Mesothelioma Images, Diagrams, and Graphs

 A diagram outlining the effects of asbestos on the body. Click the image to enlarge.
 A diagram of the lung and its parts. Click the image to enlarge.
 A diagram of the lung showing the effects of pleural mesothelioma. Click the image to enlarge.
 A diagram of the abdomen showing where peritoneal mesothelioma occurs. Click the image to enlarge.
 A diagram of the heart showing where pericardial mesothelioma occurs. Click the image to enlarge.
 A chart showing malignant mesothelioma deaths. Click the image to enlarge.
 A chart showing pleural mesothelioma susceptibility. Click the image to enlarge.
 A chart showing mesothelioma survival rates. Click the image to enlarge.
 A chart showing the combined effects of smoking and asbestos exposure. Click the image to enlarge.
 An image of different types of malignant mesothelioma cells. Click the image to enlarge.
 An overview of how cancer spreads at the cellular level. Click the image to enlarge.
 A diagram of asbestos use in the home. Click the image to enlarge.
 A diagram of asbestos exposure areas in naval vessels. Click the image to enlarge.
 A diagram of asbestos use in automobiles. Click the image to enlarge.
 A chart showing the percentage of mesothelioma victims that are veterans. Click the image to enlarge.
 A chart showing mesothelioma deaths by state. Click the image to enlarge.

Issues Relating to Asbestos and Mesothelioma

A number of issues and topics relating to asbestos and mesothelioma are covered in this section. Since asbestos was mined and used in manufacturing worldwide, other countries outside the United States have also faced the burdens and consequences of asbestos use, particularly in Australia and the United Kingdom. Though mesothelioma disproportionally affects men due to occupational exposure, women are also affected by this cancer.
Mesothelioma is just one of the diseases caused by asbestos exposure. Another equally threatening asbestos-induced medical condition is known as asbestosis, a disease that affects the lungs. A number of asbestosis treatments are available, though there is no cure for this condition. Only asbestosis symptoms can currently be treated and the progression of the disease cannot be reversed.
In addition, there are other diseases related to asbestos exposure that are considered diseases in their own right, but can also be considered symptoms of more complex conditions (such as asbestosis or mesothelioma). Some of these related diseases include pleural plaques, COPD and interstitial lung disease.
For more information on these topics and others, browse through the Related Issues section to learn more about the other problems and concerns surrounding asbestos exposure and mesothelioma cancer

