Mesothelioma Facts: What the
Elderly Need to Know
March 27,
2015 | by Lynda Neuenschwander
Why do you need to know about mesothelioma?
The
incidence of malignant pleural mesothelioma (MPM) in elderly patients is
increasing. Owing to the long latent period following asbestos exposure, MPM is
often diagnosed late in life. A high rate of diagnosis in elderly patients is
reported by several mesothelioma registers and epidemiological studies (Price and Ware, 2004; Marinaccio et al, 2005). The median age of
disease onset in the United States has been recently reported to be 74 years,
according to the Surveillance, Epidemiology, and End Results database (SEER Database, 2007). [7]
What is Mesothelioma?
The
tissue that lines your lungs, stomach, heart, and other organs is called
mesothelium. Mesothelioma is a tumor of that tissue. It usually starts in the
lungs, but can also start in the abdomen or other organs. [1] Most often,
mesothelioma occurs in the lining of the lungs, called the pleura. [4] It can
be benign (not cancer) or malignant (cancer.) Malignant mesothelioma is a rare
but serious type of cancer.
Causes of Mesothelioma
Most
people who get it have worked on jobs where they inhaled asbestos particles.
After being exposed to asbestos, it usually takes a long time for the disease
to form. [1] Other causes [of mesothelioma] include zeolites, radiation, and
more. [2] There are many veterans who are now in their elderly years, and
because they served in the military when asbestos was frequently used for many
of military materials, they are at a higher risk for contracting the disease of
mesothelioma.
Mesothelioma Among Veterans
Exposure
to asbestos is the No. 1 risk factor for mesothelioma. There are numerous ways in which a veteran may have been
exposed to asbestos while in the service of our country.
Navy - The most frequent asbestos exposures from any armed service
occurred in the Navy due to the need for fire resistance aboard Naval vessels.
Sleeping quarters, engine rooms, fire rooms, boiler rooms and insulated pipes
were just a few of the many sources of asbestos a Navy Veteran may have been
exposed to on a daily basis. The act of firing deck guns could cause a
shockwave to reverberate throughout asbestos insulation aboard ships which
released plumes of asbestos dust. Shipyard workers were also exposed to asbestos
in insulation for boilers, miles of steam pipes, incinerators and hot water
pipes. Gaskets, sealing compounds, packing for valves and even a hull of a ship
often contained asbestos for fireproofing. Virtually every ship commissioned by
the Navy between 1930 and 1970 contained asbestos or asbestos-containing
materials.
Army – There are dozens of military bases around the U.S. and
outside of the U.S. that have been proven to contain asbestos products. In
addition to asbestos flooring tiles, ceiling tiles, insulation, and cements
used in various army barracks, several trades in the army were frequently
exposed to asbestos including, auto mechanics, firefighters, masons,
carpenters, engineers, plumbers and electricians. A whole fleet of Army
vehicles from Jeeps to tanks contained asbestos. Many Veterans working in the
motor pool were exposed to asbestos containing brakes, clutches and gaskets. In
the late 1990’s, the Army spent over $1 billion dollars on asbestos removal at
32 different Army bases.
Air Force – Asbestos was used in aircraft components including engine
insulation, electrical insulation, brake pads and adhesives. Aircraft mechanics
would also have been exposed to asbestos through fire and heat retardant
insulation, heat shields, fire sleeves, and engine gaskets and clamps.
Marines – Similar to Army Veterans, Marines were exposed to asbestos in
their barracks as well as through various trades. As Marines often coordinated
with the Navy, they were likely to be exposed to asbestos aboard Naval ships.
Other possible sources of asbestos exposures for Marines include land
transports, airplanes and vehicles, and barracks exposure.
Proof of
asbestos exposure in the service is necessary for compensation claims involving
service connected disabilities. [6]
Agent Orange – Chronic Conditions, Service-Connected
with No Time Limit
Herbicides
were used in Vietnam to defoliate trees in order to remove cover for the enemy.
