Mesothelioma is incurable, and is usually fatal within 12 months of diagnosis. Sufferers are advised to get their affairs in order as soon as possible, as decline in health occurs very rapidly in the late stages. Hospice referral should be organised immediately in order to alleviate the extreme pain, breathlessness, coughing and weakness which almost always occur.
Mesothelioma is an aggressive and incurable cancer that occurs on the outer surface of the lungs. It can also occur in the abdomen. It is caused by exposure to asbestos, usually from breathing in invisible fibres on a job where asbestos was used. The cancer starts as a weeping of the lung surface – causing pleural effusion – and then progresses to small nodules which eventually coalesce into a large thick sheet of growth which envelops and squeezes the lungs. This causes pain, breathlessness and weakness, to which sufferers then succumb. The time latency between breathing in the asbestos and the development of the disease is long – typically more than 20 years – but the risk is life-long, and increases with age. The more fibres one has breathed in and the longer the fibres stay in the lungs, the greater one’s risk. The lungs are unfortunately a cul-de-sac for these microscopic fibres and they cannot be cleared nor removed. The number of fibres required to initiate mesothelioma can be relatively low, so people who are environmentally or occasionally exposed to asbestos are also at risk. Mesothelioma is remarkably quite rare even in occupationally exposed groups, but it is devastating for the individual.
Early recognition as to the cause of the pleural effusion – differentiating it from other causes like TB – is key to good medical and palliative management. Surgery is generally advised for diagnosis only.
