Causes of Mesothelioma – Malignant Mesothelioma Information #causes #of #mesothelioma, #malignant #mesothelioma #asbestos #asbestosis #cancer


Causes of Mesothelioma

Asbestos exposure is one of the most common causes of mesothelioma. Over 50 percent of mesothelioma patients have a history of asbestos exposure. This exposure could occur while directly handling the fibrous material, or it could occur through just environmental exposure.

There are numerous documented cases where patients contracted the disease due to living close to the asbestos mines or by coming in contact with asbestos when some of the fibers became airborne. Persons most commonly afflicted include shipyard workers, construction workers, automobile mechanics (particularly those working on brake linings), insulation workers, pipe and heater installation and flooring workers and roofers.

Also, for those who have had asbestos exposure and who smoke, the risk becomes exaggerated. Studies show that asbestos workers who also smoke are 55 times more likely to die of mesothelioma than nonsmokers without asbestos exposure.

Erionite

Erionite is a mineral that has a long, thin rod-like amphiboles structure. Exposure to this mineral has been associated with increased incidence of mesothelioma. Many cases of mesothelioma due to erionite exposure have been diagnosed in the Central Anatolia region of Turkey.

Exposure to asbestos is the primary cause for malignant mesothelioma in most patients. If you or a loved one has been exposed to asbestos, then you are at risk. There is no minimum level of exposure that is deemed safe. Insure that during your routine health care, you advise your doctor of previous asbestos exposure, particularly if you experience any chest pressure, shortness of breath, chest pain or coughing. While these symptoms do not indicate the presence of the disease, they are the most common symptoms and should be further investigated if you have had asbestos exposure.

[Page updated February 2005]

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Statistics – Asbestos related lung cancer #statistics, #statistical, #data, #diseases, #asbestos, #asbestosis, #lung #cancer, #tobacco #smoke, #exposure, #mesothelioma, #deaths, #


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Asbestos related lung cancer

Summary

  • The overall scale of asbestos-related lung cancer deaths has to be estimated rather than counted.
  • Research suggests there are currently about as many lung cancer deaths attributed to past asbestos exposure each year in Great Britain as there are mesothelioma deaths.
  • This implies there are currently in excess of 2,000 asbestos-related lung cancer deaths each year.
  • This estimate is uncertain, and since asbestos and smoking act together to increase the risk, it is affected by past smoking habits as well as asbestos exposure.

Background information

Asbestos is one of a large number of agents that can cause lung cancer, the most important of which is tobacco smoking.

Lung cancer usually has no specific clinical signs suggesting a particular cause and asbestos exposure and smoking act together to increase the risk. This – together with the fact that cases usually take many years to develop – makes it difficult to be sure about the cause of individual cases. As a consequence, data sources that rely on the counting of individual cases attributed to asbestos exposures, such as Industrial Injuries Disablement Benefit (IIDB) and the Health and Occupation Reporting (THOR) schemes, tend to underestimate the true scale of asbestos-related cases.

Epidemiological analyses that are representative of the British population suggest that there are likely to be about as many lung cancer cases attributed to past asbestos exposure each year in the population as a whole as there are mesotheliomas 1. 2. This implies there are currently in excess of 2000 asbestos-related lung cancer deaths each year.

This estimate is uncertain. Since asbestos and smoking act together to increase the risk of lung cancer, it is affected by past smoking habits as well as the extent of asbestos exposure. The ratio of lung cancers to mesotheliomas is expected to fall over time, a reflection of reductions in both asbestos exposure and the prevalence of smoking. Among more specific groups of workers heavily exposed to asbestos in the past there were typically a greater number of excess lung cancer cases than there were mesotheliomas 3.

Lung cancer is still typically fatal within a few years of diagnosis and so, as with the mesothelioma, the number of annual deaths is similar to the annual incidence of new cases.

In recent years there have been, on average, around 300 new cases of asbestos-related lung cancer each year within the IIDB scheme and less than 100 cases identified by chest physicians each year within the THOR scheme.

Estimates of the burden of lung cancer attributable to occupational exposures other than asbestos are available based on the Burden of Occupational Cancer research.

References

  1. Darnton A, McElvenny D, Hodgson J (2005). Estimating the number of asbestos related lung cancer deaths in Great Britain from 1980-2000. Annals of Occupational Hygiene 50(1): 29-38.
  2. Gilham C, Rake C, Burdett G et al (2015). Pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden. Occup Environ Med. 73(5):290-9.
  3. McCormack V, Peto J, Byrnes G et al (2012). Estimating the asbestos-related lung cancer burden from mesothelioma mortality. Br J Cancer. 106(3):575-84.

