Mesothelioma is a form of cancer that develops in the lining around the lungs (the ?pleura?), abdomen (the ?peritoneum?) or heart (the ?pericardium?). In contrast, lung cancer refers to a malignancy of the lung itself. And, unlike lung cancer, which may have other causes as well as asbestos exposure, mesothelioma is virtually always the result of exposure to asbestos. It generally does not appear until decades after the asbestos exposure.

Diagnosis of mesothelioma can be very difficult because its symptoms may not appear for decades after exposure to asbestos. Unfortunately, this lengthy time delay not only prevents diagnosis, but also complicates treatment efforts, given that mesothelioma is usually detected in the late stages, after serious side effects begin to present themselves.

Learn more about the specific symptoms associated with three kinds of asbestos-related malignant mesothelioma:

• Pleural Mesothelioma, which affects the lining of the lungs;
• Peritoneal Mesothelioma, which attacks the membrane surrounding the abdominal cavity; and
• Pericardial Mesothelioma, which invades the membrane around the heart.
• Cell Types of Mesothelioma

Many of the symptoms of mesothelioma mirror those of other more common physical conditions. In fact, this is another factor that contributes to the difficulty in diagnosing mesothelioma; its symptoms are often mistaken for the flu, bronchitis, pneumonia or heart disease. Still, patients with any of the symptoms discussed below and a history of asbestos exposure should see a physician. If symptoms persist, you should ask your doctor for a thorough evaluation.

Finally, this discussion is not intended as a tool for self-diagnosis, nor is it intended to be a substitute for consulting with a doctor who specializes in the diagnosis and treatment of mesothelioma. This information is designed to help you learn about mesothelioma.

To date, most research has centered around asbestos workers and their families, with whom it has been proven that chronic breathing of asbestos fibers causes permanent scarring of the lungs (?asbestosis?), lung cancer, or mesothelioma.

At present, however, no definitive research links these diseases to incidental exposure in the home. Data are difficult to gather in so broad a segment of the population, particularly because asbestos-related health problems may show up 30 to 40 years after exposure. This doesn?t necessarily mean there?s no risk. Agrowing number of doctors and researchers are concerned about the long-term effects of low-level exposure. As a rule, asbestos fibers tend to attach themselves permanently to lung tissue; long term, residual accumulation might eventually cause disease.

The prudent assumption, according to the EPA, is that there is ?no safe exposure? to airborne asbestos.

If you or someone you know has an asbestos related disease ? like asbestosis, lung cancer, or mesothelioma - then you are angry, hurt, and you probably hold the company responsible for not warning you of the dangers of asbestos. You know that either you or your loved one was exposed to asbestos fibers decades ago when it was used in a wide array of products. So now what do you do? One common course of action is to bring a lawsuit against the asbestos manufacturer.

To do that, you need an asbestos lawyer. One of the topics in this section is devoted to help you make the right decision in choosing the right asbestos lawyer for your case.

Choosing a lawyer to represent you in court can be a very stressful, confusing, and trying task. Here are some tips that can help you to make the right decision:

Does the lawyer have asbestos lawsuit experience?

Most lawyers specialize in a particular field of law. You want to make sure that the lawyer you choose is familiar with your issues and has relevant experience in mesothelioma law. A lawyer that regularly drafts wills may not be the best choice when the subject is an asbestos law.

Do your research before selecting a mesothelioma lawyer.

Ask the lawyer what experience he or his firm has in handling asbestos cases. Ask how many cases the firm has handled, how many cases the firm has tried, and how your case will be handled.

Make sure you know the role of the asbestos lawyers.

Once you've decided to hire an asbestos lawyer, be sure that you understand the terms of your agreement. How often will the lawyer update you? What information will you have to provide for the lawsuit? Do you understand all of your options? What will the total cost be? If you are not clear on exactly the lawyer is doing, ask for clarification. Even though your chances of success cannot be guaranteed, discuss the approaches to your case. You should be comfortable with your lawyer as you approach your case. Be up front on all the facts and circumstances that surround your asbestos lawsuit. You want to get the agreement you make with your lawyer in writing.

Lawyer and asbestos lawsuit fees and costs.

Ask what the cost will be for the asbestos lawyer service before any work begins. Also ask whether you will be responsible for other fees and charges. State ethics rule that lawyers are required to charge a reasonable fee. The American Bar Association recommends that lawyers explain their fees, preferably in writing, within a reasonable time after agreeing to represent you. Some state bars require that lawyers put their fees in writing before they take a case. Your lawyer may charge you extra for copying documents, court filing fees, courier service, or research services. Make sure that you understand what you will be charged for and for how much.

Asbestos lawyer and asbestos lawsuit payment arrangements.

