What Is Mesothelioma?
Mesothelioma is a type of cancer that typically begins in certain cells that line the chest, heart, and abdominal cavities. The mesothelium (i.e., the lining) of the pleura, peritoneum, pericardium, and tunica vaginalis (the lining of the testicles) can develop cancerous tumors just like any other part of the body – similar to the lungs, skin, and blood.
Compared to other cancers, mesothelioma is rare in the United States. While only about 3,000 new people are diagnosed with the disease each year (many of whom are military veterans), the cancer is abnormally aggressive. Consequently, most patients are diagnosed at an advanced stage of the disease and cannot undergo curative treatments.
Types of Mesothelioma
Of all the diagnosed mesotheliomas, pleural (in the lining around the lungs) is the most common, making up over 75 percent of all diagnoses. Peritoneal is the second-most common and represents a majority of the residual diagnoses. Among all mesotheliomas, tunica vaginalis and pericardial (in the lining surrounding the heart) mesothelioma are especially rare.
Often, the rarity of the disease means many doctors are not familiar with it. Too, mesothelioma’s common respiratory symptoms (such as shortness of breath and cough) contribute to many early misdiagnoses.
|Type||% of Diagnoses||General Prognosis (compared to other types)|
|Epithelioid||More than 50%||Best outlook|
|Sarcomatoid||10% to 20%||Worst outlook|
|Biphasic (mix of both)||20% to 30%||Varies|
Who Is at Risk?
Between the 1970s and 1990s, diagnoses of the disease peaked. Most cases were so advanced that only palliative care was available to patients. The majority of these cases were caused by occupational exposure to asbestos decades before.
Due to the prevalence of carcinogenic exposure among certain career fields, certain groups have a notably higher risk of mesothelioma. To date, men are more likely to develop the disease than women in the U.S. Additionally, white and Latino Americans have been diagnosed more often than African and Asian Americans.
Due to a long latency period between the cancer’s initiation and the onset of symptoms, mesothelioma is most-commonly diagnosed in the elderly. For instance, the average age for patients receiving a pleural mesothelioma diagnosis is 72 years old.
Causes and Risk Factors
Asbestos exposure is considered the primary risk factor for causing the cell mutations that lead to mesothelioma. In fact, between 70 and 80 percent of patients have a history of interaction with asbestos products.
The use of asbestos in building materials was popular across America during the 19th century, exposing a wide range of workers – like those in construction, military personnel, and shipyards – to hazardous airborne toxins. Other occupations that have been linked to asbestos-related diseases include:
- Brake mechanics
- Demolition workers
- Home renovators
Doctors rely on a number of risk factors that an individual’s risk for mesothelioma. Approximately one percent of diagnosed patients inherited certain genetic factors that made them more likely to develop the cancer.
Factors like cigarette smoking can raise a person’s risk of cancer. Combined with asbestos exposure, smoking is a significant factor in developing the disease. Too, radiation exposure (such as the type of radiation received for cancer treatment) can cause mesotheliomas to develop in the body. However, researchers are still struggling to understand why.
Do Veterans Have a Higher Risk for Mesothelioma?
The U.S. military used asbestos extensively, especially in the Navy (putting Marines at risk, too) and on Army/Air Force and bases. Because it is durable and fireproof, the material was used to build ships, submarines, aircraft, transport vehicles, barracks, and mess halls. Consequently, many servicemen and women (as well as civilian staffers) were exposed to deadly asbestos dust and particles.
If you were exposed to asbestos while enlisted in the United States Armed Forces and have since developed mesothelioma or another asbestos-caused illness as a result, you could be eligible for veterans benefits through the Department of Veterans Affairs (VA).
Learn more about veterans, asbestos, and mesothelioma, including how to get help filing for VA benefits.
Initially, mesothelioma is often mistaken for diseases like lung cancer because they share a set of similar symptoms. Thus, early detection and diagnosis are vital for giving a patient an accurate diagnosis followed by focused, effective treatment.
Depending on the location of the tumors, symptoms vary.
Symptoms of pleural mesothelioma include:
- Chest pain
- Coughing (with pain)
- Difficulty swallowing
- Lumps under skin on chest
- Shortness of breath
- Unplanned weight loss
Symptoms of peritoneal mesothelioma include:
- Abdominal pain
- Loss of appetite
- Swelling in the gut
- Unplanned weight loss
Symptoms of tumors in the mesothelium of the tunica vaginalis include swelling or lumps on the testicles.
Signs that you may have other mesotheliomas are harder to detect, due to their rarity. Sometimes, the pericardial form is accompanied by chest pain and trouble breathing. Regrettably, this form is most often diagnosed during an autopsy.
Usually, diagnosing mesothelioma begins with a physical exam of your symptoms followed by other types of tests. Mesotheliomas might not be your doctor’s first assumption when examining your symptoms. As such, he or she may ask about your work history and any possible exposure to carcinogens.
Imaging tests (such as X-rays, CT scans, and MRIs) are often used to confirm the presence of tumors in the body. Before ordering a surgical test, your doctor may send you to radiology for imaging scans of your problem areas. However, while an imaging test can tell your doctor there are lumps or nodules in your body, it cannot confirm whether or not they’re cancerous.
Next, you’ll likely undergo a surgical biopsy of the area where your doctor suspects tumors are growing. Using a long, thin, and hollow needle, a doctor will remove a tiny amount of tissue to be analyzed in a laboratory. In the lab, they will inspect your cells with a microscope and look for signs of cancer.
