Sunday, April 17, 2005

Welcome to WebKEW!

After I published How to make a million dollars, I started getting a lot of email. People are asking great questions, especially about the Web and creating new Web sites. I thought it would be interesting to create a blog to answer questions and talk about different techniques that people are using on the web to make money. So here we are. The idea behind WebKEW is to collect together ideas, techniques, case studies, stories, etc. that will help you learn how to create successful web sites.

If you are interested in starting a business and making a million dollars, the Web is certainly one place to do it. And it is a relatively straightforward and inexpensive place. With the Web you can work from home in off hours. Depending on what you are trying to create, startup costs can be very low. You can try ideas on the web quickly and at relatively low cost until you find something that works.

WebKEW Table of Contents (updated weekly)I hope that the ideas presented here help you to create highly profitable Web sites. If you have suggestions, links or feedback, please see the contact information available at MarshallBrain.com.

Thanks,

Marshall Brain

169 Comments:

At 4:31 PM, Anonymous Anonymous said...

Thank you for doing this! I am learning so much.

 
At 10:33 PM, Anonymous Anonymous said...

Your explanation is so simple! I hope I'll make it. Will let you know.

 
At 11:45 AM, Anonymous Anonymous said...

omg this is helpful

 
At 9:33 AM, Anonymous Anonymous said...

What the heck does WebKEW mean? KEW? It stands for something?

 
At 5:33 PM, Anonymous Anonymous said...

I think this is a good idea and I've liked what I've read. But how can I decide what kind of website to do? I need some more help. Thanks.

 
At 10:49 PM, Anonymous Anonymous said...

Help me understand how to get my site into Google. I have tried but it is impossible.

 
At 3:17 AM, Anonymous Anonymous said...

You have actually gotten me to really put the ideas about Web marketing into practice. Will keep you informed when I start making money out of it.

 
At 2:14 AM, Anonymous Anonymous said...

You've taken plenty of information and put into one easy location. Many thanks!

 
At 8:00 PM, Anonymous Anonymous said...

Thank you so much for putting this together. It is very helpful. Do you have any recommendations for finding researchers and specialists? I have an idea for a product but do not know where to start with finding the right people to brainstorm and build a prototype. Any advice is much appreciated! Thanks again.

 
At 6:14 AM, Anonymous Anonymous said...

nice site =)
thanks

 
At 9:42 PM, Anonymous Anonymous said...

This site will be my homepage for the next couple of weeks. Thank you.

 
At 2:07 PM, Anonymous Anonymous said...

Great site. Keep the content coming!

 
At 4:27 PM, Anonymous Anonymous said...

brilliant content, this site has showed me alot about many possible future options, thanks alot.

 
At 10:57 PM, Anonymous Anonymous said...

This content hade made some great points! It will inspire me and many more. THANKS!

 
At 7:49 AM, Anonymous Anonymous said...

Hi

View my blog

http://moralminded.blogspot.com/

Mark

From Australia

 
At 2:58 AM, Anonymous Anonymous said...

Thanks for such a such a nice blog. This was exactly what I was looking for.
From MNJaga

 
At 7:52 PM, Anonymous Anonymous said...

Marshall, what you are doing here is great, I am learning so much here. Thank you for all your effort!

 
At 9:57 AM, Anonymous Anonymous said...

You know what you have the brain I like your stuff most. Jesther from Phils.

 
At 1:38 PM, Anonymous Anonymous said...

interesting experimente, this site.
i would love to have an afternoon with your visitor statistics.

 
At 12:55 PM, Anonymous Anonymous said...

hey man...your post was so helpful...thanks!!!

 
At 11:18 AM, Anonymous Anonymous said...

So, this is a "blog" website that you set up at blogger.com, correct? Now, is this a free blog website? If so, I'm curious about setting up a free blog and advertising on that blog for profit. How does that work?

 
At 3:10 AM, Anonymous Anonymous said...

Check out my new Free Softwares Website
All Free Softwares

 
At 1:00 PM, Blogger ehanson said...

Thank you for sharing your knowledge with us. With your words of encouragement I've started my own blog about making money.
The Stanton Report

This is just what I was looking for. Thanks again.

 
At 10:42 AM, Anonymous Anonymous said...

wow great site love the tips and all keep it up please!!!

