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Mesothelioma Basic

Mesothelioma Basics

Mesothelioma is a rare form of cancer in which malignant (cancerous) cells are found in the mesothelium, a protective sac that covers most of the body's internal organs.

What is the mesothelium? The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.

The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart.

What is mesothelioma? Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.

How common is mesothelioma? Over 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. See statistics for more details.

What are the risk factors for mesothelioma? Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in the majority of cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos.

Who is at increased risk for developing mesothelioma? Since the early 1940s, millions of American workers have been exposed to asbestos dust. An increased risk of developing mesothelioma was originally found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other trades people. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

There is evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers.

What are the symptoms of mesothelioma? Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.

How is mesothelioma diagnosed? Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful.

A biopsy confirms a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist removes a sample of tissue for examination under a microscope by a pathologist. (See Pathology Diagnosis to learn why some patients request a second opinion.)

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

What is the conventional approach to treating mesothelioma? Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Standard treatment for all but localized mesothelioma is generally not curative.

Surgery - Extrapleural pneumonectomy in selected patients with early stage disease may improve recurrence-free survival, but its impact on overall survival is unknown. Pleurectomy and decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and pain caused by invasive tumor. Operative mortality from pleurectomy/decortication is <2%,>

Radiation/Chemotherapy - The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients treated; however, the duration of symptom control is short-lived. Single-agent and combination chemotherapy have been evaluated in single and combined modality studies. The most studied agent is doxorubicin, which has produced partial responses in approximately 15% to 20% of patients studied. Some combination chemotherapy regimens have been reported to have higher response rates in small phase II trials; however, the toxic effects reported are also higher, and there is no evidence that combination regimens result in longer survival or longer control of symptoms.

Alimta - The only FDA approved chemotherapy for malignant pleural mesothelioma (in combination with cisplatin) is pemetrexed (Alimta). In the key clinical trial that led to its approval, Alimta was combined with another chemotherapy drug (cisplatin) and compared with cisplatin alone. The patients who received the two drugs (Alimta and cisplatin) had their cancers progress (grow/spread) in 5.7 months (median). The patients who only received cisplatin had their tumors progress in 3.9 months (median). The median survival for the patients who received both drugs was 12.1 months versus 9.3 months for cisplatin only.

For some physicians, these therapeutic gains are not impressive. For example, some have written, "For the treatment of mesothelioma, there is little evidence that current therapies (chemotherapy, radiation, surgery) provide significant benefit for survival or quality of life.[R]adical treatments, occupying the 3 months after diagnosis, can take up the best 3 months that the patient might have had.Malignant mesothelioma has largely defeated treatment.

Obama met with his half brother

BEIJING – Wednesday that Mr.Obama met briefly with a half brother who lives in China and who recently wrote a semi-autobiographical novel about the abusive Kenyan father they share.

Obama, who spent three days in China during his first official tour of Asia, acknowledged the meeting in an interview with CNN. He offered no details. An aide said later that the meeting took place Monday night after Obama arrived in Beijing, the Chinese capital.

The White House had declined to say whether the president and Mark Ndesandjo would meet. And no White House official mentioned the visit until Obama did when asked about it.

"I don't know him well. I met him for the first time a couple of years ago," Obama told CNN. "He stopped by with his wife for about five minutes during the trip."

Describing the meeting as "overwhelming" and "intense," Ndesandjo told The Associated Press in an interview Wednesday that he had long anticipated the chance to welcome his famous brother to China.

"I think he came directly off the plane, changed some clothes and then came down and saw us," Ndesandjo said. "And he just gave me a big hug. And it was so intense. I'm still over the moon on it. I am over the moon. And my wife. She is his biggest fan and I think she is still recovering."

In the CNN interview, Obama said he hadn't read his brother's book, "Nairobi to Shenzhen," which features a protagonist who is the son of a Jewish mother and an abusive father from Kenya.

