Mesothelioma

Mesothelium is the name for the tissue that lines your lungs, stomach, heart and other organs. Rarely, a tumour can grow from this tissue, in which case it is called a mesothelioma.

Such tumours can be benign (not cancer) or malignant (cancer). Most times such tumours start in the lungs, but can also start in the abdomen or other organs.

What causes mesothelioma?

Most (about 70–80%) of people who get mesothelioma have been exposed to airborne asbestos particles at some stage in their lives, according to studies reported by the National Cancer Institute in the US. 

When asbestos fibres are inhaled or ingested, the body is unable to break them down or expel them. Those fibres remain in your body causing scarring and damaging sensitive tissues. That damage can eventually lead to cancer or other asbestos-related diseases.

Most cases of mesothelioma are seen in workers who were exposed to asbestos many years earlier, before we knew the risk. This has led to an increased rate of mesothelioma in Aotearoa New Zealand men aged 50–60. 

To protect workers from this serious disease, there are now strict rules about working with any asbestos-related materials.

What is mesothelioma?

(Macmillan Cancer Support, UK, 2020)

What are the symptoms of mesothelioma?

Symptoms of a mesothelioma can include:

  • shortness of breath or trouble breathing
  • a persistent cough
  • pain under the rib cage
  • fever and sweating particularly at night
  • pain, swelling, or lumps in the abdomen
  • weight loss for no known reason.

Diagnosis is made using imaging studies, such as chest x-ray, CT scan and a biopsy. Depending on where the tumour is, a range of procedures can be used to obtain a biopsy such as a thoracoscopy (a small incision between two ribs with a thin, tube-like instrument with a light and viewing lens inserted into the chest to obtain a small sample of tissue as a biopsy).

What is the treatment for mesothelioma?

Treatment depends on whether the tumour is malignant or benign and at what stage it is diagnosed. Common options include surgery, radiation, and/or chemotherapy for malignant mesothelioma.

The prognosis (chance of recovery) depends on a number of factors:

  • the stage of the cancer (how advanced it is at the time of diagnosis)
  • tumour size – is it large?
  • position – can the tumour be completely removed by surgery?
  • the amount of fluid in the chest or abdomen
  • the patient's age and general health, including lung and heart health
  • the type of mesothelioma cancer cells
  • whether the cancer has just been diagnosed or has recurred (come back). 

Learn more/h2>

The following links take you to other websites that provide further information on mesothelioma. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.

Mesothelioma Cancer Council Victoria, Australia
Mesothelioma NHS, UK
Development of regulations to support the new Health and Safety at Work Act 2016 Ministry of Business, Innovation and Employment, NZ
Working with asbestos? Rules changed April 2016  Worksafe NZ
Malignant mesothelioma NIH, National Library of Medicine, US

Information for healthcare providers

If someone presents with mesothelioma, it is important to consider if this is due to work exposure. If yes, then a claim to ACC can be made with a range of possible benefits and support including subsidy for Pemetrexed.

Occupational causes of cancers of the trachea, bronchus and lung ACC NZ, 2007
Review of pemetrexed in the treatment of malignant pleural mesothelioma (Word document) ACC NZ, 2011
Kjellstrom T1, Smartt P. Increased mesothelioma incidence in NZ – the asbestos-cancer epidemic has started NZ Med Jnl. 2000 Nov 24;113(1122):485-90.
Takala J, Hämäläinen P, Saarela KL, et al. Global estimates of the burden of injury and illness at work in 2012 Journal of Occupational and Environmental Hygiene. 2014;11(5):326-337. doi:10.1080/15459624.2013.863131.
Malignant Mesothelioma Treatment (PDQ®) – Health Professional Version National Cancer Institute, National Institutes of Health USA, 2015

Credits: Health Navigator Editorial Team.