Mesothelioma Facts: What the Elderly Need to Know
March 27, 2015 | by Lynda Neuenschwander, NCPC
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:
[1] nlm.nih.gov/medlineplus/mesothelioma.html
[2] webmd.com/lung-cancer/mesothelioma-directory
[3] webmd.com/drugs/condition-13394-Malignant+Mesothelioma+of+Pleura.aspx
[4] webmd.com/lung/mesothelioma-tests-diagnosis-and-treatments
[6] mesotheliomabook.com/us-veterans-compensation-benefits.html
[7] nature.com/bjc/journal/v99/n1/full/6604442a.html
[8] Book: How to Apply for Department of Veterans Affairs Benefits for Veterans and Their Survivors
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