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The likelihood of developing mesothelioma is directly proportional to the length of exposure to asbestos, and how much a person inhaled. People in jobs with high exposure, such as on construction sites, steel mills, or power plants, have the highest risk of developing the disease.
Even family members who have never entered an asbestos-rich environment can be exposed. Workers exposed to asbestos can accidentally carry fibers home in their clothing, and become inhaled by other members of the household.
The World Health Organization (WHO) said that approximately 125 million people globally were exposed to asbestos at work in 2005, despite their employers having known about the link to cancer and other lung diseases for over six decades. Most work-related exposure today occurs in developing nations.
In much rarer cases, mesothelioma may be linked to:
irradiation
inhalation of fibrous silicates such as erionite, zeolite and intrapleural thorium dioxide
Diagnosis:
Mesothelioma is often diagnosed at a more advanced stage of the cancer.
The doctor will ask about personal and family medical history and conduct a physical examination. They will also ask about previous employment if mesothelioma is suspected, to assess any potential exposure to asbestos.
If mesothelioma is suspected, imaging scans such as an X-ray or computed tomography (CT) scan will be used to assist with diagnosis.
Biopsy
A biopsy can confirm the diagnosis. The type of biopsy depends on where the symptoms are.
In the the chest or abdominal area: The doctor will use a fine-needle aspiration. A small needle is inserted into the abdomen and chest to remove and test some fluid or piece of tissue.
In the chest area only: The doctor will run a thoracoscopy. A thoracoscope is inserted through a small incision between the patient's ribs. A thoracoscope is a tube with a small camera at the end, designed for examining the chest cavity. The surgeon then removes a piece of tissue.
Thoracotomy
In a thoracotomy, the surgeon opens the chest between the ribs to see the target area and check for signs of cancer. Some tissue may be removed for testing in the laboratory.
Laparoscopy or laparotomy
If there are symptoms in the abdominal area, the doctor may carry out a laparoscopy or laparotomy to examine the area and take tissue samples for testing.
A laparoscopy involves inserting a laparoscope into a small incision in the abdominal wall. The laparoscope has a small camera, like the thoracoscope. Samples can be taken.
If more information is needed, a laparotomy may be requested. The surgeon opens and examines the abdomen. Tissue samples may be removed and sent to the lab.
A pathologist can look at the tissue or fluid samples through a microscope, to see whether there is malignancy, what types of cells are involved, and how advanced the cancer is.
If the surgeon plans to remove all or part of a lung, lung function tests may be carried out to assess how well the lungs are working, before surgery. This will show whether it is safe to carry out surgery.
Staging
Diagnosis will confirm whether cancer is present, and how far it has spread. The stage of the cancer will be assigned between stage 1 and stage 4.
Stage 1 mesothelioma the cancer is still localized inside the lining around the lung. It has not spread. At Stage 4, it has spread to distant organs and around the chest.
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