The first pleural tumor was reported in 1767, but mesothelioma was not characterized until 1931. In the past it was thought that the presence of mesothelioma correlated with the type of fiber. It was thought that the shorter fibers were less carcinogenic while the longer fibers were more carcinogenic. Because chrysotile fibers are shorter, to this day people still argue that this is the “safe asbestos”, although that has proven to be false. Based on animal studies, it has been found that chrysotile is indeed carcinogenic.
Both the WHO and the International Agency for Research on Cancer classify all types of asbestos as class I carcinogens. It is also thought that living close to places where asbestos was mined or processed can cause mesothelioma.
Asbestos can cause different diseases, such as mesothelioma, lung cancer and asbestosis. Up to 20,000 asbestos-related lung cancers and 10,000 cases of mesothelioma occur each year across North America, western Europe, Scandinavia, Japan and Australia.
Biomarkers
Mesothelioma biomarkers can be used to predict the effectiveness of treatment for mesothelioma, as well as to detect the cancer early and to detect risk. A biomarker is a measurable substance in an organism whose presence indicates some phenomenon such as infection, disease, or environmental exposure. Mesothelin is a biomarker that has been widely studied. Mesothelin is a glycosylphosphatidyl inostil-anchored, membrane-bound glycoprotein involved in cell adhesion. In simpler terms, it is a protein on the surface of a cell that exists on mesothelial cells lining the pleura, peritoneum and pericardium. Other biomarkers that have been studied for mesothelioma include cancer antigen 125, osteopontin, hyaluronic acid, fibulin 3 and high mobility group box 1.
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Staging
Those who are in stage I or II and sometimes stage III may benefit from treatment to ease symptoms. Newer treatments are neoadjuvant and adjuvant therapies.
Radiation therapy may also be administered to mesothelioma patients. It has mostly been used in three different studies of which are “(1) prophylactically for the prevention of procedure tract metastasis after large-bore pleural biopsy; (2) palliatively for treatment of pain or an area at risk of compression, such as the esophagus or superior vena cava; and (3) radically in the form of high-dose hemithoracic radiation to improve local control and possibly improve survival.”
Chest radiographs as well as a physical exam show a large pleural effusion in 80 percent to 95 percent of patients with pleural mesothelioma. Staging is important when it comes to deciding the proper treatment a patient should undergo. When a patient is in stage I, the tumor is confined to the parietal pleura for stage Ia, and for stage Ib there is minimal visceral pleural involvement. When a patient is in Stage II, they are lymph node-negative patients with confluent
superficial tumor on all surfaces of the pleura or there is involvement of muscles of the diaphragm or lung parenchyma. Stage III includes patients whose tumor has extended into soft tissues of the chest wall, mediastinal fat, pericardium or endothoracic fascia. It also includes patients with metastasis to certain lymph nodes. Stage IV is the final stage, in which the tumor has spread to various areas of the body.
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