What are the symptoms of mesothelioma? How long does it take to get sick? And who is at greatest risk?

1. What is mesothelioma?
«An aggressive tumor that affects the mesothelium, a membrane that lines various organs and structures including the lungs and the internal part of the rib cage (pleura), heart (pericardium), intestine (peritoneum) and testes. The vast majority of cases develop in the pleura.”

2. Why is it classified as an occupational disease?
«Because in over 90% of cases it is due to exposure to asbestos or asbestos fibres. In Italy, all asbestos extraction, processing and trade activities have been banned since 1992.”

3. Which sectors are most affected?
«Production of Eternit products, shipbuilding and construction, from which 60% of the tumors cataloged in the national register derive. Due to the presence of shipyards and factories where asbestos was used, mesothelioma is “typical” of some areas of our country, such as Casale Monferrato, Mestre, Savona, Ancona, Monfalcone, Trieste, Bari”.

4. How long does it take for the tumor to appear?
«The latency period between exposure to risk factors and the appearance of cancer is 20-40 years. Therefore, although in Italy there are approximately two thousand cases of mesothelioma per year, the peak incidence has not yet been reached. Unfortunately, it doesn't take much to be in danger: just inhale the asbestos fibres. Today all removal and reclamation operations must be carried out by specialized workers and in a protected manner.”

5. What are the symptoms?
«The first signs are “vague”, such as chest pain, difficulty breathing and cough, usually already present for a few months when the tumor is diagnosed. The most frequent sign is the formation of pleural fluid in the chest. Surveillance of the people most exposed to the risk of falling ill, such as former workers, is therefore essential.”

6. What therapies are there?
«Until a few years ago, a diagnosis of mesothelioma was almost always characterized by an unfavorable prognosis, with an average survival of less than a year. Today something has moved thanks to immunotherapy, which appears more effective than chemotherapy.”

(Marilina Piccirillo, oncologist and researcher at the Pascale Cancer Institute in Naples, answered the questions)