Mesothelioma Staging

For many decades, doctors have been addressing the seriousness of particular cancers in terms of stages. Throughout the years, various staging systems have been developed to assist cancer doctors in determining diagnosis and the best form of treatment for the individual patient.
There are three popular mesothelioma staging systems used to examine the extent of pleural mesothelioma. Since other forms of mesothelioma are even less common than the occurrence of pleural mesothelioma, there currently are no formal staging systems for other forms of this aggressive cancer (although they can be applied if desired). Each of the three different staging systems measure various factors of malignant mesothelioma, including the extent of the tumor (primary mass), the metastasis (spreading), and the involvement of the lymph nodes.
The knowledge of what particular stage a patient is in after they are diagnosed with mesothelioma greatly affects what treatment options are recommended by doctors. We offer a personalized comprehensive packet that details the various stages of mesothelioma and available treatment options and we can cater this information to meet a patient’s specific situation. Click here to receive your complimentary packet overnight.
Butchart System - Mesothelioma Staging Systems
The Butchart System is the oldest staging system for malignant mesothelioma and is the one most commonly used by doctors and specialists to diagnose and treat malignant mesothelioma. The Butchart System is based on the tumor size (mass) and divides malignant mesothelioma into four stages:
Stage 1 - Malignant mesothelioma has affected the right or left side of the chest cavity (pleural lining) and may be seen in the diaphragm.
Stage 2 - Malignant mesothelioma has been found in the pleura on both sides of the body and may have also moved into the heart, stomach, or esophagus on both sides. Lymph nodes may be affected.
Stage 3 - Malignant mesothelioma has reached the abdominal cavity (peritoneum). Lymph nodes past the chest may be affected.
Stage 4 - Malignant mesothelioma has reached other organs and has entered the blood stream.
TNM System - Mesothelioma Staging Systems
The TNM System is a more modern staging system for malignant mesothelioma. The TNM System is based on the extent of the tumor, metastasis, and lymph node involvement. Again, the TNM System divides malignant mesothelioma into four stages:
Stage 1 - Malignant mesothelioma is present in the left or right chest cavity (pleura) and may have metastasized to the lung, the sac around the heart (pericardium) or the diaphragm on the same side. Lymph nodes at stage 1 are not involved.
Stage 2 - Malignant mesothelioma has reached from one side of the chest cavity to a lymph node near the lung area on the same side as the cancer. The cancer has metastasized to the diaphragm, pericardium (sac around the heart), or the lung on the same side as the primary tumor.
Stage 3 - Malignant mesothelioma has penetrated the chest lining, heart, esophagus, muscle, ribs and vital organs within the chest cavity on the same side as the cancer. Lymph nodes may or may not be involved during this stage.
Stage 4 - Malignant mesothelioma has metastasized to the pleural area and the lymph nodes on the opposite side of where the cancerous tumor is located. It may also have reached the chest cavities or lungs on both sides, or may have spread to the abdomen.
Brigham System - Mesothelioma Staging Systems
The Brigham System is the most modern of the three malignant mesothelioma staging systems. The Brigham System looks at different variables such as the involvement of the lymph nodes and the surgical ability to remove a malignant mesothelioma tumor (respectability). For this reason, it is not often used to refer to mesothelioma stages, as the cancer is rarely operable. The Brigham System divides malignant mesothelioma into four stages:
Stage 1 - Malignant mesothelioma tumor is still resectable (able to be removed surgically) and the lymph nodes are not affected.
Stage 2 - Malignant mesothelioma tumor is still resectable, but the lymph nodes are now affected.
Stage 3 - Malignant mesothelioma tumor is not resectable and the malignant mesothelioma has penetrated the heart, chest wall, abdominal cavity or diaphragm. Lymph nodes may or may not be affected.
Stage 4 - Malignant mesothelioma tumor is not resectable and has completely metastasized (spread throughout the body).
Staging Malignant Mesothelioma
When mesothelioma is diagnosed by a physician or specialist, they must determine the extent of the cancer and how far it has spread. Most often, they will use imaging procedures to see inside the chest or abdomen to help determine the staging of the malignant mesothelioma. The imaging options physicians may use include:
Chest x-ray
CT scan of the chest and/or abdomen
MRI scan of the chest and/or abdomen
PET scan of the chest and/or abdomen
Once the doctor is able to determine the stage of the mesothelioma, they will be able to formulate a plan for treatment and provide a prognosis.
Mesothelioma Final Stages
Unfortunately, most cases are diagnosed in the final mesothelioma stages of cancer development. Due to the common late diagnosis of the disease, treatment options are often limited for many mesothelioma patients. Detecting mesothelioma at an earlier stage can open up more treatment options and can improve a patient's prognosis.
If you have been exposed to asbestos in the past it is important to seek regular health screenings and lung X-rays to test for signs of asbestos-related disease. Be sure to inform your doctor or health care provider of your asbestos exposure history.

