My name’s Sanjay Popat, I’m a consultant medical oncologist at the Royal Marsden Hospital.
Mesothelioma is a cancer of a membrane that lines various organs in the body called the
mesothelium. Now the mesothelium is found in various places,
mainly in the chest and also in the abdomen, or tummy.
The majority of cases that we see as doctors are actually plural mesothelioma. So these
are cancers of the lining of the lung. Usually this tumour is really quite silent
and it is very difficult to pick it up at a very early stage
because it grows silently within the chest cavity.
When patients become unwell and they seek medical input it’s usually because they’re
feeling short of breath, they’re not able to do things with as much
capacity as they could before - Going uphill, walking up the stairs,
or even just resting and talking to people is becoming more difficult because of breathlessness.
Other symptoms that patients can have, other than breathlessness, is weight loss.
In fact weight loss without trying to diet is generally indicative of underlying problems
such as cancer, and should be investigated further.
Mesothelioma is predominantly seen in patients that have been exposed to asbestos.
Nearly 8 or 9 out of 10 patients with a diagnosis of mesothelioma
report that they have worked either in an industry which has had asbestos associated
with it or have known to have been exposed to asbestos
in the past. Smoking by itself doesn’t cause mesothelioma,
but patients that have known that they’ve been exposed to asbestos should not smoke.
They should give up smoking if they do because that massively increases the risk
of lung cancer because the airways become more damaged because
of the smoke. And often there can be a long lag period between
asbestos exposure and the cancer forming. The average lag period that we see is anywhere
between 15 to 60 years, with most patients having a lag period around
40 years or so. Some patients who have cared for patients
who have been exposed to asbestos and then developed mesothelioma might be at
increased risk. This is generally the typical setting of the
wife of a man that has worked in the construction industry
who has potentially brought his overalls or work shoes or work cap home to be cleaned
and the asbestos fibres from such materials can then be in the home environment.
The one thing to emphasise is that mesothelioma does not seem to be hereditary, so you can’t
inherit that from your parents. Neither is it infectious, you can’t catch
mesothelioma from another patient that has mesothelioma.
There are a number of tests that doctors do to make a diagnosis of mesothelioma.
Usually a GP will do an examination, will listen to the chest to see whether there is
any fluid present or not and then arrange for a chest x-ray to be performed.
The mainstay of treatment of mesothelioma is generally with chemotherapy.
The aim of this is very much to improve the quality of life of our patients.
There’s very good evidence that this can potentially in some patients shrink the cancer
and also keep the cancer under control for longer than it would do otherwise,
and sometimes that can improve length of life as well.
Other treatments that can be considered include radiotherapy
and that can be useful in very specific cases, either to prevent cancer from growing along
biopsy sites, or to target a specific area that might be
causing pain or discomfort. We’re expecting more cases of mesothelioma
over the next few years because of the lag phase between asbestos exposure
and the disease becoming clinically manifest. If patients have known they’ve been exposed
to asbestos it’s worth them just touching base with their GP
so they can just have a general assessment to make sure they’re okay.