Mesothelioma Lawyers & Your Legal Rights

n response to numerous requests for legal information, Asbestos.com has partnered with Brent Coon and Associates (BCA) to handle mesothelioma and lung cancer cases nationwide. Due to high medical bills, choosing the proper mesothelioma lawyer will be one of the most important decisions that your family makes post diagnosis.

The sad truth is that finding a good lawyer to represent you in your mesothelioma case can be a daunting task due to the fact that most people are unfamiliar with what distinguishes a good firm from a bad firm. Unfortunately, repercussions of choosing the wrong firm can have a tremendous impact on your family's future economic well being. The good news is that at Asbestos.com we have done the research for you.

Brent Coon and Associates has built a national reputation on getting top notch results for the American worker. In the last year, Brent Coon has been featured on 60 minutes, Good Morning America, The Today Show, The CBS Early Show, The Wall Street Journal, The New York Times, USA Today, The Fox News Channel and CNN. Brent Coon was named "National Trial Lawyer of the Year" in 2007 and was awarded the prestigious Steven J. Sharp Award (link to the award) for Excellence by the American Association of Justice.

In order to be in the best position to help mesothelioma clients, Brent Coon and Associates has established 17 offices strategically located across the country. The firm is one of the largest trial law firms in the nation and is the epitome of the 21st century law practice. With over 60 experienced attorneys, the firm has a proven track record for handling mesothelioma occupational exposure cases.

The truth about mesothelioma claims is that each case rises and falls on its own set of facts. Specifically, most cases depend on whether the injured is able to identify where he or she was exposed to asbestos during their lifetime. Many times a knowledgeable lawyer will be able to assist an individual in recalling names of products they were exposed to. Often times a person with mesothelioma has been exposed to multiple asbestos products, all of which contributed, whether in a small or large way, to the development of the mesothelioma cancer. Please keep in mind that mesothelioma cases are not class actions and each case is unique and should for the most part be filed separately. Thus, you need a law firm with proven mesothelioma litigation ability to represent you and your family in your time of need. If you are interested in contacting Brent Coon and Associates for a case evaluation please fill out the form below or simply call 1-800-ASBESTOS and ask to be connected with a BCA lawyer standing by to answer your questions.

Why Seek Legal Action?

Every year, thousands of people die or become ill due to the negligence of asbestos manufacturers. If this has happened to you or a loved one, you should contact a mesothelioma lawyer as soon as possible. You may have been powerless to prevent current medical problems, but you do have legal options. Hiring a lawyer with extensive experience and knowledge of asbestos claims can help you receive compensation from those responsible.

Mesothelioma, which is almost exclusively caused by asbestos exposure, and other asbestos-related illnesses are attributed to negligence because asbestos companies knew about the associated health risks and decided not to tell employees or leak this information to the general public. As early as the 1920s asbestos companies were completely aware that their product not only caused harm to human health, but that it held the potential to claim the lives of those exposed to the substance.

By the 1930s and '40s, medical evidence had clearly linked asbestos exposure to lung disease and deadly asbestos cancers. Asbestos companies had been extensively warned of these dangers, but instead of choosing to use alternative substances (and many were available at the time), the industry chose soaring profits over the preservation of human health. It is because of these unethical actions that asbestos manufacturers are held liable for the undue suffering of those dealing with asbestos-related disease. To read more about this illustrious scandal, please see The Asbestos Cover-Up.

As a result, those with mesothelioma have legal options and are allowed to seek compensation through the court system because of these criminal actions. Filing a claim against the entity responsible for your asbestos exposure will not only bring justice to the corrupt asbestos industry, it will also afford the opportunity to be compensated for the costs, as well as pain and suffering, associated with asbestos-induced illness. The following include some of the expenses for which you can pursue compensation:

• Lost wages
• Medical bills
• Group support for you and your loved ones
• Funeral expenses
• Travel expenses relating to medical treatments
• Expenses not covered by health insurance

A mesothelioma lawyer can review even more expenses that could be covered under your lawsuit, as each case varies. Make sure to save all medical and financial records relating to your asbestos-induced illness for this purpose. Aside from providing these sorts of documents and answering questions about your condition and how you may have been exposed to asbestos, you will not have to be involved with other stages of the case. Mesothelioma lawyers understand that their clients are far too ill and concerned with spending time with their families to deal with the details of filing a lawsuit or attending trial. For this reason, mesothelioma lawyers handle every aspect and detail of the case.

