large cell carcinoma
* Adenosquamous cell carcinoma
* Undifferentiated carcinoma

Each category of non-small cell cancer are physiologically similar and they respond to treatment differently than to small cell lung cancer.

Squamous cell carcinoma is a common type of primary lung cancer. This type of cancer is also linked to smoking and it develops from the cells than line the airways in the lungs. Squamous cells are thin, flat cells that look like fish scales. Commonly the tumor growths are located in the center of the lungs near the large airways (bronchi). It is also referred to as epidermoid carcinoma. It comprises approximately 30 to 35% of the non-small cell cancer in the US, affecting men and the elderly most frequently.

Adenocarcinoma, like squamous cell carcinoma, develops from tissues in the lung airways. But, it develops from the glandular secretory tissues. (tissues that produce mucus). It is often found in the outer airway passages, not the main bronchi, like the squamous cell variety. The incidence of this cancer is increasing. It comprises about 40% of the non-small cell lung cancer in the US and is the most common lung cancer among women.

Large cell lung cancer is named after its appearance. The cells look large and unnatural under the microscope. These types of cells grow quite quickly.

Adenosquamous carcinoma are cells that appear flat under the microscope, like the squamous cells, but derive from the glandular secretory cells, like the adenocarcinoma.

Undifferentiated carcinoma includes cancer cells that cannot be identified as one of the other groups. The cells appear abnormal under the microscope and multiply uncontrollably.
Secondary Lung Cancer

Secondary lung cancer is cancer that has spread to the lungs from other organs. Many different types of cancer spread to the lungs, because of its very high blood supply. These include breast cancer and colon cancer.

The type of cancer is very important when it comes to treatment. The different types of cancer cells respond differently to different types of chemotherapy and other therapies. When cancer cells spread from other organs to the lungs, then the lungs have to be treated for the other type of cancer, not lung cancer. This is an important distinction. For example, breast cancer that spreads to the lungs, has to be treated for breast cancer, not lung cancer.

Mesothelioma Risk Factors

Mesothelioma Risk Factors

The biggest and almost exclusively known risk factor for mesothelioma is exposure to asbestos. Those who have inhaled or ingested the toxic mineral are prime candidates for developing the disease. Even indirect exposure (known as secondary exposure) has been linked to cause mesothelioma in many instances.
Risks from Direct Exposure

Anyone who has encountered asbestos is at risk for developing mesothelioma. Asbestos and asbestos-containing products were commonly used in a wide variety of industries throughout most of the twentieth century. Some workers in those industries encountered the dangerous mineral on a daily basis, unknowingly exposing themselves to a substance that would eventually wreak havoc on their lungs.

Workers who may have encountered asbestos on the job include:

* Shipyard workers
* Insulators
* Construction workers
* Electricians
* Plumbers
* Pipefitters
* Steamfitters
* Welders
* Railroad employees
* Power plant employees
* Chemical plant employees
* Boilermakers
* Auto mechanics
* 9/11 first responders/emergency personnel

In addition to these professions, individuals who perform do-it-yourself projects at home where asbestos is present may be at risk for developing the disease. Such asbestos-containing building materials that were used in homes include attic and pipeline insulation, drywall and drywall glue, floor and ceiling tiles, "popcorn" ceilings, cements, shingles, and much more.
Risk from Secondary Exposure

In the past decade, more and more cases of secondary exposure to asbestos have come to light. Those subject to secondary exposure are often people who live in a household where someone else works with asbestos. These individuals usually inhale asbestos fibers brought home on the hair and clothes of other family members.

Many secondary exposure cases have been discovered in young people who sat on their father's or grandfather's lap when they came home from work. Other examples of secondary exposure have been found among those who lived near a factory that produced asbestos-containing products or near mines that harvested asbestos-laced vermiculite. While these individuals had no direct contact with the toxic mineral, the amount of asbestos dust in the air was enough to cause them to develop mesothelioma or another asbestos-related disease.
Smoking

Studies have shown that smoking does not cause mesothelioma. However, those that smoke and are exposed to asbestos have a much higher chance of developing the disease. As a matter of fact, some statistics show that smokers are as much as 90 percent more likely to develop mesothelioma after being exposed to asbestos. This is an important risk factor and one that is often overlooked by long-time smokers. In addition, those who have already developed asbestosis should avoid smoking at all costs, as the combination of the two significantly raises the risk of contracting mesothelioma.

