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Mesothelioma is a rare cancer that¡¯s most commonly found in the lining of the lungs or abdomen, but it can also start in the lining of the heart or testicles in rare cases.

Mesothelioma is most common in men ages 45 to 85. Typically, it occurs in those who¡¯ve been exposed to asbestos, a fibrous mineral used in construction and manufacturing until it was banned by the in 1989. But not everyone who¡¯s been exposed to asbestos will get mesothelioma.

In rare cases, mesothelioma can be passed down in families through the BAP1 gene, or BRCA1-associated protein 1.

Not everyone who¡¯s been exposed to asbestos will get mesothelioma, but if you¡¯ve been exposed, you could be at risk. To learn about mesothelioma symptoms, diagnosis and treatment options, we spoke with Here¡¯s what she shared.

What are common mesothelioma symptoms?

Mesothelioma symptoms often don¡¯t appear until it¡¯s advanced. It may be 20-30 years or more after you¡¯ve been exposed to asbestos.

When it begins in the lungs, it¡¯s called pleural mesothelioma. Shortness of breath is one of the first symptoms, but fluid in your lungs may also cause constant coughing or wheezing. As the tumor grows, it may press against other parts of your body, causing chest pain.

Peritoneal mesothelioma begins in the lining of the abdomen; its first sign is usually abdominal bloating.

You should tell your doctor if you experience any of these symptoms.

How is mesothelioma diagnosed?

If you¡¯re experiencing shortness of breath, your doctor will most likely perform a chest X-ray. This would show any fluid in your lungs.

If the X-ray shows fluid in your lungs, your doctor may perform a procedure called a thoracentesis. During this procedure, your doctor will insert a needle into the space between the lungs and chest wall to remove fluid. Once the fluid is drained, it will be examined for cancer cells.

Unfortunately, cancer cells only show up 30% of the time, so your doctor may have to do more than one thoracentesis to find cancer cells. ?

How is mesothelioma typically treated?

The type of treatment your doctor recommends depends on the stage and location of the tumor, as well as your age and overall health.

There are two different types of surgery your doctor may recommend:

• Extrapleural pneumonectomy removes all organs where mesothelioma has spread. This may include the lung, lymph nodes, diaphragm or lining of the heart. The diaphragm and heart lining are then rebuilt with a sheet of artificial material.?
• Pleurectomy/decortication involves peeling the tumor away from the lung, diaphragm and chest wall.
  

Radiation therapy after surgery can reduce the chances of cancer coming back. In some cases, it may also help relieve pain or discomfort. Your doctor may recommend a technique called intensity modulated radiation therapy, or IMRT. It focuses multiple radiation beams of different intensities directly on the tumor using the highest possible dose. IMRT may lead to better results and fewer side effects than other types of radiotherapy.

Chemotherapy, immunotherapy, or targeted therapy may also be used to slow tumor growth and prevent organ damage.

Which treatment options are best for which patients?

Your doctor may recommend extrapleural pneumonectomy if the mesothelioma is diagnosed early, before it has spread or caused serious damage to your organs. Because this complex surgery involves removing a lung, it¡¯s only an option if you¡¯re in good physical shape.

Pleurectomy/decortication may be a surgical option if you¡¯re not eligible for an extrapleural pneumonectomy. Since the tumor usually can¡¯t be removed entirely, there¡¯s a risk of recurrence.? But this procedure relieves pain and shortness of breath, so your quality of life may improve.

Unfortunately, many mesothelioma patients aren¡¯t diagnosed until the disease is more advanced. In these cases, surgery is not an option. When this happens, our goal is to give you more time with your family, improve your quality of life and relieve any cancer pain you have.

Anything else you want mesothelioma patients to know about treatment?

No matter when you¡¯re diagnosed or what type of treatment your doctor recommends, it¡¯s important to be as physically active as possible and maintain a balanced diet. This can help your body stay healthy enough for treatment and its side effects. If you¡¯re an MD Anderson patient, ask your care team for a referral to one of our dietitians and the Integrative Medicine Center.

It¡¯s also important to keep in mind that we have new ways to treat mesothelioma that weren¡¯t options even two or three years ago, thanks to research and clinical trials.

Finally, there¡¯s always hope. As long as you¡¯re healthy enough to undergo treatment, there are options for you. If you have mesothelioma, you can have a good quality of life.

or by calling 1-877-632-6789.