There are two types of lawsuits you may rightfully file in asbestos injury cases. If a family member has passed away from an asbestos-induced disease, you can file a wrongful death suit. In a personal injury claim, the individual suffering with an asbestos-related illness must be the one to file suit. Specific rights in these lawsuits depend on the county and state where the case is filed.

Employees of companies who used asbestos are not the only individuals who have rights against asbestos companies. Although the vast majority of cases are between employers and employees, other groups have rights as well. For example, if you have developed an asbestos-related disease because a spouse or family member worked for a company using asbestos, you may also have a case. Asbestos readily attaches to and travels well on clothing and hair, making it easy to track home after working around the material.

Having a mesothelioma lawyer is essential to successfully file suit against a corporation in an asbestos-related case. Although you have the legal right to pursue compensation, the entity being sued also has the legal right to try to disprove your case, and this is why it is so important to hire an experience mesothelioma attorney who has the knowledge and experience to bring justice to those responsible for your illness.

The resources at Asbestos.com offer exceptional referrals for some of the most experienced asbestos and mesothelioma lawyers in the nation. For more information on your legal rights and other issues surrounding asbestos litigation, please fill out the form on the right or call us at 1-800-ASBESTOS (1-800-272-3786) to receive a comprehensive and informative packet.

Asbestos Abatement - Overview

The majority of people know asbestos is a very dangerous substance, but many do not understand what it is or why the mineral is bad for the body. Understanding asbestos is important because the illnesses associated with the substance can cause serious medical problems and even death. Knowledge truly is power and it is crucial to know what asbestos is and how to take precautions to avoid it.

What is Asbestos?

Asbestos is a naturally occurring mineral that has been mined for commercial use since the late 1800s. Though the U.S. Bureau of Mines has listed more than 100 types of asbestiform minerals, only six are regulated by the government. Although it is well known that asbestos is a dangerous mineral, a few countries still allow for it to be mined. The United States still allows the use of asbestos and many roofing and construction materials still contain the toxic mineral, as well as brake pads and clutches. Of all the asbestos types, chrysotile is most commonly used throughout the world.

Why Worry About Asbestos?

The light, fine, and virtually indestructible fibers wreck havoc on the human body. Free asbestos fibers in the air are easily inhaled into the the lungs, and are quite difficult to expel. The lungs try to repair the tiny irritations, which can result in scarring. Scarred lung tissue cannot readily absorb oxygen from the air or easily pass back carbon dioxide. As a result of this process, asbestosis can develop, and may even turn into cancer.

Asbestos exposure can also cause cancer, such as mesothelioma and lung cancer, and has been linked to gastrointestinal and colon cancer, as well as a slew of other cancers. Mesothelioma most commonly affects of the lining of the lungs, known as pleural mesothelioma. This cancer can also affect the abdominal cavity (peritoneal), the lining of the heart (pericardial), and in very rare cases, the testes.

Some of the highest incidences of mesothelioma have not been from adults who worked with asbestos, but among their children. Children are more susceptible to its effects than adults and were often exposed to asbestos since it was carried home on parents' work clothes. This is why there is so much concern about asbestos-containing materials (ACM) in school buildings. Many institutions of higher learning have published surveys of ACM in their buildings, which include plans to manage and prevent further exposure, plans to remove it, and programs to educate local populations about the dangers of disturbing ACM. Some universities even maintain their own accredited asbestos testing labs and abatement crews. If you are at risk for these illnesses because high levels of asbestos exposure, have regular medical checkups.