---
http://blogrenee.com/

 
At 8:43 AM, Anonymous Anonymous said...

many many thanks Marshall! now im on the way to making a million dollars!;-))
http://www.themilliondollarweblog.com

 
At 4:10 AM, Blogger crown said...

many thanks, please visit my website

http://www.rahulcreations.com

Rahul

 
At 7:54 AM, Anonymous Anonymous said...

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At 6:51 AM, Anonymous Anonymous said...

hi folks
this has greatly helped me iam atoastmaster from hyderabad and a web developer pls see www.veduku.com iam on the way to win million dollar see my plan at my site also comment about my site
thx
rahul ceo www.veduku.com

 
At 5:30 AM, Anonymous Anonymous said...

This website is very usefull if you wanna be informed about web development (and other topics) news. It's a good aggregator that retrievies feeds from main sources:

http://www.awordabout.com

add it to your delicious

 
At 11:49 AM, Anonymous Anonymous said...

Excellent site Mr, will definately be buying the book when it comes out, you have gioven me some food for thought.

www.chesterstuff.com

 
At 10:36 PM, Anonymous Anonymous said...

It is a question, not a comment. If you have adsense put ads on your site, do they choose what ads to use and do the ads change all the time? I might consider giving them access to my site, but there are some things that I would not want advertised because of the conflict with the beliefs expressed on my site.

 
At 12:35 PM, Blogger Alex Balin said...

my site www.business-key.com has been worked and make $50-$100 per month, so i want to make a billion)) your article is helpful

 
At 12:38 PM, Blogger Alex Balin said...

so friends sites rating increase the rating of my site, is good idea?

 
At 12:40 PM, Anonymous Anonymous said...

affilate programms good way to make money,
i recomended this partnership: www.cipollino.info

 
At 9:33 PM, Blogger Nita Sweeney said...

Thanks so much. I'm trying your tips out on my Writing Blog and my Cute Dog Photo blog.

 
At 12:14 AM, Anonymous Anonymous said...

Thanks for all the info. I started my own website following your advice. Please check it out at http://www.thedollarfactory.com Let me know what you think.

Cheers!

 
At 9:42 AM, Anonymous Anonymous said...

Thank you very much for your free part time job guide. You are a great man. Congratulations....

 
At 11:22 PM, Anonymous Anonymous said...

Too bad that you don't update this blog anymore! But thank you.

The Dollar Factory: Portal for Webmasters

 
At 6:54 PM, Anonymous Anonymous said...

cool story & tips http://www.allthehitsandmore.com

 
At 5:57 PM, Anonymous Anonymous said...

Thanks. I'm trying your ideas on this site.Medical Practice Marketing

 
At 3:03 AM, Anonymous Anonymous said...

I found your site out of LUCK. I found it very informative and encouraging. Over the years I have had many business ideas i wanted to pursue. I have read taken business courses and written business plans for many of them but have not gone past that point. The way that you have laid out things in this article make me feel much more at ease about just diving in and trying one of them right away and to continue on if it doesnt work. I guess it was mainly fear of failure that stopped me from moving forward but after reading this i feel i have nothing to lose and everything to gain. As said in one link i followed I need to get out of my comfort zone and stay out.


Thank You for your time and ideas

Mike Giles

 
At 7:31 PM, Anonymous Anonymous said...

Forget trying to make money on the Internet. Just enjoy life and play soccer...Your soccer central is here Soccer Headquarters

Champions League is starting soon and so are the Euro 2008 qualifiers!

 
At 3:02 PM, Anonymous Anonymous said...

Thank you for making this site! I tried my luck and have my first project up and running.
You can have a look at: www.godsbeauties.com

 
At 1:35 AM, Blogger Velu said...

Great site! Thanks for the info on setting up the blogs.

 
At 10:21 PM, Blogger Big Jay said...

Great blog! I just stumbled across it today and linked to it.

 
At 3:47 AM, Anonymous Anonymous said...

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At 1:54 AM, Anonymous Anonymous said...

Thanks for all your help Marshall, you are a true inspiration to me and countless others. I remember quite a while ago when I found your book online, The Teenagers Guide to the Real World. It was a totally amazing read and, being a teenager myself, it opened my eyes to a lot of things.

