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Slow to Develop, Mesothelioma Turns Aggressive

Network - Winter 2009


By Mary Brolley

A struggle to catch your breath. Pain in the front or back of the chest. A cough that won’t go away.

These may be the first signs of malignant pleural mesothelioma, a rare and deadly form of cancer caused by exposure to asbestos fibers. The initial exposure to asbestos leads to genetic changes that develop slowly and silently over several decades, which ultimately can lead to cancer. Once mesothelioma appears, it’s all business.

A cancer of the lining of the lungs, malignant pleural mesothelioma is relatively rare, striking about 3,000 new patients a year. Unfortunately, it’s often diagnosed in its later stages, leaving few effective treatment options beyond palliative measures. And its incidence is growing.

But a multidisciplinary team of physicians in the Mesothelioma Program at M. D. Anderson has made strides in developing the most accurate staging and the best treatments. They also are conducting research that may discover an eventual cure for this difficult disease.

Most people with malignant pleural mesothelioma were exposed to asbestos decades before developing the disease. Once diagnosed, for some patients the treatment is arduous — extensive surgery, radiation and chemotherapy.

Because of the disease’s aggressive nature, physicians who specialize in it believe it is essential for newly diagnosed patients to seek expert care immediately.

“Sometimes primary care physicians assume there’s nothing that can be done,” says Anne Tsao, M.D., assistant professor in the Department of Thoracic/Head and Neck Medical Oncology and director of the Mesothelioma Program. “But if we see patients early enough, there are a number of options, including surgery.”

Tsao wants to raise awareness of the disease and the importance of seeking the latest treatments once a diagnosis is made. To that end, the M. D. Anderson Mesothelioma Program includes more than 30 physicians who are all experts in their fields and in the disease.

An example of the team’s innovative approach is their development of a more thorough method of staging, assessing and describing the extent of the disease.

The extended surgical staging process developed by these physicians allows them to provide more precise information on how far the cancer has spread, eliminating unnecessary and ineffective treatment and better predicting who might benefit from surgery.

“We use the latest techniques all the way through the process from staging, to the most accurate radiation techniques, to running a variety of clinical trials,” she says.

Word is getting out about the need to seek expert care and treatment for mesothelioma immediately upon diagnosis, Tsao says. “We get new patients who were referred by patients we’ve already treated. When former patients learn that someone else has been diagnosed, they send them straight to us.”
Malignant pleural mesothelioma

What to know

Know your risk
Have you worked with or been exposed to asbestos, even many years ago? Get regular check-ups with your primary care doctor, who can help you monitor your health.

Seek expert care
If you are diagnosed with malignant pleural mesothelioma, find physicians in the field who specialize in this rare and deadly disease. For example, if surgery is an option, says Tsao, rather than a general surgeon, “You want a surgeon who does a lot of these operations — a thoracic oncologic surgeon, who is familiar with mesothelioma treatment.”

Participate in research, if appropriate
For a variety of reasons, malignant pleural mesothelioma has not been studied extensively. Much remains to be learned. An advantage to being treated in a comprehensive cancer center is that patients may be eligible to participate in promising clinical trials.


© 2014 The University of Texas MD Anderson Cancer Center