Mesothelioma Prognosis

Pleural mesothelioma is a difficult cancer to treat because it can spread so extensively and it is generally not diagnosed until it is in the more advanced stages, making surgical removal of all the cancer difficult or impossible. Because it is a relatively rare cancer, mesothelioma has not been studied as much as more common forms of cancer. The stage at which treatment for mesothelioma is begun has a tremendous impact on the patient’s prospects for long-term survival.

The American Cancer Society reports that some pleural mesothelioma patients in stage I have had their mesothelioma successfully removed through an involved surgical procedure called extrapleural pneumonectomy. Extrapleural pneumonectomy is a grueling surgery only offered to patients in otherwise good health. The entire affected lung plus the pleural lining of the chest wall, diaphragm, and pericardium on the affected side are removed. Surgeons then reconstruct the diaphragm and the pericardium. This procedure works best for patients with epithelioid cell mesothelioma.

Some patients who have had a successful extrapleural pneumonectomy are now enjoying long remissions. A study of 120 patients, who underwent extrapleural pneumonectomy at the Dana-Farber Cancer Institute in Boston between the years 1980 and 1995, revealed that 22 percent of these patients survived five years or longer. The surgery for these patients had been followed by chemotherapy and radiation (Cancer Help UK, 2008).

Removing most of the mesothelioma from patients in stage II and III in a procedure called pleurectomy/decortication may also increase a patient’s life expectancy. The aim of this procedure is palliative, as it can control fluid buildup and relieve pain and pressure.

Factors Influencing the Prognosis

The patient’s overall health status and age affect the prognosis. The American Cancer Society reports that 75 percent of those diagnosed with mesothelioma are 65 years old or older. Men are five times more likely to have mesothelioma than women are.

When mesothelioma is diagnosed, the doctors look at how far the cancer has spread and several health factors. Pleural mesothelioma patients have a poorer prognosis if they are experiencing chest pain, shortness of breath, inability to perform daily tasks, weight loss, a low red blood cell count, a high white blood cell count, and high blood levels of a substance called LDH. According to the American Cancer Society, most mesothelioma patients who have all these factors present pass away within six months of their diagnosis. It is rare for these seriously ill patients to live two years after their diagnosis. Patients without these serious risk factors at the time of their diagnosis have a better outcome.

Mesothelioma and Asbestos

While a rare disorder in the general population, mesothelioma is not rare among individuals exposed to asbestos. There are two to three thousand new diagnoses of mesothelioma every year.

Exposure to asbestos is the only confirmed cause of mesothelioma. Most mesothelioma victims were exposed to asbestos in the workplace and were never told of its dangers or given proper protective gear. Others were exposed through family members who brought asbestos home on their clothes or through home renovation projects. Unlike many other predominantly pulmonary-related cancers, cigarette smoking has no known causative effect on mesothelioma incidence, although asbestos workers who smoke do have a much greater likelihood to develop lung cancer — even more so than regular smokers who don’t work with asbestos.

One of the most difficult aspects of mesothelioma to come to terms with is its long latency period, which is the period of time between first exposure to asbestos and the onset of the disease. Mesothelioma can develop anywhere between 10 to 70 years after the initial exposure

Mesothelioma Early Symptoms

The early symptoms of mesothelioma are generally non-specific, and may lead to a delay in diagnosis. Sometimes resembling viral pneumonia, pleural mesothelioma patients may present with shortness of breath, chest pain and/or persistent cough; some patients show no symptoms at all. A chest x-ray may show a build-up of fluid or pleural effusion (discussed below). The right lung is affected 65% of the time, with involvement of both lungs being seen in approximately 6% of patients at the time of diagnosis. Less common symptoms of pleural mesothelioma include fever, night sweats and weight loss. Symptoms of peritoneal mesothelioma may include pain or swelling in the abdomen due to a build-up of fluid, nausea, weight loss, bowel obstruction, anemia or swelling of the feet.
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About Mesothelioma

What is mesothelioma?
Mesothelioma is an asbestos caused cancer of the serous membranes that surround many of the body’s vital organs. These membranes, known as mesothelium, secrete a lubricating fluid that provide an easy movement of the organs within the body. The most common form of the disease is pleural mesothelioma, which affects the membranes that surround the lungs. The next most common form of the disease is peritoneal mesothelioma, which affects the lining of the abdomen. Other forms of the disease do exist, but they are rare occurrences.

While considered a rare cancer, mesothelioma is not rare among individuals exposed to asbestos. The great tragedy of mesothelioma is that it was preventable. Many of the corporations that manufactured and profited from the sale of asbestos-containing products were aware of the hazards of asbestos.

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