From there, I read your How to Make a Million Dollars article and that changed everything. I am also a big fan of HowStuffWorks, and of course, WebKew, which got me started in the world of making websites.

So thank you once again.

Julien
Build Gaming Computers

 
At 5:52 AM, Anonymous Anonymous said...

Before starting to write about web, I had nothing to write about. However, once started, there was nothing to stop me!

 
At 5:20 PM, Anonymous Anonymous said...

I have tried my luck at a site. Please check it out.

Shuffle4nada.com

Thanksnq

 
At 5:48 PM, Anonymous Anonymous said...

I just started a website about real estate, mortgages, etc. pls check it out filr.blogspot.com

 
At 5:51 PM, Anonymous Anonymous said...

filr.blogspot.com

 
At 2:51 PM, Anonymous Anonymous said...

Great blog, i really learned something here.

check out my site

Blaad for all your payment info

 
At 10:57 PM, Anonymous Anonymous said...

You the man M.B! Let u know what happens. God Bless!

 
At 2:44 PM, Blogger Alba & Maarten said...

very interesting blog, I also decided to start one: http://meverz.blogspot.com/

keep up the good work

 
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At 1:58 PM, Anonymous Anonymous said...

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At 7:37 AM, Anonymous Anonymous said...

Well, I guess somebody needs to start charging people for putting unnecessary and absolutely unprofessional advertising for their own cheesy sites on this blog.

 
At 1:41 PM, Anonymous Anonymous said...

this is fascinating. you give me hope that I won't be poor in my old age!
from a baby boomer nurse who's waking up to smell the coffee...

 
At 7:23 PM, Anonymous Anonymous said...

I Love Hockey! My favotite hockey team is NHL Washington Capitals! They the best!

 
At 11:33 AM, Anonymous Anonymous said...

Thank you Marshal Brain, for creating this.

I'm starting a diet book, after I had managed to lose 80 pounds in 4 months using a low calorie diet and video games (such as wii and ddr) for exercising. I think it's a cheaper and better approach then going to the gym. If anyones interested my blog site is...

http://gamersdiet.blogspot.com/feeds/posts/default

 
At 11:36 AM, Anonymous Anonymous said...

http://gamersdiet.blogspot.com/

 
At 8:20 PM, Anonymous Anonymous said...

I need all the help I can get when it comes to making money... and keeping it, too!

Financial portal promotes bill consolidation of loans and credit card debt. pay off bill - get out of debt and live life once again.

 
At 11:30 AM, Anonymous Anonymous said...

thanks for that

 
At 6:00 PM, Anonymous Anonymous said...

Dear Mr. Brain -

Thank you very much for the information. You're wonderful for doing this.

Suzana, NY

 
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At 1:58 AM, Anonymous Anonymous said...

Marshall, this has been the best education ever... It was the catalyst to start my first business using EZ-Web... I did not stray from your stratigies and instructions. So far it has been a success. For those of you interested in seeing what the first pass at making a website looks like, check out www.SoCalMxTour.com for an example.

EZ-Web offers templates that are easy to populate. I also chose to use the $20 tool that they offer to create the site. I am glad that I did... The one thing that I was concerned with during this undertaking is learning a new tool and constraining my time. This was not the case. I would also be open to constructive feedback on the site... Thanks for letting me share!

 
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At 9:14 PM, Anonymous Anonymous said...

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At 3:21 PM, Anonymous Anonymous said...

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At 6:13 AM, Blogger Marcellg said...

Great tips to those who want to make a living online, as a web designer for web design leeds I often get asked from friends "where can I earn money" or "is it as easy they say to make money online" I will guide them to your blog for the tips and information you provide.

 
At 4:19 AM, Anonymous Anonymous said...

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At 12:13 AM, Anonymous Anonymous said...

Hi Marshall,

I believe I found a mistake on Inside a Nuclear Power Plant.

Please check your diagram and the sentence near the lower half ""The advantage to this design is that the radioactive water/steam never contacts the turbine.""

The diagram clearly shows the steam contacting the turbine and that is what turns the turbine and shaft to the generator.

A few sentences prior to that also state ""The steam drives a steam turbine, which spins a generator to produce power. ""

Thanks,

Phil

 
At 5:11 AM, Blogger Unknown said...

