What is pleural mesothelioma?
Pleural mesothelioma is a rare aggressive cancer which develops in the thin layer of soft tissue known as the ‘pleura’ or ‘pleural membrane’ which surround the lungs. The pleura has a space between an inner and outer layer in which a lubricant type fluid is produced to enable the lungs to move in and out smoothly and allow you to breathe easily.
When mesothelioma develops the pleura thickens and creates pressure against the lungs which can cause fluid to build up (pleural effusion) which causes breathing difficulties.
In the UK more than 2,600 people are diagnosed with mesothelioma each year 50% of whom are men aged 75 years and over.
Mesothelioma is more commonly found in the lungs (pleural mesothelioma) but can also develop in the stomach (peritoneal mesothelioma), within the lining of the heart (pericardial mesothelioma) and rarest of all within the testicles (testicular mesothelioma).
How is pleural mesothelioma caused?
In 90% of all cases the cause of mesothelioma is attributed to fine asbestos fibres encountered across a wide range of industrial settings where asbestos materials were commonly used and fibres were allowed to become airborne. Once inhaled the harmful fibres travel through the lung tissue and become trapped in the outer lining of the membrane where the body’s defence mechanism tries to break them down and remove them. Inflammation and irritation develops over many years causing scarring to the lungs which can lead to cancerous changes. Typically mesothelioma can take 15 – 60 years to develop.
In addition to workers, other groups of people might be at risk of developing mesothelioma which would include family members of workers who have been exposed to asbestos dust and fibres brought home from places of work on the workers clothes and skin. Physical contact could result in the fibers being inhaled as too could shaking and washing soiled clothing and this type of exposure is often referred to as ‘secondary exposure’. Instances are reported were wives have developed mesothelioma from hugging their husbands as too have young children during play and contact.
Residents who lived near asbestos factories and people who worked and were present in buildings where asbestos was present in the fabric of the building, which was disturbed or damaged during maintenance, improvement or through general decay are also at some risk.
Who is most at risk of developing pleural mesothelioma?
There are various ways to measure risk in developing a disease like mesothelioma but this does not always mean a disease or cancer will develop. Certain types of cancer have different risk factors and with mesothelioma the risk is higher in people exposed to asbestos before the age of 30.
It is estimated that almost 6% of British men born in the 1940’s who worked in carpentry for more than 10 years before the age of 30 develop mesothelioma. A high risk group would typically include those who have worked in manufacturing asbestos and those who have used asbestos materials and products in one or more of the following industries;
- Building industry
- Power stations motor industry
- Plumbing & heating
- Insulation (‘Laggers’)
- Telephone exchanges
Common symptoms of pleural mesothelioma
Symptoms develop gradually and typically might include;
- Chest pain
- Shortness of breath
- Persistent cough
- Loss of appetite and unexplained weight loss
- Clubbed fingertips
How is pleural mesothelioma diagnosed?
It is likely you will first be seen by your GP who will examine you and wherever necessary refer you for further tests at your local hospital.
A number of tests are used to diagnose pleural mesothelioma and if a previous exposure history is indicated it is likely the first test will be a chest x-ray. Further tests might include a blood test, CT Scan, pleural biopsy, CT or ultrasound guided biopsy, thoracoscopy;
A blood test in itself will not detect mesothelioma but it is recognised that people with mesothelioma have higher concentrations of certain proteins in their blood. Blood tests can help determine how advanced a cancer is. Researchers in Japan are developing advanced blood tests using an enzyme-linked system to detect a protein biomarker (N-ERC/mesothelin) which could enable earlier diagnosis of mesothelioma. Early diagnosis and early intervention offers a more favourable outcome in terms of treatment options and survival periods.
This straight forward test looks for abnormalities in your lungs such as fluid build-up around the lungs (pleural effusion) or thickening of the pleura which could indicate mesothelioma and wherever possible comparison can be made to earlier images.
CT (computerised tomography) scan
A CT Scan involves a series of x-rays to produce a 3D image of the body which is important to any diagnosis of mesothelioma and can help differentiate malignant disease from benign disease. The scan takes between 10 – 30 minutes and is considered painless using only small amounts of radiation. Where a CT scan is inconclusive it might then be necessary to undertake further investigation.
A biopsy is normally required to enable a diagnosis of mesothelioma and involves taking a tissue sample, usually from the thickened pleura and occasionally from lymph nodes located in the chest. There are various types of biopsy which can be considered in each particular case, including;
- Pleural Aspiration – Mesothelioma cells irritate the pleura causing fluid to develop and build up which causes pressure upon the lungs and often results in difficulty breathing. Laboratory examination of a fluid sample will help to provide a diagnosis which is obtained under local anaesthetic with the aid of an ultrasound scan. This enables a needle to be guided into the pleural space around the lung where sample fluid can be drawn off using a syringe.