During the manufacturing process, significance amounts of harmful contaminants
called dioxins were produced. Different blends of herbicides were used but the
most common was one called "Agent Orange." Being on the ground in
Vietnam, during the war or on the inland waterways is sufficient for
presumption for service connection. Harmful exposure other than the automatic
"boots on the ground" for Vietnam is generally considered to be
inhalation and not topical.
Exposure
also occurred in Thailand, the demilitarized zone in Korea and presumably on
certain ships offshore from Vietnam (those proven to be in harbor). In
addition, numerous storage, spraying operations, testing and loading sites –
outside the country and inside the US – could have resulted in exposure.
Kaposi’s
sarcoma (or mesothelioma) is presumed by VA to be service-connected for Agent
Orange veterans. [8]
Symptoms of Mesothelioma
Trouble
breathing
Pain
under the rib cage
Pain,
swelling, or lumps in the abdomen
Weight
loss for no known reason [1].
Diagnosis of Mesothelioma
Sometimes
it is hard to tell the difference between malignant mesothelioma and lung
cancer. [A] doctor uses imaging tests and a biopsy to make the diagnosis.
Malignant mesothelioma is often found when it is advanced. This makes it harder
to treat. NIH: National Cancer Institute [1]
Because
mesothelioma is uncommon, it is often misdiagnosed initially. If you have
symptoms that suggest you might have mesothelioma, your doctor will likely take
a complete medical history to check for symptoms and possible risk factors,
especially asbestos exposure. Your doctor will also ask about your general
health and perform an exam to check for possible signs of mesothelioma. These
may include fluid in the chest cavity, abdomen, or pericardium (the thin
membrane around the heart). Depending on the findings of the exam, your doctor
may refer you for mesothelioma testing. [4]
Prognosis of Mesothelioma
Certain
factors affect mesothelioma prognosis as well as your options for mesothelioma
treatment. They include the following:
1. The
stage of the cancer, or the extent of cancer in the body. The stage is usually
based on the size of the tumor, whether there are cancer cells in the lymph
nodes, and whether cancer has spread beyond its original site.
2. The
size of the mesothelioma.
3.
Whether the mesothelioma can be removed completely by surgery.
4. The
amount of fluid in the chest or abdomen.
5. Your
age and general health.
6. The
type of mesothelioma cells.
7.
Whether cancer has just been diagnosed or has already been treated and come
back. [4]
Treatments for Mesothelioma
Three
standard types of treatment are used: surgery, radiation, and
chemotherapy. Treating mesothelioma often involves a combination of two
or all three.
Surgery. The four main
surgeries used in mesothelioma treatment are:
Wide
local excision, which removes the cancer along with some of the healthy
surrounding tissue.
Pleurectomy
and decortication, in which the surgeon removes part of the covering of the
lungs, chest lining, and outside surface of the lungs.
Extrapleural
pneumonectomy, which involves removing one whole lung and part of the lining of
the chest, the diaphragm, and lining of the sac around the heart.
Pleurodesis,
which involves using chemical or drugs to make the lung lining scar and stick
to the lung. The scarring stops the buildup of fluid.
Radiation Therapy. This type of
cancer treatment uses high-energy X-rays and other types of radiation to kill
mesothelioma cells or keep them from growing. Radiation may be administered
externally or internally. External radiation therapy uses a machine outside the
body to send radiation toward the cancer. Internal radiation uses a radioactive
substance sealed in needles, seeds, wires, or catheters that are placed
directly into the area near the mesothelioma.
Mesothelioma Medications (WebMD). Chemotherapy is a cancer treatment that uses drugs to
stop the growth of mesothelioma cells, either by killing the cells or by
stopping them from dividing. Chemotherapy can be given by mouth, injected into
a vein or muscle to enter the bloodstream and reach mesothelioma cells
throughout the body, or it can be placed directly into the affected area of the
body to mainly affect mesothelioma cells in that area. Sometimes doctors use
more than one chemotherapy drug. This is called combination chemotherapy.
Sources:
[8] Book:
How to Apply for Department of Veterans Affairs Benefits
for Senior Veterans and Their Survivors