Ndesandjo has revealed in previous interviews that his father, Barack Obama Sr., beat him and his mother. The president also wrote about his father, who abandoned him as a child, in his best-selling memoir.

"It's no secret that my father was a troubled person," Obama said. "Anybody who has read my first book, 'Dreams from My Father,' knows that, you know, he had an alcoholism problem, that he didn't treat his families very well. Obviously it's a sad part of my history and my background but it's not something I spend a lot of time brooding over."

Ndesandjo said he bought tickets months ago to fly from the southern boomtown of Shenzhen, where he has lived since 2002, to Beijing, in hopes of reconnecting with his brother. The two last met in January when Ndesandjo attended Obama's inauguration as a family guest.

The three chatted on Monday, with Obama being introduced to Ndesandjo's wife, a native of Henan, China, whom he married a year ago, he said. He gave few details of what they discussed.

"All I can say is, we talked about family, and it was very powerful because when he came in through that door, and I saw him and I hugged him, and he hugged me and hugged my wife. It was like we were continuing a conversation that had started many years ago," he said.

The two men did not grow up together. Ndesandjo's mother, Ruth Nidesand, was Barack Obama Sr.'s third wife. Before arriving in Beijing on Monday, Obama had been in a townhall-style meeting with students in Shanghai, and joked that a family gathering at his house "looks like the United Nations."

President Obama's father had been a Kenyan exchange student who met his mother, Kansas native Stanley Ann Dunham, when they were in school in Hawaii. The two separated two years after he was born.

The senior Obama married Ndesandjo's mother after divorcing the president's mother. They returned to Kenya to live, where Mark and his brother, David, were born and raised.

Obama Sr. died in an automobile accident in 1982 at age 46.

Ndesandjo lives near Hong Kong and earns a living as a marketing consultant. For most of that time, he has maintained a low profile, with few people knowing of his connection to the U.S. president.

A CITY PRIDE AND JOY

The swell of pride was tangible at the newly completed Nelson Mandela Bay stadium this weekend as thousands of fans filled the 2010 FIFA World Cup arena to watch South Africa take on Japan in a friendly international.

The stadium echoed with the awesome power of the vuvuzela, giving a voice to the jubilation of the South African fans, dressed to the hilt in the colours of the rainbow nation.

The clash saw South Africa hold off the Blue Samurai to a 0-0 draw. Moreover, it saw the successful hosting of an international football game in the first completed, newly built stadium in South Africa, ahead of next year’s 2010 FIFA World Cup™.

Fans were impressed by the “stunning” stadium and the smooth running of the match.

“I’m very proud of the stadium, it really lives up to the name ‘Nelson Mandela’ stadium,” said technician Vuyani Sqokwana, on his third visit to the completed football arena with his wife and an 11-month old daughter.

The whole family had a honk on their vuvuzela, even toddler, Ibongwe. When asked if he thought South Africa was ready for the World Cup, Sqokwana’s resolute reply was: “We are ready now.”

Philip Dada, a football player himself for local veterans team − Eastern Cape Legends − took time to enjoy the game with his family for a change. “This is a nice family outing, and for once we can watch together instead of them watching me out on the field.”

Given his history in football, he believes he is well placed to judge whether or not things have run smoothly.

“There is no doubt that we are ready for the World Cup. We showed at the Confederations Cup that we are prepared and we did it again today in our perfect stadium.”

Brothers Andrew (41) and Duncan Stewart (37) have watched the building go from “inception to completion” and, although they are not big football fans, they could not resist the opportunity to watch the national team in their local stadium.

“We came to see what it’s all about, we wouldn’t normally watch soccer, but this is Bafana Bafana. They are our national team, so we had to come out and support.

“We are amazed at how full it is, the turn-out from the people is very impressive. I can’t imagine anyone sitting in a stadium like this and not being impressed,” said Andrew Stewart, an exhibition stand designer, with Duncan Stewart chirping in that the success shows “we will be ready”.

