Pleural mesothelioma is the most common type of mesothelioma, a rare cancer that develops in the mesothelium (a membrane that lines many of the body's organs and cavities). In the case of pleural mesothelioma, the cancer develops in the lining of the lungs, called the pleura or pleural membrane.
Pleural mesothelioma is caused by the inhaling of asbestos fibers. Once these fibers have entered the lungs, they work their way to the pleural membrane, and the body has great difficulty getting rid of the fibers. Over a long period of time - typically two decades or more - asbestos fibers cause changes in the pleural cells. Those changes may cause scarring of the lungs and, long term, the formation of tumors.
When pleural cells become cancerous, they begin to divide continuously, reducing lung capacity and generating fluid buildup between pleural layers.
The prognosis for pleural mesothelioma patients is generally poor because it often is caught in its later stages. However, an early diagnosis can greatly improve a patient's prognosis and life expectancy.
Find out more about improving your life expectancy. The Mesothelioma Center offers a free packet with information on pleural mesothelioma, its symptoms and the best treatment options. Get your free packet by completing the form below.
Mesothelioma of the Lung
The pleura is comprised of two layers, which provide support and protection for the lungs and chest cavity. The outer layer, or the parietal layer, lines the entire chest cavity and the diaphragm. The inner layer, or visceral layer, covers the lungs. Pleural mesothelioma typically develops in one layer, but can metastasize, or spread, to the other layer. If the cancer spreads to distant locations, the mesothelioma prognosis can become poorer.
Like all mesothelioma cancers, pleural mesothelioma is caused by asbestos exposure and develops when the toxic asbestos fibers become trapped in the spaces between the mesothelial cells.
Pleural Mesothelioma Symptoms
Once trapped in the body, asbestos fibers cause cancerous cells to divide abnormally, resulting in the thickening of the pleural membrane. This has the potential to encourage build-up of fluid (called pleural effusion). The fluid begins to place pressure on the lungs and the respiratory system in general, preventing normal breathing. Symptoms of pleural mesothelioma are largely caused by these developments and may include the following:
- Pleural Mesothelioma Diagram
- Pleural mesothelioma specifically develops in the pleural lining of the lungs.
- Persistent dry or raspy cough
- Coughing up blood (hemoptysis)
- Difficulty in swallowing (dysphagia)
- Shortness of breath that occurs even when at rest (dyspnea)
- Persistent pain in the chest or rib area, or painful breathing
- Development of lumps under the skin on the chest
- Night sweats or fever
- Unexplained weight loss
- Fatigue
Pleural Mesothelioma Diagnosis
A pleural mesothelioma diagnosis is made partly on the basis of symptoms, but additional diagnostic tests are needed to confirm the presence of cancer. Following a medical history review and physical examination, patients typically undergo imaging tests, such as X-rays or CT scans, to confirm the location of cancer. A patient also usually undergoes fluid and tissue tests, known as biopsies, to confirm the type of cancer involved. Once tests and biopsies confirm a diagnosis of pleural mesothelioma, those test results are used to develop a treatment plan.
Pleural Mesothelioma Treatments
Pleural mesothelioma is traditionally treated with either surgery, chemotherapy, radiation therapy, or a combination of these options. A patient's general health and stage of their cancer must be evaluated before they are considered candidates for surgery. In most cases, only patients diagnosed with Stage 1 or Stage 2 receive surgery that attempts to cure the cancer. Chemotherapy and radiation may also be effective if tumors have not spread to other locations. Alternative treatments are also available and include photodynamic therapy, immunotherapy and gene therapy.
Treatments for pleural mesothelioma may be palliative or potentially curative depending on which stage the cancer is in. Patients who are diagnosed after potentially curative treatments are no longer effective may instead receive palliative treatments to relieve pain and improve quality of life. For pleural mesothelioma patients, early detection is key to improving prognosis and expanding treatment options.
Surgery options for pleural mesothelioma patients typically include pleurectomy/decortication or extrapleural pneumonectomy, which attempts to remove all or part of the affected lung lining. The most common chemotherapy option for pleural mesothelioma involves the drugs cisplatin and pemetrexed (Alimta). Some of the top doctors in the field of mesothelioma treatment that specialize in using these techniques include Dr. David Sugarbaker, Dr. Robert B. Cameron, Dr. Harvey Pass and Dr. Valerie Rusch.
Understanding available treatment options is very important to patients and their loved ones. We offer a complimentary informational packet detailing treatment options for pleural mesothelioma patients. Click here to receive your packet overnight or call 800-615-2270 to speak with a patient and family advocate available at no charge to answer questions and offer guidance.
If the disease is diagnosed early enough, surgery to remove localized tumors followed by chemotherapy or radiation therapy can be an effective treatment. Curative surgery candidates must be in a good general state of health, and their cancer must not have spread beyond localized sections of the lungs.
Pleural Mesothelioma Prognosis
When pleural mesothelioma is diagnosed before the cancer has greatly progressed, a patient is typically in the first stages of mesothelioma. Doctors typically address the seriousness of cancer in terms of stages ranging from one to four, with the level of the cancer’s progression increasing with each stage. Patients diagnosed with pleural mesothelioma in stage one or two generally have greater treatment options and a better prognosis.
According to some current studies, approximately 10 percent of all pleural mesothelioma patients will survive for three to five years following diagnosis. Of that 10 percent, half the patients will survive five years or more.
Pleural mesothelioma patients who are not diagnosed early enough for curative treatment have fewer treatment options, mostly limited to palliative treatments, designed to relieve pain and discomfort to improve a patient's quality of life, rather than their prognosis. Palliative treatments include removal of built-up fluid from the pleural spaces, and surgical removal of tumors to relieve pressure on the lungs.
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