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Thursday, May 10, 2007

Disease Development And Progression

The latency of mesothelioma has been one of its greatest problems and may partly explain why a connection with asbestos exposure took so long to be accepted as the primary cause. Mesothelioma latency isn’t known exactly since exposure to asbestos doesn’t always equate directly or immediately to an insult to the tissues. Consequently, estimates of latency vary widely with mesothelioma patients being reported in age ranges from early teens to octogenarians. The accepted figure falls somewhere between 15 and 50 years from the date of exposure to asbestos although it’s anyone’s guess as to when the asbestos first triggered the cellular damage that translated into mesothelioma.

Since symptoms are often misdiagnosed or even absent during early stage mesothelioma, the rate of progression of the disease is also a guess. The most commonly available figures pertain to median survival time from the date of diagnosis but many mesothelioma experts believe the tumor may be in existence for quite some time before diagnosis.

Even survival times vary widely with no clear consensus emerging. On the low side, survival times of 4 to 8 months are reflected in the information to be gleaned from obituaries and tributes paid to the afflicted. On the high side, 12 to 18 months is considered the norm, although this number is demonstrating some upward movement and tends to become differentiated when mesothelioma types, categories and treatments are considered as part of the assessment.

Of the three subtypes, epithelial, mixed type, or sarcomatous, the latter two have by far the worst prognosis for survival. Patient groups of sarcomatous subtype, or those with lymph node involvement, tend to have no long term survivors. Two year survival rates for these groups are 0% and median survival time is only 5.5 months. Epithelial cases without lymph node involvement, and who are younger than 50, have the best chance for long term survival. Median survival numbers for this group are trending up, and vary based on the type of treatment chosen.

Mesothelioma patients of all subtypes rarely survive long enough for medical science to establish conclusively whether or not mesothelioma actively metastasizes or not. As median survival times lengthen, we may find that mesothelioma is no different from other cancers in this respect.

In pleural mesothelioma, the tumor tends to appear only in one lung, with a right/left preference of 60% to 40%. Pleural mesothelioma occurs about four times more frequently than peritoneal, with peritoneal being on the decline and pleural on the upswing. Men are five times more likely than women to get pleural mesothelioma and both sexes are equally represented with peritoneal.

As of this time, there are no medical procedures that are proven to be curative. Most of the leading treatments (covered under the treatment section of this web site) involve experimental procedures, clinical trials of drugs and novel technologies.

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