Sisters Sharmilla and Prishana Rajput had neither been to the stadium nor a football match before and were undoubtedly impressed.

“I drive past the stadium everyday, but seeing it and being inside it are two different things. It is a totally magical experience − you can definitely feel the vibe and energy and it makes me excited for next year,” said Sharmilla Rajput.

Prishana Rajput said the impact on the city can already be felt. “The World Cup is on our doorstep,” she said. “We are definitely ready and waiting in Port Elizabeth.”

The stadium can seat over 45 000 people. Eight games, including a third and fourth place playoff and a quarter Quarter Final, will take place at the Nelson Mandela Bay stadium during the World Cup.

2010 FIFA WORLD CUP

Memorable Moments
The long road to determining the 2010 FIFA World Cup™ champions commenced in the Samoan capital of Apia way back on 25 August 2007. On that occasion New Caledonia captain Pierre Wajoka had the honour of scoring the first goal in the global campaign for South Africa 2010 with his ninth-minute penalty enough to edge Tahiti 1-0 in a Francophone derby. It proved to be the commencement of a solid campaign for the New Caledonians who were only admitted to FIFA in 2005.

The first stage of qualifying saw ten teams split into two groups with Group A comprised of Cook Islands, Fiji, New Caledonia, Tahiti and Oceania Football Confederation associate member Tuvalu. Group B featured American Samoa, Samoa, Solomon Islands, Tonga and Vanuatu.

Fiji and New Caledonia finished well clear of the opposition to claim their position in the semi-finals of Round 1, with Tahiti four points away from progressing. The Solomon Islands started their campaign in bright fashion as the Pacific football hotbed maintained momentum from their previous campaign which saw them finish ahead of New Zealand. The Solomon Islanders progressing to the semi-finals in imperious fashion winning all four matches and conceding just one goal.

Joining them were Vanuatu who had also impressed in the qualifying campaign for Germany 2006. Samoa, captained by Chris Cahill, elder brother of Australian superstar Tim, recorded two wins to finish ahead of Tonga and American Samoa with the latter scoring its first-ever FIFA World Cup goal through the boot of Ramin Ott.

The semi-final stage produced a major shock as the Solomon Islands lost firstly to 3-2 to New Caledonia, and then to 2-0 to Vanuatu in the play-off, to miss qualification for Stage 2. New Caledonia defeated Fiji 1-0 in the final, with both teams joined by Vanuatu in progressing to the next stage where New Zealand awaited.

There was little room for error with only six matches each in the four-nation Stage 2. New Zealand set up their campaign nicely with two tough away wins first-up in Fiji and Vanuatu, and the Kiwis never looked back, winning their first five matches to seal the title of Oceania champions. Fielding an under strength line-up the All Whites did lose their last group match against Fiji, who were edged from second spot by New Caledonia, seven points behind the Kiwis.

New Zealand had to wait 11 months to face the fifth-placed Asian nation in an intercontinental play-off for a berth to South Africa 2010. Bahrain defeated regional giants Saudi Arabia to book their meeting with New Zealand. The first leg in Manama was a hard-fought affair in oppressive heat and despite goal opportunities for both teams, the match finished scoreless.

The second leg in front of a record crowd in the New Zealand capital of Wellington saw Rory Fallow score in the final minute of the first half with what proved the only goal of the game. A second-half penalty save from Mark Paston helped ensure the All Whites first FIFA World Cup appearance since 1982.

The revelations
Fiji striker Osea Vakatalesau claimed the honour of finishing as the globe’s top-scorer during South Africa 2010 qualifying, along with Burkina Faso’s Moumouni Dagano, by grabbing a dozen goals from nine matches. The goal-ace forming a dynamic partnership with young sharpshooter Roy Krishna but it wasn’t enough for the Fijians who finished eight point behind New Zealand.