Thanks for the inspiration. I have now finally got round to creating my first EVER blog. It is about things I feel strongly about.

PS - if the link above doesn't work, my blog page is http://iamcontroversial.blogspot.com/

 
At 7:08 AM, Blogger Unknown said...

I've now made another blog as well!!!

The link is themustdolist.blogspot.com

VISIT IT NOW!!!

 
At 10:25 AM, Blogger Unknown said...

This is very helpful. Thanks for sharing!

www.jpius.com

 
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At 3:12 AM, Anonymous Anonymous said...


First DUI Offense in California
1st Drunk Driving Conviction
Jail for no less than 96 hours and no more than 6 months. The fine will be no less than $390 and no more than $1,000. Your drivers license will be suspended for six months, however, if allowed, the court may grant the convicted a temporary restricted license. Your drivers license will not be reinstated until proof of financial responsibility and proof that you have completed a "driving under the influence" program approved by the state.
Second DUI Offense in California
2nd Drunk Driving Conviction
Jail for no less than 90 days and no more than 1 year. The fine will be no less than $390 and no more than $1,000 . Your drivers license will be suspended for 1 year. Your drivers license will not be reinstated until proof of financial responsibility and proof that you have completed a "driving under the influence" program approved by the state.

Third DUI Offense in California
3rd Drunk Driving Conviction
Jail for no less than 120 days and no more than 1 year. The fine will be no less than $390 and no more than $1,000 . You will be considered by the state a "habitual traffic offender" for 3 years following your conviction and have your license suspended for 2 years. Your drivers license will not be reinstated until proof of financial responsibility and proof that you have completed a "driving under the influence" program approved by the state. The person may apply for a restricted driver's license under certain circumstances by the court.
Fourth DUI Offense in California
4th Drunk Driving Conviction
Jail, Prison or both, for no less than 180 days and no more than 1 year. The fine will be no less than $390 and no more than $1,000 . You will be considered by the state a "habitual traffic offender" for 3 years following your conviction and have your license revoked for 3 years. Your drivers license will not be reinstated until proof of financial responsibility and proof that you have completed a "driving under the influence" program approved by the state. The person may apply for a restricted driver's license under certain circumstances by the court. The person may apply for a restricted driver's license under certain circumstances by the court.
Drunk driving laws in The State of California are similar to many other DUI laws across the United States. California's DUI law prohibits a person from driving when they have a concentration of .08 percent or more alcohol in their blood system. This is the standard measurement use by all states for the "impaired" driver.

 
At 9:07 PM, Anonymous Anonymous said...

