Pleural Mesothelioma

Pleural mesothelioma is a rare type of asbestos-caused cancer. It affects the protective tissues that line the lungs and chest (pleura). While the prognosis is poor, there are treatment options that can extend life expectancy.

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What Is Pleural Mesothelioma?

Pleural mesothelioma is a relatively new cancer, and its complexities are not yet fully understood by doctors. With fewer than 3,000 new cases per year in the United States, it remains an extremely rare cancer that’s difficult for doctors to identify.

The other 2 main forms of mesothelioma — peritoneal (abdomen) and pericardial (heart) — only account for an estimated 30% and less than 1% of all disease cases, respectively.

Pleural mesothelioma forms in the tissue lining that covers the lungs and chest wall. Tissues that cover organs are called the mesothelium, and the mesothelium that covers the lungs and chest is called the pleura. Pleural tumors first form on one side of the chest and can spread to distant sites if left untreated.

Highly technical surgical procedures can aggressively remove tumors and potentially extend patients’ lives by several months to years.

If you’ve been diagnosed with pleural mesothelioma (or believe you may have it), here is what you need to know about this disease:

  • Rare cancer caused by asbestos exposure that affects the lungs and chest
  • The most common form of mesothelioma, accounting for 80% of all new cases
  • Average life expectancy is 12-21 months but can be extended with aggressive treatments
  • Doctors diagnose by stages 1-4 based on how far cancer has spread
  • Standard treatments include surgeries, chemotherapy, and radiation
  • New and novel therapies are undergoing testing in clinical trials, which can give end-stage patients new hope
  • Best outcomes achieved when treated by mesothelioma specialists located at cancer centers across the country

Symptoms of Pleural Mesothelioma

Mesothelioma has a latency period of 20-50 years, meaning it can take decades for symptoms to develop after asbestos exposure.

Symptoms are notoriously difficult to detect. Vague respiratory-related symptoms often get mistaken for other more common and less severe conditions.

Primary symptoms include:

  • Chest pain
  • Coughing up blood
  • Difficulty breathing and shortness of breath
  • Fever, night sweats, and fatigue
  • Fluid buildup in the lungs (pleural effusions)
  • Persistent, dry cough
  • Unexplained weight loss

The most commonly reported symptoms in patients are chest pain and chronic cough.

One of the leading signs of mesothelioma is thickening and fluid buildup within the pleura, which occur due to pleural inflammation caused by metastasizing (spreading) tumors.

Because vague symptoms can easily be mistaken for conditions like pneumonia or emphysema, it’s vital that you report your history of asbestos exposure to your doctor. This can help you identify your condition sooner so you can undergo the correct treatments.

Who Gets Pleural Mesothelioma?

The majority of mesothelioma patients are men over the age of 60, as asbestos was used in many industrial occupations and the military from the 1940s to the 1980s. Many of these jobs were dominated by men.

Pleural mesothelioma can affect people from all walks of life. Because it was used so extensively and contaminated anything and everything around it, women—including wives, mothers, daughters and sisters of asbestos workers — and even younger adults in their 20s and 30s can develop mesothelioma due to secondhand exposure.

Causes of Pleural Mesothelioma

The only known cause of pleural mesothelioma is asbestos exposure. Used extensively during the 20th century, asbestos was a fireproof insulation material installed in buildings and added to industrial products.

Anyone who worked extensively around asbestos is now at risk of developing mesothelioma and other asbestos-related diseases.

Asbestos fibers are microscopic, yet indestructible. When they become airborne, asbestos particles can be inhaled by those nearby. Inhaled asbestos fibers lodge themselves into the lung’s protective lining (pleura) where they can never be expelled.

Here is what happens after asbestos fibers become trapped in the pleura:

  1. Irritation can trigger genetic mutations in healthy mesothelial cells.
  2. Healthy cells become cancerous mesothelioma cells and grow at abnormal rates.
  3. Mesothelioma cells lump together and form metastatic tumors (cancerous tissue) that can spread to distant sites.
  4. As mesothelioma tumors grow, they damage the lungs, the heart and the lymphatic system (the body’s filtration mechanism).

Left untreated, this disease becomes fatal due to complications resulting from the malignant (cancerous) tumors. With treatment, patients can have tumors removed or shrunk, which may increase life expectancy.

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Pleural Mesothelioma Stages

With most cancer types, doctors apply a standard medical practice called staging, which tells doctors how far advanced the disease is. By knowing where the cancer has spread to, doctors can decide which treatments will be most effective either at resecting (removing) the mesothelioma or managing the patient’s symptoms (palliative).

Doctors use three different staging systems each with their own criteria.

