Malignant pleural mesothelioma: history, controversy and future of a manmade epidemic

Malignant pleural mesothelioma: history, controversy and future of a manmade epidemic



Asbestos is the term for a family of naturally occurring minerals that have been used on a small scale since ancient times. Industrialisation demanded increased mining and refining in the 20th century, and in 1960, Wagner, Sleggs and Marchand from South Africa linked asbestos to mesothelioma, paving the way to the current knowledge of the aetiology, epidemiology and biology of malignant pleural mesothelioma. Pleural mesothelioma is one of the most lethal cancers, with increasing incidence worldwide. This review will give some snapshots of the history of pleural mesothelioma discovery, and the body of epidemiological and biological research, including some of the controversies and unresolved questions. Translational research is currently unravelling novel circulating biomarkers for earlier diagnosis and novel treatment targets. Current breakthrough discoveries of clinically promising noninvasive biomarkers, such as the 13-protein signature, microRNAs and the BAP1 mesothelioma/cancer syndrome, are highlighted. The asbestos history is a lesson to not be repeated, but here we also review recent in vivoand in vitro studies showing that manmade carbon nanofibres could pose a similar danger to human health. This should be taken seriously by regulatory bodies to ensure thorough testing of novel materials before release in the society.


Mesothelioma is a cancer that attacks the mesothelium, which is a thin layer of tissue that covers most of the internal organs. Some of the organs that have the mesothelium include the lungs (pleura), stomach (abdomen), heart (pericardial), and testicles (tunica vaginalis). This cancer is classified as aggressive and many sufferers are not treated successfully.

Mesothelioma – alodokter

Mesothelioma most commonly affects the lung mesothelium (called pleural mesothelioma) and chest wall. Another type of mesothelioma that is less common is peritoneal mesothelioma, which attacks the mesothelium of the abdominal cavity. Mesothelioma is different from benign mesothelioma in the chest which is also called a solitary fibrous tumor.

Mesothelioma causes
Cancer that attacks the body’s organs begins with cell mutations that cause its growth to become uncontrolled and then multiply. Experts still cannot ascertain the cause of this cell mutation. Even so, the interaction between lifestyle, hereditary conditions and the environment allegedly can be a trigger factor for cancer.

Although the exact cause of mesothelioma is unknown, the main risk factor for mesothelioma is asbestos. This disease is relatively rare before commercial use of asbestos begins. Asbestos is a mineral that is used as an ingredient to make brakes, floors, roofs and insulation.

Asbestos dust that is inhaled or swallowed will accumulate in the lungs and stomach for a long time, usually around 20-50 years, before eventually developing into mesothelioma. Mesothelioma is also more commonly diagnosed in men than women, and in someone over 65 years of age.

Some other factors that can trigger this disease, namely:

An environment where the soil has asbestos content.
Living in the area or living with someone who has a job related to exposure to Asbestos can also be attached to the skin and clothing so that it can carry asbestos into other homes or environments.

Have been exposed to asbestos or have a family member suffering from mesothelioma.
Symptoms of Mesothelioma
Symptoms of mesothelioma can vary based on the location of cancer cells. Pericardial mesothelioma may cause chest pain and difficulty breathing, while tunica vaginalis mesothelioma will show symptoms of swelling in the testicles.

Pleural mesothelioma has the following symptoms:

Cough with unbearable pain.
Shortness of breath due to the buildup of fluid in the chest.
Unusual bumps on the tissue behind the chest skin.
Weight loss for no apparent reason.
Often overloaded by fatigue.
Fever is accompanied by sweating especially at night.
Swollen fingertips.
Chest pain felt under the rib cage.
Peritoneal mesothelioma has the following symptoms:

Pain in the stomach area.
There is a lump in the stomach tissue.
Swelling in the abdominal area.
Weight loss without cause.
Diarrhea or constipation.
Given the symptoms of mesothelioma that are not specific and can be associated with other conditions, then you should immediately see a doctor when you feel the symptoms above, especially if there is a history of exposure to asbestos.

Diagnosis of Mesothelioma
The examination will begin with anamnesa about the symptoms suffered, personal and family medical history. History is a conversation conducted by a doctor directly to the patient as a way to obtain data about the conditions and medical problems that are being experienced by the patient. In addition to history, the doctor will perform a physical examination to check for any lumps or other abnormal signs.

The doctor may then instruct him to do a supporting examination as part of the effort to diagnose the disease. Common tests are done to diagnose mesothelioma, including X-rays to check for abnormalities in the chest and CT scan to examine the area of ​​the chest and abdomen.

Biopsies or other tests can also be done to determine what disease causes symptoms to appear. A biopsy is a laboratory examination of a small amount of tissue that can be taken from different parts of the body, depending on the location of the disease. The tissue is then examined in a laboratory to find out what type of cell is causing the disorder, as well as knowing the type of cancer they have. As for some types of biopsies that might be recommended for the diagnosis of mesothelioma, namely:

A biopsy uses a small fine needle to pull a sample of tissue or fluid from the chest or abdomen.
Laparoscopy – Biopsy by making small incisions in the abdominal area to take tissue. This procedure is assisted with a very small operating device and camera.
Laparotomy – Biopsy by open open abdomen to take tissue that will be examined for the presence of other diseases or disorders.