Frequently Asked Questions

Strong efforts are made to ensure the safety of persons participating in mesothelioma clinical trials; however, some risks are still present. As with all prospective mesothelioma treatments, discuss your risks with your physician before you decide to participate in one.

Before you commence a mesothelioma clinical trial, you will be required to sign an informed consent or agreement form. By signing this, you are admitting that a healthcare professional has explained the risks and benefits associated with the mesothelioma treatment that is going to be applied on you, and that you have agreed to these formalities. The consent and agreement form is a way to make sure you know of the benefits or the risks involved with carrying out such an activity.

Finding out about ongoing mesothelioma clinical trials by calling 1-800-933-2244

You should also be able to obtain information from the doctor treating you for mesothelioma.

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Standard mesothelioma treatments have not proven very effective, so there may be benefits to trying something new.

You may not qualify for certain standard mesothelioma treatments, such as surgery, because of your health condition or any other hazardous factor, but there may be new treatment methods that you can take advantage of by participating in a clinical trial.

If you participate in a clinical trial part of the cost of your mesothelioma treatment may be free of charge.

During the trials, doctors and nurses will monitor your health closely, for side effects and fluctuations in your health conditions.

You might get personal satisfaction if you go for a mesothelioma clinical trial. You will feel good about the fact that you are helping to advance mesothelioma treatments, and helping health professionals find a cure for this cancer.

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A mesothelioma clinical trial is a research study used to evaluate a treatment for sufficiency or capacity and safety. It usually involves an unusual approach to treatment, and is conducted by a university or a college hospital.

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Pleural mesothelioma, pleura mesothelioma, or malignant pleural mesothelioma is mesothelioma cancer in the lining of the lungs. This is different from lung cancer, which refers to any type of malignant tumor that originates in the lungs.

The pleura, is the tissue lining or covering that surrounds the lungs. There are two pleura. These can be called pleural membranes. The gap between them is called the pleural space. The pleura are fibrous sheets. They help to protect the lungs. They produce a lubricating fluid that fills the gap between the two pleura. This helps the lungs to move smoothly in the chest when they are inflating and deflating as we breathe.

Pleural mesothelioma is the most common form of mesothelioma accounting for 80-90% of mesothelioma cases.

In general, the clinical presentation of pleural mesothelioma may include the following:

1. Cough
2. Shortness of breath, difficulty breathing
3. Difficulty sleeping
4. Pain in the chest and abdominal regions, which is generally unresponsive to analgesics
5. Progressive loss of appetite and weight loss
6. Pleural effusions (fluid in the chest cavity)

Management of pleural mesothelioma depends largely on the staging of the tumor. Early diagnosis and surgical intervention may lengthen life expectancy. However, surgery may not be a viable option depending on the age and physical condition of the patient. In addition to surgical options, radiation treatment and chemotherapy may be helpful in the overall therapeutic program for treating pleural mesothelioma. Pain management and home care are typical alternatives in the later stages of pleural mesothelioma.

Pleural mesothelioma is of two kinds: (1) diffuse and malignant (cancerous), and (2) localized and benign (non-cancerous.)

Benign pleural mesothelioma can often be removed surgically, is generally not life-threatening, and are not usually related to asbestos exposure. Malignant pleural mesothelioma, however, is very serious. Fortunately, they are rare—about two thousand people are diagnosed with pleural mesothelioma in the U.S. each year.

The remainder of this section focuses on diffuse malignant pleural mesothelioma.

Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs. Its only known cause in the U.S. is previous exposure to asbestos fibers, including chrysotile, amosite, or crocidolite. This exposure is likely to have happened twenty or more years before the disease becomes evident, since it takes many years for the disease to "incubate." It is the most common type of mesothelioma, accounting for about 75% of all cases.

Pleural mesothelioma is sometimes diagnosed by coincidence, before there are any symptoms. For instance, tumors have been discovered through routine chest x-rays. However, when symptoms occur, they may include shortness of breath, weakness, weight loss, loss of appetite, chest pains, lower back pains, persistent coughing, or difficulty in swallowing. An initial medical examination often shows a pleural effusion, which is an accumulation of fluid in the pleural space—the area between the lungs and the chest wall.

The first step in detecting pleural mesothelioma is, typically, a chest x-ray or CT scan. This is often followed by a bronchoscopy, using a viewing scope to look inside the lungs.

The actual diagnosis usually requires obtaining a piece of tissue through a biopsy. This can be done with a needle biopsy, an open biopsy, or through a tube with a camera (thoracoscopy or chest scope.) If an abnormality is seen through the camera then a tissue sample can be taken at the same time, using the same tube. This is a hospital procedure that requires anesthesia, but is not usually painful. A pathologist then tests the tissue sample.

Fluid build-up from the pleural effusion can generally be seen on a chest x-ray and heard during a physical examination, but a firm diagnosis of pleural mesothelioma can only be made through a biopsy and pathological testing. This is important because there are also benign pleural effusions and other tumors that have a similar appearance to pleural mesothelioma. Diagnosing pleural mesothelioma can be quite difficult; it requires special lab stains, and much experience in understanding them.

