Mesothelioma is a form of cancer that affects the Mesothelium, which is a thin membrane that lines the inner surface of the chest wall where it is known as the pleura. It also surrounds the organs found within these cavities for example the heart and lungs. It is far more common to have mesothelioma in the chest than in the abdomen, there is approximately 1 case of peritoneal mesothelioma to every 12 cases of pleural mesothelioma. The pleural lining has two layers: the visceral (inner) layer is next to the lung and the parietal (outer) layer lines the chest wall. The pleura produces fluid that lubricates the space between the two layers, this allows the two layers to slide comfortably over each other as we breathe in and out. Pleural mesothelioma causes the pleura to thicken. This thickening of the pleura might begin to press onto the lungs or attach itself to the inside of the chest wall. In either case the expansion of the lung becomes progressively restricted by the tumour. Fluid, sometimes several litres, can collect between the two layers of the pleura; this affects the lungs ability to expand and causes the person to feel breathless. This is known as a pleural effusion. Peter had a large pleural effusion on his lung and underwent a Pleurodesis in June 2011. Pleurodesis is a method of making the two layers of the pleural membrane stick together which obliterates the space between them thus preventing the formation of further effusions. The procedure involves introducing an irritant material, usually sterile talc, via a tube (either a chest drain or thoracoscope) into the space between the pleural layers (any fluid has to be drained first). This is sometimes aided by video-camera viewing of the inside of the chest – a VATS (video-assisted thoracoscopy) procedure. Pleurodesis tends to be successful in most cases, particularly if performed early on in the disease. Unfortuantly this procedure didnt work for Peter and his right lung totally collaped in July 2011 and it was then that he was given his diagnosis. In August 2011 he underwent a procedure to insert a permanent plueural catheter which meant Mandy could drain his lung at home to ease his symptoms. The pain in his chest continued to increase and Mandy searched the internet for treatments until finding a leading doctor in Portsmouth to perform a procedure called a Percutaneous Spinal Cordotomy in October 2011. The procedure involves heating some of the pain nerves in the spinal cord that transmit pain information to the brain. It involves placing an electrode (about the size of a blood test needle) into these pain carrying pathways, using special x-ray guidance. It is done under a local anesthetic; the patient is awake so that they can communicate any sensations felt during the procedure. Peter didnt particually enjoy the experience and was left with a few side effects from the treatment but in all it meant he could reduce his drugs and survive just on Paracetamol, Ibuprofen and the odd amount of oromorph. He said he would recommend the treatment to anyone as although he suffered from mirror pain it was no where near as intense as the pain he had previously suffered. This treatment enabled him to forfill his wishes and to go on holiday to the Caribbean to celebrate his birthday with Mandy. After he returned from holiday on 25 November he suffered from jetlag and then a feeling of being unwell. He was admitted to R.U.H in Bath on 9 December for a blood transfusion after blood tests revieled anemia.But something else was happening and the medics couldnt agree on what it was. Some thought it was an infection and some thought it was disease progression. He underwent a series of tests. It was the morning of 17 December that the biggest shock of all came when Mandy recieved a phonecall from the hospital to say Peter was semi conscious and for all family members to get there as quick as they could. He suprised all the nurses though and came round after 8 hours wanting a drink of Tropicana orange juice! He was named star patient of the ward that night! Mandy and Heather thought he would need rehabilitation to regain his strength before coming home so enquires where made into the Dorothy House Hospice in Winsley. It was arranged he would go there on 21 December but that morning he took another turn for the worst and Mandy undertook a huge battle against the doctors to allow him to be moved to the hospice. She in the end kept speaking to him and said "open your eyes if you want to go to Dorothy House" to which he did for a brief moment. Luckily a nurse witnessed this and over rode the doctors decission and Peter was transferred. He took another turn for the worst on Chrsitmas day and said his goodbyes to people, but in the evening Peter sat up and said "I feel a bit of a prat, I had been told I was dying and had talked myself into it" He continued to wake and sleep for the next week enjoying the moments he was awake with friends and family until New Years eve when finally his lungs could take no more. After being unconscious for 15 hours where Mandy stayed by his side he passed over on New Years day at 3.14am