Mesothelioma is a rare form of cancer that affects the mesothelial lining (mesothelium) which is present around certain organs in different parts of the body. It may be more likely to occur in the lining around the lungs (pleural mesothelioma) or abdominal cavity (peritoneal mesothelioma) although it can also occur in the lining around the heart (pericardial mesothelioma) or testicles. Mesothelioma has received a significant amount of media attention, especially pleural mesothelioma (lung), due to its link with environmental factors and asbestos. In South Africa, mesothelioma has been in the spotlight more than once, mainly relating to claims against mining companies.
Causes of Mesothelioma
Exposure to asbestos has been linked to the development of mesothelioma. This does not mean that every person exposed to asbestos fibres will develop a mesothelioma. In the early part of the 20th century, asbestos was widely used in South African homes, offices and factories. South Africa also mined a significant amount of asbestos. While asbestos is not used in construction any longer, there is still much controversy surrounding mesothelioma and asbestos exposure in South Africa, particularly in claims against mining companies. It is impossible to say when or if you may develop a mesothelioma but some cases have been reported up to 30 to 40 years after possible exposure.
While asbestos has been identified as a possible cause of a mesothelioma, it should be noted that other toxins and contributing factors could also play a part in it. Cancer research is ongoing, not only in the treatment of cancer but also in identifying potential carcinogens (cancer causing chemicals) and new findings are constantly being published. Family history and lifestyle also play a major role in most forms of cancer.
Signs and Symptoms of Mesothelioma
It is important to bear in mind that South Africa has a high incidence of respiratory diseases and pulmonary related complaints. This is due to the prevalence of TB (tuberculosis) as a result of the high HIV/AIDS rate, lung cancer seen in miners and cigarette smokers and cardiac (heart) disease, which affects the breathing and the functioning of the lungs as well. If you suspect that your symptoms may be related to mesothelioma, please consult with a pulmonologist, exclude other common lung diseases and report any incidents in your past where you may have been exposed to asbestos to allow the medical specialist to conduct the necessary investigation.
Some of the signs and symptoms of a mesothelioma in the lung may include :
- Difficulty breathing and/or shortness of breath.
- Pain when breathing and/or coughing.
- Dry, persistent cough.
- Lumps that may be felt between the ribs.
In cases of a peritoneal mesothelioma (abdomen) :
- Abdominal pain with or without swelling.
- Diarrhoea or constipation.
- Lumps that may be felt under the skin.
Other signs and symptoms associated with any malignancy include loss of weight, night sweats and/or fever and fatigue. It is always advisable to consult with your doctor if you have any cause for concern. All the signs and symptoms of any medical condition may not be present in every sufferer so your doctor will need to conduct further tests to make a conclusive diagnosis.
Depending on your doctor’s clinical findings after a thorough case history and extensive physical examination, he/she may request further tests and procedures. You doctor will most likely refer you to a chest physician (pulmonologist) for the follow up testing, or you may be referred immediately to an oncologist (cancer specialist). An x-ray or CT scan may be considered and if any lump can be identified, a biopsy may be necessary. If a diagnosis of mesothelioma is then confirmed, further tests may be requested to identify the stage of the cancer, plan the best course of treatment and allow your doctor to make a prognosis.
Treatment of a Mesothelioma
As with most cancers, there are three possible routes – surgery, radiation therapy or chemotherapy (drugs). However, not all 3 options may be viable for your case and your oncologist will discuss the possibilities with you. While many of us often fear the treatment options for cancer more than the tumour itself, it is important to note that proper treatment under the supervision of an oncologist will increase your lifespan and give you a better quality of life in the long run.