Where Asbestos Can be Found: Naturally Occurring Asbestos

If you live in an area where asbestos occurs naturally, limit your exposure by being aware of where there are or have been commercial operations to mine and process asbestos. Some helpful hints include:

• Use paved trails rather than open soil to hike, bike, walk, or jog; wheeled vehicles such as mountain bikes, dirt bikes, and ATVs are especially likely to throw dust into the air.
• Perform outdoor activities in areas where the ground is covered with mulch, wood chips, sand, pea gravel, grass, asphalt, or rubber.
• Label soil that does not contain asbestos. Never dig without wetting the soil thoroughly to keep the asbestos in the soil instead of the air.
• Do not use a leaf blower. It is better to use water to clear sidewalks and patios, or at least to wet the surface dust down before clearing it with a broom (that should be left outside).
• Prevent the family or pets from tracking dry soil into the house - use doormats or remove shoes. Do not allow the pets to bring in dry dust from outside.
• Keep windows and doors closed when it is windy or when any of the neighbors are digging for construction, gardening, or other purposes.
• Drive slowly over unpaved roads with the car windows closed, and share your concern with local authorities. Get the car washed often and pave your own driveway and walkways.
• Always use wet rags and mops to clean up dust from furniture, floors, and outdoor equipment. Wash the rags before they dry, and never shake a dust mop or rag to clean it.
• Use washable area rugs on easily mopped floors; wash both often.
• Vacuum the carpet often and use a machine with a HEPA (high-efficiency particulate air) filter, and wet down the contents of the dust cup before emptying.

Where Asbestos Can be Found: A Brief History

Asbestos has been useful to humans for thousands of years. Archaeologists discovered that asbestos was mixed into clay pots made in Finland in 2500 BC. Ancient documents have been found that describe asbestos fibers being used for everlasting lamp wicks and to weave shrouds for wrapping bodies for cremation. The first real industrial application began with textiles from Italy in the early nineteenth century.

The United States has embraced asbestos in commercial use since the late 1800s. Asbestos use grew as the Industrial Revolution came to full maturity with mass production techniques and new demands for friction products, such as brake shoes and clutches for automobiles. Demand and production fell off during the Great Depression of the 1930s, but World War II brought another boost to the use of asbestos for thermal insulation and fire prevention, among many other uses. Through the 1950s and '60s, asbestos continued to be heavily used for its many advantages. It was integrated in more than 3,000 different commercial and domestic products. It was light, fireproof, strong, insulating (both thermally and electrically), and mixed well with a number of other building materials.

A 1984 survey by the Environmental Protection Agency found friable asbestos (susceptible to releasing its fibers into the air) in 42 of the agency's own 270 buildings. In 1988, the EPA found asbestos in at least 700,000 public and commercial buildings across the country, more than a half million of them with damaged (friable) asbestos.

Where Asbestos Can be Found: In the Home

The amount of asbestos that can be found within a home depends on when the home was built or renovated. If the house, or anything in it, was built before the mid-1970s, there is a good chance of finding asbestos-containing materials. However, asbestos was still used in homes though the 1980s and is found in construction products made today. These materials can be found in a variety of places ranging from the roof to the basement.

Asbestos materials that are difficult to locate include vinyl wall coverings, ceiling tiles, and sprayed or troweled on "popcorn" textured coatings. For these products, the only way to find the asbestos-containing fibers is to scientifically sample them for testing by using an EPA-certified lab.

It is important to determine if asbestos is located in the water or steam pipes. If the pipes do contain asbestos, they are safe as long as they are not damaged by water leaks or by children playing nearby. It is best to coat them with modern protection such as plastic sheeting or sprays that will harden and encapsulate the asbestos fibers. These protections, however, will make it more difficult to remove the insulation and will have to be removed at a later date. Most states and/or municipalities require separate removal and proper disposal of all asbestos-containing materials when any building is demolished, or when an area is renovated where such materials are present.

What is the Difference Between Friable and Non-Friable?

There is a major distinction between friable and non-friable asbestos materials. Asbestos-containing material (flooring, roofing, pipe wrap, insulation, etc.) in the home can be crushed, pulverized, or turned to powder by the pressure of the average human hand are known as friable materials and can release dry asbestos fibers into the air. Non-friable materials are either tough or flexible enough to contain the embedded asbestos fibers, but with age and normal wear and tear, these non-friable materials can become friable.

