Information About New Jersey Asbestos and Mesothelioma Cases
What is Mesothelioma?
Mesothelioma is a rare form of cancer. Approximately 2,000 new cases of mesothelioma are diagnosed in the United States each year. The average life expectancy for someone diagnosed with mesothelioma is usually between 8 to 24 months from the date of diagnosis. There is presently no known cure for mesothelioma.
Mesothelioma is commonly associated with asbestos exposure[i]. Asbestos is the only widely used commercial product which is known to cause mesothelioma. All types of asbestos fibers are associated with the causation of malignant mesothelioma. A continuous exposure to asbestos fibers is not necessary for the onset of the tumor to occur. Mesothelioma is commonly observed between 20 to 35 years after the first exposure to asbestos, although mesothelioma has been diagnosed in cases where the first exposure to asbestos was as little as 7 years prior. Minimal exposures to asbestos are capable of causing mesothelioma.
What is Asbestos?
Asbestos is a fibrous mineral used in a variety of products. Asbestos minerals break down into smaller particles that remain in the air or stick to clothing, making it easy to inhale or swallow. This characteristic is known as friability. People who breathe in asbestos particles are at a risk of developing life-threatening illnesses such as mesothelioma[ii].
What is Asbestosis?
Asbestosis is a respiratory disorder caused by inhaling large amounts of asbestos fibers. If these fibers accumulate in the lungs, damage occurs. Symptoms will not usually appear for decades after exposure (usually 20 to 40 years after exposure)[iii].
After fibers enter the air sacs of the lungs, an inflammatory reaction starts. The scar tissue reduces the amount of oxygen transferred into the blood therefore, lung capacity is reduced[iv].
People that develop asbestosis usually experience the following symptoms:
Shortness of breath
Cannot perform physical activity
Mild to severe chest pain
Who may have been exposed to asbestos?
For many years, asbestos fibers were commonly found in a variety of products, from materials used in heavy industry such as thermal insulation and conduit (piping) to such household items as hair dryers and ironing board covers. Some products such as automotive brakes may still contain asbestos fibers today. Most individuals never knew that the products they were using contained asbestos fibers. The following list identifies some of the people who routinely worked directly with or around asbestos-containing products. This list is not all-inclusive. If you worked in any of these trades, especially during the time frame 1940 to 1980, you may have been exposed to asbestos-containing products[v].
Industry and Workplace Asbestos Exposure
Former US Navy Personnel
Gas Station Attendants
Glass Factory Workers
Home Improvement Workers
Loading Dock Workers
Oil Refinery Workers
Paper Mill Workers
Power Plant Workers
Sheet Metal Workers
Types of Mesothelioma and Common Symptoms
Because Mesothelioma symptoms are not specific, it often leads to delay in diagnosis.
Pleural Mesothelioma is the most common type of mesothelioma.
Weight loss/ Loss of Appetite
Persistent Cough/Hemoptysis (coughing Up blood)
Dysphagia (Difficulty swallowing)
*Pleural effusion is a common symptom of pleural mesothelioma. Pleural effusion is a buildup of fluid within the chest cavity which interferes with the normal functioning of the lung, causing shortness of breath.
Note: Only a doctor can make a definitive diagnosis.
Peritoneal (Abdominal) Mesothelioma
An estimated 100 to 500 cases of peritoneal mesothelioma occur annually.
Shortness of breath
Coughing up blood
Pain or Swelling in the Abdomen
Swelling around the neck and face
* Note: Only a doctor can make a definitive diagnosis.
Pericardial Mesothelioma is the rarest form of mesothelioma. It affects the lining of the heart. It is often too late to treat effectively[vi].
Coughing up blood
Shortness of breath
Weight loss/ Loss of Appetite
Note: Only a doctor can make a definitive diagnosis.
Stages of Mesothelioma
The following charts may be used by medical professionals to identify the severity of the mesothelioma tumor as an aid in prescribing the appropriate treatments.
The Butchart System is the oldest system used to describe the stages of mesothelioma[vii].
Stage I – Mesothelioma is present in the right or left lung, including part of the diaphragm.