Mesothelioma Biopsy

Mesothelioma is a very rare form of asbestos cancer that is most effectively treated when detected early. Unfortunately, the nature of the disease and the fact that it remains latent for decades usually results in detection after the cancer has spread to other parts of the body, making it extremely difficult to treat. Since the only proven cause of mesothelioma is exposure to asbestos, ongoing check-ups and testing after exposure make early detection a greater possibility.
One method used in the detection of mesothelioma is a surgical biopsy. There are a few different types of biopsies available for those who have developed mesothelioma.
First, a cancer doctor may surgically remove the tissue in question. With an incisional biopsy or a core biopsy, just a small part of the tissue is removed. This is common if the sample is in a location that makes it easy to collect.
However, in the case of mesothelioma, the cancerous cells develop in places that do not lend themselves to core biopsy, particularly the pleura, peritoneum, and pericardium. Rather than operating and removing just a small piece of the tissue in question, doctors are more likely to remove the entire effected area of a patient with mesothelioma. This is known as excisional biopsy.
Excisional biopsy naturally comes with greater risks. Surgery will be longer and more complicated and doctors may need to remove a significant portion of the sensitive linings surrounding major organs. However, it is much less risky to perform just one surgery than to operate twice if the cells prove to be cancerous.
The third type of diagnostic biopsy is called needle aspiration biopsy. In many cases, this is the technique most preferred by surgeons because it is a safe, quick procedure. Although most often used for tumors that are close to the skin's surface, needle aspiration biopsy (also called fine needle aspiration cytology or fine needle aspiration) can also be used to diagnose mesothelioma. Essentially, this technique uses a long, hollow needle to remove a sample of cells from the body to be tested and properly diagnosed.
After the cells are removed from the body in one of the three aforementioned procedures, experts analyze the cells to determine if mesothelioma is present. This work is done by a pathologist, a doctor that specializes in diagnosing diseases. The pathologist examines the cells under a microscope to determine the diagnosis. There are a number of techniques that can be used to diagnose the cells after biopsy, but in most cases the pathologist removes a very thin layer of tissue from the sample, places it on a microscope slide, adds dye to make cells more visible, and seals the slide so it can be examined under a microscope. A pathologist is trained to analyze abnormal cell growth, which can indicate mesothelioma as well as other diseases.
Biopsy also allows the oncologist to examine the possible spread of cancer to other parts of the body. When the tumors in the body are removed, the pathologist carefully examines the margins to see if cancer is present. "Negative margins" means the cancer has probably not spread; the appearance of "positive margins" means there is a good chance that doctors have not completely removed the cancer. Mesothelioma travels quickly, so if doctors are concerned about metastases, they will run additional tests that may include biopsies and x-rays on parts of the body that are commonly affected, such as the lymph nodes