Staging and Prognosis
When doctors first suspect a patient has cancer, they order a series of screening tests that typically include imaging tests and tissue biopsies. More complex versions of these tests are also commonly used to determine the patient’s stage of cancer. The stage of cancer helps determine the patient’s prognosis (i.e., the disease’s anticipated outcomes and spread).
Currently, only pleural mesothelioma has an official staging system – the Butchart system grades cancer from one (1) to four (4) based on the spread of tumors. Conversely, the Brigham systems stages cancer from one to four based on the spread via lymph nodes and how removable the tumors are.
First developed by the International Mesothelioma Interest Group, the TNM system (tumor-node-metastasis) measures the size of tumors, the involvement of lymph nodes, and how far the tumors have metastasized (i.e., spread throughout the body).
For other mesotheliomas, doctors may use the standard staging models approved by the American Joint Committee on Cancer (i.e., Stage I, Stage II, Stage III, Stage IV), though no official staging systems have been approved for peritoneal or pericardial forms. In general, stages I and II are considered “early-stage cancer” and stages III and IV are considered “advanced-stage cancer.”
Because most mesothelioma patients are diagnosed with an advanced stage, treatment for malignant mesotheliomas typically involves multiple types of cancer therapy. In most hospitals, the four most common types of treatment for the disease are chemotherapy, surgery, radiation, and targeted therapy.
In addition to these care methods, immunotherapy medications are being tested in clinical trials to help patients’ immune systems recognize and attack cancer cells.
Due to the aggressive nature of mesotheliomas, a significant majority of patients are only able to receive palliative, end-of-life care. Usually, these patients get altered versions of the same treatments as those diagnosed with earlier stages of the disease. For instance, chemotherapy may be used before or after surgery to shrink tumors too small for resection. But, it may also be used to shrink tumors blocking an airway that are too numerous to remove via surgery.
A cancer care team of doctors, nurses, and pharmacists will work together to coordinate the most effective treatment for each patient.
Finding Treatment for Veterans
Depending on where you live, you may have several options for cancer treatment as a veteran. Veterans Affairs (VA) offers healthcare benefits and ongoing medical care to all eligible prior servicemembers and their dependents. If you haven’t yet applied for medical benefits, you can do so through the Veterans Benefits Administration in person, online, or by mail.
VA hospitals are also located across the country – 1,255 Veterans Health Administration centers serve over 9 million vets each year. Anyone who is eligible to receive VA care can visit one of these centers for treatment. If your benefits allow, you may also be able to visit a primary care physician or hospital closer to your home.
The National Cancer Institute also maintains an up-to-date database of designated cancer treatment centers and ongoing clinical trials.
Financial Compensation for Victims and Families
If you’ve been diagnosed with mesothelioma, you were likely exposed to asbestos at some time in your life. Decades of occupational exposure litigation have revealed that companies knew about the dangers of asbestos. Yet, many neglected to protect their employees.
To compensate victims of asbestos exposure, asbestos trust funds have been established. An experienced mesothelioma attorney can help you decide which trust fund to apply to as well as help you file your claim. Additionally, a lawyer can guide you in deciding whether or not to file a personal injury (or wrongful death) lawsuit for financial compensation.
For more information about cancer care as well as legal options for compensation, read our free mesothelioma guide for veterans.
Support and Resources for Vets and Their Families
Being diagnosed with mesothelioma can come with many new worries and responsibilities. Veterans with mesothelioma may need emotional support, home caregiving, transportation assistance, and more. Below are a few mesothelioma resources available to veterans and their loved ones.
- American Cancer Society Patient Programs and Services – Free and low-cost resources to assist patients before, during, and after treatment.
- Cure Mesothelioma, Mesothelioma Pleural and Peritoneal Patient Support, Mesothelioma Caregiver Conversations and Support, Mesothelioma Loss Support Group – Facebook groups for mesothelioma support
- Lotsa Helping Handsand SignUpGenius – Organize caregiving tasks with friends and family.
- Veterans Assistance from the VFW (Veterans of Foreign Wars) – The VFW and its branches offer VA claims assistance, financial grants, and mental wellness programs.
Frequently Asked Questions
- How common is mesothelioma among veterans? About 3,300 new cases of mesothelioma are diagnosed in the U.S. each year. Among them, approximately a third are veterans of military service.
- Is mesothelioma curable? Currently, there are no cures for mesotheliomas growing in the body. Nonetheless, clinical trials continue to study potential curative treatments.
- If a veteran files a legal claim, are they suing the military or the VA? No. When a veteran or one of their dependents files a lawsuit, it is against the company (or companies) responsible for the manufacture of asbestos-containing products.
- Are veterans eligible for extra benefits if they’ve been diagnosed with mesothelioma? The VA may decide to increase your disability rating if you’ve been diagnosed with an asbestos-related disease connected to your military service. Speak with a VA representative to adjust your health and financial benefits.
- What should I do if I’ve been diagnosed with mesothelioma and am looking for victims’ compensation?After a mesothelioma diagnosis, determining the potential source of asbestos exposure is necessary in building a legal case for compensation. Speak with a mesothelioma attorney to identify the possible causes and companies responsible. A lawyer will also help you navigate legal timetables (such as state statute of limitations).