A Guide to Mesothelioma

Around 2,300 people are diagnosed with mesothelioma in the UK each year and the number of cases diagnosed is still increasing.

04 July 2012

This guide about mesothelioma describes the causes and symptoms of mesothelioma, likely treatment options if you are diagnosed with this type of cancer and advice on how you can claim compensation, even if the company responsible for you contracting this industrial disease is no longer in business.

What is Mesothelioma?


Mesothelioma is a tumour of the mesothelium - the thin membrane that lines the chest and abdomen (tummy) and surrounds the organs in these parts of the body. The mesothelium has different names depending on where it's located in the body. It's called the pleura in the chest and the peritoneum in the abdomen while the membrane surrounding the heart is called the pericardium. A cancer of any mesothelium is called a malignant mesothelioma, but is more usually referred to simply as mesothelioma.

The majority (3 in 4) cases of mesothelioma develop in the pleura (the delicate lining of the lungs) which are normally lubricated by fluid and slide over each other as you breathe. Mesothelioma causes these linings to thicken and press inwards on the lung.

Around 1 in 4 cases of mesothelioma develop in the peritoneum (the outer lining of the abdomen) causing thickening of the linings surrounding the abdominal organs and a collection of fluid in the abdomen.

What causes mesothelioma?


Asbestos is the most common cause of mesothelioma with up to 9 out of 10 cases of mesothelioma demonstrably caused by exposure to asbestos fibres. In very rare cases mesothelioma can develop in people who have never been exposed to asbestos, but the definite causal link between mesothelioma and asbestos has been established for many years. Mesothelioma is not infectious or contagious and isn't a hereditary illness. You may contract the disease if you have been in contact with or inhaled asbestos fibres or dust or worked with asbestos without using adequate face masks or other protective equipment or clothing. Blue, brown and white asbestos can all cause mesothelioma.

The dangers of asbestos


There are three main types of asbestos: blue asbestos (crocidolite), brown asbestos (amosite) and white asbestos (chrysotile). Asbestos was commonly used as a building material in many UK industries and imports of blue and brown asbestos were not halted until the 1980s. It was only as recently as 1999 that the use of white asbestos in any industrial or domestic application was finally banned. When asbestos is disturbed or damaged, it releases very fine mineral fibres that can be easily inhaled, penetrating into the smallest cervices of the lung. The body's natural defence mechanisms try to break these fibres down, but because they are mineral-based, our natural defences are ineffective and the end result is inflammation in the lung tissue. The asbestos fibres are so fine that they can also settle in the outer lining of the lung (the pleura) and cause mesothelioma to develop over the course of many years.

Who is at risk of contracting mesothelioma?


The people most at risk of contracting mesothelioma are those who handled, used or came into contact with asbestos during their daily work. That could include industrial workers such as construction workers, boilermakers and shipbuilders. These types of job were mostly done by men (indeed  mesothelioma is five times more common in men than in women) but family members of men who've worked with asbestos and brought the dust home on their work clothes could also develop mesothelioma. You could also be at risk if you lived near an asbestos factory or worked in an office, school or any building containing asbestos material that was disturbed or damaged. As asbestos remains in so many public buildings there is also concern for joiners, plasterers, plumbers and electricians who may inadvertently come into contact with the hazardous substance.

What are the symptoms of mesothelioma?


Pleural mesothelioma often starts as a lot of tiny lumps (nodules) in the pleura, which may not show up on scans or x-rays until they are quite large and the disease has progressed.
Mesothelioma symptoms don't usually develop until many years after the initial exposure to asbestos. It can take around 10–60 years before any symptoms of mesothelioma become 'clinically manifest' although the average time for symptoms to become apparent is usually about 20-30 years.  The symptoms of pleural mesothelioma can include:

• Breathlessness or difficulty in breathing
• Pain in the chest
• Chest feels heavy and dull or aching (especially when you breathe)
• Weight loss
• Fever and sweating (especially at night)
• Hoarseness (caused by pressure on the nerve that supplies the voice box)
• Persistent  cough that doesn't go away

These symptoms do not prove that you definitely have mesothelioma. They can be caused by several other conditions, but if you do experience any of them, especially if they don't go away after a couple of weeks, you should always see your GP straight away. Your family doctor will examine you and may arrange for x-rays to be taken. The GP may also refer you to hospital for further tests and a consultation with a specialist.

