Most common type of mesothelioma, makes up more than 80% of diagnoses
Average age at diagnosis for pleural mesothelioma
Approximate new mesothelioma cases diagnosed each year
Symptoms can take 10 – 50 years after exposure to appear
01. Mesothelioma Overview
What Is Mesothelioma?
Mesothelioma, a rare and aggressive form of cancer, develops in the linings of certain tissues. Pleural and peritoneal are the two most common types of mesothelioma. These types develop in the lining around the lungs or the abdomen, respectively. Other types are pericardial mesothelioma and testicular mesothelioma. There are also different mesothelioma cell types.
Mesothelioma develops after exposure to asbestos. Asbestos is a fibrous mineral that often creates dust or powder. If inhaled or ingested, the fibers can lodge in internal organs and later cause tumors to develop. People with occupational asbestos exposure risks have a higher risk of developing mesothelioma.
Mesothelioma survival ranges from 18 to 31 months, with treatment. In general, treatment may help improve factors like quality of life and survival. Treatment plans may include traditional methods like chemotherapy or newer methods like immunotherapy. Multimodal plans, which are plans with different treatments combined, are common.
Mesothelioma symptoms can take 10 – 50 years to present after initial asbestos exposure. When symptoms do appear, they can easily be mistaken for less serious illnesses. Similar symptoms may occur with the flu, pneumonia or intestinal troubles.
This latency period and delay in symptom reporting may complicate the mesothelioma diagnostic process. If you or a loved one have a history of asbestos exposure, it can be helpful to disclose that exposure to a doctor who can do periodic checkups. This may help lead to an earlier diagnosis and treatment plan.
With an earlier diagnosis, patients may have different treatment options. In some cases, early detection may improve a mesothelioma prognosis.
Common Symptoms of Mesothelioma
The amount, severity and type of mesothelioma symptoms vary for each patient. Common signs and symptoms of mesothelioma include:
- Abdominal pain
- Chest pain
- Coughing or wheezing
- Difficulty breathing (dyspnea)
- Fever and night sweats
- Fluid buildup
- Loss of appetite
- Muscle weakness
- Shortness of breath
- Unexplained weight loss
Causes of Mesothelioma
Asbestos is the only definitive cause of mesothelioma. When asbestos fibers are inhaled or ingested, they may embed in the lining of the lungs, abdomen or heart. Over time, the fibers can cause inflammation and scarring. This irritation can later lead to the development of mesothelioma tumors.
How Mesothelioma Develops
- An individual is exposed to asbestos fibers, which are easily inhaled or ingested.
- The asbestos fibers become lodged in the linings of internal organs, including the lungs (pleura), abdomen (peritoneum) and heart (pericardium).
- Embedded fibers irritate and damage surrounding tissue.
- Over time, tumors begin to form in the damaged tissue.
Before the 1980s, many industries used asbestos. Along with other industries, the construction and automotive industries frequently exposed workers to asbestos.
Who Is at Risk of Developing Mesothelioma?
Individuals who were often in contact with asbestos are the most at risk of developing this disease. However, any amount of asbestos exposure can cause mesothelioma.
Workers in asbestos industries generally experienced higher rates of exposure. These workers may have experienced asbestos exposure at their jobsite. Veterans also faced high exposure risks. Asbestos can also be a danger to individuals who did not work with it.
For example, workers can bring home the small fibers on their clothing, hair and skin. In this way, it can expose the families and loved ones of workers to asbestos. This is called secondary exposure, or secondhand exposure. Secondary exposure is a risk factor for anyone living with asbestos workers.
High-risk occupations for exposure include:
- Aircraft mechanics
- Auto mechanics
- Boiler workers
- Construction workers
- HVAC workers
- Industrial workers
- Machine operators
- Mine workers
- Oil refinery workers
- Shipyard workers
- Textile Mill Workers
Veterans are also at higher risk of asbestos exposure. For decades, the military used asbestos throughout the different branches. As a result, many veterans of the Air Force, Army, Coast Guard, Marine Corps and Navy may have encountered asbestos during their time in active service.
Did You Know?
Types of Mesothelioma
There are four main types of mesothelioma, each based on the location of tumors. The most common type is malignant pleural mesothelioma. These main types of mesothelioma fall into categories based upon the kinds of cells in the tumor. The three main mesothelioma cell types are:
- Epithelioid mesothelioma: The tumors contain epithelioid cells that look similar to epithelial cells found in the skin and other common tissues. This is the most common mesothelioma cell type. Compared to other cell types, epithelioid mesothelioma responds well to treatment.
- Sarcomatoid mesothelioma: The tumors contain sarcomatoid cells that look like sarcoma cells, which are a type of cancer cell. This cell type makes up approximately 10% – 20% of all mesothelioma diagnoses. It may respond to immunotherapy better than chemotherapy.
- Biphasic mesothelioma: The tumors contain a combination of epithelioid and sarcomatoid cells. In general, this type occurs in the pleura (lung lining) or peritoneum (abdominal lining). The percentage of each cell type may affect which treatment options are available.
