Mesothelioma in the United States

According to latest researches, 2,000 to 3,000 people are diagnosed with mesothelioma in US each year. What is more alarming is the news that this figure appears to be on the rise.
Mesothelioma is a very serious and deadly disease bringing widespread dangers to human lives. Caused by asbestos, it can cause a patient’s death within 16-18 months of its diagnosis. Another startling fact is that only 20% of the patients are known to survive 5 years after the diagnosis of the disease.

It has been found that men are 3 to 5 times more likely to have mesothelioma in US as compared to women. Most of the men who are diagnosed with this disease are 50 to 70 years old. The reason being that the symptoms of mesothelioma appear 20-50 years after the patient has been exposed to asbestos. These people might have been exposed to asbestos in their youth but it is in later years that mesothelioma is manifested.

Reasons for High Mesothelioma Rate in United States

Naturally occurring asbestos in US

One of the main reasons for large number of mesothelioma patients in US is the vast deposits of asbestos in various states. According to US Geological Survey (USGS) California, Georgia and Montana have large deposits of naturally occurring asbestos. Huge amount of vermiculite was mined in Libby, Montana which was highly contaminated with asbestos. Studies show that people who worked in the mine were exposed to dangerously high levels of asbestos.

However, this does not mean that other states of US are safe from mesothelioma and asbestos.

Asbestos shipments and processing plants in US

It was during 1948 and 1993 that thousand of tons of asbestos contaminated vermiculite was shipped from Montana to all over the US including Oregon, Hawaii, Alabama, North Dakota, Maryland, Massachusetts, Washington, Texas, Pennsylvania and other parts of the country.

All these states had processing plants where asbestos was exfoliated. When this exfoliation of vermiculite took place, large amounts of asbestos dust and particles were released and inhaled by millions of people which caused mesothelioma.

Lack of workplace safety in US caused mesothelioma

Another of the reasons for high mesothelioma cases in US is the lack of implementation of workplace safety standards and rules for workers. Asbestos was handled by the workers without any protective gear or masks which lead to asbestos inhalation. Millions of workers became victims of mesothelioma during this time. It was only in 1989 that its true dangers were realized. Thus, commercial use of asbestos was banned and workplace standards were enforced by EPA.

Use of asbestos in US naval ships

Oregon had the largest shipping industry where US naval ships were made. Also, it was during the World War II that asbestos was widely used in ships and workers of this industry were exposed to asbestos.

US naval ships also used asbestos in various applications. It was especially used in insulation, pipes and boilers from 1930’s to 1970’s. US Navy used asbestos products in ship construction, repair and overhaul. Numerous people worked in these industries and came in daily contact with asbestos. Many of the US naval veterans are now being diagnosed with mesothelioma as a result of their exposure to asbestos.

During the construction boom in US from 1960 to 1980, asbestos also was widely used in construction materials without any protective measures.

Asbestos materials could be found in various naval boats and Navy ships including:

Aircraft Carriers Airships Amphibious Ships Battleships Coast Guard vessels Cruisers Destroyers Destroyer Escorts and Frigates

Escort Aircraft Carriers Frigates Minesweepers Patrol Boats Steam Ships Submarines Tender Boats Torpedo Boats

Due to this, large number of US citizens became victims of mesothelioma, especially those working in asbestos related industries. Some of the naval ships are still said to have asbestos due to which a large number of people are still exposed to this white powder in form of debris from insulation.

US naval shipyards using asbestos

Some of the US naval shipyards where asbestos was found in large quantities are:

• Brooklyn Navy Yard (a.k.a. New York Navy Yard), Brooklyn, New York
• Charlestown Navy Yard (a.k.a. Boston Navy Yard), Boston, Massachusetts
• Mare Island Naval Shipyard (a.k.a. Mare Island Naval Station), California
• New London Shipyard (a.k.a. New London Naval Submarine Base), Groton, Connecticut
• Norfolk Naval Shipyard (a.k.a. Gosport Shipyard) Virginia
• Pearl Harbor Naval Shipyard, Hawaii
• Philadelphia Naval Shipyard (a.k.a. Philadelphia Naval Base), Philadelphia, Pennsylvania
• Portsmouth Naval Shipyard, Maine
• Puget Sound Naval Shipyard, Bremerton, Washington
• Washington Navy Yard, Washington, D.C

Materials which used asbestos in US

From the numerous naval records, it has been found that asbestos was used in a variety of materials related to shipyard, constructions and repairs. Some of the items which used asbestos are:

Instruments Meters Panel Insulating Materials Packing Material Prefabricated-Forms Tubes Cables Capacitors Paper-Dielectric Mixes Block Insulatio Pipe Covering Deck Covering Materials Adhesives Insulation Felts

Thermal Materials Gaskets Refractory Mortar Aggregate Mixtures Rods Valves Boilers Bonds Compounds Bedding Compounds Coatings Packing Assemblies Hydraulic Assemblies Grinder

Due to the numerous reasons mentioned above, it can be said that use of asbestos was carried out without any preventive measures in US. This lead to inhalation of asbestos by millions of Americans and thus caused mesothelioma. As it is after a latency period of 20-50 years that symptoms of mesothelioma appear, it is now that so many mesothelioma cases are being diagnosed in US.