mesothelioma Mesotheliomais a form of cancer that is almost always caused by exposure to Asbestos In this disease, malignant cells develop in the mesothelium, a protective lining that covers most of the body's internal organs. Its most common site is the pleura (outer lining of the lungs and internal chest wall), but it may also occur in the peritoneum (the lining of the abdominal cavity), the heart the pericardium (a sac that surrounds the heart or tunica vaginalis.
Most people who develop
mesothelioma have worked on jobs where they inhaled asbestos particles, or they have been exposed to asbestos dust and fiber in other ways. Washing the clothes of a family member who worked with asbestos can also put a person at risk for developing Mesothelioma Unlike lung cancer, there is no association between mesothelioma and smoking but smoking greatly increases risk of other asbestos induced cancer.Compensation via
Asbestos funds or lawsuits is an important issue in
mesothelioma The symptoms of
mesothelioma include shortness of breath due to pleural effusion (fluid between the lung and the chest wall or chest wall pain, and general symptoms such as weight loss. The diagnosis may be suspected with chest X-ray and CT scan and is confirmed with a biopsy (tissue sample) and microscopic examination. A thoracoscopy inserting a tube with a camera into the chest) can be used to take biopsies. It allows the introduction of substances such as talc to obliterate the pleural space (called pleurodesis, which prevents more fluid from accumulating and pressing on the lung. Despite treatment with chemotherapy, radiation therapy or sometimes surgery, the disease carries a poor prognosis. Research about screening tests for the early detection of mesothelioma is ongoing.
Symptoms of mesothelioma may not appear until 20 to 50 years after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural
mesotheliomaSymptoms of peritoneal
mesothelioma include weight loss and cachexia, abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity). Other symptoms of peritoneal
mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by
mesothelioma or by other, less serious conditions.
Mesothelioma that affects the pleura can cause these signs and symptoms:
chest wall pain
pleural effusion, or fluid surrounding the lung
shortness of breath
fatigue or anemia
wheezing, hoarseness, or cough
blood in the sputum (fluid) coughed up hemoptysis
In severe cases, the person may have many tumor masses. The individual may develop a pneumothorax, or collapse of the lung The disease may metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms until they are at a late stage. Symptoms include:
abdominal pain
ascites, or an abnormal buildup of fluid in the abdomen
a mass in the abdomen
problems with bowel function
weight loss
In severe cases of the disease, the following signs and symptoms may be present:
blood clots in the veins, which may cause thrombophlebitis
disseminated intravascular coagulation a disorder causing severe bleeding in many body organs
jaundice, or yellowing of the eyes and skin
low blood sugar level
pleural effusion
pulmonary emboli, or blood clots in the arteries of the lungs
severe ascites
A
mesothelioma does not usually spread to the bone, brain, or adrenal glands. Pleural tumors are usually found only on one side of the lungs
Diagnosing
mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history. A history of exposure to asbestos may increase clinical suspicion for
mesothelioma A physical examination is performed, followed by chest X-ray and often lung function tests. The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of
mesothelioma A CT (or CAT) scan or an MRI is usually performed. If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe. For pleural fluid this is done by a pleural tap or chest drain, in ascites with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis. While absence of malignant cells on cytology does not completely exclude
mesothelioma it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure
If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of
mesothelioma A doctor removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy. To obtain tissue for examination, the doctor makes a small incision in the abdomen and inserts a special instrument into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
There is no universally agreed protocol for screening people who have been exposed to
asbestosScreening tests might diagnose mesothelioma earlier than conventional methods thus improving the survival prospects for patients. The serum osteopontin level might be useful in screening asbestos-exposed people for
mesotheliomaThe level of soluble mesothelin-related protein is elevated in the serum of about 75% of patients at diagnosis and it has been suggested that it may be useful for screening. Doctors have begun testing the Mesomark assay which measures levels of soluble mesothelin-related proteins (SMRPs) released by diseased mesothelioma cells
Incidence
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. The incidence rate is approximately one per 1,000,000. The highest incidence is found in Britain, Australia and Belgium: 30 per 1,000,000 per year. For comparison, populations with high levels of smoking can have a lung cancer incidence of over 1,000 per 1,000,000. Incidence of malignant mesothelioma currently ranges from about 7 to 40 per 1,000,000 in industrialized Western nations, depending on the amount of asbestos exposure of the populations during the past several decades. It has been estimated that incidence may have peaked at 15 per 1,000,000 in the United States in 2004. Incidence is expected to continue increasing in other parts of the world. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. Approximately one fifth to one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were occupationally exposed to asbestos in the United States.[ Between 1973 and 1984, there has been a threefold increase in the diagnosis of pleural mesothelioma in Caucasian males. From 1980 to the late 1990s, the death rate from mesothelioma in the USA increased from 2,000 per year to 3,000, with men four times more likely to acquire it than women. These rates may not be accurate, since it is possible that many cases of mesothelioma are misdiagnosed as adenocarcinoma of the lung, which is difficult to differentiate from mesothelioma.
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure exists in almost all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. In rare cases, mesothelioma has also been associated with irradiation, intrapleural thorium dioxide (Thorotrast), and inhalation of other fibrous silicates, such as erionite.
asbestos
is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven.
asbestos
has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
The combination of smoking and
asbestos exposure significantly increases a person's risk of developing cancer of the airways (lung cancer bronchial carcinoma). The Kent brand of cigarettes used
mesothelioma in its filters for the first few years of production in the 1950s and some cases of
mesothelioma have resulted. Smoking modern cigarettes does not appear to increase the risk of mesothelioma.
Some studies suggest that simian virus 40 may act as a cofactor in the development of mesothelioma.
Asbestos was known in antiquity, but it wasn't mined and widely used commercially until the late 1800s. Its use greatly increased during World War II Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with
asbestos exposure were not publicly known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of
asbestos exposure in the workplace, and created guidelines for engineering controls and respirators, protective clothing, exposure monitoring, hygiene facilities and practices, warning signs, labeling, recordkeeping, and medical exams. By contrast, the British Government's Health and Safety Executive (HSE) states formally that any threshold for
mesothelioma must be at a very low level and it is widely agreed that if any such threshold does exist at all, then it cannot currently be quantified. For practical purposes, therefore, HSE does not assume that any such threshold exists. People who work with