Federal law recognizes these variations within the classification of non-friable asbestos. There are two categories of non-friable material. One distinguishes material that has become friable for one reason or another (Category I). The other is material that remains non-friable (Category II). Even Category II material may be regulated as friable material. If Category II non-friable material has been cut, scraped, sanded, or disturbed to where it produces dust, or if it is likely to be be disturbed during demolition or renovation, it falls under the friable and Category I materials.

What is Banned?

• In 1972, asbestos was banned from clothing
• In 1973, spraying asbestos-containing materials on buildings to fireproof them was no longer allowed
• In 1977, asbestos was taken out of patching compounds and gas heaters
• As of 1979, hair dryer manufacturers voluntarily recalled products that use asbestos as insulation. They replaced the asbestos with other materials and stopped using asbestos in their new products.

In 1986, the U.S. Environmental Protection Agency proposed a 10-year program that would result in a comprehensive ban on commercial use of asbestos. The ban passed in 1989 and the first phase was implemented in 1990, but the rule was overturned by a federal appeals court in 1991. After another two years of clarification, the EPA found itself with six types of asbestos-containing materials still banned, and all others nominally still on the free market (though most categories were rapidly losing popularity).

These six include:

1. Flooring felt - asbestos paper saturated with asphalt or another material to serve as underlayment for vinyl tiles or sheet flooring
2. "Commercial paper" - used in thin barriers for insulation or muffling
3. "Corrugated paper" - similar to corrugated cardboard, but with asbestos in one or more of the layers of paper
4. "Rollboard" - two sheets of asbestos paper laminated together (using a roller) into a continuous, flexible sheet. Particularly used in office partitions, garage paneling, linings for stoves and electrical boxes, and fireproofing for security boxes, safes, and file storage.
5. "Specialty paper" - for use in filters for beverages and other fluids. Also in cooling towers for liquids from industrial processes and air conditioning systems
6. "New uses of asbestos" - products have not historically contained asbestos at of the start of the regulatory process in 1989

Some other regulations under the Clean Air Act restrict other particular methods of applying asbestos-containing materials.

What are the Categories of Asbestos-Containing Materials?

To qualify as an asbestos-containing material (ACM) under the law, a product must contain more than 1 percent asbestos, either by weight for bulky materials or by area for flat ones. Regulations distinguish between friable ACM (can be reduced to dust by the crushing of hands) and non-friable ACM (cannot be crushed or damaged so easily).

There are two categories within the group of non-friable ACMs. Category I distinguishes material that has become friable because of whether, aging, or force and can release asbestos fibers into the air. Category II is everything else non-friable. Category II ACMs can also come under regulation if they are cut, sanded, or scraped to the point where they produce dust and presumably airborne asbestos fibers. During the course of renovation or demolition, both of these categories become "regulated asbestos-containing materials" (RACM).

What to Look For

It is not easy to identify asbestos-containing materials in use. But it is safe to assume any material of an appropriate age was likely made with asbestos. To really know if a material contains asbestos, it is best to hire a professional to sample the material in question, who then sends collected samples to a laboratory certified by the Environmental Protection Agency for examination. Then an experienced technician uses a polarized microscope to located asbestos fibers.

Asbestosis Overview

Four out of every 10,000 Americans suffer from asbestosis, a disease strictly caused by exposure to asbestos. An average of 10,000 deaths a year in the United States are caused by asbestos-related diseases such as asbestosis. The majority of these victims worked in at-risk occupations during the mid to late twentieth century. Due to the extended latency period associated with absestos-related illnesses, those who worked in at-risk occupations will continue to develop such diseases for the next several decades. Please see Occupations at Risk of Asbestos Exposure and Products Containing Asbestos for more information.

Asbestosis is a progressive pulmonary disease. This disease is particularly dangerous because symptoms only appear after asbestos fibers have already caused irreversible lung damage. While avoiding asbestos exposure can prevent the condition from worsening, it cannot reverse the damage that has already been done. People who develop asbestosis as a result of asbestos exposure will be affected by the condition for the rest of their lives.

