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<p begin="00:00" end="00:07">[Music]</p>
<p begin="00:07" end="00:12">My name’s Sanjay Popat, I’m a consultant medical oncologist at the Royal Marsden Hospital.</p>
<p begin="00:12" end="00:19">Mesothelioma is a cancer of a membrane that lines various organs in the body called the mesothelium.</p>
<p begin="00:19" end="00:25">Now the mesothelium is found in various places, mainly in the chest and also in the abdomen, or tummy.</p>
<p begin="00:00" end="00:32">The majority of cases that we see as doctors are actually plural mesothelioma. So these are cancers of the lining of the lung.</p>
<p begin="00:32" end="00:39">Usually this tumour is really quite silent and it is very difficult to pick it up at a very early stage </p>
<p begin="00:39" end="00:44">because it grows silently within the chest cavity.</p>
<p begin="00:44" end="00:49">When patients become unwell and they seek medical input it’s usually because they’re feeling short of breath,</p>
<p begin="00:49" end="00:54"> they’re not able to do things with as much capacity as they could before -</p>
<p begin="00:54" end="00:57">Going uphill, walking up the stairs, </p>
<p begin="00:57" end="01:04">or even just resting and talking to people is becoming more difficult because of breathlessness.</p>
<p begin="01:04" end="01:10">Other symptoms that patients can have, other than breathlessness, is weight loss.</p>
<p begin="01:10" end="01:16">In fact weight loss without trying to diet is generally indicative of underlying problems</p>
<p begin="01:16" end="01:19">such as cancer, and should be investigated further.</p>
<p begin="01:19" end="01:24">Mesothelioma is predominantly seen in patients that have been exposed to asbestos.</p>
<p begin="01:24" end="01:30">Nearly 8 or 9 out of 10 patients with a diagnosis of mesothelioma </p>
<p begin="01:30" end="01:35">report that they have worked either in an industry which has had asbestos associated with it</p>
<p begin="01:35" end="01:40">or have known to have been exposed to asbestos in the past.</p>
<p begin="01:40" end="01:45">Smoking by itself doesn’t cause mesothelioma,</p> 
<p begin="01:45" end="01:51">but patients that have known that they’ve been exposed to asbestos should not smoke.</p>
<p begin="01:51" end="01:53">They should give up smoking if they do</p>
<p begin="01:53" end="01:56">because that massively increases the risk of lung cancer </p>
<p begin="01:56" end="02:01">because the airways become more damaged because of the smoke.</p>
<p begin="02:01" end="02:07">And often there can be a long lag period between asbestos exposure and the cancer forming.</p>
<p begin="02:07" end="02:12">The average lag period that we see is anywhere between 15 to 60 years,</p>
<p begin="02:12" end="02:17">with most patients having a lag period around 40 years or so.</p>
<p begin="02:17" end="02:24">Some patients who have cared for patients who have been exposed to asbestos </p>
<p begin="02:24" end="02:27">and then developed mesothelioma might be at increased risk.</p>
<p begin="02:27" end="02:37">This is generally the typical setting of the wife of a man that has worked in the construction industry</p>
<p begin="02:37" end="02:42">who has potentially brought his overalls or work shoes or work cap home to be cleaned</p>
<p begin="02:42" end="02:51">and the asbestos fibres from such materials can then be in the home environment.</p>
<p begin="02:51" end="02:58">The one thing to emphasise is that mesothelioma does not seem to be hereditary, so you can’t inherit that from your parents.</p>
<p begin="02:58" end="03:04">Neither is it infectious, you can’t catch mesothelioma from another patient that has mesothelioma.</p>
<p begin="03:04" end="03:10">There are a number of tests that doctors do to make a diagnosis of mesothelioma.</p>
<p begin="03:10" end="03:19">Usually a GP will do an examination, will listen to the chest to see whether there is any fluid present or not</p>
<p begin="03:19" end="03:23">and then arrange for a chest x-ray to be performed.</p>
<p begin="03:23" end="03:28">The mainstay of treatment of mesothelioma is generally with chemotherapy.</p>
<p begin="03:28" end="03:33">The aim of this is very much to improve the quality of life of our patients.</p>
<p begin="03:33" end="03:38">There’s very good evidence that this can potentially in some patients shrink the cancer</p>
<p begin="03:38" end="03:42">and also keep the cancer under control for longer than it would do otherwise, </p>
<p begin="03:42" end="03:45">and sometimes that can improve length of life as well.</p>
<p begin="03:45" end="03:49">Other treatments that can be considered include radiotherapy</p>
<p begin="03:49" end="03:56">and that can be useful in very specific cases, either to prevent cancer from growing along biopsy sites,</p>
<p begin="03:56" end="04:01">or to target a specific area that might be causing pain or discomfort.</p>
<p begin="04:01" end="04:06">We’re expecting more cases of mesothelioma over the next few years because of the lag phase between asbestos exposure</p>
<p begin="04:06" end="04:10"> and the disease becoming clinically manifest.</p>
<p begin="04:10" end="04:16">If patients have known they’ve been exposed to asbestos it’s worth them just touching base with their GP</p>
<p begin="04:16" end="04:20">so they can just have a general assessment to make sure they’re okay.</p>
<p begin="04:22" end="04:25">For information, help, or if you just want to chat</p>
<p begin="04:25" end="04:33">call the Macmillan Support Line on 0808 808 00 00. Or visit macmillan.org.uk</p>
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