Older homes and buildings may contain asbestos. In many cases, it's more dangerous to remove the asbestos than it is to leave it intact. Breaking up asbestos may cause fibers to become airborne, where they can be inhaled. Consult experts trained to detect asbestos in your home. These experts may test the air in your home to determine whether the asbestos is a risk to your health. Don't attempt to remove asbestos from your home — hire a qualified expert. The Environmental Protection Agency offers advice on its Web site for dealing with asbestos in the home.

Follow all safety precautions in your workplace, such as wearing protective equipment. You may also be required to shower and change out of your work clothes before taking a lunch break or going home. Talk to your doctor about other precautions you can take to protect yourself from asbestos exposure.

No alternative medicine treatments have proved helpful in treating mesothelioma. But complementary and alternative mesothelioma treatments may help control signs and symptoms. Discuss options with your doctor.

Mesothelioma can cause pressure within your chest that can make you feel as though you're always short of breath. Breathlessness can be distressing. Your doctor may recommend using an oxygen mask or taking medications to make you more comfortable, but often these aren't enough. Combining your doctor's recommended treatments with complementary and alternative approaches may help you feel better.

Alternative treatments that have shown some promise in helping people cope with breathlessness include:

• Acupuncture. Acupuncture uses thin needles inserted at precise points into your skin.
• Breath training. A nurse or physical therapist can teach you breathing techniques to use when you feel breathless. Sometimes you may feel breathless and begin to panic. Implementing these techniques may help you feel more in control of your breathing.
• Relaxation exercises. Slowly tensing and relaxing different muscle groups may help you feel more at ease and breathe easier. Your doctor may refer you to a therapist who can teach you relaxation exercises so that you can do them on your own.
• Sitting near a fan. Directing a fan to your face may help ease the sensation of breathlessness.

Complications from spreading cancer

As pleural mesothelioma spreads in the chest, it puts pressure on the structures in that area. This can cause complications, such as:

* Difficulty breathing
* Chest pain
* Difficulty swallowing
* Swelling caused by pressure on the large vein that leads from your upper body to your heart (superior vena cava syndrome)
* Pain caused by pressure on the nerves and spinal cord
* Accumulation of fluid in the chest (pleural effusion), which can compress the lung nearby and make breathing difficult

Death

Mesothelioma that progresses can lead to death. People who die of mesothelioma usually die from related complications, such as lung failure, heart problems, stroke and other causes.

A diagnosis of mesothelioma can be devastating not only to you, but also to your family and friends. Take time to experience the sadness and despair and to grieve. And remember that you decide how you'll spend your time and with whom you'll spend it.

In order to regain a sense of control, try to:

■Learn everything you can about mesothelioma. Write down a list of questions to ask your doctor. Ask your health care team for information to help you better understand your disease. Consult the National Cancer Institute (NCI) and the American Cancer Society (ACS). Both organizations have Web sites and toll-free telephone information lines. Call the NCI at 800-4-CANCER (800-422-6237). Call the ACS at 800-ACS-2345 (800-227-2345).
■Surround yourself with a support network. Close friends or family can help you with everyday tasks, such as getting you to appointments or treatment. If you have trouble asking for help, learn to be honest with yourself and accept help when you need it.
■Seek out other people with cancer. Ask your health care team about cancer support groups in your community. Sometimes there are questions that can only be answered by other people with cancer. Support groups offer a chance to ask these questions and receive support from people who understand your situation. Online support message boards, such as the ACS's Cancer Survivors Network, can offer similar benefits while allowing you to remain anonymous.
■Plan for the unknown. Ask your health care team about advance directives that give your family guidance on your medical wishes in case you can no longer speak for yourself. Talk to a lawyer about your will, if you haven't already done so.

If you have signs and symptoms that might indicate mesothelioma, your doctor will conduct a physical exam to check for any lumps or other unusual signs. Your doctor may order imaging scans, such as a chest X-ray or a computerized tomography (CT) scan of your chest or abdomen, to look for abnormalities.

It's not uncommon for mesothelioma to be misdiagnosed initially because mesothelioma is rare, and its signs and symptoms aren't specific. Your doctor will likely rule out other more common conditions before considering mesothelioma.