Prognosis, symptoms and treatment options vary depending on cell type. These factors are also influenced by where the mesothelioma occurs in the body.
Recommended treatment methods vary based on mesothelioma cell type and location. Doctors can create customized treatment plans based on each individual case.
Resources for Mesothelioma Patients
It is important to diagnose mesothelioma as early as possible. After recognizing symptoms, doctors will confirm a mesothelioma diagnosis with a biopsy. Biopsies are the only way to definitively diagnose mesothelioma. Other diagnostic tools may help determine location and staging.
Common Tests for Diagnosing Mesothelioma
Before performing a tissue biopsy to diagnose mesothelioma, doctors may check for abnormalities. This process may involve various tests, like bloodwork and imaging scans.
Doctors often use imaging scans in the initial stages of a mesothelioma diagnosis. These tests commonly include CT scans, MRIs and X-rays. Scans, like a chest X-ray, can help doctors determine the extent and location of tumors. Doctors may also use imaging to see how far the disease has progressed.
Each scan has different benefits and limitations. Depending on each case, doctors may recommend more than one type of imaging scan. After a diagnosis, doctors may again use these tests to help determine the stage of the disease, monitor spread and check for any fluid buildup.
Biopsies are an important step in diagnosing and treating mesothelioma. A biopsy, which removes tissue or fluid for testing, is the only way to diagnose mesothelioma. Imaging scans and other tests can play a role in the diagnosis process, but only biopsy testing can be conclusive. A biopsy can also help determine important disease factors, like cell type.
A biopsy is often performed with a needle that extracts a fluid or tissue sample. After the procedure, a pathologist will analyze the sample. Some biopsy methods are less invasive than others.
Blood tests measure indicators of mesothelioma, called biomarkers, in a blood sample. Doctors may combine bloodwork with a biopsy to confirm a mesothelioma diagnosis. Blood tests alone cannot diagnose mesothelioma.
MESOMARK® is a blood test that has approval for some mesothelioma monitoring. While other tests may identify general cancer indicators, MESOMARK is specific to mesothelioma indicators. Advances in blood test methods may someday support earlier mesothelioma diagnosis.
Staging is another important step in the initial diagnostic process. After confirming a mesothelioma diagnosis, doctors often go on to estimate its stage. The most common mesothelioma staging method is the tumor node metastasis (TNM) staging system. Stages range from early stages (1 and 2) to later stages (3 and 4).
This information helps doctors understand prognosis and treatment options. In stages 1 and 2, patients may have varied treatment options. In stages 3 and 4, the cancer has spread, or metastasized. This may mean patients have different treatment options in these later stages versus earlier stages.
With stage 1 mesothelioma, the cancer is only in specific, or localized, areas of the body. Aggressive treatments, like surgery, are often still an option. Life expectancy ranges from 21 months to more than 5.5 years with treatment.
With stage 2 mesothelioma, the cancer has spread to nearby organs and lymph nodes. Some aggressive treatments, like surgery, may still be an option. Life expectancy ranges from 19 months to about 5.5 years with treatment.
With stage 3 mesothelioma, the cancer spreads further to other organs and tissue. Treatment options may become more limited. Life expectancy ranges from 16 months to nearly 5 years with treatment.
With stage 4 mesothelioma, the cancer spreads further to distant organs and tissue. Most treatment options are palliative and aim to increase patient comfort. Life expectancy ranges from 12 to 26 months with treatment.
Doctors use several factors to estimate prognosis, but an individual’s experience may differ from this estimate. Patients from stages 1 to 4 have outlived their original life expectancy. Research advances continue expanding treatment options for early- and late-stage cases.
Prognosis is the medical expectation for how a patient’s disease will progress. A mesothelioma prognosis includes life expectancy, quality of life and other aspects of a patient’s experience. Doctors use information like stage and cell type to estimate survival time and the best treatment options for improving prognosis.
When discussing their prognosis, patients will often hear other related terms, including:
- Life expectancy: An estimate of the amount of time they will live after diagnosis. This is presented in months or years.
- Survival rate: The percentage of people in a certain group who are still alive at a specific point in time. This is typically reported in 1-, 2-, 3- or 5-year increments.
Each patient’s prognosis will vary based on many individual factors. In general, treatment can help improve a patient’s prognosis. Mesothelioma specialists can create a personalized treatment plan for each patient.
A prognosis is a complex estimate and many factors affect it. Treatment generally helps improve prognosis. With treatment, some mesothelioma patients are able to outlive their initial life expectancy by months, years or even decades.
For example, Heather Von St. James is a pleural mesothelioma survivor of more than 16 years. During her diagnosis, doctors said she had 15 months to live. Heather had a multimodal treatment plan that included surgery and heated chemotherapy. Today she supports mesothelioma patients and advocates for awareness of this disease.
Mesothelioma Treatment Options
Treatment is the best way to help improve a mesothelioma prognosis. This can include improving quality of life and extending life expectancy.
