Current surgical management of malignant pleural mesotheliomaMalignant pleural mesothelioma is a rare and very aggressive malignancy with an increasing incidence. Single-modality therapy has failed to improve median survival. Current surgical therapies include palliative and cytoreductive procedures. The rarity of the disease, the lack of randomized surgical studies, and the lack of a universally accepted and validated staging system make it difficult to reach consensus and establish stage-specific protocols. However, with strict criteria, subsets of patients can be identified who can benefit from aggressive cytoreductive surgical approaches, such as extrapleural pneumonectomy, and adjuvant chemoradiation protocols. Our experience with this type of protocol in carefully selected patients has resulted in increased median survival. The lack of cure in any of the published protocols demonstrates the need for new therapies and approaches for this disease.
Asbestos Hazards Asbestos is not always an immediate hazard. In fact, if asbestos can be maintained in good condition, it is recommended that it be left alone and periodic surveillance performed to monitor it’s condition. It’s only when asbestos containing materials are disturbed or the materials become damaged that it becomes a hazard. When the materials become damaged, the fibers separate and may then become airborne. In the asbestos industry, the term ‘friable’ is used to describe asbestos that can be reduced to dust by hand pressure. ‘Non-friable’ means asbestos that is too hard to be reduced to dust by hand. Non-friable materials, such as transite siding and floor tiles are not regulated by the State provided it does not become friable. Machine grinding, sanding and dry-buffing are ways of causing non-friable materials to become friable.