Causes of Asbestosis

Asbestosis is caused by breathing in tiny asbestos fibers. Once inhaled into the lungs, these fibers cannot be destroyed or expelled by the body. They remain embedded in the lung tissue and cause chronic irritation and inflammation. Over time, as this irritation continues, scar tissue develops and replaces healthy lung tissue. Scar tissue is inflexible and cannot contract and expand, which leads to symptoms of asbestosis.

Symptoms of Asbestosis

Symptoms of asbestosis begin to appear when lung function has been damaged by asbestos exposure. One of the first signs of asbestosis is when breathing has become noticeably difficult. Many asbestosis patients compare the symptoms they experience to those of asthma. Generally, the first symptom of asbestosis is shortness of breath during physical exertion. As the condition worsens, shortness of breath may be experienced even when resting. Other symptoms of asbestosis include painful breathing and coughing. For further information, please see Asbestosis Symptoms.

Diagnosis of Asbestosis

Diagnosis of asbestosis first requires that the patient gives their doctor a full medical history, including details of any known asbestos exposure. If previously exposed, this information is crucial to ensure a correct diagnosis.

In addition, patients will undergo several tests, which may include a pulmonary function test, chest x-ray, and CT scan. These are used to diagnose asbestosis, and may also be used for screening purposes to detect asbestosis in people who have not yet developed symptoms of the disease. For further information, please see Asbestosis Diagnosis.

Treatment for Asbestosis

There is no cure for asbestosis, and no treatments that can reverse the lung damage caused by exposure to asbestos. Asbestosis treatments are designed to relieve symptoms and improve quality of life for people with asbestosis. Treatments for asbestosis are split into three main categories: surgical treatments, drugs, and alternative treatments.

Surgical Treatment

Surgery for asbestosis includes both diagnostic and treatment procedures. Treatment procedures are typically carried out to ease the symptoms of the disease, rather than to cure it. However, for patients with very severe asbestosis, a lung transplant may be considered. For further information about surgical options for asbestosis diagnosis and treatment, please see Asbestos Treatment - Surgery.

Drugs

Drug treatments for asbestosis include pain medication, bronchodilators, and antibiotics. Bronchodilators are prescribed to help ease shortness of breath. These work by relaxing the airways so that more air can be inhaled into the lungs. Bronchodilators for asbestosis are similar in design to those used by asthmatics. Pain medications for asbestosis include over-the-counter medications such as Tylenol, and prescription medications. People with asbestosis will also receive antibiotic treatment to reduce the risks of infection. Please see Asbestos Treatment - Drugs for further information.

Alternative Treatments

As with other types of asbestosis treatment, alternative treatments cannot provide a cure. However, many patients find treatments such as acupuncture, homeopathy, and herbal medicine help relieve symptoms of the disease. For further information about these treatments, please see Asbestos Treatments - Alternative.

Complications of Asbestosis

People with asbestosis may also develop dangerous complications that occur as a result of reduced lung function. These include high blood pressure, heart disease, and buildup of fluid in the lungs. In addition, people who have developed asbestosis may be at risk of other asbestos-related diseases such as mesothelioma cancer. For further information about complications of asbestosis, please see Asbestosis Complications. For information about mesothelioma cancers, please see Mesothelioma Overview.

Types of Asbestos

The term "asbestos" refers to six fibrous minerals that have been commercially exploited and occur naturally in the environment. The U.S. Bureau of Mines has named more than 100 mineral fibers as "asbestos-like" fibers, yet only six are recognized regulated by the U.S. government. This is largely due to influential lobbying by the asbestos and stone industries, which powerfully shaped how the public perceives asbestiform minerals. The six asbestiform minerals recognized by the government include, tremolite asbestos, actinolite asbestos, anthophyllite asbestos, chrysotile asbestos, amosite asbestos, and crocidolite asbestos. Each of these minerals is categorized into two groups, serpentine and amphibole. Chrysotile asbestos is the only member of the serpentine group and the others belong to the amphibole group. The difference between these two groups is characterized by the physical components of the asbestos fibers. The serpentine group is made up of minerals that have a layered form and curly fibers and the latter group contains minerals that have straight fibers with a chain-like structure.

In order to fully understand the importance and function of these minerals, it is necessary to examine each mineral in more detail.