Oceania Player of the Year Shane Smeltz led the way in the crucial Stage 2 qualifying section, picking up eight goals in just five outings. Smeltz set to lead the line for the Kiwis in South Africa alongside target-men Chris Killen and Rory Fallon.

The Quote
"We've waited 27 years to resurrect something very important to us. This group have given it everything, four years of total commitment. We’re back, we’re there. South Africa, here we come,” New Zealand coach Ricki Herbert.

The Stat
Oceania recorded the highest goals per match average (4.02) across all six FIFA confederations, and the biggest win in South Africa 2010 qualifying: American Samoa-Vanuatu 0-15

The qualified team
New Zealand

The top-scorers
12 goals - Osea Vakatalesau (Fiji)
9 - Seule Soromon (Vanuatu)
8 - Shane Smeltz (New Zealand)
7 – Commins Menapi (Solomon Islands)
6 - Iamel Kabeu (New Caledonia), Francois Sakama (Vanuatu), Roy Krishna (Fiji)
5 - Etienne Mermer (Vanuatu), Michel Hmae (New Caledonia)
4 - Teariki Mateariki (Cook Islands)

World Cup

KHARTOUM (AFP) – Sudan's security forces threw a tight security cordon around Khartoum to prevent violence between fans of Algeria and Egypt, who clash on Wednesday for a place at the World Cup football finals.

Thousands of rival supporters from Cairo and Algiers have invaded Khartoum, a rare venue for such a showdown in international football.

On Tuesday night, Algerian fans with their country's flag draped over cars cruised through the streets, while groups of Egyptians gathered to dance, sing and chant slogans.

The authorities have deployed 15,000 police to segregate fans in a bid to prevent clashes before, during or after the match, which follows an inconclusive play-off in Cairo last Saturday.

With the North African rivals contesting Africa's last place in next year's finals in South Africa, Egyptian supporters stoned the Algeria squad's bus last week, injuring three players, as it made its way to the team's Cairo hotel.

Away fans were also hurt after Saturday's match, prompting revenge attacks on Egyptian companies based in Algeria.

On the eve of Wednesday's decider, the head of the Algerian football federation told reporters in Khartoum that his Egyptian counterpart Samir Zaher was to blame for the violence.

"He is the origin of all the events that have occurred, including the barbaric aggression that injured ... our players, shocked them and put them under extremely unfavourable conditions," Mohammed Raouraoua said.

World football's governing body FIFA arranged the play-off in neutral territory after Egypt's 2-0 home win over Algeria left the teams deadlocked.

Algeria and Egypt have each been allocated 9,000 seats for the game at Al-Merreikh stadium in Khartoum's twin city of Omdurman. The normal capacity of 41,000 has been cut to 35,000 to allow for strict segregation of the fans.

Both the Algerian and Egyptian embassies have been handing out their match ticket allocations, with many supporters also having been offered free or low-price air tickets.

The gates are to open at 3:30 pm (1230 GMT) and close two hours before the 8:30 kick-off, with fans kept apart at different ends of the stadium and due to be channelled out by different routes.

A 400-member medical team, with 120 ambulances on standby, are to be on duty at the stadium, said Hassan Abdelaziz, head of a medical committee set up for the match.

Schools and offices are to close early, at 1 pm, to clear the streets and allow easier access to the stadium in the city on the Nile of almost five million people.

Several foreign embassies have urged their nationals to stay at home.

A senior Muslim cleric, Sheikh Yussef Qardawi, who is of Egyptian origin, has issued an appeal for calm and urged Arab fans not to wreck their countries' ties over what was "only a game" after all.

Meanwhile, authorities have also gone on alert in Egypt and Algeria, as well as in France, which is home to large North African communities.

The two North African rivals have a history of bad blood in footballing terms, with riots breaking out after Egypt defeated Algeria in a 1989 match in Cairo. Egypt last qualified for the World Cup in 1990, and Algeria in 1