In general, the four stages of pleural mesothelioma are:

  • Stage 1: Mesothelioma remains localized in one or both layers of the pleura.
  • Stage 2: Mesothelioma has metastasized slightly outside the pleura and possibly into nearby lymph nodes.
  • Stage 3: Mesothelioma has metastasized into nearby tissues, organs or lymph nodes.
  • Stage 4: Mesothelioma has invaded distant sites like the peritoneum, pericardium and/or the other side of the chest.

Most cases are diagnosed at stage 3 or 4. No matter how far advanced your condition is, though, there are treatments available for every stage.

Treatment Options

Specialists have developed effective treatments for pleural mesothelioma. The hope for increased life expectancy is much higher today compared to 20 years ago thanks to new methods and approaches to treating even late-stage patients.

Standard treatments include a combination of surgery, chemotherapy, radiation therapy, and palliative treatment.

For treatments to be most effective, plans must involve:

  • Experienced pathologists capable of accurately diagnosing the cancer type
  • Multidisciplinary teams of specialists across a range of medical fields
  • Highly skilled surgeons who specialize in removing pleural tumors

As part of treatment, patients may be eligible for surgeries. Surgeries can either fully or partially remove tumors and improve survival.

The 2 standard surgeries are:

  1. Extrapleural Pneumonectomy: Surgeons remove the diseased lung, pleura, lymph nodes, pericardium and part of the diaphragm. Patients can live with only one lung, but it may decrease the quality of life for some.
  2. Pleurectomy With Decortication: During a less radical surgery, surgeons remove the diseased pleura and all visible tumors nearby. Though this procedure allows patients to keep their lung, there’s debate over whether or not it leads to higher rates of recurrence (when cancer comes back).

Most patients also undergo chemotherapy or radiation therapy or both. These anti-cancer treatments help shrink tumors and kill off remaining microscopic mesothelioma cells left behind after surgery.

Seeing a Specialist

Patients should seek treatment from a specialist for their best chance at survival. General oncologists do not have the experience necessary to effectively treat mesothelioma. It’s a rare cancer, and most doctors only see 1 or 2 cases in their careers. Since the disease affects each person differently, personalized treatment plans from experienced specialists are vital.

By seeing a specialist, you’ll be treated by an entire team of mesothelioma experts who have dedicated their careers to researching and treating this disease.

Treatment teams include thoracic surgeons and medical and radiation oncologists who can provide the latest treatment technologies and approaches.

The U.S. has many of the world’s top specialists, including:

  • Dr. Robert Cameron — Thoracic Surgical Oncologist, UCLA Medical Center, and Los Angeles VA, Los Angeles CA
  • Dr. Anne Tsao — Thoracic Medical Oncologist, MD Anderson Cancer Center, Houston TX

Mesothelioma can only be accurately diagnosed by a specialist. If you’ve received a diagnosis from a general oncologist, then it’s crucial to get a second opinion from a pleural mesothelioma specialist.

A second opinion can either confirm your diagnosis or provide you with a different one, which will alter your treatment plan.

It’s common for pleural mesothelioma to be misdiagnosed as another type of cancer. To avoid wasted time, be sure to contact a mesothelioma specialist immediately before starting on any treatment plan.

Compensation for Mesothelioma Victims

Treatments for pleural mesothelioma are available at top cancer centers across the country. All major cancer centers with mesothelioma programs accept health insurance plans. However, some plans won’t cover all the costs associated with treatments. In addition to medical bills, patients often need to travel great distances to undergo treatment, which can incur significant costs not covered by most health insurance.

A mesothelioma diagnosis is a major emotional and financial burden to patients and their families. By filing for legal compensation, you may be able to cover your treatments costs, travel, and accommodation expenses and any other damages you’ve suffered such as lost wages.

This compensation comes from manufacturers of asbestos-containing products who hid the dangers of asbestos exposure for decades. Court-ordered trusts have been established to pay those injured by asbestos.

Veterans may also be eligible for medical benefits through the VA. If you can prove that your mesothelioma was caused by asbestos exposure during your time as an active duty military member, then you may be able to receive monthly payments from the VA.

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Author:Stephanie Kidd

Editor-in-Chief of the Mesothelioma Justice Network

Stephanie Kidd

Stephanie Kidd works tirelessly as a dedicated advocate for the vulnerable and underrepresented. Stephanie worked as a copywriter for an agency whose focus was communicating safety procedures on construction work sites. With her extensive background in victim advocacy and a dedication to seeing justice done, Stephanie works hard to ensure that all online content is reliable, truthful and helpful.

Last modified: July 2, 2019

View 2 Sources
  1. Mayo Clinic, “Mesothelioma Overview.” Retrieved from: Accessed on December 30, 2017.
  2. Medscape, “Malignant Pleural Mesothelioma Treatment Protocols.” Retrieved from: Accessed on December 30, 2017.
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