Chrysotile asbestos is better known as white asbestos and is made up of fine, silky, flexible white fibers. Chrysotile consists of minerals crystallized in a serpentine pattern, which means its crystals are formed in sheets. This is the most common type of asbestos comprising approximately 95 percent of all asbestos commercially used in the United States. Due to the widespread use of this fiber, chrysotile accounts for the majority of asbestos-related health problems throughout the world.

Tremolite is a relatively common mineral found in most metamorphic rocks. Its color ranges from a creamy white to dark green. Tremolite asbestos has been used for industrial purposes (though not as much as chrysotile) and has been identified as an ingredient in some household products, primarily talcum powder (which is also a known carcinogen). This form of asbestos is the major asbestiform contaminant of the infamous vermiculite mine in Libby, Montana.

Actinolite asbestos is a relatively common mineral existing in metamorphic rocks. This type of asbestos is usually green, white, or gray and it is closely related to the aforementioned tremolite mineral (actinolite contains a greater presence of iron over magnesium than tremolite). Actinolite does not have a strong history of commercial or industrial use, but it may be a contaminant in asbestos products. There are non-fibrous variants of actinolite that do not pose the same health threats associated with exposure to commercially exploited forms of asbestos.

Anthophyllite asbestos is commonly identified by its brittle white fibers that are made of crystals and have a chain-like appearance. This type of asbestos is formed by the breakdown of talc in ultramafic rock, and as such, anthophyllite is a common contaminant of talc. Although anthophyllite asbestos is not often used for industrial purposes, the fibers can occasionally be found among natural minerals that expand with the application of heat, such as vermiculite (which is commonly added to gardening soil).

Amosite asbestos is identified by its straight, brittle fibers that are light gray to brown in color. Amosite is also referred to as brown asbestos and its name is derived from the asbestos mines located in South Africa. In years past, amosite was often used as an insulating material and at one time it was the second-most commonly used type of asbestos. Throughout recent decades, commercial production of amosite has decreased and its use as an insulating material has been banned in many countries.

Crocidolite asbestos, better known as blue asbestos, is markedly identified by its straight blue fibers. This form is believed to be the most lethal form of asbestos. Crocidolite asbestos occurs naturally in locations such as Australia, South Africa, Bolivia, the former Soviet Union, and Canada.

Asbestos Exposure

Thousands have been afflicted with mesothelioma, a cancer caused by exposure to asbestos, and even more have contracted asbestosis, a serious lung disorder that can develop into cancer. Because asbestos exposure can be so dangerous, it is important to learn about exposure and how to avoid this toxic mineral.

There are several ways to learn about asbestos exposure. The extensive resources made available by the Mesothelioma Cancer Center on this website is a great start. More information can be obtained by filling out the form on this page to receive a comprehensive information packet. Medical professionals can also provide information and can even check for asbestos-related illnesses. Mesothelioma lawyers also serve as a wealth of information for asbestos exposure and the resulting diseases..

Before increased regulation, asbestos was used in thousands of industrial and domestic products. Asbestos was most commonly used in the construction industry, especially for insulation materials. Asbestos was also widely used in shipbuilding and a multitude of other occupations as well.

When an individual inhales or ingests asbestos fibers they can become lodged in the mesothelial lining that protects the body's organs and cavities. The shape of asbestos fibers is what contributes to them becoming lodged, and scientists and medical professional believe the fibers' shape is also what causes inflammation and cellular damage. Over time, the lodged fibers can lead to the development of asbestosis, lung cancer, mesothelioma cancer, and can increase one's risk of gastrointestinal, throat, esophagus, kidney, gallbladder, and colorectal cancers.

Unfortunately, diseases caused by asbestos exposure are usually not detected until later stages of development, which greatly complicates treatment options. Those who may have been exposed to asbestos should see a medical professional or cancer doctor to be assessed for possible exposure.

Mesothelioma Staging Systems

For many decades, doctors have been addressing the seriousness of particular cancers in terms of stages. Throughout the years, various staging systems have been developed to assist cancer doctors in determining diagnosis and the best form of treatment for the individual patient.