- CT or ultrasound guided biopsy – Under local anaesthetic a special type of needle is inserted into the affected area and guided by ultrasound or CT scanner it enables the targeted removal of tissue samples.
- Thoracoscopy (also referred to as VATS, video assisted thoracoscopy) – This is a preferred and reliable method of obtaining tissue sample for biopsy which is less invasive than surgical lung biopsy and obtained under general or local anaesthetic. A thin tube with a lighted scope and camera (thoracoscope) is inserted through an incision made in the chest wall allowing for detailed examination of the pleura and other lung structures. During this procedure it might be necessary to drain fluid (pleural effusion) from the lungs to prevent re-accumulation. This procedure is called pleurodesis and involves the use of sterile talc which is inserted into the chest and pleural spaces in an effort to close the pleural space where the fluid collects.
Factors to consider following a diagnosis of pleural mesothelioma
Initial diagnosis of mesothelioma can be overwhelming, both physically and emotionally not only for the sufferer but their loved ones and friends and the enormity and implication of such a diagnosis cannot be overstated. Given the prognosis, sufferers might feel burdened by the responsibility of getting their affairs in order and coping with the knowledge of a reduced life-expectancy.
Sufferers will deal with their diagnosis in different ways but in most instances there will be fundamental steps one could take to make dealing with their situation that much easier.
- Consider a second opinion – A second opinion is very important not only to ensure your original diagnosis is correct but also to ensure you receive the most appropriate treatment and you should discuss this with your existing Consultant who will appreciate and understand your position. Ensure any second opinion is obtained from a specialist who is conversant in all available treatments of mesothelioma.
- Consider your treatment options – Living with mesothelioma will require decisions in terms of lifestyle changes and understanding more of the various treatment options, prognosis and availability of clinical trials which you should discuss with your specialist.
- Decide on a treatment Plan – Your ultimate treatment options are likely to be decided by the stage of your mesothelioma, your state of health and quality of life issues. Deciding upon any treatment plan is likely to involve many questions being asked of your specialist, such as, which treatment will extend your life the longest, what are the side effects of each treatment, what can be done to improve the quality of your life whilst living with mesothelioma, how you might best prepare for your treatments and those lifestyle steps you might take to ensure living the highest quality life possible.
- Improve your health – Wherever possible you should consider improving your health including diet which can help to maintain your immune system during the stressful and often debilitating period of your treatment. Smoking can exacerbate your condition and should be avoided as too are high stress levels which can be reduced by certain enjoyable activities such as reading, aromatherapy, yoga or indeed any other activity which uplifts you mentally, spiritually or physically.
- Contact us immediately – Mesothelioma is a serious terminal condition which in almost all cases has been brought about through workplace exposure to asbestos dust and fibres and as such is a condition brought about through no fault of your own. We can provide you with easy and fast access to specialist Industrial Disease solicitors who understand your condition and will recover for you and your family the maximum compensation available. We can also help you with appropriate benefit entitlement with The Department for Work and Pensions (DWP). You can get in touch with us on FREEPHONE 0808 164 6018.
Treatments available for pleural mesothelioma
Malignant pleural mesothelioma is an incurable condition and difficult to treat, particularly in an advanced state with most available treatments aimed at relieving symptoms and extending a quality life for as long as possible.
Treatments for pleural mesothelioma are similar to that in other types of cancer and in most instances will be dictated by certain factors such as the stage of the mesothelioma, age and general fitness/health of the sufferer and the symptoms experienced.
Drugs – A range of drugs and clinical trials are continually tested and evaluated. If appropriate, your specialist will advise upon the most suitable medicines for you.
Surgery – There are two main procedures used the first of which is referred to as a ‘pleurectomy’ which involves the removal of all or part of the affected pleura (membrane lining of the lung) and is recognised as a major operation. Removal of part of the pleura can sometimes be achieved by keyhole surgery and will normally require a 7 day stay in hospital followed by a further recovery period of between 4-6 weeks. Removal of the entire pleura is normally only conducted in a specialist hospital requiring a 10 – 15 day stay in hospital followed by a further 6 – 8 weeks recovery.
