What Is Pleural Mesothelioma? Symptoms & Diagnoses

Malignant pleural mesothelioma is a rare type of cancer that develops in the pleura, the thin lining that connects the lungs to the chest cavity. When asbestos fibers become lodged in the lining of the lungs, they can cause irritation and scarring, leading to disease.

Pleural mesothelioma is the most common type of cancer, accounting for 70% to 79% of mesothelioma cases. Doctors diagnose more than 3,000 new patients with mesothelioma annually in the United States.

What Causes of Pleural Mesothelioma?

The leading cause of mesothelioma is asbestos exposure.

Mesothelioma develops when a person breathes in asbestos, and the fibers become lodged in the lining of the lungs. After the microscopic mineral fibers are inhaled, their sharp, dark texture causes them to install in the lungs and slowly move away. Over the years, these fibers cause irritation, chronic inflammation, and changes in DNA, which turn healthy cells into cells.

Who Is At Risk?

Occupational asbestos exposure is the number one cause of mesothelioma, and many occupations pose a higher risk.

Malignant mesothelioma usually takes 20 to 60 years to develop after a person is first exposed to asbestos. Because of this delay, the disease often affects people over 70.

  • Veterans:The U.S. military used asbestos extensively in machinery and construction materials. Shipyard workers were among the most prominent.
  • Firefighters:In addition to exposure to asbestos in burning buildings, firefighting equipment, including fans and masks, are made of asbestos.
  • Construction Workers:No industry uses more asbestos than the construction industry. For this reason, construction workers are in professions that may be exposed to mesothelioma.
  • Electrical Workers:Asbestos was used in arc pipes, electrical storage, electrical equipment, etc., representing many electrical workers in the United States.
  • Industrial workers:Those who work in industrial workplaces and use industrial materials are exposed to asbestos.

These workers often bring asbestos fibers home with their clothing and equipment, leading to second-hand exposure.

Environmental exposure is a rare form of exposure but can affect the entire population. For example, the city of Libby, Montana, recently cleaned up asbestos contamination from mining asbestos-contaminated vermiculite.

Symptoms of Pleural Mesothelioma

People with mesothelioma have symptoms that make breathing difficult. Some patients also experience swelling of the face or hands, back pain, or muscle pain.

Symptoms of benign mesothelioma may include:

  • Difficulty breathing
  • Chest pain or shortness of breath
  • Dry cough or cough
  • coughing up blood
  • It’s hard to swallow
  • Pain in the lower back or side
  • Unexplained weakness and fatigue
  • Swelling of the face or hands
  • Night sweats or hot flashes
  • Lumps under the skin on the chest.
  • Fluid in the lungs

For most people,symptoms of mesotheliomado not appear until the cancer has advanced. Very rarely do patients report weight loss and fatigue when they visit their doctor. These symptoms may only appear as cancer progresses.

Various cancer markers can indicate a person’s history of asbestos exposure and the potential for mesothelioma. Based on years of research on people exposed to asbestos, these symptoms include plaque, pulmonary effusion, and benign tumors.

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Small areas of swelling in the pleura are a common sign of a history of asbestosis. Pleural plaques are not cancerous and usually do not cause symptoms, but they can indicate a higher risk of cancer.


Irritation from asbestos fibers can cause excess fluid to collect between the two layers of the pleura. This condition, called pleural effusion, is present in most mesothelioma cases. Some juice between the genitals is healthy. Too much of it puts pressure on the lungs, causing chest pain and worsening coughing or shortness of breath.


Breathing can be difficult and painful when large parts of the pleura are hardened due to scarring. Hypertension in both lungs is a sign of severe asbestosis. Repeated episodes of pleural effusion can cause the swelling to harden as scar tissue develops.


Asbestosis is a lung disease characterized by gradual tissue damage caused by exposure to asbestos. This feature does not affect the network. Asbestos patients have a higher risk of developing asbestos-related lung cancer than pleural mesothelioma, but the latter is documented in the medical literature.

How Pleural Mesothelioma Is Diagnosed

The process of diagnosing mesothelioma begins when the doctor examines the first symptoms of the disease. Chest pain and shortness of breath prompt a chest x-ray, which may show fluid or swelling around the lungs.

The primary care physician refers the patient to a specialist when more tests are needed. A biopsy is the most important diagnostic test for mesothelioma because it can detect cancerous cells.

Assessment tools include:

  • Physical exam:During a physical exam, the doctor will look for abnormalities, such as skin lumps, and check any parts of the body that are tender or painful.
  • Imaging scans:X-rays, MRIs, and PET scans help locate tumors.
  • Blood testsshow cancer biomarkers, but they cannot diagnose mesothelioma alone.
  • Biopsy:Biopsies are physical samples that can confirm cancer.