Post 9/11 Mesothelioma Situation in the US

9/11 and Asbestos Exposure

The two towers of World Trade Center in New York City became the victim of terrorist attacks on September 11, 2001 a.k.a 9/11. The fall of twin towers led to the release of massive amounts of toxics which included tons of asbestos among other pollutants. Most of this asbestos came from the floor tiles and ceilings which had asbestos as their primary agent. It was discovered that during the construction of World Trade Center, a suspension of asbestos and cement was sprayed to make the building fireproof.

Due to this, large numbers of rescue workers as well as people living or working in the close by areas were exposed to this deadly mineral when they inhaled it. It took a long period of time for asbestos dust and particles to settle and by then numerous people had already inhaled it.

Research shows that there has been an increase in asbestos related diseases several years of the World Trade Center collapse. It was reported that symptoms like coughing, shortness of breath, wheezing and bronchial problems doubled in number after 9/11. These symptoms resemble those of asbestosis and mesothelioma, the malignant cancer caused by asbestos exposure.

Asbestos is a dangerous carcinogen as it causes a fatal cancer in human beings. As large number of people inhaled asbestos during the incident of 9/11, many are yet to be diagnosed with this malignant cancer. It may take up to several decades before the results of this harmful carcinogen are discovered.

Post 9/11 Mesothelioma Situation in the US

9/11 not only increased the risk of mesothelioma among New Yorkers, it endangered the lives of people living in other cities too. When the twin towers collapsed, it released tons of concrete, glass, jet fuel and other construction materiel which formed a toxic cloud in the city as well as in the near by cities. According to experts, the toxic debris from the fallen towers reached as far as two miles from ground zero (WTC site). It has also been acknowledged that lighter particles such as asbestos, traveled as far as Pennsylvania, exposing thousands of people to this toxin.

Due to this, people of Pennsylvania are also at risk for developing mesothelioma in the upcoming years due to asbestos inhalation. Asbestos particles are very light and invisible. They can stay airborne for a long time period and travel with air to far and wide areas. Thus, with this incident, mesothelioma risk in many cities of US has gone up.

Study Reports

After 9/11, a study was carried out to inspect the dust particles and debris of the World Trade Center by the United States Environmental Protection Agency (EPA). It was found that though the outdoor atmosphere in lower Manhattan preceding 9/11 contained asbestos, it was below industrial level and thus no action was taken. However, the controversy over the presence of asbestos in the air pervading the city of New York is no closer to an end.

According to the medical practitioners, unlimited exposure and inhalation of asbestos causes mesothelioma. However, due to long latency period of the disease; it may take up to 40 years for the symptoms of mesothelioma to appear. Even before 9/11, numerous mesothelioma cases were being reported due to asbestos processing plants and natural deposits of asbestos all over the US especially Georgia, Montana and California. The 9/11 incident further aggravated this situation as it led to the release of massive amounts of asbestos dust in New York and other US cities.

Mesothelioma Stages and Staging Systems

To keep a track of mesothelioma cancer, the extent of its spread and the size of tumor(s); mesothelioma has been divided into a few stages or staging systems. These mesothelioma staging systems keep a track of the development of cancer in the human body and also help in planning future treatments and the line of action for taking care of the mesothelioma patients.

An important aspect is that as pleural mesothelioma is the most common among all types of cancer and occurs frequently, these staging systems are devised to mark its stages.

The three established and recognized clinical staging systems for mesothelioma are:

• The Butchart System
• TNM Staging
• The Brigham System

Butchart Staging System

This staging system was used quiet frequently in the past. It is mainly based on the extent of primary tumor mass and divides mesothelioma into 4 stages depending upon the extent of tumor.

Stage I - In the first stage, mesothelioma is present in the right or left pleura or lining of the lungs. It can also include the lungs, pericardium or diaphragm on the same side.

Stage II – This stage marks the invasion of chest wall or esophagus, heart or pleura by mesothelioma cancer. In this stage, the lymph nodes in the chest may also become affected.

Stage III - By this stage, mesothelioma has penetrated through the diaphragm into the peritoneum, the lining of the abdominal cavity. In this stage, the lymph nodes beyond the chest may also become affected.

Stage IV – In this stage, there is evidence of distant metastases. This means the cancer might have spread to other organs of the body through blood.