Mesothelioma Life Expectancy

Doctors and researchers have attempted to improve the life expectancy of mesothelioma patients for decades. While there is no definitive cure available for mesothelioma, patients may choose to undergo treatment that may improve life expectancy and enhance their overall quality of life.
Life Expectancy Factors
Mesothelioma is a cancer most notably caused by asbestos exposure. The life expectancy of a mesothelioma patient may be impacted by a number of aspects, including latency period of symptoms, age at diagnosis, type of diagnosis and certain prognosis factors such as gender, histology and cigarette smoking.
Staging – Staging mesothelioma has demonstrated a significant impact on life expectancy.
Patients who have been diagnosed with Stage 1 mesothelioma (the earliest detection stage) may be a candidate for surgery to remove tumors. Prognosis at this stage can be very positive and the potential for a full recovery may be possible.
A Stage 2 diagnosis is considered an advanced stage because it often indicates the cancer has spread beyond its original point of origin. Surgery and other treatments may still be an option, but the projected life expectancy has decreased.
Stage 3 cases of mesothelioma are typically diagnosed after symptoms have arrived and the cancer has already progressed to an advanced stage of development. Palliative (non-curative) treatments to reduce symptoms may be considered during this stage.
At Stage 4, the cancer has spread to distant locations and the patient may be experiencing severe pain. Palliative treatments may be used to improve comfort, but the life expectancy of patients diagnosed during this stage has decreased significantly.
Age – The age of a patient at diagnosis can significantly compromise treatment options due to the presence of other health-related problems. Most reports indicate the average age of a mesothelioma patient is 60 years old. However, some researchers state the average age is dropping due to the influx of cases resulting from secondary exposure, which occurs when a friend or family member brings asbestos fibers into the home from an outside setting such as a workplace.  
Mesothelioma Diagnosis – There are two major types of mesothelioma. The most common type is pleural mesothelioma, which impacts the lining of the lungs. The other major type is peritoneal mesothelioma and this form affects the lining of the abdomen. A third type of mesothelioma is pericardial mesothelioma, which affects the lining of the heart and is very uncommon. In rare cases, a fourth type of mesothelioma known as testicular mesothelioma may develop. Depending on the location of the tumor, a patient may be able to undergo surgery and other treatments to prolong life expectancy.
Asbestos-Related Latency – The severe latency period associated with the onset of symptoms may result in a late diagnosis. When referencing mesothelioma, latency period is defined as the period of time between exposure to asbestos and the moment the cancer become noticeable. Mesothelioma patients diagnosed in the later stages of development will often receive treatment to ease pain and discomfort rather than try to cure the disease.
Gender – Males are predominantly affected by mesothelioma cancer in comparison to females largely because of the relationship of asbestos exposure in certain occupational settings. While most studies only involve a small number of female patients, the majority of data collected points to a better prognosis for females. The explanation for this is still unclear.
Histology – The histological subtype is one of the most important prognosis factors for malignant mesothelioma. Patients with epithelioid mesothelioma have a much better life expectancy than those with a sarcomatoid or biphasic (mixed) subtype.
Cigarette Smoking – Another prognostic factor that can impact life expectancy is smoking. Those who have been diagnosed with mesothelioma should stop smoking as treatment results may be affected. Mesothelioma patients who have never smoked often live longer than patients who have smoked previously in life.
In addition to these prognostic factors, the efficacy of treatment is important when considering impacts on life expectancy. Treatment is improving with research and new medical advancements, and this is having a positive impact on the five-year relative survival rate. The graph below represents the percent of patients reaching five-year survival according to their age at diagnosis.
5-Year Relative Survival (Percent) 1999-2006
Age at DiagnosisPatients Reaching 5-Year Survival (%)
< 4539.7%
45-5415.7%
55-647.5%
65-746.0%
75+2.7%
Source: SEER Cancer Incidence Report
Prolonging Life Expectancy
There are a number of options for patients to relieve symptoms and extend their life expectancy. Patients can elect to undergo treatment to combat the disease, remove the cancer or kill cancerous cells, reduce pain or manage metastasis. Some factors that may improve life expectancy include:
Second Medical Opinion – Mesothelioma is often misdiagnosed. Patients could be diagnosed with Stage 3 mesothelioma at one hospital, and then discover from a second opinion they truly have Stage 2 mesothelioma. This initial misdiagnosis could have a big impact on treatment options and life expectancy.
Traditional Treatment – Surgery, chemotherapy and radiation therapy are the three forms of traditional treatment currently available to extend life expectancy. Tests to diagnose mesothelioma in its earliest stage of development are also being explored to enhance the effectiveness of current traditional treatments.
Untraditional Treatment – Therapies such as immunotherapy, gene therapy, photodynamic therapy and hormonal therapy are a class of experimental treatments. These therapies have improved life expectancy in some patients, but are only available through clinical trials since they are still in an experimental stage of medical testing.
Clinical Trials – Mesothelioma researchers are testing new medications and treatment approaches through clinical trials with the hope of improving life expectancy. Clinical trials allow patients to take advantage of new treatments that may extend survival, but may also come with an element of risk. Several mesothelioma clinical trials are currently recruiting patients, such as:  
Pemetrexed (ALIMTA) Plus Cisplatin Followed by Surgery and Radiation Therapy for Mesothelioma
Video-Assisted Surgery or Talc Pleurodesis in Treating Patients with Malignant Mesothelioma
Extrapleural Pneumonectomy/Pleurectomy Decortication, IHOC Cisplatin and Gemcitabine with Amifostine and Sodium Thiosulfate Cytoprotection for Resectable Malignant Pleural Mesothelioma
Phase II Study of IMC-A12 in Patients with Mesothelioma Who Have Been Previously Treated with Chemotherapy
Alternative Treatment – A selection of mesothelioma patients have benefitted from alternative or complimentary therapies such as acupuncture, meditation, massage or yoga. These alternative therapies do not aim to cure the disease, but can reduce stress and pain and may improve quality of life.
Nutrition – A number of dietary changes can affect a cancer patient’s life expectancy. Considering nutrition in the treatment plan could have positive impacts on pain, stress levels and response to treatment. The Mesothelioma Center offers a complimentary nutrition book to mesothelioma patients looking to learn more about diet and cancer.
Immune System Enhancers – Researchers report that a boosted immune system may be a unifying factor among many mesothelioma survivors.
Patients who are searching for a second opinion or an experienced mesothelioma doctor can contact the Doctor Match department at the Mesothelioma Center to learn more about their options depending upon their unique diagnosis and location. To take advantage of this complimentary service, please call the Doctor Match department at (800) 549-0544.