Stage II – During this stage of mesothelioma, the chest wall, esophagus, heart and/or lymph nodes in the chest may become involved.
Stage III – Mesothelioma has penetrated the diaphragm and moved into the lining of the abdominal cavity or peritoneum. The surrounding lymph nodes may also become involved.
Stage IV – During this stage, metastasis has spread through the bloodstream and vital organs.
The TNM system shows tumors spreading through the lymph nodes[viii].
Stage I – This stage involves the lining of the lung, pericardial area, or diaphragm. The lymph nodes have not been affected yet[ix].
Stage II – This stage starts when mesothelioma spreads from the lining of the lung and moves to the lymph nodes on the same side. Cancer may begin to spread to the lungs, pericardium, or diaphragm[x].
Stage III – This stage begins in the chest wall, muscle, ribs, heart, esophagus, and other organs in the chest.
Stage IV – During this stage, mesothelioma spreads to the lymph nodes in the chest, but is located on the opposite side of the tumor connecting to the abdomen or neck[xi].
The Brigham System
The Brigham System is the most up to date system. It detects whether or not the mesothelioma can be surgically removed.
Stage I – The lymph nodes are not affected.
Stage II – The tumor can be removed, but the mesothelioma started to affect the surrounding lymph nodes.
Stage III – During this stage, the tumor cannot be removed. It extends from the chest wall, heart, through the diaphragm into the peritoneum.
Stage IV – During this stage, the disease has spread to the vital organs such as the liver, brain, or bloodstream[xii].
Diagnosis of Mesothelioma
Mesothelioma is diagnosed by conducting assessments to find abnormalities in tissue. A medical professional will review a patient’s medical history, followed by a complete physical examination, including x-rays of the chest or abdomen. A biopsy must be completed to confirm the diagnosis of Mesothelioma.
The following procedures are commonly used to aid medical professionals in reaching a definitive diagnosis:
Chest x-rays can show pleural effusions. 60 to 65% of the time, the pleural effusion is present in the right lung, while 40 to 45% of the time, it is present in the left lung[xiii]. Pleural thickening, the thickening of the lung’s lining, is also detected in chest x-rays[xiv].
Computed Tomography (CT Scan)
Computed tomography scans use x-rays to show images of the human anatomy and disease[xv].
Magnetic Resonance Imaging (MRI)
An MRI is a pain-free medical procedure containing a magnetic field that provides 3-dimensional images of the body. This procedure creates a cross-sectional view of the body without using radiation[xvi].
A needle biopsy is conducted by removing the tissue or fluid around the infected area. Often times, these samples are not adequate in determining different cell types because fluid diagnosis can be unreliable.
Pleural Biopsy (Thoracoscopy)
A pleural biopsy is the surgical removal of a sample of the tissue that lines the area of the lungs and interior chest wall. A thoracoscope, an instrument with a lighting tube, is used to examine the chest cavity. It is inserted through an incision in the chest wall. If fluid buildup is present, it is drained with a needle (thoracentisis)[xvii].
Peritoneal biopsy (Laparoscopy)
A peritoneoscopy (laparoscopy) is conducted by inserting a peritoneoscope into the abdominal cavity. If fluid buildup is present, it is removed by a procedure known as paracentesis. If abnormal tissue is found, a small piece of the abnormal tissue is removed and analyzed[xviii].
A pericardial biopsy is conducted by a needle or catheter. It is inserted into the sac around the heart. If fluid buildup is present, fluid is removed (pericardiocentesis)[xix].
Video Assisted Thoracic Surgery
Video Assisted Thoracic Surgery is an alternative process to a thoracoscopy. The examiner makes small incisions and inserts a camera into the pleural space to obtain tissue for analysis.
Mediatinoscopy is a lit tube is inserted into the chest cavity under the breast bone. Lymph nodes in the area are analyzed because of the threat of cancer.
Treatments of Mesothelioma
At this time there is no known cure for mesothelioma. The average life expectancy for someone diagnosed with mesothelioma is usually between 8 and 24 months from the date of diagnosis. However, some treatment centers have reported survival rates of up to five years from the date of diagnosis of mesothelioma.