asbestos wear personal protective equipment to lower their risk of exposure. Recent findings have shown that a mineral called erionite has been known to cause genetically pre-dispositioned individuals to have malignant mesothelioma rates much higher than those not pre-dispositioned genetically. A study in Cappadocia, Turkey has shown that 3 villiages in Turkey have death rates of 51% attributed to erionite related
mesotheliomaExposure to
asbestos fibres has been recognised as an occupational health hazard since the early 1900s. Several epidemiological studies have associated exposure to asbestos with the development of lesions such as asbestos bodies in the sputum, pleural plaques, diffuse pleural thickening, asbestosis, carcinoma of the lung and larynx, gastrointestinal tumours, and diffuse mesothelioma of the pleura and peritoneum.
The documented presence of
asbestos fibres in water supplies and food products has fostered concerns about the possible impact of long-term and, as yet, unknown exposure of the general population to these fibres. Although many authorities consider brief or transient exposure to
asbestos fibres as inconsequential and an unlikely risk factor, some epidemiologists claim that there is no risk threshold. Cases of mesothelioma have been found in people whose only exposure was breathing the air through ventilation systems. Other cases had very minimal (3 months or less) direct exposure.
Commercial
asbestos mining at Wittenoom, Western Australia, occurred between 1945 and 1966. A cohort study of miners employed at the mine reported that while no deaths occurred within the first 10 years after crocidolite exposure, 85 deaths attributable to mesothelioma had occurred by 1985. By 1994, 539 reported deaths due to mesothelioma had been reported in Western Australia.
Family members and others living with
asbestos workers have an increased risk of developing
mesothelioma and possibly other asbestos related diseases. This risk may be the result of exposure to
asbestos dust brought home on the clothing and hair of
asbestos workers. To reduce the chance of exposing family members to asbestos fibres, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
Many building materials used in both public and domestic premises prior to the banning of
asbestos may contain
asbestos Those performing renovation works or activities may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos was banned at the end of 1999. Brown and blue
asbestos was banned in the UK around 1985. Buildings built or renovated prior to these dates may contain asbestos materials.
For patients with localized disease, and who can tolerate a radical surgery, radiation is often given post-operatively as a consolidative treatment. The entire hemi-thorax is treated with radiation therapy, often given simultaneously with chemotherapy. Delivering radiation and chemotherapy after a radical surgery has led to extended life expectancy in selected patient populations with some patients surviving more than 5 years. As part of a curative approach to
mesothelioma radiotherapy is also commonly applied to the sites of chest drain insertion, in order to prevent growth of the tumor along the track in the chest wall.
Although
mesothelioma is generally resistant to curative treatment with radiotherapy alone, palliative treatment regimens are sometimes used to relieve symptoms arising from tumor growth, such as obstruction of a major blood vessel.
Radiation Therapy when given alone with curative intent has never been shown to improve survival from
mesothelioma The necessary radiation dose to treat mesothelioma that has not been surgically removed would be very toxic.
Chemotherapy is the only treatment for
mesothelioma that has been proven to improve survival in randomised and controlled trials. The landmark study published in 2003 by Vogelzang and colleagues compared cisplatin chemotherapy alone with a combination of cisplatin and pemetrexed (brand name Alimta) chemotherapy) in patients who had not received chemotherapy for malignant pleural mesothelioma previously and were not candidates for more aggressive "curative" surgery. This trial was the first to report a survival advantage from chemotherapy in malignant pleural
mesothelioma showing a statistically significant improvement in median survival from 10 months in the patients treated with cisplatin alone to 13.3 months in the combination pemetrexed group in patients who received supplementation with folate and vitamin B12. Vitamin supplementation was given to most patients in the trial and pemetrexed related side effects were significantly less in patients receiving pemetrexed when they also received daily oral folate 500mcg and intramuscular vitamin B12 1000mcg every 9 weeks compared with patients receiving pemetrexed without vitamin supplementation. The objective response rate increased from 20% in the cisplatin group to 46% in the combination pemetrexed group. Some side effects such as nausea and vomiting, stomatitis, and diarrhoea were more common in the combination pemetrexed group but only affected a minority of patients and overall the combination of pemetrexed and cisplatin was well tolerated when patients received vitamin supplementation; both quality of life and lung function tests improved in the combination pemetrexed group. In February 2004, the United States Food and Drug Administration approved pemetrexed for treatment of malignant pleural mesothelioma. However, there are still unanswered questions about the optimal use of chemotherapy, including when to start treatment, and the optimal number of cycles to give.
Cisplatin in combination with raltitrexed has shown an improvement in survival similar to that reported for pemetrexed in combination with cisplatin, but raltitrexed is no longer commercially available for this indication. For patients unable to tolerate pemetrexed, cisplatin in combination with gemcitabine or vinorelbine is an alternative, although a survival benefit has not been shown for these drugs. For patients in whom cisplatin cannot be used, carboplatin can be substituted but non-randomised data have shown lower response rates and high rates of haematological toxicity for carboplatin-based combinations, albeit with similar survival figures to patients receiving cisplatin.
In January 2009, the United States FDA approved using conventional therapies such as surgery in combination with radiation and or chemotherapy on stage I or II Mesothelioma after research conducted by a nationwide study by Duke University concluded an almost 50 point increase in remission rates.
Treatment regimens involving immunotherapy have yielded variable results. For example, intrapleural inoculation of Bacillus Calmette-Guérin (BCG) in an attempt to boost the immune response, was found to be of no benefit to the patient (while it may benefit patients with bladder cancer.
mesothelioma cells proved susceptible to in vitro lysis by LAK cells following activation by interleukin-2 (IL-2), but patients undergoing this particular therapy experienced major side effects. Indeed, this trial was suspended in view of the unacceptably high levels of IL-2 toxicity and the severity of side effects such as fever and cachexia. Nonetheless, other trials involving interferon alpha have proved more encouraging with 20% of patients experiencing a greater than 50% reduction in tumor mass combined with minimal side effects.
A procedure known as heated intraoperative intraperitoneal chemotherapy was developed by Paul Sugarbaker at the Washington Cancer Institute. The surgeon removes as much of the tumor as possible followed by the direct administration of a chemotherapy agent, heated to between 40 and 48°C, in the abdomen. The fluid is perfused for 60 to 120 minutes and then drained.
This technique permits the administration of high concentrations of selected drugs into the abdominal and pelvic surfaces. Heating the chemotherapy treatment increases the penetration of the drugs into tissues. Also, heating itself damages the malignant cells more than the normal cells.