Mesothelioma Immunohistochemistry

In general terms, immunohistochemistry (IHC) involves the process of locating proteins in tissue cells. The process uses staining to identify proteins, as well as the principle that antibodies bind to specific antigens in human tissue. Immunohistochemical staining is widely used in the diagnosis of cancerous cells and other abnormal cells. Mesothelioma immunohistochemistry is used to diagnose the histological type of a mesothelioma tumor, such as epithelial or sarcomatoid mesothelioma, which can effect treatment options.
Mesothelioma immunohistochemistry can be most useful in differentiating epithelial mesothelioma from other types of epithelial tumors. It has shown to be less effective for sarcomatoid mesotheliomas, but can be helpful when distinguishing sarcomatoid mesothelioma from sarcomatoid carcinoma.
Professionals in the field of mesothelioma note that immunohistochemistry data should be used in context with other diagnostic data. In other words, the results of a mesothelioma immunohistochemistry analysis should not be considered a primary indicator for a mesothelioma diagnosis. Contributing expert to the book Malignant Mesothelioma, Betta Peir-Giacomo, M.D. writes, "As for the capacity of IHC to provide possible clues to a more accurate diagnosis of MM (malignant mesothelioma), first it is necessary to underline that the contribution of IHC cannot be generalized, but differs in relation to each diagnostic setting, each with its own peculiar set of morphologic and immunophenotypic variables."
To learn more about the diagnostic process and treatment options available to mesothelioma patients, please fill out this form to receive an informative and complimentary packet in the mail.
Mesothelioma BerEP4
BerEP4 is a human antibody that can be expressed in epithelial cells. Antibodies, also known as "immunoglobulins," are specific proteins found in the blood which are used by the immune system to identify and neutralize foreign and unwanted objects, such as viruses and bacteria.
In the case of mesothelioma, BerEP4 has shown to be helpful in the diagnosis of epithelial mesotheliomas. However, immunohistochemists are still researching the efficacy of BerEP4 as a diagnostic indicator for mesothelioma, as this antibody has appeared both in mesotheliomas and other similar tumors. Thus, the presence or lack of BerEP4 does not always indicate a malignant mesothelioma
Mesothelioma Vimentin
Vimentin is a protein, more specifically a filament protein. Research has shown that vimentin proteins attach to the nucleus (and two other organelles) of a cell and help to anchor the position of the nucleus and other organelles.  The dynamic structure of vimentin is important to the flexibility of a cell and it is generally accepted that this protein is important to maintaining cell integrity.
Like the antibody BerEP4, vimentin has shown to help diagnose mesothelioma, but the protein also appears in other tumors aside from mesotheliomas. Because vimentin appears in mesotheliomas as well as other malignant tumors, it is not considered a discriminatory marker for mesothelioma, but rather a piece of the diagnostic puzzle

