Once these fibers enter the lungs, they are on their way to the pleural membrane, and the body has great difficulty in the expulsion of these fibers. For a long period of time – usually two or more decades – asbestos fibers cause changes in the pleural cells and causes scarring of the lungs and eventually form tumors.

When cells become cancerous pleural, not governed by the same mechanisms that control normal cell division healthy. They begin to divide continuously, and this causes thickening of the pleural membranes. As a result, lung capacity is reduced, and fluid begins to accumulate between the pleural layers.

Exposure to asbestos is the major risk factor for the development of mesothelioma. The first association between asbestos and cancer was established in 1955 in a case-Control study, appearing in 1960 related data that also pleural mesothelioma. As discussed in previous chapters, there are two types of asbestos fibers, the “curvilinear” (chrysotile) and “straight” (crocidolite), the latter being primarily involved in tumor pathogenesis are being transported to the periphery of the lung and contact with the pleural surface, while the former remain in the central airways and are eliminated more easily. The latency period between initial exposure and death varies widely, with an average of 48 years.

Numerous epidemiological studies have demonstrated the relationship between exposure to asbestos and mesothelioma as well as its development after the intrapleural instillation or inhalation of asbestos fibers. However, although 80% of patients have a history of exposure to asbestos, only 10% of those exposed developed mesotelioma which suggests the existence of other associated factors among which highlights the role given to the simian virus SV- 40 as a cofactor in the pathogenesis of mesothelioma after checking the expression of viral sequence animales8 models. Some chromosomal abnormalities and deletions of regions 1q, 3p, 9p and 6q chromosome 22 have also been cited in the pathogenesis of mesothelioma.

Antman and col9 and col10 Roviaro and have found no relationship between the existence of prior radiation and presence of calcification postuberculosa, respectively, with cases of mesothelioma. There is no definitive evidence that snuff increases the risk of developing the disease.

The risk factors of mesothelioma is exposure (and in particular inhalation), asbestos, asbestos, exposure to thorium dioxide (thorotrast) for diagnostic purposes and the zeolite. In particular, the majority (70%) of inhaled fibers being eliminated in the sputum or feces.

The remaining 30% through the endothelium by penetrating into the interstitial tissues. The fibers tend to accumulate mostly at the lower third of the lung in a position contiguous to the visceral pleura. The alveolar macrophages are able to transform into carcinogenic polycyclic assets.

The activation of alveolar macrophages leads to production of cytokines and the de-regulation of some proto-onocogeni, including PDGFB, with subsequent proliferation of mesothelial cells. Dose and exposure time are directly related to the risk. The tumor can develop within 20 years after first exposure, with a peak incidence between 35 and 45 years.

Dffusione Mesothelioma
In Italy there are every year a thousand deaths from mesotheliomas: it affects every year, two Italian males per 100,000, while the rate is halved for women (one in every 100,000).
In the past we created a national registry that allows you to monitor new cases and five regions (Piedmont, Liguria, Tuscany, Puglia, Emilia-Romagna region) is very efficient.

The Director of the Department of Environmental Epidemiology Institute of Health: “Even at international level, it discusses the increase of mesotheliomas. In the U.S. cases were significantly increased between the sixties and late eighties, when she came to a head the massive exposure to asbestos suffered especially during the Second World War, especially among the workers of the shipyards where they were built aircraft carriers and battleships.

The cases are, however, declined since the late nineties: this suggests that the peak of the epidemic curve has already been achieved, the maximum number of cases for years has already seen and now, thanks to the banning of asbestos timely, has begun the downward slope.
“The mesotheliomas are tumors that have a low propensity to expand and develop metastases in the body, but they are difficult to heal because – being very aggressive at the local level – are able to determine devastating damage already in the place of occurrence, ie the membrane surrounding the lungs, “says Ugo Pastorino, Director of Thoracic Surgery National Cancer Institute of Milan.

Depending on its size can be classified into two forms:
Solitary forms
Solitary forms are silent for a long period of time. At this stage are frequent paraneoplastic syndromes such as osteopathy , platelets, low blood sugar. The first symptoms that appear are due to an increase of volume compression causes symptoms including pain and heaviness.
Diffuse forms
Even the forms are spread undetected for a long period of time. With the progression of the disease appearing chest pain (often radiating to the back-end), dyspnea on exertion first and then even at rest, cough, fever, weight loss and hemorrhagic pleural effusion free or bag. In advanced stages with mediastinal involvement may have vocal cord paralysis, Horner’s syndrome and compression of the veins quarries.

According to experts, the research published in American Journal of Respiratory and Critical Care Medicine (American Journal of Respiratory Medicine and Intensive Care) – will help doctors more accurately diagnose the cause of abnormalities in the lungs.

Construction malignant

Mesothelioma is a very difficult cancer to treat due to its location as the tumor does not seem to respond well to chemotherapy.

The disease can strike people who have no history of exposure to absesto, but overall, it is known that the main risk factor is the inhalation of mineral dust free.

Decades ago I used to use asbestos in construction materials and other products, so those most affected are usually the construction workers such as bricklayers, plumbers and electricistas.En developed countries have established regulations banning asbestos exposure and production with mineral materials. But in many other nations have no such restrictions. And because the development of mesothelioma can take many decades, experts believe the number of cases could increase in coming years.

Diagnosis difficult

“The accumulation of fluid in the pleural cavity can be extremely difficult to diagnose because there are a variety of benign and malignant causes,” says Dr. Helen David, Center for Respiratory Medicine, University of Oxford, who led the research.

“But one of these causes malignant pleural mesothelioma, and although a relatively rare cancer incidence is rapidly increasing globally,” he adds.