The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle. With the lungs restricted, they get smaller and less functional, and breathing becomes more difficult. At first a person with pleural mesothelioma may be breathless only when he or she exercises, but as lung function drops, he or she can become short of breath even while resting.

The tumor spreads by direct invasion of surrounding tissue. As it spreads inward it can compress the lungs. As the tumor spreads outward it can invade the chest wall and ribs, and this can be extremely painful.

Current medical science does not know exactly how and why, at a cellular level, asbestos fibers cause mesothelial cells to become abnormal (malignant or cancerous). Thus it is not known whether only one fiber causes the tumor or whether it takes many fibers. It seems that asbestos fibers in the pleura can start a tumor as well as promote its growth; the tumor does not depend on any other processes for its development.

There is as yet no known cure for malignant pleural mesothelioma. The prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment. Many clients live for five to ten years after diagnosis, most of them in good health for a majority of those years; however, some pleural mesothelioma victims succumb within a few months. The average survival time is about a year.

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Pericardial mesothelioma is the most infrequent form of this rare asbestos-linked cancer. Individuals with pericardial mesothelioma have cancerous growths in tissues surrounding the heart. Due to the rarity of this cancer, pericardial mesothelioma has not been definitely associated with asbestos exposure, although strong links between asbestos and pericardial mesothelioma have been made.

The early symptoms indicating pericardial mesothelioma include chest pain, dyspnea, cough, and palpitations. Patients displaying the symptoms of pericardial mesothelioma are usually given either an X-Ray or a CT scan to look for evidence of pericardial mesothelioma. If there are growths or abnormalities in the tissue around the heart, doctors may attempt to diagnose pericardial mesothelioma through biopsy surgery. Once a thorough assessment of the situation has been made, the pericardial mesothelioma patient and the doctor will discuss possible treatment options; including whether to attempt to defeat the pericardial mesothelioma or just to improve the patient’s quality of life for the time remaining. Decisions about pericardial mesothelioma usually involve consideration of the patient’s age and condition, the stage to which the pericardial mesothelioma has advanced, the tumor size, and location. Most patients are in advanced stages of pericardial mesothelioma at the time of diagnosis and therefore choose to have surgery to address the discomfort.

While pericardial mesothelioma has not been definitively linked to asbestos exposure, the indications are strong that pericardial mesothelioma is related to asbestos, as are the other forms of mesothelioma. Patients with pericardial mesothelioma may be eligible to recover medical fees and other costs associated with pericardial mesothelioma from parties proven responsible for asbestos exposure.

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Peritoneal mesothelioma is a form of cancer caused mainly by exposure to asbestos. Asbestos workers have been experiencing deadly health conditions like peritoneal mesothelioma for years. Asbestos companies have known dangers like peritoneal mesothelioma can occur but continued to expose workers to the dangers.

Peritoneal mesothelioma occurs in the abdomen membrane. There are few treatments for peritoneal mesothelioma that are effective. The chances for successfully battling the peritoneal mesothelioma will depend on the stage it is in. Patients with peritoneal mesothelioma may be eligible to recover medical fees and other costs associated with peritoneal mesothelioma from parties proven responsible for asbestos exposure.

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One study estimated that 3,000 different types of commercial products contained asbestos. The amount of asbestos in each product varied from as little as one percent to as much as 100 percent. Many older plastics, paper products, brake linings, floor tiles, and textile products contain asbestos, as do many heavy industrial products such as sealants, cement pipe, cement sheets, and insulation. The final Asbestos Ban and Phaseout Rule prohibits the manufacture, processing, and importation of most asbestos products.

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Individuals who have been exposed (or suspect they have been exposed) to asbestos fibers on the job or at home via a family contact should inform their physician of their exposure history and any symptoms. Asbestos fibers can be measured in urine, feces, mucus, or material rinsed out of the lungs. A thorough physical examination, including a chest x-ray and lung function tests, may be recommended. It is important to note that chest x-rays cannot detect asbestos fibers in the lungs, but they can help identify any lung changes resulting from asbestos exposure. Interpretation of the chest x-ray may require the help of a specialist who is experienced in reading x-rays for asbestos-related diseases. Other tests also may be necessary.

If any of the below symptoms develop, a physical examination should be scheduled without delay:

1. Significant weight loss
2. Pain in the chest or abdomen
3. Shortness of breath
4. Difficulty in swallowing or prolonged hoarseness
5. A cough or a change in cough pattern
6. Blood in the sputum (fluid) coughed up from the lungs

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Exposure to asbestos may increase the risk of several serious diseases:

* Asbestosis—a chronic lung ailment that can produce shortness of breath, coughing, and permanent lung damage
* Lung cancer
* Mesothelioma—a relatively rare cancer of the thin membranes that line the chest and abdomen
* Other cancers, such as those of the larynx, oropharynx, gastrointestinal tract, and kidney.

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The only known cause of mesothelioma in the U.S. is previous exposure to asbestos fibers. Asbestos manufacturers knew about the hazards of asbestos seventy years ago—but they kept this knowledge to themselves. The first warnings to workers exposed to asbestos were given in the mid-1960s, and they were terribly inadequate. Even today, workers are not always told they are working around asbestos and are therefore at risk for asbestos disease.

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