There are three popular staging systems used to examine the extent of pleural mesothelioma. Since other forms of mesothelioma are even less common than the occurrence of pleural mesothelioma, there currently are no formal staging systems for other forms of this aggressive cancer (although they can be applied if desired). Each of the three different staging systems measure various factors of malignant mesothelioma, including the extent of the tumor (primary mass), the metastasis (spreading), and the involvement of the lymph nodes.

Butchart System

The Butchart System is the oldest staging system for malignant mesothelioma and is the one most commonly used by doctors and specialists to diagnose and treat malignant mesothelioma. The Butchart System is based on the tumor size (mass) and divides malignant mesothelioma into four stages:

• Stage 1 - Malignant mesothelioma has affected the right or left side of the chest cavity (pleural lining) and may be seen in the diaphragm.
• Stage 2 - Malignant mesothelioma has been found in the pleura on both sides of the body and may have also moved into the heart, stomach, or esophagus on both sides. Lymph nodes may be affected.
• Stage 3 - Malignant mesothelioma has reached the abdominal cavity (peritoneum). Lymph nodes past the chest may be affected.
• Stage 4 - Malignant mesothelioma has reached other organs and has entered the blood stream.

TNM System

The TNM System is a more modern staging system for malignant mesothelioma. The TNM System is based on the extent of the tumor, metastasis, and lymph node involvement. Again, the TNM System divides malignant mesothelioma into four stages:

• Stage 1 - Malignant mesothelioma is present in the left or right chest cavity (pleura) and may have metastasized to the lung, the sac around the heart (pericardium) or the diaphragm on the same side. Lymph nodes at stage 1 are not involved.
• Stage 2 - Malignant mesothelioma has reached from one side of the chest cavity to a lymph node near the lung area on the same side as the cancer. The cancer has metastasized to the diaphragm, pericardium (sac around the heart), or the lung on the same side as the primary tumor.
• Stage 3 - Malignant mesothelioma has penetrated the chest lining, heart, esophagus, muscle, ribs and vital organs within the chest cavity on the same side as the cancer. Lymph nodes may or may not be involved during this stage.
• Stage 4 - Malignant mesothelioma has metastasized to the pleural area and the lymph nodes on the opposite side of where the cancerous tumor is located. It may also have reached the chest cavities or lungs on both sides, or may have spread to the abdomen.

Brigham System

The Brigham System is the most modern of the three malignant mesothelioma staging systems. The Brigham System looks at different variables such as the involvement of the lymph nodes and the surgical ability to remove a malignant mesothelioma tumor (respectability). For this reason, it is not used very often to stage mesothelioma, as the cancer is rarely operable. The Brigham System divides malignant mesothelioma into four stages:

• Stage 1 - Malignant mesothelioma tumor is still resectable (able to be removed surgically) and the lymph nodes are not affected.
• Stage 2 - Malignant mesothelioma tumor is still resectable, but the lymph nodes are now affected.
• Stage 3 - Malignant mesothelioma tumor is not resectable and the malignant mesothelioma has penetrated the heart, chest wall, abdominal cavity or diaphragm. Lymph nodes may or may not be affected.
• Stage 4 - Malignant mesothelioma tumor is not resectable and has completely metastasized (spread throughout the body).

Process of Staging Malignant Mesothelioma

When mesothelioma is diagnosed by a physician or specialist, they must determine the extent of the cancer and how far it has spread. Most often, they will use imaging procedures to see inside the chest or abdomen to help determine the staging of the malignant mesothelioma. The imaging options physicians may use include:

• Chest x-ray
• CT scan of the chest and/or abdomen
• MRI scan of the chest and/or abdomen
• PET scan of the chest and/or abdomen

Once the doctor is able to determine the stage of the mesothelioma, they will be able to formulate a plan for treatment and provide a prognosis.

Malignant Sarcomatoid Mesothelioma

Cancer specialists use a variety of different methods to categorize malignant mesothelioma. The most well-known method is categorization of the cancer according to its point of origin in the body. For example, pleural mesothelioma develops in the lining of the lungs, pericardial mesothelioma develops in the lining of the heart, and peritoneal mesothelioma develops in the lining of the abdominal cavity. For more information about the different types of mesothelioma, please see Mesothelioma Overview.