What is the mesothelium?
The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs to glide easily against adjacent structures.
The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart. The
mesothelioma tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women.
What is mesothelioma?
mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs.
cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
How common is mesothelioma?
Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age.
What are the risk factors for mesothelioma?
Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in about 70 percent to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos.
Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.
Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung.
Who is at increased risk for developing mesothelioma?
Asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
The risk of asbestos-related disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma On the other hand, not all workers who are heavily exposed develop asbestos-related diseases.
There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to
asbestos dust brought home on the clothing and hair of
asbestos workers. To reduce the chance of exposing family members to
asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.
What are the symptoms of mesothelioma?
Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to
asbestos Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.
These symptoms may be caused by
mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis
How is
mesotheliomadiagnosed?
Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.
A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the
cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the
cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.
If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
How is
mesotheliomatreated?
Treatment for mesothelioma depends on the location of the
cancerthe stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.
Surgery is a common treatment for
mesotheliomaThe doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural
mesotheliomaa lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.
Stereo Tactic Radiation Therapy also called radiotherapy, involves the use of high-energy rays to kill
cancercells and shrink tumors Radiation therapy affects the
cancercells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the
cancercells are found (internal radiation therapy).
Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat
mesotheliomaare given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).
To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation Therapy and surgery may also be helpful in relieving symptoms.

 
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