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Treatment Options

Treating cancers like mesothelioma that form deep within the body remains one of the most difficult challenges for medical science.  However, for those who have been diagnosed with mesothelioma, existing treatments can make a difference in prognosis and quality of life.

Mesothelioma treatments have two main goals: Curing the cancer, and reducing pain and other symptoms.  Which of these goals doctors will focus on depends on how early it is diagnosed. If the cancer is caught at a relatively early stage, it is likely that doctors will act aggressively to purge it from the body.  This is often accomplished by combining the three major types of treatment: surgery, radiation and chemotherapy.

Chemotherapy is a type of drug that attacks any rapidly dividing cell in the body.  Since cancer cells divide rapidly, this has the effect of shrinking tumors, but it also attacks healthy cells that divide fast (like hair follicles), causing unpleasant side effects. The drugs can be taken as a pill, or injected into the area where the cancer is spreading.  Chemotherapy by itself will not cause cancer to go into remission, but can increase longevity and reduce symptoms.

Radiation is another treatment designed to shrink tumors by killing cells.  In radiology, a high-energy beam is aimed at the tumor—the exact size, shape and location of the beam is designed by a radiologist to target the tumor and spare healthy tissue. Beams are aimed from multiple directions to target the disease in three dimensions. Radiation treatment is fast and does not hurt, but must be repeated multiple times a week for a period of weeks.
Surgery is a more risky option with a chance of removing the cancer altogether. 

The most extreme type of curative surgery is extrapleural pneumonectomy, in which a cancerous lung is removed along with nearby tissues such as heart lining, chest lining and lymph nodes.  This treatment allows patients to go back to living a normal life, and has some chance of stopping recurrence. A less drastic option is pneumonectomy, removal of an entire lung.  Finally, a pleurectomy is a removal of just the lining of the lung (usually performed along with decortication, removal of other tumors in the chest cavity).  

A goal of these surgeries is to remove as much of the tumor masses as possible; the fewer cancer cells are left, the less likely they are to spread, and the more likely it is that the cancer will go into remission. However, these surgeries may be done without the hope of cure, to improve symptoms and quality of life.  Doctors may also perform surgeries designed to address symptoms, such as by inserting a tube into the chest cavity to remove fluid buildup.

Whether aggressive treatment will be effective depends on a patient’s overall health and on how extensively the tumors have spread. For patients in the later stages, doctors may focus on shrinking the tumors to reduce symptoms.  Patients who have not responded to existing treatments may be eligible to participate in a clinical trial of experimental treatments.  Finally, alternative treatment like acupuncture and meditation can help sufferers cope with the pain and anxiety caused by the disease.

What is Asbestos

Asbestos is a naturally occurring substance; however, the term does not actually refer to a specific mineral.  Rather, it is a commercial term that describes a specific form in which a variety of minerals can appear. A mineral that comes in the form of long, thin, flexible fibers bundled together is said to be asbestiform.  Many such substances exist in nature. Since all these asbestiform minerals have similar properties, including resistance to fire and heat, they are all known by the same term.

The six most common types are chrysotile, amosite, crocidolite, tremolite, anthophyllite and actinolite. All of these minerals are classed as ”serpentine” or “amphibole” by mineralogists. They are essentially a type of very soft metamorphic rock.
Chrysotile is the most common form of asbestos, accounting for up to 95 percent of commercial applications around the world.  It is the only form that comes from the serpentine family, and is also known as white asbestos. Studies have shown that it is slightly less dangerous than the other forms, but it is still a powerful carcinogen. It is still legal even in areas where the other types have been banned, a result of industry lobbying.
The other five types are in the amphibole group and are slightly physically different because their fibers are straight, not curly. Amosite, or brown asbestos, is very strong and heat resistant; it is found in natural deposits in South Africa. Crocidolite, or blue asbestos, may be the most dangerous and able to cause cancer with the lowest levels of exposure. It is less heat-resistant than the other types. It was once mined in Africa and Australia, but mining of the mineral is now very rare. Researchers estimate that almost 20 percent of crocidolite miners died of mesothelioma.

Tremolite, anthophyllite and actinolite are much less common, but basically similar to the more common forms.

Although these minerals have had commercial applications, any mineral with the same physical properties would have the same dangerous health effects.  One example is erionite, a zeolite mineral that develops from volcanic ash. Although no commercial use has ever been found for it, in areas where it has been dug up, for instance as part of gravel mining, it has caused mesothelioma.  This has occurred in Turkey and in North Dakota.
If a person knows they have been exposed to asbestos (or to a mineral like erionite), it does not matter what variety it was.  What makes a difference is the form the fibers were in: For instance, spending time in a building with large sheets of asbestos insulation is much more dangerous than if the asbestos is mixed into concrete used to build a wall.  The most dangerous form of all is asbestos that has become brittle or damaged, since this allows more fibers to escape into the air.

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