Biopsy


Biopsy, a procedure to remove a small portion of tissue for laboratory examination, is the only way to determine whether you have mesothelioma. Depending on what area of your body is affected, your doctor selects the right biopsy procedure for you. Options include:

■Fine-needle aspiration. The doctor removes fluid or a piece of tissue with a small needle inserted into your chest or abdomen.
■Thoracoscopy. Thoracoscopy allows the surgeon to see inside your chest. In this procedure, the surgeon makes one or more small incisions between your ribs. A tube with a tiny video camera is then inserted into your chest cavity — a procedure sometimes called video-assisted thoracoscopic surgery (VATS). Special surgical tools allow your surgeon to cut away tissue for testing.
■Laparoscopy. Laparoscopy allows the surgeon to see inside your abdomen. Using one or more small incisions into your abdomen, the surgeon inserts a tiny camera and special surgical tools to obtain a small piece of tissue for examination.
■Thoracotomy. Thoracotomy is surgery to open your chest between the ribs to allow a surgeon to check for signs of disease. He or she removes a sample of tissue for testing.
■Laparotomy. Laparotomy is surgery to open your abdomen to allow a surgeon to check for signs of disease. He or she removes a sample of tissue for testing.
The tissue sample is analyzed under a microscope to see whether the abnormal tissue is mesothelioma and what types of cells are involved. The type of mesothelioma you have determines your treatment plan.

Staging


Once mesothelioma is diagnosed, your doctor orders other tests to determine the extent, or stage, of the cancer. Imaging tests that may help determine the stage of your cancer include:

■Chest X-ray
■CT scans of the chest and abdomen
■Magnetic resonance imaging (MRI)
■Positron emission tomography (PET)
Once the extent of pleural mesothelioma is determined, a stage is assigned. Formal stages aren't available for other types of mesothelioma because these types are rare and aren't well studied. The stages of pleural mesothelioma are:

■I. Stage I pleural mesothelioma is considered localized cancer, meaning it's limited to one portion of the lining of the chest.
■II. Stage II mesothelioma may have spread beyond the lining of the chest to the diaphragm or to a lung.
■III. Stage III mesothelioma may have spread to other structures within the chest and may involve nearby lymph nodes.
■IV. Stage IV mesothelioma is an advanced cancer that has spread to distant areas (metastasized). Mesothelioma most commonly spreads (metastasizes) to the brain, lymph nodes in the chest and areas of the lung that are away from the tumor.

You're likely to start by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a doctor who specializes in lung diseases (pulmonologist) or abdominal problems (gastroenterologist).

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do


■Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
■Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
■Write down key personal information, including any major stresses or recent life changes. If you're worried about mesothelioma, make a list of all your occupations, even those you had for only a few months.
■Make a list of all medications, as well as any vitamins or supplements, that you're taking.
■Take a family member or friend along, if possible. Sometimes it can be difficult to soak up all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
■Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For mesothelioma, some basic questions to ask your doctor include:

■What is likely causing my symptoms or condition?
■What are other possible causes for my symptoms or condition?
■What kinds of tests do I need?
■Is my condition likely temporary or chronic?
■What is the best course of action?
■What are the alternatives to the primary approach that you're suggesting?
■I have these other health conditions. How can I best manage them together?
■Are there any restrictions that I need to follow?
■Should I see a specialist? What will it cost, and will my insurance cover seeing a specialist?
■Is there a generic alternative to the medicine you're prescribing me?
■Are there any brochures or other printed material that I can take home with me? What Web sites do you recommend?
■What will determine whether I should plan for a follow-up visit?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

What to expect from your doctor


Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time to cover other points you want to address. Your doctor may ask:

■When did you first begin experiencing symptoms?
■Have your symptoms been continuous, or occasional?
■How severe are your symptoms?
■What, if anything, seems to improve your symptoms?
■What, if anything, appears to worsen your symptoms?
■Do your symptoms affect your ability to work?

What you can do in the meantime


Try to avoid anything that worsens your signs and symptoms. For instance, if you're experiencing shortness of breath, try to take it easy until you can meet with your doctor.