Mesothelioma Causes

Mesothelioma is a highly aggressive cancer that is difficult to both diagnose and treat. Between 2,000 and 3,000 cases of malignant mesothelioma are diagnosed each year in America, and these figures are projected to increase throughout the next decade.
A significant amount of research has been conducted on potential mesothelioma causes (also known as mesothelioma etiology) and scientific discoveries continue to help medical professionals further understand how this cancer develops.
In an effort to help patients understand the causes of mesothelioma, Asbestos.com offers a complimentary packet that contains treatment options and other helpful resources tailored to your specific diagnosis. The packet also covers the nation's top mesothelioma doctors and cancer centers, as well as financial assistance options to help cover medical costs. To receive your packet in the mail, please enter your information below.
 Name:Phone Number:Address:Email Address:City, State, Zip:Diagnosis: Select... Mesothelioma Lung Cancer Asbestosis Severe Asbestosis UnknownCountry:Comments: USA United Kingdom Canada Australia  
Causes of Mesothelioma Cancer
An overwhelming body of scientific and medical evidence has proven that the primary cause of malignant mesothelioma is exposure to asbestos. The exact method by which asbestos causes mesothelioma is still being researched, but medical professionals have a number of theories:
Asbestos causes irritation and inflammation of mesothelial cells, which results in irreversible scarring, cellular damage, and eventually cancer.
Asbestos fibers enter cells and disrupt the function of cellular structures that are essential for normal cell division, causing cellular changes that lead to cancer.
Asbestos causes the production of free radicals. These molecules damage DNA, and cause cells to mutate and become cancerous.
The presence of asbestos causes cells to produce oncoproteins. These molecules cause mesothelial cells to ignore normal cellular division restraints, and s can lead to the development of cancer.
The element that ties each theory together is the fact that asbestos results in cellular damage. This causes cells to lose control over normal cell cycles and results in uncontrollable division. Healthy cells follow cycles of cell division that ensure tissues do not grow and duplicate beyond normal conditions - in cancerous cells, these restraints are lost.
In cases of mesothelioma, the result of the cellular damage is that membranes in the affected location begin to thicken, and fluid builds up in the spaces between membrane layers. As cancer cells continue to divide and pile on top of one another, tumors begin to form. The uncontrolled division of cancer cells results in the impaired function of the body's organs and systems (primarily due to factors such as internal pressure caused by the growth of tumors, and the reduction of essential nutrients for organs), resulting in a number of symptoms.
For further information on available treatment options to reduce the severity of symptoms, please see the Mesothelioma Treatments page.
Additional Risk Factors
Other risk factors that may cause malignant mesothelioma include:
Radiation: Some mesothelioma patients with no traceable history of asbestos exposure do share a history of radiation exposure. Around 45 cases of mesothelioma following radiation therapy have been reported and discussed in medical literature.
Nonasbestos Mineral Fibers: A few nonasbestos mineral fibers have been linked to malignant mesothelioma, such as erionite and taconite.
Simian Virus 40: Originating in the rhesus monkey and contaminating millions of polio vaccines administered in the 1950s and ’60s, simian virus 40 has been linked to malignant mesothelioma and several other malignancies.
Additional risk factors that are not as well-researched in medical literature include chronic inflammation, chest injuries, genetics and organic chemicals.
It should be noted that cancer doctors and research scientists know that smoking does not cause mesothelioma, but it can aggravate other asbestos-related conditions (such as asbestosis) and compromises the body’s ability to fight the biological effects of asbestos fibers. Additionally, asbestos exposure and smoking has a synergistic affect that can increase a person's risk of developing lung cancer by as much as 84 times or more. For this reason, those who have been exposed to asbestos are highly advised not to smoke.
For those who would like to learn more, extensive information about mesothelioma and treatment options are available to patients and their family members by filling out this form or calling 800-615-2270 and speaking with an educated patient and family advocate