Resources


Lung-Sparing Surgery May Up Mesothelioma Survival #mesothelioma, #mesothelioma #treatment, #surgery, #lung, #lung #cancer, #mesothelioma #surgery, #asbestos


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Lung-Sparing Surgery May Up Mesothelioma Survival

By Maureen Salamon

FRIDAY, Dec. 23, 2016 (HealthDay News) — Surgery that preserves the lung. when combined with other therapies, appears to extend the lives of people with a subtype of the rare and deadly cancer mesothelioma. a new study suggests.

Tracking 73 patients with advanced malignant pleural mesothelioma — which affects the lungs’ protective lining in the chest cavity — researchers found that those treated with lung-sparing surgery had an average survival of nearly three years. A subset of those patients survived longer than seven years.

Mesothelioma patients treated with chemotherapy alone, which is standard care, live an average of 12 to 18 months, the researchers said.

Study participants received lung-sparing surgeries and another treatment called photodynamic therapy that uses light to kill cancer cells. Ninety-two percent of the group also received chemotherapy.

The study volunteers achieved far longer survival times, said study author Dr. Joseph Friedberg.

“When you take the [entire] lung out, it’s a significant compromise in quality of life,” said Friedberg. He’s director of the University of Maryland Medical Center’s Mesothelioma and Thoracic Oncology Treatment and Research Center in Baltimore.

“For all intents and purposes, this [lung-sparing surgical approach] is the largest palliative operation known to man, since chances of curing mesothelioma are vanishingly small,” said Friedberg. He completed the research while at his previous post at the University of Pennsylvania.

“Plus, most of these patients are elderly, so preserving quality of life was really the goal,” he added.

About 3,000 Americans are diagnosed with mesothelioma each year, the American Cancer Society says. Many of these people were exposed to the mineral asbestos in industrial occupations, according to the U.S. National Cancer Institute (NCI).

Used in products such as insulation, building shingles and flooring, asbestos dust fibers can be inhaled or swallowed, settling in the lungs, stomach or other body areas. Often, it takes decades after exposure for mesothelioma to develop, the NCI says.

Friedberg and his team performed the lung-sparing surgeries on study participants between 2005 and 2013. Overall average survival was 35 months, the study showed. But survival time more than doubled to 7.3 years for 19 patients whose cancer had not spread to their lymph nodes.

Continued

Most of the patients in the study had stage 3 or stage 4 cancer. Typically, Friedberg said, only about 15 to 20 percent of mesothelioma patients are treated with surgery, which often removes an entire lung as well as the diaphragm and the sac surrounding the heart .

Friedberg said that between 20 and 40 percent of pleural mesothelioma patients with the epithelial subtype might be eligible for lung-sparing surgery. He explained that this surgery removes all visible traces of cancer. It typically has fewer complications and a lower risk of dying in the 90 days following the 10- to 14-hour procedure.

“It’s still relatively new that people do lung-sparing surgery for this disease, and it’s not established that this is what we need to do,” said Friedberg.

“I would say this is one of the most lethal cancers known to man. There’s a pressing need for new and innovative treatments,” he noted.

Another mesothelioma expert said he was cautiously optimistic about the new study’s results.

“It’s not a randomized trial and I think they selected out. only those patients who were well enough to get to surgery and those with the epithelial subtype who are the patients who tend to do the best,” said Dr. Gregory Masters.

He is principal investigator with the U.S. National Cancer Institute Community Oncology Research Program at the Helen F. Graham Cancer Center and Research Institute in Newark, Del.

“Taking the best patients is going to skew the study and make the outcome look very good,” added Masters. “But I am encouraged they can take a large group of patients and show such a good outcome at three years.”

Dr. Daniel Petro, a medical oncologist/hematologist at the University of Pittsburgh Medical Center, said lung-sparing surgery for mesothelioma is also done at academic centers such as his, and he was not surprised by the study’s results.

“This [surgical approach] is a step forward with this particular terrible cancer,” Petro said, “and we’ve got to keep coming up with better options to eradicate it.”

The study was published in the December issue of Annals of Thoracic Surgery.

WebMD News from HealthDay

Sources

SOURCES: Joseph S. Friedberg, M.D. director, Mesothelioma and Thoracic Oncology Treatment and Research Center, University of Maryland Medical Center, and professor, surgery, and head, Division of Thoracic Surgery, University of Maryland School of Medicine, Baltimore; Gregory A. Masters, M.D. principal investigator, U.S. National Cancer Institute Community Oncology Research Program (NCORP), Helen F. Graham Cancer Center and Research Institute, Christiana Care Health System, Newark, Del.; Daniel Petro, M.D. medical oncologist/hematologist, Hillman Cancer Center, University of Pittsburgh Medical Center; December 2016, Annals of Thoracic Surgery

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Virginia Beach Asbestos Mesothelioma Lawyers – Local Attorneys & Law Firms in Virginia Beach, VA #mesothelioma #lawyer #virginia


Virginia Beach Asbestos Mesothelioma Lawyers, Attorneys and Law Firms – Virginia

Need help with an Asbestos matter?