Until now the standard test to detect mesothelioma in patients with pleural effusion is pleural fluid cytological examination, but this is not very accurate.

Dr. Davies and his team, looking for ways to distinguish mesothelioma as a cause of pleural effusion, focused on the mesothelin, a protein found in high levels in the pleural fluid of most patients with the disease.

The researchers analyzed samples of pleural fluid of more than 200 patients who had been referred to a specialist clinic in respiratorias.Descubrieron diseases that levels of the protein were almost six times higher in patients with mesothelioma in patients with secondary lung cancer and 10 times higher than in those whose behind wrong causes were benign.

According to Dr. Davies, “this study shows a way to identify more quickly and since the beginning of mesothelioma cases.

“Because mesothelioma has a median survival time of 12 months to minimize the number of invasive procedures and tests that patients need is vital to reduce death and how long to spend in hospital.

The researcher adds that “early diagnosis also allows for more rapid relief of symptoms and start other treatments such as chemotherapy or radiotherapy.

“And you can also encourage the patient to seek compensation for their condition once the diagnosis is confirmed,” says Helen Davies.

According to the World Health Organization, about 90,000 people die each year from diseases related to asbestos exposure. And 43,000 of these deaths are caused by malignant mesothelioma.

What are the causes?

The pleura and the pleura is a double, smooth and slippery membrane around the lungs is: one membrane (pleural) holds the lungs and other membrane holds the chest wall.
Inhalation (inhalation or inspiration) sets the chest (or chest) out. Thanks pleural as an interface serving, put the lungs. The pleura may be an outbreak of cancer. Pleurakanker is 50 to 70% of the cases due to exposure to asbestos, mostly in the context of a professional (insulation, textiles, construction, filters). Pleurakanker is not caused by smoking.

Natural perilously

Asbestos is a natural product, a silicate of iron, magnesium and calcium (ie a mineral) that is flexible fibers that can not rot and fire resistant. Canada is the world’s leading producer of asbestos. Zgn. “amphibole” asbestos fibers are commonly used for heat and sound insulation and the ‘chrysotile’ asbestos fibers are used to make cement. Inhalation (or inhalation) of amphibole fibers may cause pleurakanker. The countries that produce chrysotile asbestos fibers to produce cement, chrysotile fibers do not claim that pleurakanker cause. The European experts argue that that risk is still very likely (but difficult to express in figures given the relatively low incidence of mesothelioma Fri).
As a reminder, exposure to asbestos fibers can cause three types of diseases:

* Pulmonary fibrosis (asbestosis) with progressive evolution to respiratory failure,
* Bronchuskanker (but we know that smoking is an important risk factor is asbestos),
* Pleurakanker of mesothelioma

Exposure to asbestos has been sometimes very short and sometimes very long ago (up to 40 years ago). The number of cases pleurakanker increases by 25% per 3 years!

When to consult?

The main sign of an outpouring of mesothelioma is fluid between the lung two membranes (pleural effusion or pleurisy). Possible symptoms are pain and burden breathing.

But other diseases, including lung infections, can cause a pleural effusion. Given that the effects of asbestos are manifest until years later, it is important to investigate if the lungs are believed to have ever been in contact with asbestos. This goes for people who years ago for a very short time or been exposed to asbestos.

What are the investigations?

The diagnosis is made with an ordinary X-ray of the lungs and a CT scan. In those studies can assess the level of local invasion. A biopsy with reduction of tissue samples is necessary to guarantee a diagnosis. A biopsy is taken under general anesthesia (or sedation) during a short hospital stay. The study of tissue samples may take several days.

What is the treatment?

Pleurakanker If the diagnosis is made, it is unfortunately too late.
Usually one can only palliative (treatment not the cause of the disease heals) treat (chemotherapy, surgery), which mainly seeks to relieve the pain, which may be severe. The patient dies after several months. Hence the importance of screening as it sounds ever to have had contact with asbestos!

Pleural mesothelioma, the most common form of mesothelioma by far and makes 75% of all cases of pleural mesothelioma affects the respiratory system to said areas of the body such as the lungs more precisely, attacks the cancer of the lining of the lungs called the pleura and ribs. Hence the name pleural mesothelioma, the main cause of pleural mesothelioma, asbestos exposure, only a few months after the deadly exposed to asbestos dust and fibers without protection can lead to pleural mesothelioma thirty to fifty years later. Older men in age sixty to seventy are most at risk to asbestos because it was the generation that have worked with asbestos with little protection against dust and fibers due to the long latency period of pleural mesothelioma (30-50 years).

These men very only to discover they have the deadly cancer currently many of these men are lodging million dollar lawsuits against the company exposed them to asbestos. Asbestos fibers get into the lining of the lungs caused by inhalation and in the lung, the symptoms associated with pleural mesothelioma are submitted, are persistent cough, difficulty swallowing, swelling of the face, the weight loss, fever, rasping and coughing up blood patients also experience short breath expands, because the tumor on the lining of the lungs, which leaves less room for the lungs to some patients work properly, also begin to feel severe pain in the chest and this is similar at the spread of cancer cells, many of these symptoms to diseases and conditions that are far more than mesothelioma.

Pleural mesothelioma, that means the joint is often very difficult to diagnosed until it is too late, the treatment of pleural mesothelioma is limited and so far there is no real cure research is conducted in all laboratories in the United States and many pharmaceutical companies are also testing for new treatments for mesothelioma. Treatments include chemotherapy, radiotherapy and surgery A patient’s age, medical history, weight and other factors into account before treatment made the rule of survival is much more likely if pleural mesothelioma is treated aggressively in its early stages, because if the cancer develops mature and it is very difficult to heal.