Specialist Information
Dr. Tim Peel
Consultant in general and respiratory medicine and palliative medicine Particular interest is in lung cancer and mesothelioma.
It is likely that the numbers of cases of mesothelioma will continue to increase over the next 10 – 15 years. This is because there is a 40 – 50 time lag between exposure to asbestos and developing the disease. Imports of asbestos reached their peak in the early 1970’s. Mesothelioma usually starts in the pleura (membrane surrounding the lungs). The symptoms that people notice initially include breathlessness, pain on the affected side or cough. Diagnosis is made by a chest x-ray followed by sampling the fluid that has formed between the pleura (pleura effusion) or by a more formal biopsy procedure. This may be performed under local or sometimes general anesthetic. The extent of the tumour is assessed by computerized tomography (CT scan) and this information then dictates what treatment is appropriate.
Sion Barnard
Thoracic surgeon Newcastle upon Tyne Freeman hospital.
Mesothelioma is a tumour of the internal lining membranes of the chest (pleura), heart (pericardium) and abdomen (peritoneum). It usually affects only one of these areas.
Its association with asbestos exposure has been known about for many years and although there was UK legislation regarding asbestos as early as 1932, it was only after publication of a paper from South Africa, in 1960, outlining the high rate of mesothelioma in asbestos miners there, that regulations were put in force in the UK to protect workers from the effects of asbestos dust.
The shipbuilding and heating/insulation trades are two of the highest risk occupations and the North East has one of the highest incidences in the UK on the basis of its history of a major shipbuilding region. The incidence (number of new cases per year) is increasing and this increase is set to continue for the next 15 years at least.
There are three main types-epithelioid, sarcomatoid and a third type where there is a mixture of these two. Major surgery is only reserved for the epithelioid type. Mesothelioma is a slow growing, insidious tumour and tends to present in the late stages of the disease. Symptoms are usually of breathlessness, often associated with dull chest pain. A chest X-ray will show fluid around the lung and a few mls of this can be drawn off into a syringe and the cells looked at under a microscope to make the diagnosis. Assessing the extent of the disease may be undertaken by further scans e.g. a CT scan and occasionally an MRI scan. This can allow an estimate to be made of the extent of disease-the “stage”. The type of treatment can then be decided upon based on the stage and other factors such as the mesothelioma type, fitness of the patient etc.
