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Showing posts with label cancer. Show all posts
Showing posts with label cancer. Show all posts

Saturday, 13 February 2010

Mesothelioma cases rising in Mexico

Recent studies done my America journal of Industrial Medicine shows that the diagnoses of mesothelioma which are caused by asbestos exposure are raising in Mexico. Developed nations like EU and North America already banned or regulated the use of asbestos while many other countries still continue to use it.

Since there is no so much demand in developed nations, the asbestos sellers are trying to increase their exposure in developing countries. If Mexico has to contain their rising cases of mesothelioma they either have to ban or at least regulate the use of asbestos in industries.

Many cases diagnosed for mesothelioma are as a result of exposure to asbestos at work places and many workers are not very aware of the side effects of playing at workplaces which involved working with asbestos.

There are many lawsuits that are being files in US for settlements with the employers.  There is a huge percentage of lawyers that from Houston, San Diego, Ohio. Houston mesothelioma lawyers are famous just for the percentage of the lawyers that hail from that region. Houston mesothelioma lawyers will sometimes fly to your place to understand the case as such is the returns in those cases.

Overall, Mexico has to either ban or at least regulate the use of asbestos at work places.

Monday, 8 February 2010

Radiation therapy as a treatment for Mesothelioma

In this post I will discuss one of the treatments to treat mesothelioma. The treatment is Intensity-modulated radiation Therapy (IMRT). IMRT is a kind of radiation therapy which uses x-rays of high energy to kill mesothelioma cancer cells to destroy the tumors.


Two types of radiation therapy are

1) External radiation therapy

2) Internal radiation therapy

External radiation therapy uses a machine to beam x-rays into the body where the mesothelioma cells are located. Proper care has to be taken in this method as some times good cells adjacent to the bad cells could also get damaged. IMRT is a type of three-dimensional therapy. A computer delivers the radiation as it moves around the patient’s body. The machine can shape the beams; adjust the strength of the beams and the angle at which they are delivered.

Internal radiation therapy also called at brachytherapy is a process in which chemicals are introduced to produce radiation at the mesothelioma cancer affected location in the body. A thin plastic tube is used and is inserted into the chest or abdomen.

Mesothelioma tumors are not discrete solid tumors but are usually spread over a large area and because of this it is very difficult to deliver radiation in sufficient doses properly to kill the tumor without damaging good cells. For this reason, radiation is mainly used to kill the remaining tumors after a surgery. Another usage of radiation is to relieve symptoms of mesothelioma. However, radiation has its side effects as in the process good cells can also get damaged.

Source: mesothelioma-data.com

Friday, 5 February 2010

Mesothelioma - Employer Sued

Today I was going through the news articles and found there was a Woman who sued the employer on behalf of his father. Samuel Mann server the US army 3 years from 1959 to 1961 and later he worked as a mechanic at crown cork till early 1970s and later he did construction work for 7 years for Norfolk Southern Railroad.

His daughter is suing these companies for letting his father exposed to asbestos at work without prior indication. As you see, Mann had worked in asbestos related work many years ago but the effects are visible now after several 10’s of years. Mesothelioma is very hard to diagnose and the survival rate is very low among the patients.

As per other statistics, every year 2 to 3 thousand of new patients are recorded to be affected by this deadly cancer which is caused my mesothelioma.

On a whole, the patients family has to go through severe crisis but if they win the settlement cases the make against the employers, they get sometimes millions of dollars but the loss of a human is not comparable to the money they get. Hope the employers around the US make their employees know the bad effects of asbestos and they themselves can escape from costly lawsuits.

Source: http://www.asbestos.net/

Saturday, 31 October 2009

Chemotherapy for Mesothelioma

Chemotherapy is a treatment in which doctors use drugs on patients which kills the cancer cells. Chemotherapy for mesothelioma can be used in different situations such as


1) To minimize the tumor before surgery

2) To kill remaining cancer cells after surgery

3) To kill cancer tumor that recurs

4) To use on patients who are not surgical candidates.

Chemotherapy is being continually developed by the researchers. Good news for the mesothelioma patients is that, there is considerable progress is the systematic treatment of this disease in last few years. Pemetrexed is seen as the most promising drug to treat mesothelioma. This is an inhibitor of proteins including thymidylate synthase and dihydrofolate reductase which are required in synthesis of DNA.

Chemotherapy drugs are often used in combination of others and this process is called combination therapy. When cancer occurs, bad cells in the body keep growing as exponential rate and the anticancer drugs can help the bad cells keep in control and during the process good cells may also get damaged which is the main reason for side effects. The cells most likely to be affected are the fast-growing normal cells such as the blood cells forming in bone marrow, and cells in the digestive tract which includes the mouth, stomach, intestines, and esophagus. Hair follicles may also be affected, hence, hair loss during chemotherapy. Some drugs affect cells of vital organs, such as the heart, kidney, bladder, lungs, and nervous system.

Saturday, 6 June 2009

What is mesothelioma cancer?

Malignant mesothelioma, a disease in which a tumor of cancerous nature grows on the mesothelium – the lining of the internal body cavities. In this disease, cells in mesothelium develop into malign cells. Its most common site is the pleura but may also occur in the heartm peritoneum, the pericardium or tunica vaginalis.


