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What is involved? (including coding of cases) SABRE Case Studies and Information
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Malignant Diseases due to Asbestos Exposure
Malignant mesotheliomaMalignant mesothelioma is an invasive malignant disease of the pleura or peritoneum, with most cases developing in the pleura (Browne, 1994). Between 69% to 85% of mesothelioma cases are associated with prior asbestos exposure, most commonly amphiboles, and usually have a 20 to 50 year latency period (i.e. time from the initial exposure to the development of the disease) (Greenberg & Davies, 1974; Milne 1976; Whitewell et al., 1977; Zwi et al., 1989, Johnson, 1997, thesis). Internationally, the incidence of malignant mesothelioma continues to escalate, with Australia having one of the highest national rates of mesothelioma in the world (Yeung et al 1999; Johnson, 1997, thesis). The prognosis for individuals with malignant mesothelioma is poor because of the inability to effectively treat mesothelioma with any of the conventional therapies (i.e. radical surgery, radiotherapy or chemotherapy). The macroscopic features of the pleural tumour are variable, ranging from a hard thin layer of tumour covering some of the lung to a thick soft mass which totally encloses the entire lung (Browne, 1994). Similarly, the peritoneal tumour ranges from nodules of the intestines, peritoneum and other organs to a mass totally encasing the abdominal organs. Growth of these tumours causes obliteration of the enveloped organs which ultimately is usually the cause of death. Microscopically, mesothelial tumours are pleomorphic and are difficult to differentiate from adenocarcinoma. There are three predominant histological types, namely, epithelial, mesothelial, and mixed. Of the three types, the prognosis for individuals with epithelial type tumours is marginally improved (Hillerdal, 1983; Van Gelder et al., 1994). Pleural tumours are often accompanied by a pleural effusion and hence clinically, patients present with breathlessness and a dull, persistent chest pain (Begin, 1998). Median survival from diagnosis is in the order of 9-12 months (Johnson, 1997). References:
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