Mesothelioma Reference Center
Our feature article “Mesothelioma: A Historical Perspective”, will give you a better understanding of the treatments available for anyone suffering from Mesothelioma.
Mesothelioma affects the linings of the cavities around the lungs, stomach, and heart. It is caused by inhaling asbestos fibers, but the cancer usually does not appear until 10 to 40 years after a person first inhales asbestos.
The existence of malignant mesothelioma as a primary tumor of the pleural, peritoneum, pericardium, and other organs has long been controversial. As early as 1767, however, Joseph Lieutaud is credited with describing two cases of probable mesothelioma in a study of 3,000 autopsies, and E. Wagner recognized the disease as a pathologic entity in 1870.238,239,298 Klemperer and Rabin described in detail the histologic features of benign (localized) and malignant (diffuse) mesotheliomas in 1931.143
A case record of malignant pleural mesothelioma discussed in 1947 led neither to the recognition of the diagnosis nor to the suspicion of asbestos as a causative factor, even though the introductory sentence included the term asbestos worker, and later the patient's work was described as 'cutting asbestos insulating board."48 This controversy lasted until 1960, when the major etiologic factor (i.e., asbestos) was established in a seminal report by J. C. Wagner and colleagues in 32 of 33 cases of mesothelioma, largely by environmental exposure in the 'Asbestos Hills" of Cape Province in South Africa.295 Such a singular relationship, confirmed in many other countries including the United States, established the disease as a distinct nosologic entity.236
Incidence and Epidemiology
Mesothelioma has been such a rare disease, or one recognized so infrequently, that it has not been coded as a separate cause of death and has been seriously underestimated in mortality statistics.71,236 The age-adjusted incidence of pleural and peritoneal mesothelioma in the United States has been estimated at 14.2 per million per year, with almost a three-fold increase for pleural mesothelioma in Caucasian males between 1973 and 1984.71 The male-female ratio is about 4:1, and 80% arise from the pleura.71 Cases tend to be clustered in areas of asbestos product plants and shipbuilding facilities.94 Similar trends have been reported in other industrialized countries, such as England. 104 In autopsy studies, the frequency of malignant mesothelioma varies from 0.02 to 0.7%, with a rate of 0.2% in the largest series.127
In most hospital series, the pleura is more often involved than the peritoneum, with a predominance of the right side over the left (60:40).127 In some epidemiologic studies monitoring cohorts of asbestos workers, however, the peritoneal form is more common than the pleural.238 The mean age of patients is approximately 60 years,16,93,214,305 but the disease can occur at any age, including in childhood.116 In a review of 80 children with a diagnosis of malignant mesothelioma, the mean age was 9.7 years, and 59% were male. Only 2 children were noted to have a history of possible asbestos exposure, 1 had received radiotherapy for Wilms' tumor, and 1 had been exposed to isoniazid in utero.102
Mesothelioma Treatments
Traditional mesothelioma treatment options include surgery, chemotherapy and radiation therapy. Traditional treatments are also used to combat other types of cancer such as asbestos lung cancer, carcinomas, sarcomas, lymphomas, etc.
New mesothelioma treatment options include new chemotherapy agents, photodynamic therapy (PDT), immunotherapy, mesothelioma gene therapy and intensity modulated radiation therapy (IMRT).
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