People who have worked on jobs where they inhale asbestos particles or any other jobs where people are exposed to asbestos dust develop mesothelioma. Compensation via asbestos funds or lawsuits is an important issue in mesothelioma.

Symptoms of this cancer are,

1) Shortness of breath

2) Chest wall pain

3) Weight loss


This could be diagnosed with X-ray and CT scan but could only be confirmed with a biopsy and microscopic examination. Even after treatment with radiation, chemotherapy etc the disease carries a poor prognosis.

Will cover more signs and symptoms in my next post.

Friday, 20 March 2009

Mesothelioma Is The Largest Man Made Epidemic

It is documented that Australia had the highest per capita use of asbestos in the world from the 1950’s until the 1970’s. As a tragic consequence, Australia now has the highest per capita incidence of mesothelioma in the world. With more than 500 Australians contracting mesothelioma per year, it is estimated that up to 18,000 Australians will die from this asbestos related cancer by the year 2020.

Despite the growing awareness of the dangers of asbestos, there are many people who have not heard of Mesothelioma. This asbestos related cancer is defined as: a malignant spreading tumor of the mesothelium of the pleura, pericardium, or peritoneum, arising form the inhalation of asbestos fibers.

One of the most baffling and frightening known facts concerning Mesothelioma is that many years may pass, between inhalation of asbestos dust and its deadly legacy of disease; it is not uncommon for four decades or more to pass before symptoms due to asbestos dust inhalation become apparent.

In November 2004, I was an invited speaker at the Global Asbestos Congress 2004, held in Tokyo Japan. Over 800 participants from 40 countries around the world were in attendance. To be a part of such a large gathering of fellow humans, united in a quest to rid the poison of asbestos from our environments was an intensely moving experience. Having lost my husband to mesothelioma I know first hand the suffering this cruel disease places on its innocent victims.

There were many speakers and each told a tale, of pain, death and heartache. We listened, we understood and we ached for the past, present and future victims of the killer asbestos and its legacy of mesothelioma and other asbestos related diseases. We listened and we were shocked and angered to learn that despite the growing awareness of the dangers of asbestos and the increasing incidence of asbestos related disease, there remains some countries who are mining asbestos with little or no regard for their workers or people who will come into contact with asbestos products.

Asbestos disease Association member’s world wide are working tirelessly and fighting almost insurmountable odds to ban asbestos from all countries of the world. It is a sobering and frightening fact, that even if we were successful today in this quest, the legacy of asbestos related diseases will continue for five decades.

Add your voice to the many who want this killer product erased from the worlds environments – Add your voice to the call that pleads for adequate compensation for victims and their families. Sign the online petition at Asbestos Disease Awareness Organization:

The Asbestos Disease Awareness Organization (ADAO) continues to raise public awareness about the dangers of asbestos exposure and the incurable and often deadly asbestos related diseases. ADAO is quickly expanding and uniting veterans, fire-fighters, shipbuilders, teachers and thousands of other innocent people around the world. Asbestos Awareness leads to education, prevention, new treatments and ultimately a cure.
http://www.asbestosdiseaseawareness.org

Article written by: Lorraine Kember – Author of “Lean on Me” Cancer through a Carer’s Eyes. Lorraine’s book is written from her experience of caring for her dying husband-an asbestos victim - in the hope of helping others. It includes insight and discussion on: Anticipatory Grief, Understanding and identifying pain, Pain Management and Symptom Control, Chemotherapy, Palliative Care, Quality of Life and Dying at home. It also features excerpts and poems from her personal diary. Highly recommended by the Cancer Council. “Lean on Me” is not available in bookstores - For detailed information, Doctor’s recommendations, Reviews, Book Excerpts and Ordering Facility - visit her website http://www.cancerthroughacarerseyes.jkwh.com

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Tuesday, 10 July 2007

Legal issues

The first lawsuits against asbestos manufacturers were in 1929. Since then, many lawsuits have been filed against asbestos manufacturers and employers, for neglecting to implement safety measures after the links between asbestos, asbestosis, and mesothelioma became known (some reports seem to place this as early as 1898). The liability resulting from the sheer number of lawsuits and people affected has reached billions of dollars. The amounts and method of allocating compensation have been the source of many court cases, and government attempts at resolution of existing and future cases.

History

The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. It was not until 1960 that an article published by Wagner et al first officially established mesothelioma as a disease arising from exposure to crocidolite asbestos. The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker. The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.

In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.

Despite proof that the dust associated with asbestos mining and milling causes asbestos related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information.

By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.

Prevention & Expectations

What can be done to prevent the disease? Since the 1970s, the Environmental Protection Agency and the Occupational Safety and Health Administration have regulated the asbestos industry in the U.S. In the past, asbestos was used as a fire retardant and an insulator. Other products are now used in its place. The controversy involving exposure to different forms of asbestos continues.

There are two major types of asbestos: chrysotile and amphibole. It is thought that exposure to the amphibole form is more likely to cause mesothelioma. However, chrysotile has been used more frequently, hence many mesotheliomas are caused by chrysotile.

