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Frequently Asked Questions About Malignant Mesothelioma

Here are some answers to frequently asked questions about malignant mesothelioma.

Q: What is malignant mesothelioma?

A: Malignant mesothelioma is a rare kind of cancer. It starts in the mesothelial cells which form a lining called the mesothelium. This lining protects internal organs, including the lungs, heart, and organs in the abdomen.

Photo of medical professionals looking at a chest x-ray.

The cancer can start in any of these places. When this cancer starts in the lining of the lungs, doctors call it pleural mesothelioma. This is the most common type. This cancer can also start in the lining of the heart or abdomen, but this is not as common. Rarely, mesotheliomas can start in the lining around the testes.

Q: Who gets malignant mesothelioma?

A: Most people who get this type of cancer have worked with asbestos in the past. More men get it than women. Most people who get it are older than 65.

Q: What are the risk factors for malignant mesothelioma?

A: Certain factors can make a person more likely to get this type of cancer than another person. These are called risk factors. Just because a person has one or more risk factors does not mean he or she will get malignant mesothelioma. In fact, a person can have all of the risk factors and still not get the disease. On the other hand, a person may have no risk factors and get malignant mesothelioma. Here are some things that may put a person at risk for this cancer:

  • Exposure to asbestos. The main risk factor for this cancer is contact with asbestos. People who have worked with asbestos include miners, factory workers, construction workers, insulation manufacturers and installers, ship construction workers, railroad and automotive workers, and those in other asbestos-related fields.

  • Family factors. Having a family member with heavy exposure to asbestos may increase a person's risk.

  • Geographic location. Asbestos is a naturally occurring mineral. It exists in dust and rocks in certain parts of the world, including parts of Turkey and the U.S. Having contact with asbestos in the natural environment can put people at risk for this cancer.

  •  X-rays done in the 1930s and '40s. Thorium dioxide (Thorotrast) is a material that was used in X-rays during that time period. It may be linked to some forms of cancer, including mesothelioma. Thorotrast has not been used for many years.

  • Past radiation treatment. A small number of people with this cancer, especially those with the cancer in the chest, have had radiation for cancer of the lymph glands in the chest.

  • Age. Most people who get this disease are older than 65.

  • Gender. More men than women get this disease.

Q: What are the symptoms of malignant mesothelioma?

A: Usually, there are no symptoms in the early stages of the cancer before it has spread. A person may notice symptoms when the cancer is more advanced. Symptoms depend on where the cancer is located. Some people will have pain under the rib cage or in the chest itself. Some may have shortness of breath. Other people may have pain, swelling, or lumps in the stomach, trouble swallowing, fever, or other problems.

Although these are symptoms of malignant mesothelioma, they may also be caused by other, less serious medical problems. If a person has any of these symptoms they should talk with a doctor.

Q: How is malignant mesothelioma diagnosed?

A: If a person has symptoms of malignant mesothelioma, the doctor will ask about their health history, their family's history of cancer, and other risk factors, such as working with asbestos.

The doctor will also do a physical exam. The exam can help tell if there is fluid in the chest, stomach, or heart. This fluid can be a sign of mesothelioma. Then the doctor may do one or more of these tests to find out if a person really has this cancer:

  • X-rays

  • CT scan

  • MRI

  • Positron emission tomography, or PET, scan

  • Biopsy of the tumor

Q: Should everyone get a second opinion for malignant mesothelioma?

A: Many people with cancer get a second opinion from another doctor who is an expert in treating the specific type of cancer. There are many reasons to get one. Here are some of those reasons:

  • Not feeling comfortable with the treatment decision

  • Being diagnosed with a rare type of cancer

  • Having several options for how to treat the cancer

  • Not being able to see a cancer expert

Many people have a hard time deciding which treatment to have. It may help to have a second doctor look at the diagnosis and treatment options before starting treatment. It is important to remember that in most cases, a short delay in treatment will not lower the chance that it will work. Some health insurance companies even require that a person with cancer get a second opinion. Many other companies will pay for a second opinion if asked.

Q: How can someone get a second opinion for malignant mesothelioma?

A: There are many ways to get a second opinion:

  • Ask a primary care doctor. He or she may be able to suggest a specialist. This may be a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or hospitals. Never be afraid to ask for a second opinion.

  • Call the National Cancer Institute's Cancer Information Service. The number is 800-4-CANCER (800-422-6237). They have information about places to get treatment. These include cancer centers and other programs supported by the National Cancer Institute.

  • Look for other options. Check with a local medical society, a nearby hospital or medical school, or support group to get names of doctors who can give you a second opinion. Or ask other people who have had cancer for their recommendations. The internet also has a number of sites where you can learn more about a person's options.

Q: How is malignant mesothelioma treated?

A: There are several treatments for this cancer. The kind of treatment a person gets depends on his or her age, the stage of the cancer, and how much the cancer has affected the person's health.

Treatment can be local, systemic, or both:

  • Local treatments get rid of the cancer in one area. These treatments are surgery, radiation, and chemotherapy that doctors put directly into the chest or abdomen.

  • Systemic treatments wipe out cancer cells all through the body. Getting chemotherapy through your veins is systemic treatment.

Q: What's new in malignant mesothelioma research?

A: Cancer research should give you hope. Doctors and researchers around the world are studying better ways to treat malignant mesothelioma. They are also finding ways to diagnose it earlier.

Doctors are also looking at ways of preventing the cancer from forming in the first place. They are looking at new treatments for this cancer. New treatments include a combination of surgery, radiation, and chemotherapy. There are also new drugs being tested in clinical trials.

Q: What should I know about clinical trials for malignant mesothelioma?

A: Clinical trials are studies of new kinds of cancer treatments. Doctors use clinical trials to learn how well new treatments work and what their side effects are. Sometimes, doctors find new treatments that work better or have fewer side effects than current treatments. People who join these studies get to use the treatments before the FDA approves them for the public. People who join trials also help researchers learn more about cancer and help future people with cancer.