ABSTRACT

I. Introduction Malignant pleural mesothelioma (MPM) is an aggressive tumor, which originates from mesothelial cells of the pleura. Once considered rare, its worldwide incidence has been steadily rising due to massive asbestos use in the past decades. Asbestos is the main etiologic factor for MPM and a thorough search for exposure should be done in face of a suspected or confirmed MPM diagnosis. Attention for this disease is on the rise for many reasons including its forecasted increase in incidence in the next two decades, its widespread workplace-related exposure in various professions and the associated professional disease compensations and other potential medicolegal aspects related to this, the notion of environmental exposure linked to the absence of a known safe threshold of asbestos exposure, and the widespread media attention it has received (more the 3 million internet web pages are devoted to mesothelioma). There has also been a shift in paradigm in the treatment of mesothelioma in recent years. What used to be a rapidly lethal disease now sees a real investment in medical care including better acceptance of surgery, use of new and more effective cytotoxic drug combinations, emerging biotherapies, and new radiotherapy schedules. Most importantly, the recent development of multidisciplinary approaches has allowed the design of prospective randomized-controlled studies, which were critically lacking in this field of oncology (1).