Mesothelioma and the UK

Mesothelioma is a cancerous tumour of the lung's lining or the abdomen. The lung form is more common than the abdominal form. It is directly related to the exposure the patient has had with asbestos (especially blue asbestos). Miners, pipe fitters, shipyard workers, builders, construction workers, etc are at higher risk as they are working around the material. Symptoms are breathlessness, and pain or tenderness, with a cough and fever. There may be weight loss and weakness. The symptoms may progress slowly and a patient is symptomatic for 10-15 years. It is nearly always fatal; death occurring approximately two years after the diagnosis. A pleural biopsy is the definitive test for the cancer. There are four stages to the cancer: stage one is where the disease is only found in the parietal pleura( ipsilateral pleura, lung, pericardium, and diaphragm); stage two is stage one with the addition of intrathoracic (N1 or N2) lymph nodes; stage three is extension into the chest wall ,heart or through the diaphragm, peritoneum, with or without contralateral (N3) lymph node involvement; the final stage four is thorough metastases.

The death rate numbers and other vital statistics on mesothelioma in the UK are published each year by HSEs Epidemiology and Medical Statistics Unit (EMSU). These statistics are taken from the mesothelioma register that is maintained by the EMSU and lists all the death certificates were "mesothelioma" is mentioned. Although it affects both men and women, 85% of�mesothelioma deaths are male. 99% of those males are between the ages of 20-89.

According to the Royal Marsden NHS Trust in Surrey, the estimated death toll from mesothelioma will rise from near 1500 in 2000, to near double in 2020. However, for comparison, the first year that the registry was set up in 1968 the death toll was 153. This is a massive increase percentage-wise over the years. Now the Trust are studying a delayed form of chemotherapy and its response rate with mesothelioma as a possible new treatment. Chemotherapy in the UK is usually MVP (mitomycin, vinblastine, and cysplatin). There is now a national group working toward a single agent of vinorelbine and comparing chemotherapy with MVP.

For more information: www.hse.gov.uk.