You’ve come to the right place. If you have been exposed to asbestos in consumer products, the environment, or from working in an industry likely to be exposed to asbestos — like construction, mining, manufacturing, longshore — and have developed health issues resulting from asbestos exposure, an asbestos and mesothelioma lawyer can help.

Use FindLaw to hire a local asbestos lawyer to seek compensation for medical expenses resulting from asbestos exposure or mesothelioma cancer.

Need an attorney in Virginia Beach, Virginia?

FindLaw’s Lawyer Directory is the largest online directory of attorneys. Browse more than one million listings, covering everything from criminal defense to personal injury to estate planning.

Detailed law firm profiles have information like the firm’s area of law, office location, office hours, and payment options. Attorney profiles include the biography, education and training, and client recommendations of an attorney to help you decide who to hire.

Use the contact form on the profiles to connect with a Virginia Beach, Virginia attorney for legal advice.

How do I choose a lawyer?

Consider the following:
Comfort Level – Are you comfortable telling the lawyer personal information? Does the lawyer seem interested in solving your problem?
Credentials – How long has the lawyer been in practice? Has the lawyer worked on other cases similar to yours?
Cost – How are the lawyer’s fees structured – hourly or flat fee? Can the lawyer estimate the cost of your case?
City – Is the lawyer’s office conveniently located?

Not sure what questions to ask a lawyer?

Here are a few to get you started:

  • How long have you been in practice?
  • How many cases like mine have you handled?
  • How often do you settle cases out of court?
  • What are your fees and costs?
  • What are the next steps?

Want to check lawyer discipline?


Epithelial Mesothelioma: Treatment Options and Prognosis #epithelioid #mesothelioma


Epithelial Mesothelioma

Epithelial pleural mesothelioma is a type of asbestos-related cancer defined by the appearance and location of its cancerous cells. If diagnosed with this type of mesothelioma, you may be given a better prognosis and be more responsive to treatment than patients diagnosed with other types of this aggressive cancer.

There are four types of mesothelioma, including pleural mesothelioma. that affect different parts of the body and that are formed by different cell types, including epithelial, sarcomatoid and biphasic. About 50 to 70 percent of all mesothelioma cancers are epithelial.

Epithelial pleural mesothelioma refers to a specific type of mesothelioma that affects the protective tissue surrounding the lungs, called the pleura, and where epithelial cells are present, which look like small, square cells with a tubular configuration and visible cell nucleus. When these cells become cancerous, they are referred to as epithelioid cells.

How Is Epithelioid Pleural Mesothelioma Diagnosed

Epithelioid pleural mesothelioma can be difficult to diagnose. Patients often first visit their primary care physician with complaints of chest pain or shortness of breath. Referral to a pulmonologist is common before an oncologist (cancer doctor) becomes involved.

Diagnosing pleural mesothelioma quickly can be problematic because symptoms don’t become obvious until the cancer progresses. These symptoms also often mimic less severe respiratory conditions, such as asthma or pneumonia, which may lead to an initial misdiagnosis.

Once the symptoms of pleural mesothelioma are recognized, additional diagnostic tests like imaging scans and testing tumor samples are conducted to confirm the presence of cancer.
Detecting epithelioid cells requires an experienced pathologist, who analyzes tumor samples to determine which cell type is present. There are subtypes of epithelial mesothelioma that an experienced pathologist knows how to test for, and they know how to tell these cells apart from cells of other types of cancer.

Because epithelial pleural mesothelioma can resemble adenocarcinoma cells, it’s important to have an experienced pathologist analyzing the tumor samples. For example, a pathologist should look for certain cell structures like microvilli (which are different sizes for pleural mesothelioma and adenocarcinoma) to differentiate between the two cancers.

Different characteristics help pathologists differentiate between the subtypes of epithelial mesothelioma. For example, tubulopapillary epithelioid mesothelioma cells form a cube-like shape, histiocytoid cells resemble pulmonary macrophages, and poorly differentiated cells are round or irregularly shaped.

Though statistics on all the epithelioid subtypes aren’t available, it is known that deciduoid epithelioid mesothelioma accounts for approximately 2-5 percent of all mesothelioma cases, and small cell accounts for less than 6 percent. Most epithelial cases have a tubulopapillary cell pattern, while rare cases are adenoid cystic or signet ring.

Mesothelioma Awareness Wristbands Show your support for a loved one by wearing one of our mesothelioma wristbands.

Subtypes of Epithelial Mesothelioma

How Epithelioid Cells Affect Pleural Mesothelioma Treatment and Prognosis

Treatment for mesothelioma cancer typically depends on the type and stage of cancer, rather than the cell type. This means that treatment for epithelial pleural mesothelioma is similar to treatment of other mesothelioma cell types. Chemotherapy. radiation therapy and surgery may be viable options for epithelial pleural mesothelioma patients.

