Mesothelioma

What Is Mesothelioma?

Mesothelioma is a rare and aggressive cancer caused by asbestos exposure. It affects the protective tissue lining the lungs, abdomen, heart and testes. Life expectancy after diagnosis is 12 to 21 months with treatment. Doctors treat mesothelioma with surgery, chemotherapy, immunotherapy and radiation.

Doctors classify mesothelioma by where it forms on the mesothelium. This tissue lines the body’s cavities. Tumor location also affects symptoms, treatment and prognosis. For example, pleural mesothelioma cancer causes fatigue, cough and chest pain. It also causes shortness of breath.

Mesothelioma Types

Pleural and peritoneal mesothelioma cancers are the two most common types. In pleural mesothelioma, tumors form on the lung lining and chest wall. They also grow on the diaphragm and other thoracic areas.

Peritoneal mesothelioma tumors form on the peritoneum. It lines the abdominal organs and gut wall. Rarer types of mesothelioma include pericardial mesothelioma and testicular mesothelioma.

Tumors can spread or metastasize to the lining of other organs and lymph nodes. In the later stages, tumors can spread to the liver, lungs, kidneys, adrenal glands or spleen. Mesothelioma cell types affect the speed of cancer growth and treatment difficulty.

Pleural Mesothelioma

The most common type of mesothelioma is pleural mesothelioma. It forms in the pleura, the protective lining around the outside of the lungs.

Peritoneal Mesothelioma

Peritoneal mesothelioma, which forms in the abdominal lining, is the second-most common type. It has a much higher survival rate. Surgery is usually more successful than with pleural mesothelioma.

Pericardial Mesothelioma

Pericardial mesothelioma affects about 1% of patients. Treatment options are much more limited. The median survival is 2 to 6 months.

Testicular Mesothelioma

The rarest type is testicular mesothelioma. Treatment options are much more limited. About one-third of patients live for at least 10 years.

Symptoms and Causes of Mesothelioma

Fatigue, weight loss, and fever are common in all types of mesothelioma. Mesothelioma is often misdiagnosed because its symptoms can resemble other cancers and illnesses. Talk to your doctor if you’ve been exposed to asbestos in the past and are experiencing these symptoms. Early disease diagnosis often leads to a better prognosis and longer life expectancy.

What Are the Symptoms of Mesothelioma?

Dry cough, shortness of breath, and chest pain are common symptoms of mesothelioma. Other common symptoms include abdominal pain and unexplained weight loss. Tumor location determines which symptoms develop and how severe they can become. 

Fatigue is the most reported mesothelioma symptom, regardless of cancer type. Patients with severe symptoms can opt for palliative care alongside traditional treatment. Palliative care aims to manage symptoms. It uses mild chemo, surgery, and other treatments to ease pain and breathlessness.

What Causes Mesothelioma?

Asbestos exposure is the leading cause of mesothelioma. Repeated exposure to asbestos-contaminated products increases the risk of developing mesothelioma. These products include talc and older construction materials. It takes, on average, 20 to 60 years for symptoms to develop after the first asbestos exposure. The period during which mesothelioma develops is known as the mesothelioma latency period.

Dr. Marcelo DaSilva is chief of thoracic surgery at AdventHealth Cancer Institute. He is also its medical director. When we interviewed him, he told The Mesothelioma Center that “patients inhale or ingest asbestos, which causes chronic inflammation in the mesothelium.” DaSilva said, “This can lead to genetic changes where cell DNA becomes a mesothelioma cancer cell.”

Occupational asbestos exposure is the No. 1 risk factor for mesothelioma. Workers in construction, industry, firefighting, and the military face the most asbestos exposure. The military used large quantities of asbestos. Factories and construction projects did the same.

Companies used asbestos for its low cost and its resistance to heat and electricity. It was also durable. Asbestos remains in many older building materials, machinery and consumer products.

If you or a loved one have been exposed to asbestos, get screened for mesothelioma. X-rays and other tests can help catch mesothelioma early. Tell your doctor about your exposure and ask how frequently you should be screened.

How Is Mesothelioma Diagnosed?

Doctors diagnose mesothelioma with tests of the chest and abdomen. A diagnosis confirms your cancer type, tumor cell type, stage and more. These details help your doctor create the best treatment plan for your cancer.

They can use tests, like a CT scan, to find mesothelioma. But to confirm a diagnosis, a tissue sample or biopsy is necessary. They use this tissue sample to identify specific types of mesothelioma cancer cells.

Doctors may use blood tests to aid diagnosis. But these test cannot detect mesothelioma alone. Most people undergo a chest X-ray at the beginning of the diagnostic process. Doctors recommend CT, MRI, or PET scans for abnormal growth or fluid around your lung.

After a mesothelioma diagnosis, your doctor will check your pathology report. It will show the cancer’s cell type. Mesothelioma cancer cells can be epithelial or sarcomatoid. They may also be biphasic, which is a mixture of both epithelial and sarcomatoid. The three types of mesothelioma cells have distinct responses to treatment. Their prognosis also varies.

Stages of Mesothelioma

The four stages of mesothelioma describe tumor size and location. They also address lymph node involvement and metastasis. As tumors grow and spread, the stages advance. Stages 1 and 2 are early stages. And stages 3 and 4 are late stages. Knowing the cancer stage is important. It helps doctors plan treatments and predict outcomes. Each type of mesothelioma grows and spreads depending on where the tumors originated.

