Mesothelioma is a rare type of cancer which develops in the lungs almost exclusively caused through asbestos exposure. The part to be affected is the mesothelium tissue – the thin protective membrane which surrounds the lungs, abdominal cavity or the heart. Due to the high rate of asbestos mining and use, Australia has one of the highest rates of mesothelioma incidence.
Role of asbestos and high-risk factors.

Long-term exposure to asbestos – either in industrial settings, repair shops or from old buildings – is the usual cause for the disease. When the microscopic asbestos fibres are swallowed or breathed in, they often reach the lungs or the abdominal cavity where they slowly cause inflammation and scarring. The latency period often lasts for several decades and finally results in malignant mesothelioma which makes asbestos abatement so important.

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Anyone who has worked with asbestos for a long time and sometimes their family members are at risk. Since the disease takes several decades to develop, it often develops in middle-age or later. If you have been exposed to asbestos fibres, smoking highly increases the risk of developing asbestos-related lung cancer.



Types of mesothelioma
There are three types of mesothelioma depending on where the malignant cells develop:
• Pleural: The most common form (almost 75% cases), here the disease develops in the lining of the lungs. Thanks to the number of studies, improved treatment methods and survival rates have been noted.
• Peritoneal: Here (10-20% cases), the peritoneum, the lining of the abdominal cavity is affected. A combination of surgery and heated chemotherapy is the usual treatment method.
• Pericardial: A rare form (almost 1% cases), this affects the lining of the heart and is the most difficult to treat.
A fourth extremely rare category which affects the reproductive organs, called testicular mesothelioma, has also been recorded.

Symptoms and diagnosis
Early symptoms include fatigue and mild pain around the affected area. The disease thus often goes unnoticed till the later stages. Shortness of breath, weight loss, chronic pain, spitting up sputum or blood, fluid build-up and bowel obstruction are the later stage symptoms.

A chest X-ray is usually the first step in diagnosis. If any abnormality is noticed, imaging scans like the PET scan, CT scan or the MRI are recommended. Biopsy, where tissue sample is collected from the affected region, is used to confirm the diagnosis i.e. the presence of mesothelioma cells.

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Treatment and prognosis
A multi-modal treatment plan is also adopted for mesothelioma patients. This involves one or more of the following:
• Surgery: If the tumour is in the early stages, the surgery is mostly curative. For patients in later stages, it is palliative and used to ease symptoms.
• Chemotherapy: This is often used along with surgery or radiation therapy to shrink tumours by killing malignant cells. They may prevent reoccurrence and help relieve symptoms.
• Radiation Therapy: This is also used to kill malignant cells, shrink tumours and prevent seeding.
Experimental immunotherapy and alternative treatment methods are also used by mesothelioma patients.

Depending on the size, location and stage of the tumour and the overall health of the patient, the prognosis varies. A number of recent encouraging success stories spread hope to mesothelioma sufferers across Australia.