The most expensive lawyer is not always the best one, nor is a "bargain" rate always a great deal. You want to look for the best balance of experience and cost. To lower costs, you may want to ask your asbestos lawyer if a junior lawyer or paralegal can perform some of the work. You may also want to ask if there are some tasks that you can perform yourself to save time and money. You may be able to copy, pick up or deliver documents, or other menial tasks. An asbestos lawyer may charge a flat fee for a specific task or offer other methods of payment.

Contingency fees.

A contingent fee arrangement is that your lawyer gets a percentage of the compensation money you receive as resolution of your asbestos lawsuit. If you do not receive compensation for the lawsuit then your lawyer collects no fees. However, you may owe charges for court fees, copying, and hiring expert witnesses. A contingency fee is a good option for those unable to pay hourly.

Mesothelioma lawsuit records.

Your asbestos lawyer may ask you for documents that relate to your lawsuit. Keep copies if you give your lawyer the originals. Also ask for copies of all other important documents. When you get a bill from your lawyer, review it carefully and ask for clarification about any charges that are unclear to you.

Asbestos lawsuit class actions.

In a class action, a court decides that a group of people (a "class") may have been harmed in a similar way. You may receive a notice giving you the decision to take part in the asbestos lawsuit. Read the notice carefully. If you do not take any action, you most likely will become a member of the class by default. If that happens then you are bound by the outcome of the lawsuit class action, you can't bring your own asbestos lawsuit case, and you won't have direct control of the lawsuit. If you decide to not become a member of the class, you keep the right to bring your own suit and control it directly. You will have to hire and pay for your own asbestos lawyer and you will not share in any benefits that may be won in the asbestos lawsuit class action.

Asbestos lawyer service.

You may fire your asbestos lawyer at any time if you are not satisfied with the work he or she has performed on your behalf. In some cases you may need the permission of a judge to do this. Please keep in mind that the legal system can move slowly and that an asbestos case may take some time to resolve. Weigh the costs and benefits of starting over with a new lawyer. Your lawsuit might be delayed and that could cost more. Lawyers are subject to state ethics rules and are required to charge reasonable fees; if you think that your lawyer did not treat you fairly, represent you adequately, or charged you too much, communicate with him or her and try to work out a solution. If the attempt to resolve the matter directly with your lawyer is unsuccessful, you may consider filing a complaint with your state or local bar association. For some states, arbitration is available to mediate such problems. If you are satisfied with the work your lawyer has done for you, communicate that as well.

People who are facing lung cancer are naturally concerned about what their future holds. Understanding lung cancer and what to expect can help patients and their loved ones:

Plan lung cancer treatment
Think about lifestyle changes
Make decisions about their quality of life and finances.
Patients may ask their healthcare provider about their lung cancer prognosis. Others may search for lung cancer statistics on their own.

What Is a Prognosis?

A prognosis is a medical opinion as to the likely course and outcome of a disease. In other words, the prognosis is the chance that a patient will recover or have a recurrence (return of the cancer).

Many factors can affect a person's prognosis, including:

The type and location of the cancer

The stage of the disease (the extent to which the cancer has metastasized, or spread)

Its grade (how abnormal the cancer cells look and how quickly the cancer is likely to grow and spread)

The person's age, general health, and response to treatment.

When doctors determine a person's prognosis, they carefully consider all of the factors that could affect that person's disease and treatment, and then try to predict what might happen. When possible, the doctor will use statistics based on groups of people whose situations are most similar to that of an individual patient.

The doctor may speak of a favorable lung cancer prognosis if the cancer is likely to respond well to treatment. The lung cancer prognosis may be unfavorable if the cancer is likely to be difficult to control. However, it is important to keep in mind that a prognosis is only a prediction; the doctor cannot be absolutely certain about the outcome for a particular patient.

Lung cancer is a disease in which the growth of malignant (cancerous) cells begins in the tissues of the lung. It is by far the leading cause of cancer death in the United States.

In 2002, lung cancer accounted for more deaths in the United States than breast cancer, prostate cancer, and colon cancer combined. In that year:

100,099 men and 80,163 women were diagnosed with lung cancer 90,121 men and 67,509 women died from lung cancer.

There are two general types of lung cancer: small cell lung cancer and non-small cell lung cancer. Small cell lung cancer is less common than the non-small cell lung cancer. Also, small cell lung cancer spreads more quickly than non-small cell lung cancer.

Understanding the Lungs

The lungs are a pair of cone-shaped breathing organs that are found within the chest. They bring oxygen into the body when breathing in and take out carbon dioxide when breathing out.

Each lung has sections called lobes. The left lung has two lobes. The right lung, which is slightly larger, has three. A thin membrane called the pleura surrounds the lungs.

Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also involved in lung cancer. Small tubes called bronchioles and tiny air sacs called alveoli make up the inside of the lungs.

