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Malignant mesothelioma is often called a silent killer because of the challenge that medical experts routinely encounter in diagnosing it. The key to understanding this diagnostic difficulty lies with both its notoriously ambiguous symptomology and its unusually long latency period.
The chief cause of malignant mesothelioma cancer is exposure to asbestos, usually through inhalation. It is estimated that approximately eight million Americans have been exposed to asbestos over the past 50 years as a result of their occupations.
Who is at the Most Risk of Developing Malignant Mesothelioma Cancer?
Asbestos exposure happens to workers that have experienced a substantial risk for developing mesothelioma cancer. Malignant mesothelioma cancer has a latency period of approximately 30 to 40 years between exposure to asbestos and the development of the disease.
Three thousand Americans are diagnosed with malignant mesothelioma each year. Of those diagnosed, the vast majority of cases are not caught until they are already in the late stages of the illness. What this essentially means is that most people afflicted by mesothelioma cancer are slowly being overcome by the illness without having any idea about what is happening inside of them—hence the ominous moniker.
This is largely attributed to the highly ambiguous nature of early-stage mesothelioma symptoms. Most seemingly healthy people, not having any suspicion they are at risk for developing a rare and terminal form of cancer, will pay little attention to the apparently benign symptoms of mesothelioma. These early warning signs are easily confused with symptoms related to common and relatively non-worrisome conditions like the common cold and even seasonal allergies, often called hay fever.
In a study titled Latency of asbestos disease among insulation workers in the United States and Canada, published December 15, 1980, in the journal Cancer, researchers examined 2,271 recorded deaths among 17,800 asbestos insulation workers from January 1, 1967, to December 31, 1976. They observed that:
“In general, though, the period of clinical latency was 2-4 decades or more and there were important differences among the several asbestos-associated diseases. Lung cancer peaked at about 30-35 years from onset and asbestosis at 40-45 years. Each tended to decline in incidence afterwards. Pleural and peritoneal mesothelioma reached their highest incidence later than lung cancer, but the incidence did not decline.”
Symptoms and Diagnosis of Malignant Mesothelioma
Symptoms frequently exhibited by first-stage malignant mesothelioma, which is still contained locally in a single affected organ, include coughing and wheezing, as well as a persistently hoarse voice. Fatigue is also quite common, as are mild to moderate chest pains.
Even seeking the evaluation of a physician is often ineffective in distinguishing these early symptoms unless that physician has knowledge of the patient’s full history—namely, the presence of past exposure to asbestos. Ninety percent of malignant mesothelioma cases are attributable directly to that cause, but if either the patient or doctor or both are unaware of such past exposure, the likelihood of considering mesothelioma as a diagnostic possibility is slim.
Oftentimes, patients do not know they have been exposed to asbestos in the past. Other times, this exposure is simply not on their radar because such a significant period of time has elapsed since it occurred.
Mesothelioma usually takes anywhere from 30 to 50 years to fully develop, which means people who were exposed half a century ago are routinely being diagnosed now. The long time period of the primary cause behind malignant mesothelioma constitutes perhaps its most dangerous characteristic of all.
By the time most cases of mesothelioma have been detected and treatment can begin, it is too late for that treatment to have much chance of effectiveness. This is because second- and third-stage mesothelioma have spread beyond the initially affected organ, either to the lymph nodes or beyond, into other organs. In such a scenario, traditional treatment methods like surgery and chemotherapy are unlikely to be effective in eradicating the cancer cells—resulting in an extremely high ratio of mesothelioma patients who expire within one to two years after being diagnosed.
Does the Level of Exposure Affect the Risk of Developing Malignant Mesothelioma Cancer?
There is what is referred to in medicine as a dose-response relationship between asbestos exposure and the development of the disease, meaning the greater the exposure to asbestos, the higher the risk of developing mesothelioma cancer.
In a study titled Environmental exposure to crocidolite and mesothelioma: exposure-response relationships, published January 1, 1998, in the American Journal of Respiratory and Critical Care Medicine, researchers tracked the location of the 4,659 residents of Wittenoom, Western Australia who lived there between 1943 and 1993 for at least 1 month and who were not directly employed in the crocidolite industry.
All of those who were found were sent a questionnaire. Their asbestos exposure levels were estimated from the results of environmental surveys and their duration of residence. By the end of 1993, the researchers identified 27 diagnosed cases of mesothelioma. These former residents of Wittenoom, had lived there for a longer period of time than those who didn’t develop mesothelioma, had a higher intensity of exposure, and a higher overall exposure to crocidolite, leading researchers to conclude that there is a greatly increased risk of mesothelioma cancer, which is dose-dependent.
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