Because epithelial cells have proven to respond better to treatment. epithelial pleural mesothelioma patients may be eligible for a more aggressive treatment plan and may be given a better prognosis than patients with other cell types.

It’s important to find a mesothelioma specialist who can determine the cell type of your cancer and create a specialized treatment plan. The Patient Advocates at the Pleural Mesothelioma Center can help you find a doctor.

  1. Dodson, R. and Hammar, S. (2006). Asbestos: Risk assessment, epidemiology, and health effects. Boca Raton, FL: Taylor & Francis.
  2. Galateau-Salle, F. (2010). Pathology of malignant mesothelioma. London, England: Springer-Verlag London Limited.
  3. King, J.E. Galateau-Salle, F. & Hasleton, P.S. (2006). Histopathology of malignant pleural mesothelioma. In K. O’Byrne & V. Rusch (Eds.), Malignant pleural mesothelioma (pp. 61-103). New York, NY: Oxford University Press.
  4. Miettinen, M. (2005). Rare variants of mesothelioma. In H.I. Pass, N.J. Vogelzang & M. Carbone (Eds.), Malignant mesothelioma: Advances in pathogenesis, diagnosis, and transitional therapies (pp. 517-526). New York, NY: Springer.
  5. Ross, M.H. & Pawlina, W. (2011). Histology: A text and atlas. Baltimore, M.D. Lippincott Williams & Wilkins.
  6. Sugarbaker, D.J. Strauss, G.M. Lynch, T.J. Richards, W. Mentzer, S.J. Lee, T.H. … & Antman, K.H. (1993). Node status has prognostic significance in the multimodality therapy of diffuse, malignant mesothelioma. Journal of Clinical Oncology,11(6):1172-1178.

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Mesothelioma Lawyer -Class Actions – Drug Law Firm -Baron – Budd #lawyers #for #mesothelioma


Mesothelioma is a cancer caused by exposure to asbestos. Baron Drug Injury Lawsuits • Class Action • Wrongful Death

  • Almost 63% of women diagnosed with ovarian cancer report regularly sprinkling themselves with talcum powder according to researchers in Cancer Epidemiology. Its effectiveness at eliminating odor and moisture make it a popular product for hygienic. Read More

  • The FDA approved the Essure® Birth Control device and it became available to women in the U.S. in 2002. The manufacturer, Conceptus (now owned by Bayer), assured women that this device was safe and over. Read More

  • In an encouraging move for American workers, the U.S. Supreme Court recently denied a petition to review Flores v. City of San Gabriel, and in doing so upheld that decision which determined that the amount. Read More

  • Residents of Airway Heights and Medical Lake, Wash. exposed to dangerous chemicals DALLAS – May 17, 2017 – The national law firm of Baron Budd announced today it is investigating potential lawsuits related to. Read More

  • Nearly 290,000 class members will each receive approximately $120 within 60 days DALLAS – April 17, 2017 – The national law firm of Baron Budd announced today it has received final approval of a $50. Read More

  • Authors of “Poison in the Well” article honored for distinguished writing DALLAS – April 10, 2017 – The national law firm of Baron Budd is pleased to announce attorneys Scott Summy, Carla Burke Pickrel, and. Read More

Baron Budd was selected to the National Law Journal s Plaintiffs Hot List in 2002-2006, 2008 and 2011-2012 (published by American Lawyer Media).
The Legal 500 has selected Baron Budd as a top law firm from 2007-2013 (Legalease, Ltd.).
Baron Budd shareholder Russell Budd has been selected to The Best Lawyers in America 2014. Shareholder Scott Summy has been selected 2006-2014 (Woodward White, Inc.).

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Wisconsin Mesothelioma Attorney #wisconsin, #mesothelioma, #asbestos, #attorney, #what #is #asbestos, #what #is #mesothelioma, #asbestos #attorneys, #mesothelioma #attorneys


Wisconsin Mesothelioma Attorney

If you are a victim of mesothelioma, and you have been exposed to asbestos at your job site, you should contact a Wisconsin mesothelioma attorney and file a case against the companies that exposed you to asbestos. Mesothelioma is a deadly condition and your Wisconsin mesothelioma lawyer can help you claim retribution for your suffering. Many people have lost since there are no active mines of asbestos [1] in Wisconsin where asbestos occurs naturally, all forms of asbestos exposure and the diseases associated with it originate from work related and industrial exposures to asbestos in Wisconsin. The only natural deposits in the entire state are found along Wisconsin’s border connecting it with the upper peninsula of Michigan. Paper mills, chemical and power plants and construction companies are mainly responsible for the contamination of asbestos in Wisconsin. It is also a fact that the total paper production that takes place in Wisconsin alone is greater than that which is done in most other states.

If you live near or worked at any of the asbestos contaminated job sites mentioned below, it is important for you to get a mesothelioma screening done as soon as possible. Asbestos is the only known cause of mesothelioma, which is a fatal condition. Mesothelioma takes decades to develop, and usually when it is diagnosed, it is in its latest and most dangerous stages, making treatment difficult.