Small cell lung cancer spreads quickly. In many cases, cancer cells have already spread to other parts of the body when small cell lung cancer is initially diagnosed.

In order to reach cancer cells throughout the body, doctors almost always use chemotherapy. Small cell lung cancer treatment may also include radiation therapy aimed at the tumor in the lung or tumors in other parts of the body (such as in the brain).

Some people with small cell lung cancer receive radiation therapy to the brain even though no cancer is found there. This treatment, called prophylactic cranial irradiation (PCI), is given to prevent tumors from forming in the brain.

Surgery is part of the treatment plan for a small number of people with small cell lung cancer.

You can learn more about lung cancer in the following eMedTV articles:

Lung Cancer Surgery
Lung Cancer Chemoteraphy
Lung Cancer Radiation

Peritoneal mesothelioma, a cancer of the lining of the abdominal cavity, is less common than the pleural form, comprising approximately one-fifth to one-third of the total number of mesothelioma cases diagnosed. According to the SEER (Surveillance, Epidemiology, and End Results) database, these diagnoses are approximately 54.7 per cent male versus 45.3 per cent female, with the median age being 65-69. The latency period appears to be shorter for asbestos-exposed individuals with symptoms appearing 20-30 years after exposure rather than the 30-40 year latency more commonly associated with pleural mesothelioma.

Symptoms

Clinical symptoms at the time presentation may include abdominal pain, abdominal mass, increased abdominal girth, distention of the abdomen,ascities (fluid in the abdomen), fever, weight loss, fatigue, anemia and digestive disturbances. Some patients complain of more non-specific symptoms for a number of months prior to a confirmed diagnosis. In a percentage of cases, peritoneal mesothelioma is found incidentally when the patient has sought help for another health problem such as gallbladder, hernia or pelvic mass.

Diagnosis

As with all mesotheliomas, the diagnosis of peritoneal mesothelioma can be challenging. CT findings may help differentiate between the two clinical types of peritoneal mesothelioma, termed “dry” or “wet”, since their appearances are very different upon imaging. In the “dry” type, CT may reveal multiple small masses or a single dominant localized mass. There is normally little or no ascites. In the “wet” type, CT may reveal widespread small nodules, but no dominant mass. Ascites is usually present.

If fluid is present, it may be removed in a procedure called paracentesis. Unfortunately, as is the case with pleural mesothelioma, fluid analysis offers limited diagnostic value. It is normally a tissue biopsy obtained in a laproscopic exploratory that will yield a definitive diagnosis.

Staging

There is currently no established staging system for peritoneal mesothelioma, and if the disease is staged, it is normally done in accordance with the TNM system, the most common general cancer staging system. This system refers to the status of the tumor (T), lymph nodes (N) and metastases (M). There are general categories which may also be somewhat helpful in determining stage.

The first category shows a localized lesion able to be completely resected (entirely removed). In the second category, the disease is contained within the abdominal cavity on peritoneal and organ surfaces where debulking (the removal of as much, but not all of the tumor) is possible. Category three shows disease contained within the abdominal cavity with invasion of organs such as the colon or liver. Category four shows disease extending outside the abdominal cavity.

Treatment

In recent years, multimodality treatment of peritoneal mesothelioma has become more common for a select patient population, since surgery alone and/or intraperitoneal chemotherapy alone have proven to be similarly ineffective. Cytoreductive (debulking) surgery involves the removal of all or nearly all visible tumor, and, depending on the physician’s choice, may be combined with intra peritoneal hyperthermic Chemotherapy (IPHC), intraperitoneal chemotherapy and/or radiation. "intraperitoneal chemotherapy gives high response rates within the abdomen because the peritoneal space to plasma barrier provides dose intensive therapy." Since it is not always possible to remove all tumors, the prognosis for long-term survival may be based on the completeness of cytoreduction as established by the following criteria:

Complete cytoreduction:

CC-0 No peritoneal seeding is visualized within the operative fields.

CC-1 Nodules of less than 2.5 cm persist after cytoreduction. Nodules of this size are thought to be penetrable by intracavitary chemotherapy, therefore cytoreduction is termed complete.

Imcomplete cytoreduction:

CC-2 Nodules of between 2.5 and 5 cm persist after cytoreduction.

CC-3 Nodules of greater than 5 cm or a merging of unresectable tumor nodules at any site within the abdomen or pelvis.

For patients found to have widespread disease, where surgery is not looked at as “potentially curative”, palliation of symptoms may be accomplished by debulking. Since peritoneal mesothelioma is a rare malignancy, specialized treatments should be conducted by doctors familiar with the disease.