Specialists must use imaging studies and tissue biopsies to confirm a mesothelioma diagnosis. In addition to identifying cancer, knowing cancer’s stage and cell type is essential in determining the best treatment plan.

Cell Type

The type of cell is essential in deciding the treatment plan. Three types of cells that can form mesothelioma tumors have been identified with biopsy. Most cases of malignant mesothelioma are characterized by large numbers of epithelial cells, also called epithelioid cells. This type of cell responds well to cancer treatment.

The most common cell type is sarcomatoid mesothelioma. They are aggressive and difficult to treat; most of these occur in happy patients. A biphasic cell type is a mixture of two kinds. How it responds to treatment depends on the number of cells. If there are many epithelioid cells, they will respond better than tumors with many sarcomatoid cells.


Staging pleural mesothelioma is how doctors determine cancer progression in a patient’s body. The class affects the treatment options prescribed by doctors.

The International Mesothelioma Society has developed the TNM staging system, the most widely used system for mesothelioma.

Stages 1 and 2, considered the first stages, represent localized tumors. Stages 3 and 4 illustrate the final stages and are classified as spreading tumors.

Pleural Mesothelioma Treatment

Common treatments for mesothelioma may include radiation therapy and chemotherapy. Doctors often prescribe a form of medicine known as multimodal therapy when they diagnose a patient early.

Patients can receive this treatment at leading cancer centers nationwide specializing in mesothelioma treatment. These treatments can improve symptoms, such as chest pain and shortness of breath, and improve survival.

  • Surgery:Surgery treats these cancers, reduces symptoms, and removes tumors. Stage I patients benefit most from tumor surgery. Procedures include invasive pneumonectomy and pleurectomy with decortication.
  • Chemotherapy:Chemotherapy is the most common treatment of choice. It uses one or more drugs, usually a combination of cisplatin or carboplatin and pemetrexed (Alimta), to kill cancerous cells or stop them from growing.
  • Radiation:Targeted radiation can kill cancer cells and shrink tumors. Radiation therapy cannot cure mesothelioma happily, but it is an effective way to control chest pain. Radiation can also help prevent cancer from coming back after surgery.
  • Immunotherapy:The U.S. Food and Drug Administration approved the combination of Opdivo and Yervoy for advanced mesothelioma in 2020. Patients not eligible for surgery have these drugs, known as nivolumab and ipilimumab.
  • Faster Treatments:New treatments for mesothelioma include new treatments such as gene therapy and photodynamic therapy. Researchers are developing anti-cancer treatments that are more effective and less harmful to the patient.

You may receive treatment using a mesothelioma test. Some patients may be eligible for immunosuppressive drugs and other therapies through compassionate use programs.

Palliative care physicians prescribe medications and treatments to control the symptoms of mesothelioma cheerfully and improve quality of life in all stages.

Pleural Mesothelioma Diagnosis and Survival

The overall prognosis of pleural mesothelioma is poor, with a median survival of 8 to 14 months. The 5-year survival rate is 20% for early and localized tumors and 12% for all stages. Some patients lived for more than ten years after treatment.

The prognosis for mesothelioma is poor, or the forecast for the disease is poor for many patients because this cancer progresses quickly and is resistant to many existing treatments. Life expectancy for mesothelioma is generally less than 18 months, but it depends on many factors.

Accurately predicting a person’s prognosis is difficult because this disease is complex. Everyone responds differently to a treatment.

Pleural mesothelioma annual survival rate

Source: “Changing Patterns in Mesothelioma Survival,” Oncology Review, 2015.

Things That Affect Your Thinking

Prognostic factors for mesothelioma vary from specific factors, such as age and level of activity, to factors associated with cancer, such as stage and cell type.

  • Stage:An important factor in the diagnosis of mesothelioma is the stage of the disease at the time of diagnosis. Early-stage cancers offer a better chance of survival than late-stage cancers.
  • Cell type: The celltype of mesothelioma tumorsalso plays a role in prognosis.
  • Age: Youngerpatients tend to live longer.
  • Gender:Women tend to live longer with the disease than men.
  • Fluid: Excessive fluidin the chest is associated with a poor prognosis.
  • Patient Activity Level:Most active patients have a good prognosis.
  • Recurrent cancer:Recurrence of mesothelioma is associated with a poor prognosis.

Some biomarkers may also be related to patient survival, including calcium and platelet levels. Talk to your health care team about these factors that may affect your personal health.

Improve Your Communication

Taking proactive steps makes it possible to live longer and better with malignant mesothelioma. Some patients even remission after treatment and live for years without cancer symptoms.

The inspiring stories of mesothelioma survivors reveal different ways of coping with cancer. However, many survivors take some basic steps to improve their lives.

Following your doctor’s advice and taking steps toward a healthy lifestyle, such as exercise and diet for mesothelioma, can help you improve your prognosis and increase your life expectancy.

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