Sites that increase the risk of asbestos exposure:

If you have worked at any of the below mentioned job sites, and suffer from mesothelioma, you should contact a Wisconsin mesothelioma lawyer and seek retribution for the pain and the suffering you are going through.

Paper mills: paper production companies use asbestos liberally for the purposes of insulation. Decades ago, asbestos related products as well as asbestos itself were used as components of the pulp in the form of adhesives and drying felts. It is important to change these drying felts every now and then which automatically enhances and increases the chances of asbestos exposure caused to the workers. The greatest sources of asbestos exposure in Wisconsin, as well as many other states in America are paper and pulp manufacturing industries.

Chemical and Power plants. chemical plants and power plants also use asbestos for the purposes of insulation as it has an excellent ability to absorb heat.

Construction companies. construction materials used in industrial and public buildings included asbestos before the 1970’s and 80’s, when this substance was finally banned because of its health hazards. Buildings that were constructed before these decades were made using asbestos as part of the construction material and included some or all of the following mentioned substances: concrete wallboard combined with asbestos, a spray used for insulation purposes also containing asbestos, ceiling and floor tiling with asbestos containing materials, countertops made with asbestos, paints containing asbestos fibers for heat and chemical insulation purposes.

Power generation plants: The forms of asbestos which are significantly resistant to heat energy are amphiobole asbestos. Amphiobole minerals [2] are highly toxic as well as heat resistant. Before their toxicity was known about, they were readily used in the construction of many power generation plants and units throughout the state, as well as all over the country.

Electrical machinery: Asbestos containing materials can also be found in the electrical machinery and units, electrical cloths and also conduits. These include major generators and turbines that are used for the production of electricity. Asbestos used in the manufacture of these machineries and electrical units is extremely dangerous because it allows for the release of minute and fine fibers of asbestos into the environment which can then be easily inhaled or ingested by people, causing them to fall victims to the dangerous diseases and disorders that asbestos exposure can cause.

According to a survey done in the year 2003, conducted in Puerto Rico, the chest x rays of a huge number of workers were examined. One hundred and thirty of these x rays led to the diagnosis of diseases caused by asbestos exposure. It is for this reason that it is important for all workers that have been employed at any of these industrial sites, or even people who reside in the same area as any of these plants that have confirmed asbestos exposure must immediately consult specialized mesothelioma clinics which have been established in the state in order to provide treatment and medication to those who have fallen victims to the hazards of asbestos exposure and the diseases caused by it.

Mesothelioma and asbestos:

Asbestos exposure can induce the development of a rare lung cancer known as mesothelioma, which is fatal to humans. Another disease caused by asbestos exposure is asbestosis, also known as pleural mesothelioma, which is not fatal but harmful to those exposed to the mineral. In Wisconsin over 700 people have died of mesothelioma or asbestosis since the year 1979 though the year 2001. Lung cancers caused due to asbestos exposure are also very frequent. If you or a family member suffers from mesothelioma, you should contact a Wisconsin mesothelioma attorney to help you file your case.

Mesothelioma treatment centers in Wisconsin:

The following treatment center in the state of Wisconsin offer treatment for this deadly condition:

University of Wisconsin Carbone Cancer treatment center:

This center is located in Madison. The Paul P. Carbone Comprehensive Cancer Center [3] is a top of the line treatment center for those people in the Madison and its neighboring areas in Wisconsin who may be feelings the symptoms of asbestos related conditions. The center should be contacted immediately if you have worked at any of the above mentioned job sites in the state of Wisconsin. Most workers who had been employed at these asbestos contaminated job sites were not aware of the risks of asbestos related diseases like mesothelioma, lung cancer and asbestosis.

UW PAUL P. CARBONE

COMPREHENSIVE CANCER CENTER

UNIVERSITY OF WISCONSIN

600 HIGHLAND AVENUE,

MADISON, WISCONSIN 53792-0001


Extraovarian Primary Peritoneal Carcinoma #what #is #peritoneal #mesothelioma


Extraovarian Primary Peritoneal Carcinoma

Extraovarian Primary Peritoneal Carcinoma

Extraovarian primary peritoneal carcinoma (EOPPC), a relatively newly defined disease that develops only in women, accounts for approximately 10% of cases with a presumed diagnosis of ovarian cancer. Characterized by abdominal carcinomatosis, uninvolved or minimally involved ovaries, and no identifiable primary, EOPPC has been reported following bilateral oophorectomy performed for benign disease or prophylaxis. Most cases are of serous histology; however, nonserous tumors have been observed. Although EOPPC is similar to serous ovarian carcinoma with respect to clinical presentation, histologic appearance, and response to chemotherapy, molecular and epidemiologic studies have indicated that it may be a separate entity. This review explores the clinical presentation, management, prognosis, and survival of EOPPC.