Traditional Care for Malignant Mesothelioma
- Radiation Therapy
Pleuratomy/Decortications – During the earlier stages of mesothelioma, there is an attempt to remove all tumors. If the tumor cannot be removed without the lung’s surface, then the whole lung must be removed, known as a pneumonectomy[xx].
Extra Pleural Pneumonectomy – This is the surgical removal of the entire lung. Many health care professionals say this is the best treatment for survival, but the side effects are internal bleeding and respiratory failure [xxi]
Radiation Therapy – this treatment involves the use of high-dose radiation to eliminate or reduce malignant tumor cells. The radiation used can be high-energy x-rays, neutrons, photons, cobalt or other sources of radiation. Radiation can be administered by way of internal radiation therapy, external-beam radiation therapy, or radioisotopes. Internal radiation treatment delivers radiation through, needles, wires, or catheters and placed nearby or directly into the tumor being targeted.[xxii]
Radiation therapy may be used exclusively or in combination with chemotherapy and/or surgery. As with all forms of cancer treatment, radiation therapy can produce side effects. Possible side effects from radiation treatment include temporary or permanent hair loss in the targeted area, skin irritation, temporary change in skin pigmentation in the treated area, and fatigue.[xxiii]
Chemotherapy – this treatment uses specific chemical agents or drugs that are supposed to kill malignant cancer cells and tissue. Alimta® (pemetrexed), plus cisplatin is used for malignant mesothelioma. It is an injection that reduces cellular protein stimulation in cancer cells. [xxiv]
The purpose of chemotherapy is to regulate cancer cells by preventing them from spreading into other parts of the body or slow its growth rate. It is used to decrease the size of tumors prior to surgical treatment. It is also used to kill the remaining cancerous cells. Any symptoms of pain are relieved too[xxv].
The Possible Side Effects of Chemotherapy are:
Fever usually higher than 101 degrees
Nausea or Vomiting
Tingling or Numbness
Sores in the mouth and throat
New Mesothelioma Treatment Approaches
Photodynamic Therapy utilizes photosensitizers and light to form oxygen to kill infected cells. The photosensitizer is injected into the bloodstream. Then it is absorbed by the cells, staying in the infected cancer cells for approximately 24 to 72 hours. After, the tumor is exposed and absorbs light that forms oxygen attacking the surrounding cancer cells[xxvi].
Immunotherapy was developed to repair, rejuvenate, and enhance the body’s immune system through the function of biological response modifiers. Biological response modifiers influence the body’s immune system, which improves the ability to fight disease. They contain various hormones, antioxidants, and cytokines aiding in the functions of the immune system[xxvii].
Intensity Modulated Radiation Therapy
Intensity Modulated Radiation Therapy can be used for treatment. Regulated doses of radiation are delivered to the malignant tumor site. It conforms to the shape and the size of the tumor, while minimizing exposure to the surrounding healthy tissue. It also reduces the side effects[xxviii].
Gene Therapy is a newer form of treatment that contains the introduction of a new gene into a cell. The new gene is used to replace the functions of the older and defective genes[xxix].
Palliative care is focused on alleviating all pain symptoms rather than curing the disease. It helps contribute to the quality of life for the patient[xxx].
There are two different types of treatment for pain relief: pharmacological and non-pharmacological treatments.
Pharmacological treatment is controlled through the use of opiods, non-opiod pain relievers, topical ointments and gels, and other treatments.
Non-Pharmacological treatment is controlled through non-drug related treatments such as deep breathing, relaxation techniques, imagery, meditation, acupuncture, and massage therapy[xxxi].
