If you or your loved one has been diagnosed with a serious illness like mesothelioma, the medical terms being used by your physicians and other healthcare professionals may seem overwhelming and may sound like a foreign language to you. First, you should never hesitate to ask for words to be explained or for things to be repeated. It is very important for you to understand what is going on and what procedures are being performed.
To assist you, we are providing a glossary of some medical terms that are frequently used by healthcare providers when discussing a mesothelioma diagnosis or one’s prognosis. Attorneys at the Galiher law firm have represented hundreds of mesothelioma clients over the last three decades, and know intimately what you and your whole family are going through as you face this diagnosis. If you have some understanding of what the medical terms mean, you will be able to ask further questions of your physician and others.
Here are some medical terms you might be interested in understanding:
Biopsy
A biopsy is a diagnostic test in which your doctor removes cells or tissue from your body for examination by a pathologist, a doctor with specialized training in diagnosing diseases using microscopes. Your doctor will probably order a biopsy to confirm a diagnosis of mesothelioma or other cancer.
If your doctor suspects mesothelioma, he or she will remove a sample of tissue from your chest or abdomen for testing at a pathology lab. This biopsy tissue will then be sent to your pathologist, who will issue a pathology report with a final diagnosis.
The biopsy may be done in different ways, depending on where the cancer is located. If the cancer appears to be a pleural mesothelioma, your doctor may order a core needle biopsy (CNB) or a fine needle aspiration (FNA) biopsy. He or she will use a CT machine or other imaging test such as an endoscopic ultrasound (EUS) to locate the abnormal tissue, and then insert a biopsy needle through the chest wall into the suspect lung tissue.
If your doctor is unable to get a large enough tissue sample through a needle biopsy, he or she may also make a surgical incision to remove tissue from the chest or abdomen. This is known as an incisional biopsy.
Hospice
If your loved one is suffering from mesothelioma, you may reach the point where you need additional help to care for your loved one. You may want to consider hospice care. Many of our Hawai‘i clients have found hospice to be an important resource for the entire family.
Hospice provides care to patients who are in the terminal stages of an illness. In order to qualify for hospice care, your condition must be considered incurable and terminal and your doctor must certify that your life expectancy is six months or less.
Hospice teams include medical professionals, counselors, therapists, social workers, spiritual advisors, home health aides and trained volunteers. The goal of hospice is to care for those who are in the last stages of life. It endeavors to enhance the quality of life and make the last stages of life as comfortable as possible. It provides emotional, psychological, and spiritual care and support for you and your family.
Focus on Pain Management and Family Support
In hospice, the focus of care has changed. It is no longer concerned with aggressive measures to cure a disease. Instead, it focuses on relieving pain, anxiety, and other symptoms, so those who are dying may do so with dignity and in the comfort of their own homes with their loved ones caring for them. Often this is referred to as palliative care. Hospice provides many benefits, including basic medical care with a focus on pain and symptom control, medical supplies and equipment, trained volunteer support, respite for your caregivers, counseling and guidance for you and your family, and counseling and support for your loved ones after you die.
Hospice care can take place in your own home or in a hospice center, sometimes in a nursing home, long-term care facility, or hospital. Most of the time, care will take place in your home and a family member or loved one will look after you. A member of your hospice team will visit you for an hour or so one or more times a week. The hospice team will work with your caregivers to help them give you the best possible care and to prepare them to handle situations that can arise in the home. Hospice programs offer services 24 hours a day, 7 days a week, and you or your caregivers may call the hospice team at any time. If necessary, a nurse can usually come to your home at any hour of the day or night.
Hospice also provides respite care for your caregivers. Trained volunteers may be available to relieve your caregiver for a few hours each week. Some hospice programs provide respite for several days at a time. If you enter a hospice program, you can still remain under the care of your doctor, and your doctor will work with your hospice team to stay involved in your care. You may also be treated in a hospital and then return to hospice care. If you live longer than 6 months, you can remain under hospice care. If you get better, you can leave the hospice program.
Hospice care is covered by Medicare, Medicaid, and by most, but not all, private insurance programs. It is best to find out exactly what your insurance covers before you enter a hospice program. Many hospice programs will help you to investigate your coverage.
The Decision is a Personal One
The decision to enter hospice is a personal one. It is a decision that involves the patient, his or her family, and the patient’s physician. It is often difficult for patients and loved ones to face the end of life, even just to acknowledge that it is approaching. Some people wish to pursue aggressive measures up to the very end, to do everything possible to live as long possible by any medical means possible. They may not be able to accept the concept of hospice care. Some patients and their loved ones simply do not know about hospice care or they are afraid that they will not be able to see their doctor anymore or that they won’t be able to go to a hospital or to leave the program if they get better.
Those who choose hospice care enter a comprehensive program, with dedicated professionals and volunteers who endeavor to help their patients to live out their last days in dignity and comfort, without anxiety and pain, and to help their loved ones to face the myriad issues that arise with terminal illness and death.
Latency
Latency refers to the length of time between the first exposure to a toxic or carcinogenic substance such as asbestos, and the onset of the disease caused by the toxin. Most asbestos-related diseases have a long latency period of at least 10 to 40 years.
For example, it typically takes 20 to 40 years to develop malignant mesothelioma after being exposed to asbestos. Likewise, it usually takes 20 to 30 years after the first exposure to develop pleural plaques, asbestosis, or asbestos-related lung cancer. In some cases, the latency period may be as short as 10 years after exposure. In other cases, it may take 50 years or more.
This can make it hard to identify all of the sources of your past asbestos exposure after you are diagnosed with an asbestos-related disease. Many Hawai‘i residents continue to get sick from asbestos products that they worked with during the 1960s, 1970s, or 1980s, and even as far back as the 1940s or 1950s. It can be difficult to remember all of the sources of exposure after so many years have passed. This is particularly true in cases of mesothelioma which may have been caused by very brief or low levels of exposure to asbestos, including household exposure or bystander exposure.
If you live in Hawai‘i, and you have been diagnosed with an asbestos-related disease, we urge you to contact our firm. We have over 35 years of experience with asbestos cases, and we can help you identify the source of your past asbestos exposure.
Mesothelium
The mesothelium is a membrane that forms the lining of several body cavities. In the chest or thoracic cavity, the mesothelium is a two-layer membrane that surrounds the entire surface of the lungs and heart. The mesothelial lining of the lungs is called the pleura, the mesothelial lining of the heart is called the pericardium, and the mesothelial lining of the abdomen is called the peritoneum.
The main function of the mesothelium is to protect your internal organs by producing a lubricating fluid that allows your lungs and heart to glide easily within your chest cavity. Without this protective lining, your lungs and heart would be unable to expand and contract freely. Thus, while few people have ever heard of the mesothelium, your body cannot function normally without it.
Asbestos is a powerful carcinogen. Exposure to asbestos can cause permanent damage to the mesothelium. Over time, inhaled or ingested asbestos fibers in the body cause mesothelial cells to become malignant and form a cancerous tumor known as mesothelioma. Most cases of mesothelioma are diagnosed in the plura (lungs) or peritoneum (abdomen). Unfortunately, these cancer cells can also spread (metastasize) beyond their original sites to other parts of the body. Unfortunately, the widespread use of asbestos throughout the twentieth century has led to an epidemic of mesothelioma in the United States, with many cases here in Hawai‘i.