TNM Staging System

Another recent staging system developed by International Mesothelioma Interest Group and adopted by the American Joint Committee on Cancer (AJCC) for mesothelioma staging is TNM staging system. T stands for tumor, N stands for spread to the lymph nodes and M is for metastasis. This system judges mesothelioma by the size of its tumor and its spread to other nearby organs.

In TNM staging, the information about tumor, lymph nodes and metastasis is staged in 4 steps. This staging system is more accurate than Butchart Staging System in diagnosing the extent of mesothelioma tumor.

Stage I – Mesothelioma has invaded either the right or left pleura lining the chest. In this stage it is restricted to only outer lining or at most a few spots. The lymph nodes are safe yet.

Stage II – Mesothelioma has now spread from the lining of the chest into the outer lining of the lung or the diaphragm or the lung itself.

Stage III - By this stage the cancer has spread to the first layer of the chest wall or the fatty part of the mediastinum – the cavity between the lungs that contains the heart, aorta, esophagus, trachea and thymus or a single spot in the chest wall, the outer covering of the heart or lymph nodes anywhere in the same side of chest.

Stage IV – This is the last stage when mesothelioma has spread into the chest wall, either muscles or ribs, through diaphragm, organs of mediastinum or spine, across the spine, other side of the chest, into the heart itself, nerves leading to arms, lymph nodes outside the chest or other organs through bloodstream.

The Brigham System

This is the latest mesothelioma staging system and works according to the resection or the surgical removal of the affected lymph nodes.

Stage I – In this stage the mesothelioma can be surgically removed as it has not yet spread to the lymph nodes

Stage II – Even though the cancer has spread to the lymph nodes, it can still be operated and removed

Stage III – In this stage, the tumor cannot be removed surgically as it has spread to the chest wall, heart, diaphragm and abdominal lining. The lymph nodes outside the chest may not necessarily be infected yet.

Stage IV – By this stage, mesothelioma has spread to other parts of the body and is in the final stages.

These three are the most commonly used clinical staging systems for mesothelioma. Aided by various medical tests and approaches, these staging systems check the advancement, size and spread of mesothelioma tumor or cancer in the human body. They help the doctors in diagnosing the patient’s stage of mesothelioma as well as planning the treatment and also preparing them for what to expect in the final stages.

Benign Mesothelioma

The word ‘benign’ in medical terminology means ‘not dangerous to health’. Benign mesothelioma is a rare form of mesothelioma cancer which is not considered as harmful as other forms of mesothelioma. Although caused by asbestos exposure, it is not as deadly as the mesothelioma cancer itself.

Thus, benign mesothelioma represents a type of disease, which even though is a rare form of mesothelioma, is not cancerous or does not result in death if treated on time. Benign mesothelioma occurs in the body either in form of cysts, tumors or plaques.

Important Information about Benign Mesothelioma

In most of the cases, benign form of mesothelioma is cystic or multicystic with one or more tumors in the body. It can occur in the peritoneum which is the thin membrane of mesothelium surrounding the organs in the abdomen. This peritoneum helps in smooth functioning of the abdominal organs. However, if a tumor is formed, it may cause some pain in the stomach and difficult bowel movements. In some of the cases, the benign mesothelioma also possesses the danger of turning into peritoneal mesothelioma if it progresses beyond limits.

Benign mesothelioma can also occur in the pleura which is the lining of the lungs. It may take the form of tumors in the lining of the lungs. However, if these tumors are not detected timely and taken care of, they may weigh down on the lungs causing breathing problems and other symptoms of pleural mesothelioma.

Symptoms of Benign Mesothelioma

Symptoms of benign mesothelioma are not easily recognized as they resemble those of other common problems and ailments. Some of the symptoms which occur in pleural or peritoneum benign mesothelioma are:

• Cough
• Chest pain
• Accumulation of fluid in the membranes in serious conditions
• Weight loss
• Difficulty in bowel movements
• Nausea
• Pain

Detecting Benign Mesothelioma

Detecting benign mesothelioma is not easy. It is only with help of tests and physical examinations that a benign tumor is detected. Chest or abdominal x-rays and CT scan can help in determining if a patient is suffering from benign mesothelioma.

In some cases, lung and abdominal biopsies can help in checking out the tumor. They can be used to establish the size and location of the tumor or cyst. In some cases, extensive electron microscopy and immuno-histochemical studies have been required to locate the extent of benign mesothelioma.

Treating Benign Mesothelioma

Surgery is the main treatment option for benign mesothelioma. With the help of surgery, tumor is removed from the cells, depending on the size and severity of the disease.

However, in some of the cases, hormonal therapy has also been carried out to control the size of cyst or tumor. It helps in reducing the size of cyst and alleviates pain too.

People suffering from benign mesothelioma have a good chance of recovery following prompt diagnosis and proper treatment. They can live a normal life as before. However, asbestos exposure should be avoided and proper tests should be carried out after every few months to make sure that the tumor has not recurred.