Most cases of mesothelioma are caused by exposure to a substance called asbestos. This rare cancer develops in the mesothelial cells, the thin layer of tissue that lines the chest cavity and is also known as the pleura.

But what is asbestos? How might you be exposed to it? And, is there anything you should do to lower your risk of developing asbestos-related cancers?

We spoke with , vice president and head of Cancer Prevention and Population Sciences. He¡¯s what he shared.??

What is asbestos, and how might the average person be exposed to it?

Asbestos is a group of six naturally occurring mineral fibers that have special properties, such as being fire resistant and good insulators. They are found in certain types of rock and extracted through mining. Their names are:

• Actinolite?
• Amosite?
• Anthophyllite?
• Chrysotile?
• Crocidolite
• Tremolite

Until the 1970s, asbestos was used a lot in manufacturing. It could be found in everything from roof shingles and brake pads to flooring and insulation. Once asbestos was identified as a carcinogen, though, government agencies stepped in to start limiting its use. They also developed strict protocols on how materials containing asbestos could be handled, removed and disposed of.

Asbestos exposure is not considered as much of an issue today because its use has declined so much in the past 50 years.?

Is there anything I should do to reduce my risk of asbestos exposure?

For the most part, no. Asbestos finds its way inside our bodies primarily through respiration. In other words, we breathe in the fibers and dust when we¡¯re exposed to ore or other materials containing asbestos, and they get caught inside our lungs.

Small amounts of asbestos are still used in some products and industries today. But the average person probably won¡¯t encounter it in high enough concentrations to increase their risk of developing a related cancer.?

Prolonged, repeated exposure to asbestos is required for cancer to become an issue. That¡¯s why people who lived or worked close to Ground Zero after the 9/11 World Trade Center attacks are at increased risk. And, anyone involved in the renovation or demolition of older residential or commercial structures could also be exposed to asbestos.

But unless you¡¯re a miner, auto mechanic, roofer or construction laborer who worked in those industries mostly before about 1970, your risk is pretty low.

Which cancers are caused by asbestos exposure??

Mesothelioma is by far the most common. But asbestos exposure has also been linked to lung cancer, laryngeal cancer, ovarian cancer and even some gastrointestinal cancers.?

Interestingly, asbestos was a factor in the recent lawsuits linking talcum powder to ovarian cancer, too. I¡¯ve often wondered how something that's primarily inhaled can get so far inside the body. Maybe that connection will someday become clearer.

Are there any warning signs or symptoms of asbestos exposure?

No. That¡¯s one of the challenges. There weren¡¯t any screening tests to look for asbestos-related cancers in otherwise healthy individuals back in the 1970s. There still aren¡¯t today. That¡¯s why these cancers tend to be found in more advanced stages.?

How are asbestos-related cancers usually diagnosed?

Mesothelioma and lung cancers caused by asbestos exposure are normally diagnosed with a chest X-ray in someone who complains of shortness of breath, trouble breathing, persistent coughing or other symptoms.

Why does asbestos exposure cause cancer?

There are currently three theories:

1. Chronic inflammation
2. Changes in cell signaling, or how our cells communicate with one another
3. Free radicals, or highly unstable oxygen molecules that can damage cell DNA?

But none of these offers a really satisfying explanation. So, it¡¯s still a bit of a mystery.?

Are there any unique features to help identify asbestos-related cancers?

No. I¡¯ve seen reports that researchers are exploring potential blood markers. But it¡¯s all still very experimental, so there¡¯s nothing definitive yet. And, there are no distinctive, signature mutations related to asbestos exposure that I know of.

Even when we find actual asbestos particles in a biopsy specimen and can infer that it played a major part in causing a cancer, it doesn¡¯t really influence treatment, as there is no treatment tailored to it.

What¡¯s the most important thing to know about asbestos and cancer?

This is one instance in which government regulation has been really helpful. There¡¯s always a bit of second-guessing involved at the beginning of that process, when you wonder, ¡°Are we overdoing this?¡±

But there¡¯s no doubt now that asbestos regulation has significantly decreased the incidence of all exposure-related diseases, including cancer. Recognizing the link between asbestos and cancer ¡ª and then acting on it by removing the source of exposure ¡ª has proven to be a highly effective prevention strategy.

or call 1-877-632-6789.