Median life expectancy for pleural mesothelioma ranges from 14.9 months to 22.2 months. Patients with an early-stage diagnosis tend to live closer to 2 years with treatment. Your doctor will decide on treatments based on the cancer’s stage, cell type and overall health.

How Is Mesothelioma Treated?

Doctors treat mesothelioma cancer using surgery, chemotherapy, radiation and immunotherapy. The American Society of Clinical Oncology approved these latest treatment guidelines. Your treatment plan may include many therapies or a specific order for them. Your doctor is the specialist who creates this plan. It is based on your cancer type and stage, health, and response to past therapies.

Treatment options also vary by cancer location. Pleurectomy and decortication surgery is for pleural mesothelioma. The surgery removes large portions of tissue that contain tumors. Some types of surgery may not be an option for patients with tumors in sensitive areas, such as near the heart.

Patients with the sarcomatoid cell type have few treatment options. Surgery is usually not effective. The epithelial cell type responds best to all forms of treatment. Most patients can choose supportive or palliative care. Doctors adjust these treatments to be less harmful, focusing on reducing symptoms.

“Supportive care medicine is a new field. It reduces pain, increases appetite and boosts morale,” said Dr. Jacques Fontaine, a thoracic surgeon. He is director of the Mesothelioma Research and Treatment Center at Moffitt Cancer Center. When we interviewed him, he said, “Every mesothelioma patient should ask to be seen by this type of medical specialist, in addition to a thoracic surgeon and medical oncologist.”

You may be eligible for mesothelioma clinical trials that test newer therapies. Not every mesothelioma treatment suits every patient. But most patients benefit from palliative care to manage their symptoms.

Mesothelioma Prognosis and Life Expectancy

With treatment, life expectancy for mesothelioma patients is about 12 months. Mesothelioma statistics show the 5-year survival rate is 12% for people with pleural mesothelioma. The 5-year survival rate for people with peritoneal mesothelioma is 65%.

While you can’t change your age or cancer stage, you can decide to get treatment and adopt a healthy lifestyle. Mesothelioma patients who make these positive changes may find remission. That’s a period with no signs or symptoms of cancer.

We asked peritoneal mesothelioma survivor Epifanio Figueroa about his thoughts on life after treatment. “The last time that I went to the doctor, he says we can’t see almost anything there,” Figueroa told The Mesothelioma Center. “So to all my buddies who have mesothelioma, once you get off the treatment, sweep that under the rug and keep on going forward.”

Survivor Story

Survivor Story

Daniel McCarthy Diagnosis: Pleural Mesothelioma, 2017

Mesothelioma Survivor Shares His Cancer Story

Diagnosed in 2017, pleural mesothelioma survivor Daniel McCarthy stays remarkably active at 82. Dr. Abraham Lebenthal at the Boston VA Hospital first performed an aggressive surgery. McCarthy later underwent chemotherapy and radiation. Today, he walks daily, reads considerably, and writes about his adventures.

Read Daniel’s Story

Additional Mesothelioma Resources for Patients & Families

The impact of a rare cancer diagnosis such as mesothelioma can feel like too much to handle. Worrying and feeling confused about how you can move forward is expected.

Focus on getting excellent treatment. You can empower your family with knowledge, resources and hope.

Commonly Asked Questions About Mesothelioma

How rare is mesothelioma?

Mesothelioma is an extremely rare cancer, accounting for 0.16% of all cancers. Doctors diagnose about 3,000 new cases of mesothelioma every year. The incidence rate of mesothelioma is about 1 in every 100,000 people.

Can mesothelioma go into remission?

Yes, some mesothelioma patients experience remission. Doctors define remission as a period where cancer is undetectable and there is no tumor growth. About 13% of mesothelioma patients report going into remission. Peritoneal mesothelioma patients are twice as likely to experience remission than pleural patients.

How do you know if you have mesothelioma?

You might suspect mesothelioma if you have a history of asbestos exposure. This is true if you have persistent symptoms like chest pain, a chronic cough, or shortness of breath. Mesothelioma has a long latency period. It can take 20 to 60 years to develop after exposure. So symptoms can appear decades later. If these symptoms arise, it’s essential to see a doctor for evaluation.

How is mesothelioma different from lung cancer?

Mesothelioma is not a form of lung cancer. Both are cancers. Mesothelioma grows on the pleura. It is the lining that covers the lungs, diaphragm and chest cavity. Lung cancer develops within the lung space.

Is there a cure for mesothelioma?

Mesothelioma is not curable. However, researchers continue investigating new therapy options in clinical trials. Mesothelioma is almost always fatal. But some patients live years beyond the average life expectancy. A small number of people have survived for more than a decade after diagnosis. Recent treatment advancements, such as immunotherapy, provide patients hope for an eventual cure.

Can mesothelioma be prevented?

The only way to prevent mesothelioma is to avoid asbestos exposure. It’s vital to educate yourselves and others about asbestos risks. Construction workers, veterans, and firefighters are at high risk. If you’ve been exposed to asbestos, tell your doctor. You may need tests to detect cancer early.

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