Mesothelioma Research Foundations and Centers
- The National Institute of Cancer offers comprehensive research on the symptoms, diagnostic tools, and treatment of Mesothelioma. They offer information to the public as well as health professionals on a wide range of cancer topics and research programs. <http://www.cancer.gov/>
- Mesothelioma Research Foundation of America is an organization that funds research for developing cures for mesothelioma. The organization funded the opening of the Mesothelioma Laboratory in 2001. http://www.mesorfa.org/index.html
- American Cancer Society is a national-based health organization that tries to eliminate cancer by preventing the onset of cancer in healthy patients, reducing those suffering from cancer, and reducing the amount of patients that die annually from the debilitating disease through research, education, and service. This organization is the largest private not for profit cancer research in the United States. <http://www.cancer.org/docroot/home/index.asp>
- The Alliance for Lung Cancer Advocacy, Support, and Education is a not for profit organization committed to advocating for lung cancer patients or those that are risk. They offer a hotline and Lung Cancer Awareness programs. http://www.lungcanceralliance.org>
- Cancer Hope Network is a not for profit organization that provides comprehensive information on the disease. They also offer one on one support to cancer patients and their families. Trained volunteers provide support to those that experienced similar diseases. http://www.cancerhopenetwork.org>
Cancer Centers listed by State:
University Alabama Birmingham Comprehensive Cancer Center
Patient: (800) 822 0933
Arizona Cancer Center
Patient: (800) 622 2673
University of Colorado Cancer Center
Patient Information Center (800) 473 2288
Chao Family Comprehensive Cancer Center
Patient (714) 456 8200
University of California San Francisco Cancer Center
Patient Information Center: (415) 885 3882
University of Los Angeles Surgery and Trauma Center
Patient (310) 794 7333
Yale Cancer Center
Patient: (203) 785 4095
- LEE MOFFITT CANCER CENTER & RESEARCH INSTITUTE
Patient (888) 860-2778
University of Chicago, Cancer Research Center
Patient Information Center: Karen Wendling, 773-834-7424
Northwestern University Hospital
Patient information center: (312) 908 5250
John Hopkins Oncology Center
Patient (410) 614 3891
Dana Farber Cancer Institute
Patient Information Center: (866) 408- 3324
Brigham and Women’s Hospital
Patient Information Center: 617-732-5922
- New York
Cancer Research Center, Albert Einstein College of Medicine
(718) 430 2302
Memorial Sloan Kettering cancer center integrative medicine outpatient center
Patient Information Center: 800-525-2225
New York University Comprehensive Center
(212) 263 7417
Roswell Park Cancer Institute
Patient Information Center: 1-877-275-7724
University of Michigan Cancer Center
Patient: (734) 936 5281
University of Minnesota Cancer Center
(612) 624 8484
- North Carolina
Comprehensive Cancer Center, Wake Forest University
Patient (800) 446 2255
Duke University Medical Center
Patient Information Center: (919) 668 8413
The James Cancer Hospital and Solove Research Institute (The Ohio State University Medical Center)
Patient Information Center: 1-800-293-5066
Fox Chase Cancer Center
Patient Information Center: 1 888 Fox-Chase
University of Pittsburgh Cancer Institute
Patient Information Center: 1-800-237-4PCI/ 412 647- 2811
University of Pennsylvania
Patient Information Center: 1-800-789-PENN
San Antonio Cancer Institute
Patient Information Center: (210) 616 5590
The University of Texas, MD Anderson Cancer Center
Patient Information Center: (800) 392-1611 or (713) 794-1477
University of Medical Center
Patient Information Center: (206) 598 4477
- Washington DC
Lombardi Comprehensive Cancer Center
(202) 784 4000
Comprehensive Cancer Center
Patient Information Center: (800) 622 8922
[i] National Cancer Institute: US National Institutes of Health. (2002). http://www.cancer.gov/cancertopics/factsheet/Sites-Types/mesothelioma
[ii]National Institute for Occupational Safety and Health. Department of Health and Human Services. Center for Disease and Control Prevention. (2006). Washington DC http://www.cdc.gov/niosh/topics/asbestos/
[iii] Allen J. Blaivas, D.O., Division of Pulmonary and Critical Care Medicine, UMDNJ-New Jersey Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. US National library of Medicine: National Institutes of Health (2006). Bethesda, MD
[iv] Allen J. Blaivas, D.O., Division of Pulmonary and Critical Care Medicine, UMDNJ-New Jersey Medical School, Newark, NJ. Review provided by VeriMed Healthcare Network. US National library of Medicine: National Institutes of Health (2006). Bethesda, MD
[vi] Richard Alexander. (2003). Analysis of Factors Associated With Outcome in Patients With Malignant Peritoneal Mesothelioma Undergoing Surgical Debulking and Intraperitoneal Chemotherapy. Bethesda, MD
[vii] Cancer Research Institute of United Kingdom (2006). The Stages of Mesothelioma. London, England.