A less common procedure known as ‘extrapleural pneumonectomy’ is used in early diagnosed cases of mesothelioma where the lymph nodes and other areas outside the lung have been unaffected. This major operation involves removal of the affected lung and pleura together with other structures associated to the lung and heart (pericardium) and is often accompanied with chemotherapy or radiotherapy. A debilitating treatment option which normally requires at least 2 weeks stay in hospital followed by a further 3 – 4 months recovery.
Chemotherapy – Different chemotherapy and anti-cancer drugs are available for different conditions, and most treatments are administered by cancer nurses on an outpatient basis at a local hospital or clinic. The drugs can be injected into a vein, through a drip or be in the form of a tablet and are designed to kill cancer cells and prevent them from multiplying.
Radiotherapy – This involves the use of high energy x-rays to kill and prevent the spread of cancer cells and to help alleviate symptoms of pain. It is also used following removal of fluid from around the lungs via a chest drain, or following thoracoscopy in case cancer cells have been disturbed.
Pleurodesis – A common symptom in mesothelioma is the build-up of fluid from the lungs known as a ‘pleural effusion’ which can create pressure upon the lungs and cause breathing difficulties. The fluid can be removed by various means and to prevent re-accumulation a sterile talc is inserted into the pleural spaces to close the space by sticking the two layers of the pleura together. This procedure is known as pleurodesis and is applied at hospital by way of a chest drain or during a thoracoscopy procedure.
Improving your pleural mesothelioma prognosis
- A prognosis is a doctor’s prediction on the outcome of a disease based upon a set of average national statistics and are therefore presented to a sufferer as a ‘guide only’. Many sufferers are taking on the challenge of their condition and living longer due to improved treatments, care and an improved lifestyle and diet.
- Life expectancy is assessed according to various factors which include the type and stage of the mesothelioma, age, gender and general fitness of sufferer and the type of treatments suitable to a particular individual.
- Many sufferers who take advantage of available treatments and clinical trials will outlive their initial prognosis. Sadly, the nature and often late onset of symptoms means that mesothelioma is normally diagnosed during the latter stages of the disease after it has spread into the lymph nodes or other parts of the body. If diagnosed early, treatment is likely to be more successful offering a better prognosis.
- In all cases, regardless as to how advanced your mesothelioma might be, palliative treatment is always available to ensure you maintain a longer and quality life.
- Whilst it is recognised you cannot change certain prognostic factors, you can be proactive in terms of improving your overall health and well-being by undergoing recommended treatments and dealing positively with any side effects that might occur. If you are a smoker you might consider stopping on account this can cause further lung complications and jeopardise any potential surgery.
- A healthy immune system will help to manage treatments like chemotherapy and fight off diseases which could complicate recovery. Consider improving your diet and wherever possible take exercise which can have a significant impact on your life expectancy. Mesothelioma can significantly impact a person mentally and emotionally and it is important people do not become isolated and reach out for support and help whenever required. Complementary and alternative therapies like meditation, yoga and counselling can improve your well-being.
- Mesothelioma sufferers face tough decisions and challenges throughout their treatment and hopefully many will have family and friends to support them. We understand many of the difficulties you are facing right now and would be pleased to speak with you regarding immediate access to specialist legal help for you, your family, friends and carers. We can also arrange contact with another organisation or charity on your behalf to see what other help might be available. Call us today on FREEPHONE 0808 164 6018.
Compensation & government benefits for pleural mesothelioma
- Compensation is available to sufferers of mesothelioma and is set at a level to reflect the nature of this terrible disease and give regard to those life changing costs and financial losses which inevitably follow and impact upon many families. Whilst compensation cannot bring back a loved one, reverse a diagnosis or restore former good health, it can help to provide some financial peace of mind to sufferers and their families at a very difficult time in their lives.
- Experienced specialist industrial disease solicitors are waiting to speak to you to discuss all aspects of your compensation and provide reassurance as to how they would seek to progress your claim.
- Case settlements for mesothelioma involve high value compensation, typically averaging in excess of £140K. Court provisions exist to enable your solicitor to obtain an early interim payment of £50K. Awards are obtained from those former employers and/or their relevant insurance companies who negligently exposed you to asbestos fibres in the workplace.
- Sufferers of mesothelioma are also eligible to seek the non-means tested benefit, Industrial Injuries Disablement Benefit (IIDB) which is automatically assessed at 100% disability and a weekly payment of £168. We can help you with your benefit application which might include a claim under the 2008 Diffuse Mesothelioma Scheme which provides a one-off payment to sufferers where it has not been possible to recover compensation in instances of self-employment or where exposure was caused by washing clothes of a relative or from other environmental factors perhaps living near a factory where asbestos was produced.