The hardest part of asbestos removal is making sure the particles stay out of the air. Different asbestos-containing materials (ACMs) are removed by different methods, but the one thing they have in common is to avoid filling the air with the kind of dust that's taken for granted in other demolition or renovation projects. The most general method that works well for asbestos is moisture. Though fibers do not dissolve in water, it does stick to them enough to make them settle quickly to the floor with the other components of their matrix. Even though it sounds simple, doing it well enough to protect your family can be extremely complicated, especially when there is a large amount of highly friable asbestos-containing material to be removed. The costs of expert removal start at thousands of dollars for a small, easily accessed area like a floor with relatively nonfriable ACM. Everyone concerned with asbestos agrees that removal is the remedy of last resort, and the only preventative of later accidental exposure. Removal of non-regulated asbestos-containing materials can be legally performed by homeowners, ordinary building contractors, or licensed asbestos abatement contractors. They all have to meet the same legal standards for protecting workers, the environment, and the family that will use the home after removal. These are mostly set out as the National Emissions Standards for Hazardous Air Pollutants (NESHAP) regulations (Refer to 40 CFR Part 61, Subpart M). The work also must comply with the Occupational Safety and Health Administration (OSHA) regulations delineated in 29 CFR 1926.1101. Of course those licensed asbestos-abatement contractors will be most familiar with the regulations, most experienced in meeting them, and most efficient in protecting you from liabilities and exposure to asbestos hazards. A number of states require removal of asbestos-containing materials before any structure is demolished. Several require notification and documentation of the asbestos situation even if there is no asbestos before demolition begins. Surprisingly, there do not appear to be any requirements for alerting firefighters who may be called to attend to an emergency at a building with ACM. There has not been any study conducted firefighters' exposure to asbestos on the job or training of firefighters for dealing with ACM. While firefighters now almost always wear full breathing apparatus while inside an actively burning building, those working outside or on more minor fires may not, and "civilians" attracted to the emergency certainly will not. States' regulations about demolition of a building with ACMs do apply to intentional "training burns" of buildings by firefighters.

Any work area where large amounts of ACM are being disturbed should be isolated from the rest of the house by shutting down ventilation systems -sealing them, not just closing vents - and lining windows and doors with plastic sheeting and duct tape. Workers should never come out of that area into the rest of your home without stripping off all exposed clothing and discarding it with the other asbestos-containing waste.

To minimize the creation of dust, all asbestos-containing materials should be removed in as large pieces as possible. Experienced abatement contractors are familiar with this concern and plan carefully for it. During demolitions or renovations a contractor might choose to remove an entire boiler, a section of pipe, or other facility components without first removing the asbestos insulation that is on them. A large piece of debris, even if it is heavy and unwieldy, has fewer exposed surfaces that might release dust. This is especially true if the asbestos has already been encapsulated. Still, stripping operations are the most common form of asbestos removal during renovation.

Some studies indicate that asbestos exposure also increases a person's risk of developing colorectal cancer. However, the evidence isn't clear enough to say that yes, asbestos exposure definitely causes cancer of the colon and rectum. This is because while some studies establish a clear link between asbestos exposure and colorectal cancer, others find no relationship between the two whatsoever. Let's talk about the ones that have found a relationship since they're more interesting.

Asbestos Exposure from Drinking Water

Most epidemiological studies that tested the incidence of cancer in areas where the drinking water contained high levels of asbestos, found increases in cancer rates and/or deaths. Most of the cancers formed in the gastrointestinal tract (which includes but isn't limited to the colon and rectum).

Asbestos Exposure from Insulation

In one study of 17,800 people who worked with insulation containing asbestos, 99 people died from gastrointestinal cancers. The expected death rate (that of members of the general population) was estimated at 59 deaths. This means that the insulation workers were about one and a half times more likely to die of gastrointestinal cancer than non-insulation workers.

Asbestos Exposure in the Textile Industry

In a study of 2,500 asbestos textile workers, 26 people died from gastrointestinal cancers. However, only 17 deaths were expected. This means that the asbestos textile workers were about one and a half times more likely to die of gastrointestinal cancer than people who did not work in the asbestos textile industry.

See a Pattern?

According to the Agency for Toxic Substances and Disease Registry (ATSDR), several other studies have shown similar patterns. ATSDR stresses however, that there is no consistent relationship between colorectal cancer and asbestos exposure. The Institute of Medicine of the National Academies agrees. After assessing 120 studies of asbestos exposure and cancers of the throat and digestive tract, the Insitute of Medicine determined that the evidence was suggestive but insufficient to infer a link. In English: seems like asbestos exposure might cause colorectal cancer, but they can't say for sure.

The Take-Home Message

Nobody says "Hey, there's some asbestos, let me go roll in it!" We know it's bad for us. So really, its potential to cause cancer of the colon and rectum is simply something else to keep in mind. If you've been exposed to asbestos, or work with asbestos on a regular basis, this is one more reason to make sure you adhere to colon cancer screening recommendations