What is the treatment for Mesothelioma?


The treatment you receive depends on the extent of the cancer and whether it has spread beyond the original site to other organs in the body (known as metastatic or secondary cancer). A combination of chemotherapy and radiotherapy are the most common treatments for mesothelioma. The extent of the cancer will determine how these treatments are used. There is no cure for mesothelioma.

The purpose of any treatment is simply to manage the symptoms, control the pain and retard the progress of the cancer for as long as possible. It is feasible however that the mesothelioma is so advanced that any treatment will produce all the nasty side effects associated with chemotherapy or radiotherapy with little apparent  benefit.

When a cure is not possible the best outcome that can be hoped for is to control the mesothelioma cancer for a period of time. You should discuss all your options in detail with your doctor before making any decision. Treatment options for mesothelioma include:

• Surgery
Surgery may be an option for some mesothelioma patients and can involve removing the tumour and often a portion or the whole of the lung. Due to the invasive nature of the surgery it will only usually be performed on someone in good health and where the tumour can be localised.

• Extrapleural Pneumonectomy (EPP)
This surgery may be appropriate for someone who is suffering from pleural mesothelioma, where the cancer cells have not spread to other parts of the body. It involves removing the whole lung, the diaphragm and pericardium (the sack around the heart). The diaphragm and pericardium are then reconstructed with artificial patches.

• Pleurectomy and Decortication
As mesothelioma can form a tumour around the lung which prevents it from expanding, a procedure has been developed in which the lung is "skimmed" of the tumour to help the lung expand. It is possible to perform this procedure by keyhole or alternatively by more invasive surgery, however, it doesn't completely remove the cancer cells with the result that the disease can reoccur.

• Palliative Surgery
Another option is to drain fluid from around the lung. This procedure can be performed by keyhole surgery and talc may be placed around the lung to seal the place between the pleural lining of the lung. These procedures can help the lungs function better.

• Percutaneous Spinal Cordotomy
Those suffering from mesothelioma and who have not been responding to conventional pain relief may respond to an alternative treatment called Percutaneous Spinal Cordotomy. The procedure involves placing an electrode into the pain nerve in the spinal cord which transmits pain information to the brain, using specialist X-ray guidance. The nerves are heated and the procedure is done under local anaesthetic to enable the patient to communicate any sensations felt during the procedure.  Patients who have been treated in this way are reported to have gained pain relief, although the procedure is not always successful if the nerves cannot be identified safely. Currently, there are only three centres in the UK offering this treatment and anyone considering it should discuss the appropriateness and risks with their GP or healthcare team.

• Radiotherapy
Radiotherapy may be used to help reduce the size of the cancerous tumour such as lung cancer or mesothelioma and relieve pain and discomfort.  Radiotherapy uses X-rays to treat cancer. A beam of radiation is targeted at the tumour and the aim of the treatment is to destroy the cancer cells.

• Chemotherapy
Chemotherapy is a drug treatment which is used to try and kill cancer cells or stop them spreading. Chemotherapy cannot cure mesothelioma but it is believed that those suffering from it may live longer and improve their quality of life. Chemotherapy drugs can be administered by injection, drip, infusion pump or in tablet, capsule or liquid form.

• Physiotherapy
As a result of the restrictive nature of mesothelioma which can cause breathing difficulties, there is research to suggest that early physiotherapy intervention can assist with building tolerance, strength and functional ability. Physiotherapy exercises may help maintain lung tissue elasticity and strength improving efficiency of breathing techniques.

What financial help can I get?

 

There are a number of state benefits that offer some financial help to people suffering from mesothelioma.
 