[viii] Cancer Research Institute of United Kingdom (2006). The Stages of Mesothelioma. London, England.
[ix] Cancer Research Institute of United Kingdom (2006). The Stages of Mesothelioma. London, England.
[x] Cancer Research Institute of United Kingdom (2006). The Stages of Mesothelioma. London, England.
[xi] Cancer Research Institute of United Kingdom (2006). The Stages of Mesothelioma. London, England.
[xii] Cancer Research Institute of United Kingdom (2006). The Stages of Mesothelioma. London, England.
[xiv] University of Chicago Cancer Research Program. (2006). Chicago, IL http://www.uccrc.org/about/
[xv] University of Chicago Cancer Research Program. (2006). Chicago, IL http://www.uccrc.org/about/
[xvi]University of Chicago Cancer Research Program. (2006). Chicago, IL http://www.uccrc.org/about/
- [xvii] US National library of Medicine: National Institutes of Health. (2006). David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY http://www.nlm.nih.gov/medlineplus/ency/article/003862.htm
[xviii] National Cancer Institute. (2005). Mesothelioma: Questions and Answers. Bethesda, MD.
[xix] The Cleveland Clinic Heart Center, Heart and Vascular Institute. (2006). http://www.clevelandclinic.org/heartcenter
[xx] National Cancer Institute (2006). General Information About Malignant Mesothelioma. Bestheda, MD. http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/patient
[xxi] National Cancer Institute (2006). General Information About Malignant Mesothelioma. Bestheda, MD. http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/patient
[xxii] Bucci M, Bevan A, Roach M (2005). “Advances in radiation therapy: conventional to 3D, to IMRT, to 4D, and beyond.”. CA Cancer J Clin 55 (2):
[xxiii] National Cancer Institute (2006). General Information About Malignant Mesothelioma. Bestheda, MD. http://www.cancer.gov/Templates/db_alpha.aspx?CdrID=44971
[xxiv] Eli Lilly and Company (2006). Information For Patients and Caregivers Sheet: Altima. Indianapolis, IN
[xxv] National Cancer Institute (2006). General Information About Malignant Mesothelioma. Bestheda, MD. http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/patient
[xxvi] National Cancer Institute (2006). Photodynamic Therapy for Cancer: Questions and Answers. Bethesda, MD.
[xxvii] National Cancer Institute (2006). Photodynamic Therapy for Cancer: Questions and Answers. Bethesda, MD.
[xxviii] The International Mesothelioma Program (2006). Intensity-modulated radiation therapy (IMRT). Boston, MA http://www.impmeso.org/IMRT/c77_p24/Mesothelioma_Treatments/Recent_Innovations/Intensity-modulated_Radiation_Therapy.html
[xxix] University of Oxford: Division of Public Health and Primary Health care (2006). Oxford, England http://www.dphpc.ox.ac.uk/events. UK Cystic Fibrosis Gene Therapy Consortium. “What is gene Therapy?” http://www.cfgenetherapy.org.uk/genetherapy.html
[xxx] National Coalition for cancer survivorship (2006). Palliative Symptoms for Pain Management. Silver Spring, MD
[xxxi] National Coalition for cancer survivorship (2006). Palliative Symptoms for Pain Management. Silver Spring, MD
The attorneys at Clark Law Firm, PC have created the Mesothelioma Online Center to provide mesothelioma patients and their loved ones with comprehensive and up-to-date information about the disease. Although Mesothelioma is a rare disease, it can drastically change the lives of those afflicted by the disease as well as those close to them. In addition to learning about Mesothelioma and the role asbestos plays in the development of mesothelioma, you will also learn who is at risk of developing mesothelioma as well as the symptoms of mesothelioma, medical procedures used to diagnose mesothelioma and the various options available for treating mesothelioma. We hope you find it helpful.