Malignant mesothelioma and other types of cancer are also categorized according to how far advanced each case of cancer is, in terms of factors such as the size of tumor(s), and whether the cancer has spread to lymph nodes or other locations. To read more about how cancers are categorized in this way, please see Mesothelioma Staging Systems - Overview.

In addition, malignant mesothelioma and other asbestos cancers are categorized according to the size, shape, and general appearance of cells when viewed under a microscope, as well as the types of proteins that can be detected on the surface of the cells. This type of categorization is called histology, or histopathology.

Each of these systems of categorization provides mesothelioma specialists with important information that is used to determine the exact type of cancer cells they are dealing with in a given case. This information is then used to determine how to treat each patient on an individual basis.

Biopsy and Histopathology

Patients who undergo medical evaluation to determine if they have malignant mesothelioma will undergo a variety of medical tests that determine the location and nature of the cancer. One of these is a biopsy of cells that are suspected to be cancer cells. During a biopsy samples of suspected cancer cells are removed from several different locations in the tumor site. These cell samples are then evaluated in a laboratory to determine what type of cells they are and whether the cells are malignant. For more information about biopsy procedures a mesothelioma patient might undergo, please see Mesothelioma Surgery - Biopsy.

In the laboratory, cells that are suspected to be cancerous are tested in two ways. First, they are viewed under a microscope to determine their general appearance. Second, they are tested for the presence of oncoproteins and other molecules that are produced by specific types of cancer cells.

When viewed under a microscope, mesothelioma cells and other types of cancer cells can be distinguished from normal healthy cells because of their shape and other differences in appearance. Further tests are needed to determine the exact nature of the cells. These tests evaluate the types of proteins that are present on the surface of the cells. When mesothelial cells become malignant, they begin to produce different types of proteins and some of these are present on the surface of the cells. Examining the types of surface proteins allows a histologist to determine if the cells are malignant mesothelioma, another type of cancer, or healthy cells.

Malignant Sarcomatoid Mesothelioma

In histological terms, there are four different types of mesothelioma: sarcomatoid, epithelial, biphasic, and desoplastic (a variant of sarcomatoid). Please see Epithelial and Biphasic for information on these other types of malignant mesothelioma cells.

Malignant sarcomatoid mesothelioma is the least common of the three cellular mesothelioma types. This form of mesothelioma accounts for approximately 10 to 15 percent of cases. When viewed under a microscope, malignant sarcomatoid mesothelioma cells appear as elongated spindle-shaped cells that are irregularly shaped and often overlap one another.

Desoplastic mesothelioma is considered a variant of sarcomatoid mesothelioma. This form is likely the most difficult of all mesotheliomas to diagnose. When desoplastic mesothelioma invades or metastasizes, the cells can appear very bland and can be misdiagnosed as benign fibrous tissue. Medical experts in mesothelioma say this form of mesothelioma should not be diagnosed with a needle core biopsy.

It's important to know that malignant sarcomatoid mesothelioma is sometimes difficult to diagnose on the basis of histological methods. For example, cells of another type of cancer called pulmonary sarcomatoid carcinoma are very similar in appearance (as well as other characteristics) to malignant sarcomatoid mesothelioma.

For this reason, if you are diagnosed with cancer and you know that you have been exposed to asbestos at some time in the past, obtaining a second diagnostic opinion may be important. Different types of cancer vary widely in terms of prognosis and treatment options, and if misdiagnosed, patients may not receive the most appropriate treatment for their cancer.

Prognosis and Treatment

Each of the four cellular forms of mesothelioma are generally treated in the same way. Treatment is not based on the specific type of cells involved, but instead on the location of tumors and the stage of the cancer. Please see Mesothelioma Treatment for more information about treatment options.

Each type of cancer responds to treatment very differently. In general, patients with malignant sarcomatoid mesothelioma have a poorer prognosis than patients with epithelioid mesothelioma, as sarcomatoid cancers are more aggressive and more resistant to treatment. Unfortunately, the general prognosis for all types of mesothelioma is usually poor, and the difference in prognosis between sarcomatoid, epithelioid, biphasic, and desoplastic cancers may amount to as little as only a few months.