Extraovarian primary peritoneal carcinoma (EOPPC) is an adenocarcinoma that develops from the peritoneum lining the pelvis and abdomen and is characterized by abdominal carcinomatosis, uninvolved or minimally involved ovaries, and no identifiable primary tumor. This relatively newly defined disease entity occurs exclusively in women and has been reported following bilateral oophorectomy performed for benign disease or prophylaxis.[1] It accounts for approximately 10% of cases with a presumed diagnosis of ovarian cancer.[2]

Although most cases of EOPPC are of serous histology, nonserous tumors have been reported.[3] Different investigators have referred to EOPPC as serous surface papillary carcinoma,[1,4,5] primary peritoneal carcinoma,[6] peritoneal mesothelioma,[7] multiple focal extraovarian serous carcinoma,[8] primary peritoneal papillary serous adenocarcinoma,[3] serous surface carcinoma of the peritoneum,[9] extraovarian peritoneal serous papillary carcinoma,[10,11] extraovarian mllerian adenocarcinoma,[12] normal-sized ovary carcinoma syndrome,[13] papillary serous carcinoma of the peritoneum,[14-16] and peritoneal papillary carcinoma.[17]

Extraovarian primary peritoneal carcinoma is similar in clinical presentation, histologic appearance, and response to serous ovarian carcinoma. However, molecular and epidemiologic studies[18,19] suggest that EOPPC may be a separate entity. This review examines the current literature on EOPPC, with an emphasis on its clinical presentation, management, prognosis, and survival.

History

The first case of EOPPC was reported by Swerdlow in 1959.[7] He described a 27-year-old woman experiencing pelvic pain, who, upon examination, was found to have an adnexal mass. Exploratory laparotomy revealed a friable pelvic tumor and normal fallopian tubes and ovaries. On microscopic examination, the tumor exhibited a papillary architecture and was most remarkable for large deposits of psammoma bodies.

Two years later, Rosenbloom and Foster[20] reported a case of pelvic peritoneal tumor, which they referred to as diffuse papillary mesothelioma. In 1974, Parmley and Woodruff[21] demonstrated that pelvic peritoneum had the potential to differentiate into a mllerian type of epithelium, and in 1977, Kannerstein et al[22] and Kannerstein and Churg[23] pointed out the importance of distinguishing EOPPC from peritoneal malignant mesothelioma, a condition that predominantly affects men and is associated with exposure to asbestos.

Origin

Two theories have been proposed to explain the development of EOPPC. Some authors[22] believe that embryonic germ cell rests remain along the gonadal embryonic pathway and that EOPPC develops from a malignant transformation of these cells. Other authors[21] contend that field carcinogenesis occurs, with the celomic epithelium lining the abdominal cavity (peritoneum) and the ovaries (germinal epithelium) manifesting a common response to an oncogenic stimulus.

Muto et al[18] demonstrated that four of six cases of EOPPC had different patterns of allelic loss at various anatomic sites, and one of these cases also had a p53 mutation present in some, but not all, anatomic sites. These findings are consistent with a multifocal origin for primary peritoneal carcinoma.

The same authors[24] had previously shown that, in advanced-stage epithelial ovarian cancer, the pattern of allelic loss, X chromosome inactivation, and p53 mutation was consistent with a unifocal origin. Contrary to Muto et al,[18] Kupryjanczyk et al,[25] using p53 mutation analysis, identified identical mutations in tumors obtained from different sites in two patients with primary peritoneal carcinoma. Again, these findings are consistent with a unifocal origin.

Role of BRCA1 Mutations?

Mutations of the tumor-suppressor gene BRCA1 have been implicated in the development of familial ovarian and breast cancer.[26,27] The role of BRCA1 gene mutations in the development of EOPPC is uncertain. In the only molecular study reported to date, BRCA1 germ-line mutations were identified in 3 (17.6%) of 17 EOPPC patients.[28] If these findings are confirmed by further studies, EOPPC should be considered a malignancy expressed in the familial breast-ovarian cancer syndrome.

Incidence

500 cases of EOPPC have been reported in the literature. The relatively small number of reported cases is due to the facts that (1) EOPPC is a relatively newly defined disease entity and (2) most EOPPC cases are misdiagnosed as epithelial ovarian cancer.

Some authors[10] believe that the incidence of EOPPC is increasing. Centers that document the relative frequency of EOPPC and epithelial ovarian cancer report a ratio of approximately 1:10.[17,19,29] An autopsy study by Rothacker et al[2] demonstrated that EOPPC accounts for 8% of all autopsies with the final diagnosis of serous ovarian cancer. These authors[2] estimated an incidence of 1 case per 150,000 women per year in their geographic area.