You can claim for a compensation payout from the government under the Pneumoconiosis Worker's Compensation Act 1979 which provides a cash lump sum in addition to any Industrial Injuries Disablement Benefit that may be paid. The 2008 Diffuse Mesothelioma Scheme is for people who came into contact with asbestos in any other way aside from work (for example, by washing a relative's clothes, or from a public building) or who were exposed when self-employed and  cannot claim via Industrial Injuries Disablement Benefit or the Pneumoconiosis Worker's Compensation Act  1979.  Payment is made as a one-off lump sum but the claim must be made within one year of a diagnosis of mesothelioma.

The other main state benefit payable to people with asbestos-related illnesses is Industrial Injuries Disablement Benefit. You can get more information by calling the Department for Work and Pensions Benefit Enquiry Line on 0800 882 200. The benefit starts from the date you contacted the DWP, not the date you contracted the disease. It's paid as a regular weekly allowance to people who can show that they worked in a job that exposed them to asbestos and contracted mesothelioma as a result. This benefit is not paid if you were self-employed in the work that led to the asbestos exposure.

You may also be entitled to Disability Living Allowance if you need assistance with personal care or getting around. If you were in the armed forces and you have mesothelioma because you came into contact with asbestos, you may be able to get financial help through the War Pensions Agency by contacting  the Service Personnel and Veterans Agency on 0800 169 22 77.

What about claiming mesothelioma compensation?


You may be able to claim compensation from your employer who was negligently responsible for exposing you to asbestos, even if that company is no longer in business. Or you may be entitled to claim against someone else who exposed you, for example the owner of a building or public authority.

As a general rule you usually have to start a claim within three years of when you knew you were suffering from an illness caused by asbestos exposure. This is usually taken to mean the date of diagnosis or the first 'date of knowledge' and does not mean three years from the time of asbestos exposure.

A recent High Court ruling has made it clear that however old you are when you get a confirmed diagnosis of mesothelioma, you are still entitled to compensation and it's still worth pursuing a mesothelioma compensation claim.

A later High Court ruling made it easier for claimants to claim compensation from a parent company that can be shown to have responsibility for health and safety issues of its subsidiary company if that subsidiary has gone out of business.

A Supreme Court ruling has also made it clear that it's the insurers providing cover when the asbestos was inhaled that has to pay. So people can still bring a successful claim against the company they worked for, even if it's no longer in existence and there is no current insurer to pay out.

There are many fast track legal procedures available to mesothelioma sufferers to ensure that their compensation claims are dealt with quickly and effectively. It is important that your solicitor is a specialist in mesothelioma claims to make full use of the fast track processes available. Effective use of the mesothelioma fast track procedure ensures that your claim can be brought more quickly through the courts. These procedures also make provision for an early interim payment of compensation without having to wait until the end of the case.

How do I pay for a solicitor to pursue my mesothelioma claim?


Paying for a lawyer to pursue a mesothelioma compensation claim on your behalf can be done in several different ways. Here at Shoosmiths we offer you a free initial consultation (at home or in hospital if necessary) to discuss the merits of your claim and how best to fund it. If we believe you have a good case and could make a successful claim, we'll fight your cause on a no-win-no-fee basis (sometimes called a conditional fee agreement) which means that if you win the case you receive 100% of your compensation. We would reclaim our legal costs and expenses from the other side. If you lose we make no charge for our legal costs, assuming you've complied with the terms of the agreement and any expenses or other party's costs you may be required to pay would be covered under a policy of insurance that we'd take out on your behalf, again assuming you've complied with the terms of the policy.

Why use Shoosmiths?


Our specialists have a proven track record of successfully dealing with the serious issues surrounding mesothelioma and asbestos related disease claims. We understand the importance of ensuring your claim is dealt with quickly and sympathetically. We work hard to obtain compensation that will cover both you and your family's future financial security and any care or treatment you may require as a result of your illness. Please contact us to discuss your needs in complete confidence. Home visits can be arranged or you can call us on our helpline, available seven days a week. Lines are open Monday to Friday 8 am to 8 pm, Saturday 9 am to 6 pm and Sunday 10 am to 4 pm. 

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