Traditional treatments for mesothelioma include chemotherapy, radiation and surgery. Immunotherapy is a newer, promising treatment method that is often used, too. This may be an option for mesothelioma patients.
These methods will often be combined to create a successful treatment plan. This approach is called multimodal treatment. Multimodal plans have yielded the best known patient survival outcomes.
Chemotherapy drugs kill cancer cells and stop them from multiplying. For mesothelioma, the standard first-line chemotherapy treatment is cisplatin or carboplatin with pemetrexed. It is often combined with other methods.
Immunotherapy helps the body identify and fight cancer cells. It has been successful for patients with average or complex cases. The combo of Opdivo® (nivolumab) and Yervoy® (ipilimumab) has approval for pleural cases. Clinical trials continue testing this method.
Radiation is a standard cancer treatment that uses energy to damage or kill cancer cells. It is commonly used with other methods, such as surgery, to treat pleural mesothelioma.
Surgery is the method of manually removing cancerous tissue. It may be used throughout the various stages of cancer. In later stages, surgery may have a more palliative than therapeutic intent.
Patients may receive these treatments to remove tumor mass, kill cancer cells, manage side effects or improve quality of life. Some aspects of multimodal plans can also help manage side effects from individual treatments.
Mesothelioma cancer research continues examining emerging treatment options through clinical trials. Emerging methods include gene therapy, photodynamic therapy and TTFields. Patients may have access to these treatments in clinical trials.
Find Specialized Mesothelioma Treatment
For patients with mesothelioma, receiving specialized care is important. Many doctors may not have experience in treating this rare cancer. However, there are many qualified mesothelioma specialists throughout the United States.
These doctors can develop personalized cancer care plans for patients. They stay more up to date than general oncologists on the latest mesothelioma research and treatments. Mesothelioma specialists can help patients better understand and navigate their diagnosis.
Top Mesothelioma Doctors
Mesothelioma specialist is a broad title that may include different types of doctors. These include palliative care specialists, radiation oncologists, medical oncologists and thoracic surgeons. Some specialists are also mesothelioma experts with prominent careers in this field.
Raphael Bueno, M.D.
Raja M. Flores, M.D.
James Pingpank, M.D.
Anne S. Tsao, M.D.
Patients may have a mesothelioma doctor near them. Finding the right specialist is an important step in the treatment process.
Top Mesothelioma Treatment Centers
There are cancer centers across the country with the ability to treat mesothelioma. Many mesothelioma doctors work at these mesothelioma cancer centers. Many of these centers have dedicated mesothelioma teams and may run clinical trials.
Brigham and Women’s Hospital
The University of Chicago Medicine Comprehensive Cancer Center
Lung Institute at Baylor College of Medicine
University of California Los Angeles (UCLA) Medical Center
Find doctors and cancer centers specializing in mesothelioma treatment near you by selecting your state below.
Mesothelioma Support and Resources
Patients, survivors and their loved ones can find support through the mesothelioma community. For example, support groups can connect people with others who understand this disease. There are many other ways to get involved in the community or to show support.
Below are ways to connect with others about a mesothelioma diagnosis, treatment and survivorship.
10. Common Questions
Common Questions About Mesothelioma
- Is mesothelioma treatable?
Mesothelioma is a treatable cancer. Though there is no cure for mesothelioma, several therapies can extend life expectancy. Depending on each case, treatment may also help improve aspects like comfort or survival. Treatment plans may include chemotherapy, immunotherapy, surgery and radiation therapy.
- What are the most common symptoms of mesothelioma?
Common mesothelioma symptoms include cough, fluid buildup, shortness of breath and abdominal or chest pain. Patients may exhibit any number of all possible mesothelioma symptoms. Symptoms can vary based on the type of mesothelioma, too. Patients often mistake these symptoms for mild conditions and wait to seek medical care. Individuals who have previously been exposed to asbestos and now exhibit these symptoms should see a doctor.
- What is the main cause of mesothelioma?
Asbestos exposure is the only known cause of malignant mesothelioma. Asbestos is a mineral that many industries once used in their products and materials. Since the 1980s, regulations have significantly decreased asbestos use, but mesothelioma cases continue occurring. Mesothelioma can take decades to develop after someone inhales or ingests asbestos fibers.
- Is mesothelioma a form of cancer?
Malignant mesothelioma is a rare and aggressive cancer. Pleural mesothelioma develops in the lining around the lungs but is not a form of lung cancer. Mesothelioma can also develop in the lining of the abdomen, in which case it is called peritoneal mesothelioma.
- What type of cancer is mesothelioma?
Mesothelioma is a specific, rare type of cancer that affects the mesothelium (thin lining surrounding certain tissues and organs). These organs include the lungs, abdomen and heart.
- What is the life expectancy of someone with mesothelioma?
With treatment, the average life expectancy after a mesothelioma diagnosis is 18 to 31 months. But some patients have outlived their life expectancy by more than a decade. Combination treatments with surgery and chemotherapy seem to be the most effective for improving survival. Mesothelioma specialists can help patients understand which options may be right for them.