The History Of Mesothelioma

Malignant mesothelioma remains one of the sentinel malignancies of oncology. It has a breathtakingly rapid natural history with a median survival of 6 to 8 months when untreated, is environmentally related, and has such economic and social impact that attorneys specialize in representing only mesothelioma patients. Expert witnesses devote full time to testifying, and governments are forced to consider not only the banning of the environmental agent but also a reappraisal of the whole tort system for compensation to injured victims. Furthermore, its presence in certain populations has changed the mindset of whole communities, such as Libby, Montana, Cappadocia, Turkey, Sarnia, and Ontario. Because of its infrequent occurrence, malignant mesothelioma is considered an orphan disease and managed in an anecdotal fashion in most oncologic practices. Yet this disease has set new scientific paradigms— in the clinic, laboratory, and community.

Over the last ten years, data have accumulated indicating that mesothelioma is a cancer caused by the environmental carcinogens asbestos and erionite, which interact with genetic predisposition and viral infection during cardinogenesis. The outcome of these complex interactions determines who among exposed individuals will develop
malignancy. Moreover, mesothelioma has become the ideal model to study how genetics and viral infection influence environmental carcinogenesis, as well as to discover novel targets for early detection and therapy.

Few cancers have caused so much controversy as mesothelioma. For more than 40 years scientists have argued whether chrysotile asbestos does or does not cause mesothelioma.Besides these important causality issues, conflict exists regarding the best surgical therapy for the disease and the interpretation of novel trials for mesothelioma.

The proliferation of mesothelioma-specific knowledge has led to an increase in the number of global conferences devoted to mesothelioma, at which scientists present new and exciting findings. Asufficient quantity of mesothelioma-specific research now stands strong and is no longer the stepchild at meetings devoted to lung cancer or sarcoma. Clinicians and scientists alike are being identified as “mesothelioma
experts,” and their advice in preventing and detecting the disease early, as well as in the treatment of the disease, is being solicited not only by other physicians, but by a growing number of E-mails directly from patients and their families.