Risk Factors

The risk factors for EOPPC are unknown. Unlike peritoneal mesothelioma, EOPPC has no association with exposure to asbestos.[2]

An epidemiologic study[19] that compared EOPPC patients with patients with epithelial ovarian cancer discovered some similarities and differences between the two groups. Compared with women with epithelial ovarian cancer, those with EOPPC were significantly older, had later menarche, and were less likely to have used perineal talc powder. On the other hand, there were no significant differences between the two groups with regard to race; education; income; marital status; smoking; history of the use of birth control pills or hormone replacement; history of tubal ligation or infertility; family history of ovarian, colorectal, or endometrial cancers; and personal history of breast or uterine cancers.

Clinical Picture

The clinical presentation of EOPPC is indistinguishable from that of advanced-stage epithelial ovarian cancer.[9-11,14-17] Most reported cases of EOPPC have been in white women, with a median age of 57 to 66 years.

The most common presenting symptoms include abdominal distention, pain, and gastrointestinal symptoms (nausea, vomiting, dyspepsia, or change in bowel habits). The most common presenting finding on physical examination is ascites, reported in approximately 85% of cases.

On exploratory laparotomy, a widespread intraperitoneal malignancy has been found, which usually involves the omentum and upper abdomen with minimal or no ovarian involvement. The operative findings of EOPPC are similar to those of advanced-stage epithelial ovarian cancer or peritoneal carcinomatosis from metastatic gastrointestinal cancers, except that the ovaries show minimal or no involvement and no primary can be found in the gastrointestinal tract or other organs. Because the ovaries look normal, EOPPC has sometimes been referred to as normal-sized ovary carcinoma syndrome.[13]

Approximately 3.2% to 21.2% of EOPPC patients have a history of bilateral oophorectomy for benign disease or prophylaxis.[10,14,30] Extraovarian primary peritoneal carcinoma spreads mainly transperitoneally; however, lymphatic and blood-borne metastases have been suggested.[10,14,31] Metastasis to different groups of lymph nodes,[10,14] the liver parenchyma,[14] and the brain[31] have been reported.

Levels of the tumor marker CA 125 were elevated ( 35 U/mL) in most of the EOPPC patients in whom preoperative CA 125 values were known.[3,15,32] Some authors[3] have found that CA 125 levels correlate with the clinical status of the disease and response to therapy. In a group of 29 EOPPC patients, mean CA 125 values were similar to those of a group of 27 women with epithelial ovarian cancer matched for age, stage, and grade.[15]


The 4 Mesothelioma Stages and Staging Systems Involved in Diagnosis #mesothelioma #stages


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The 4 Stages of Mesothelioma

Doctors stage mesothelioma according to factors that indicate its progression. These stages range from stage 1 (most treatable) to stage 4 (fewest treatment options).

How Advanced is My Diagnosis?

Doctors perform tests to determine what stage, or how advanced, the cancer is in after the mesothelioma is discovered. This is accomplished by examining the patient by means of X-rays, CT scans, or other diagnostic methods. The purpose of these tests is to see if the cancer has spread beyond the point of origin. The spread of cancer is known as metastasis.

Characteristics of the 4 Stages

Cancer is localized to one side of the body. There is no metastasis or lymph node spread, and curative surgical treatment is still an option. Stage 1 patients have the best life expectancy .

Cancer is still localized to one side of the body. The tumor has grown past point of origin, but there is minimal lymph node involvement. Curative surgery is still an option.

Cancer is still on one side of the body, but the tumor has spread to surrounding organs and lymph nodes. Palliative and non-surgical treatments are typically used at this stage.

Cancer has spread to both sides of the body, tumors have spread to multiple organs and has spread through lymph system and blood vessels. Palliative, radiation and chemotherapy treatments are available.

The Basics of Staging Mesothelioma

The primary factor in staging mesothelioma is the level of metastasis. The further the cancer has spread from the original site, the later the stage. There are different staging systems for categorizing early stage to advanced mesothelioma.

Knowing which stage the cancer has reached is vital to determine the best treatment plan for the patient. Patients should always seek a second opinion after their cancer is staged. The different stages of mesothelioma provide boundaries for physicians as they recommend treatment options.

Our Free Mesothelioma Guide Includes:

Stage 3 Mesothelioma

Stage 3 pleural mesothelioma hasn’t spread to the other side of the chest, but there is definite metastasis to the lymph nodes. Stage 3 is more locally aggressive and may have also spread to other nearby organs. Surgery is not always a treatment option for stage 3 patients.

Possible spread to the surrounding tissue such as:

  • Tissue between the ribs and lining of the chest wall
  • Fat in the area between the lungs
  • Soft tissue in the chest wall (not just the lining)
  • The sac surrounding the heart (pericardium)

Stage 4 Mesothelioma

Stage 4 pleural mesothelioma is the most advanced stage. Patients may experience more serious symptoms such as difficulty swallowing and coughing up blood. Treatment options are mainly palliative due to the aggressive nature of the cancer at this stage. The main treatment options for stage 4 patients are chemotherapy and radiation.