Removal is taking place in schools and other public buildings throughout the U.S. The hope is that these measures will greatly reduce the occurrence of this cancer.

What are the long-term effects of the disease? A mesothelioma is a highly aggressive tumor that is generally deadly. Current treatment of malignant mesothelioma is designed to make the person with cancer comfortable. Although long-term survival cannot usually be expected, the case of famed paleontologist Stephen Jay Gould is a noted exception.

What are the risks to others? Mesothelioma is not contagious and cannot be passed from one person to another. The exposure to the asbestos that caused the cancer occurred many years to several decades before the disease appeared. People who live with asbestos workers have a higher risk of getting this cancer.

Notable people with mesothelioma

Mesothelioma, though rare, has had a number of notable patients. Australian anti-racism activist Bob Bellear died in 2005. British science fiction writer Michael G. Coney, responsible for nearly 100 works also died in 2005. American film and television actor Paul Gleason, perhaps best known for his portrayal of Principal Richard Vernon in the 1985 film The Breakfast Club, died in 2006. Mickie Most, an English record producer, died of mesothelioma in 2003. Paul Rudolph, an American architect known for his cubist building designs, died in 1997.

Steve McQueen was diagnosed with peritoneal mesothelioma on December 22, 1979. He was not offered surgery or chemotherapy because doctors felt the cancer was too advanced. McQueen sought alternative treatments from clinics in Mexico. He died of a heart attack on November 7, 1980, in Juárez, Mexico, following cancer surgery. He may have been exposed to asbestos while serving with the US Marines as a young adult—asbestos was then commonly used to insulate ships' piping—or because of its use as an insulating material in car racing suits. (It is also reported that he worked in a shipyard during World War II, where he might have been exposed to asbestos.[citation needed]

United States Congressman Bruce Vento died of mesothelioma in 2000. The Bruce Vento Hopebuilder is awarded yearly by his wife at the MARF symposium to persons or organizations who have done the most to support mesothelioma research and advocacy.

After a long period of untreated illness and pain, rock and roll musician and songwriter Warren Zevon was diagnosed with inoperable mesothelioma in the fall of 2002. Refusing treatments he believed might incapacitate him, Zevon focused his energies on recording his final album The Wind including the song Keep me in your heart which speaks of his failing breath. Zevon died at his home in Los Angeles, California, on September 7, 2003.

Although life expectancy with this disease is typically limited, there are notable survivors. In July 1982, Stephen Jay Gould was diagnosed with peritoneal mesothelioma. After his diagnosis, Gould wrote the "The Median Isn't the Message" for Discover magazine, in which he argued that statistics such as median survival are just useful abstractions, not destiny. Gould lived for another twenty years eventually succumbing to metastatic adenocarcinoma of the lung, not mesothelioma.

Author Paul Kraus was diagnosed with mesothelioma in June 1997 following an umbilical hernia operation. His prognosis was "a few months." He continues to survive using a variety of integrative and complimentary modalities and has written a book about his experience.

Chemotherapy

In February 2004, the United States Food and Drug Administration approved pemetrexed (brand name Alimta) for treatment of malignant pleural mesothelioma. Pemetrexed is given in combination with cisplatin. Folic acid is also used to reduce the side-effects of pemetrexed.

Immunotherapy

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.

Heated Intraoperative Intraperitoneal Chemotherapy

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.

Surgery

Surgery, either by itself or used in combination with pre- and post-operative adjuvant therapies has proved disappointing. A pleurectomy/decortication is the most common surgery, in which the lining of the chest is removed. Less common is an extrapleural pneumonectomy (EPP), in which the lung, lining of the inside of the chest, the hemi-diaphragm and the pericardium are removed. It is not possible to remove the entire mesothelium without killing the patient.

Radiation

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. This approach of using surgery followed by radiation with chemotherapy has been pioneered by the thoracic oncology team at Brigham & Women's Hospital in Boston. 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.

Treatment

Treatment of MM using conventional therapies has not proved successful and patients have a median survival time of 6 - 12 months after presentation. The clinical behaviour of the malignancy is affected by several factors including the continuous mesothelial surface of the pleural cavity which favours local metastasis via exfoliated cells, invasion to underlying tissue and other organs within the pleural cavity, and the extremely long latency period between asbestos exposure and development of the disease.

Risk factors

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 asbestos 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 (SV40) may act as a cofactor in the development of mesothelioma.

Exposure

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.

Occupational

Exposure 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.

Paraoccupational Secondary Exposure

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.

Asbestos in buildings

Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos. Those performing renovation works or diy 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.

Environmental Exposure

Incidence of mesothelioma had been found to be higher in populations living near Naturally Occuring Asbestos (NOA)

Exposure

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.

Occupational

Exposure 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.

Paraoccupational Secondary Exposure

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.

Asbestos in buildings

Many building materials used in both public and domestic premises prior to the banning of asbestos may contain asbestos. Those performing renovation works or diy 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.

Environmental Exposure

Incidence of mesothelioma had been found to be higher in populations living near Naturally Occuring Asbestos (NOA)

Staging

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.