In this stage, the cancer has potentially metastasized to:

  • The lymphatic system
  • Opposite side of the chest, diaphragm, and peritoneum
  • The spine and distant organs
  • The organs within the chest cavity

Show Sources Author

  1. How is Malignant Mesothelioma Staged. American Cancer Society. Retrieved from: https://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-staging. Accessed: 2/19/13.
  2. Gutman, H. (2011). Lung Cancer and Mesothelioma. Ebook. Xlibris.
  3. Galateau-Sallé, F. (2005). Pathology of Malignant Mesothelioma. Longer. Springer-Verlag.
  4. Mesothelioma: Tests and diagnosis. Mayo Clinic. Retrieved from: https://www.mayoclinic.com/health/mesothelioma/DS00779/DSECTION=tests-and-diagnosis. Accessed: 2/19/13.
  5. Mesothelioma Workup – Staging. Medscape Reference. Retrieved from: http://emedicine.medscape.com/article/280367-workup#aw2aab6b5b4. Accessed: 2/19/13.
  6. Department of Thoracic Surgery – Mesothelioma. Vanderbilt University. Retrieved from: http://www.mc.vanderbilt.edu/root/vumc.php?site=thoracic doc=3594. Accessed: 2/19/13.

About the Writer, Andrew Devine

Andrew Devine is a contributing writer for Mesothelioma Guide. He has developed an interest in educating patients and their families on everything from new treatments to what to expect after diagnosis.

Last Edited: February 9, 2017.

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Sarcomatoid Mesothelioma #sarcoma #mesothelioma


Sarcomatoid Mesothelioma

Mesothelioma is a rare and lethal cancer affecting the thin layer of tissue surrounding the internal organs. The World Health Organization classifies malignant mesothelioma into three types, based on cell structure and type:

The rarest form of the disease is sarcomatoid mesothelioma, and it affects from 10% to 20% of all patients.

Prognosis and Life Expectancy

Sarcomatoid mesothelioma isn’t just the rarest form of the disease; it’s also the most aggressive of the three types of mesothelioma, with the least favorable prognosis. Some research indicates patients live around 6 months after diagnosis.

In one study, only 30% of patients lived past 6 months; after a year, only 10% remained alive. On the other hand, the survival rate for epithelioid mesothelioma tends to run from 12 to 24 months.

Characteristics of Sarcomatoid Mesothelioma

Sarcomatoid mesothelioma is one of three subtypes of histological mesothelioma. Histopathology, the study of tissue and the changing characteristic of diseased cells, is instrumental in diagnosing various types of cancer, including mesothelioma.

There are several variants of sarcomatoid mesothelioma, most notably the desmoplastic and lymphohistiocytoid subtypes.

Sarcomatoid cells are named for their resemblance to the cells of a sarcoma, or a cancer that grows from connective tissue cells. The cells of sarcomatoid mesothelioma tend to be elongated and spindle-shaped and overlap each other. This means they resemble different soft tissue tumors, which can make it difficult to form a precise diagnosis. In turn, that can impede the rapid treatment of the disease.

Symptoms of Sarcomatoid Mesothelioma

The symptoms include the following:

  • Chest pains
  • Trouble breathing
  • Pleural effusion—fluid buildup
  • Pain when coughing
  • The appearance of subcutaneous lumps on the chest
  • Unexplained weight loss

Once an individual is exposed to asbestos, though, it can take anywhere from 20 to 50 years for symptoms of mesothelioma to finally appear.

Diagnosing the Disease

Diagnosis of mesothelioma can be performed a number of ways. An asbestos exposure history, if known, is considered diagnostically useful. Saliva and lung biopsy samples can be examined for a higher than normal concentration of asbestos fibers. Pleural effusion, which is the liquid that can form around diseased lungs, can be examined for signs of malignancy. A more invasive but highly accurate method is called thoracoscopy, which involves taking biopsy samples from the pleural cavity using an endoscope and then performing a number of definitive histological procedures on the sample. Other diagnostic assays may also be employed.

Since the cells tend to mirror those of other diseases such as pulmonary sarcomatoid carcinoma, immunohistochemistry data is imperative to distinguish sarcomatoid mesothelioma from other spindle-type cells and diseases. Sarcomatoid mesothelioma cells are keratin-positive, meaning that they will react to some antikeratin antibodies used during the staining of cell samples.

Treating the Disease

Treatment for sarcomatoid mesothelioma is similar to that of other forms of the disease. It consists of a combination of chemotherapy, surgery, and radiation. Since a diagnosis of mesothelioma typically occurs at Stage 3 or later, the goal of treatment is usually focused on prolonging patient survival and improving quality of life.

The incidence rate for mesothelioma in the U.S. was about 0.97 per 100,000 between 1973 and 1999. Between 2,000 and 3,000 new cases are reported each year.

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