Pleural Mesothelioma

Quick Summary

Malignant pleural mesothelioma is cancer of the lining of the lungs (pleura) caused by asbestos exposure. Symptoms include chest pain, trouble breathing, and a persistent cough. The average life expectancy for pleural mesothelioma patients is 12 months.

What Is Pleural Mesothelioma?

Pleural mesothelioma is the most common form of malignant mesothelioma, making up around 80% of all cases, or roughly 2,400 people every year.

80% of mesothelioma cases are pleural

This type of cancer develops in the pleura, which is the protective lining of the lungs and chest wall. From there, it continues to spread throughout a patient’s body.

For help paying for life-extending pleural mesothelioma treatment, work with experienced mesothelioma law firm Sokolove Law. We may be able to help you receive compensation through a legal claim.

Find out if you may be eligible for compensation.

Pleural Mesothelioma Causes

The only known cause of pleural mesothelioma is asbestos exposure. People who worked in environments known to contain asbestos, such as shipyards and construction sites, have higher rates of this cancer.

Pleural mesothelioma develops in the following way:

  1. A person breathes in loose asbestos fibers floating in the air.
  2. These tiny, nearly indestructible asbestos fibers become stuck in the pleura.
  3. The fibers cause inflammation and damage the DNA of nearby cells.
  4. Over 20-50 years, damaged cells may mutate in ways that lead to uncontrolled growth.
  5. This uncontrolled cell growth in the lung lining causes pleural mesothelioma.

Who Is at Risk for Pleural Mesothelioma?

  • Blue-collar workers: From the 1930s to the 1980s, the United States construction and manufacturing industries exposed millions of workers to asbestos.
  • Veterans: The U.S. Military used thousands of different asbestos-containing products throughout the 20th century, especially in the U.S. Navy.
  • Loved ones of individuals exposed to asbestos: Workers may have unknowingly brought home asbestos fibers on their hair and clothing, exposing family members.
  • People living near asbestos deposits: Rarely, people living near a natural deposit may be exposed to asbestos, especially if fibers are disturbed by mining.

Pleural mesothelioma primarily affects men, while peritoneal mesothelioma, which develops in the lining of the abdomen (peritoneum), largely affects women.

Pleural Mesothelioma Symptoms

The symptoms of pleural mesothelioma mainly affect the lungs and chest. These symptoms often resemble common illnesses like the flu or pneumonia.

Symptoms of pleural mesothelioma include:

  • Shortness of breath
  • Chest pain
  • Persistent cough
  • Unexpected weight loss
  • Coughing up blood
  • Fatigue
  • Fluid buildup in the lungs (pleural effusions)
  • Overall declining health
  • Trouble swallowing

It can take between 20-50 years for these symptoms to appear after initial exposure to asbestos. If you are experiencing pleural mesothelioma warning signs, tell your doctor about your symptoms and any asbestos exposure history you may have.

Pleural Mesothelioma Diagnosis

Diagnosing pleural mesothelioma can be challenging even for experienced cancer doctors (oncologists).

Mesothelioma is best diagnosed by a mesothelioma specialist, who will use a patient’s asbestos exposure history, imaging scans, and a biopsy to see if a patient has pleural mesothelioma.

Imaging Tests

Doctors use imaging tests to look for pleural mesothelioma warning signs, which may include pleural plaques, pleural effusions, or tumor masses.

In most cases, imaging tests like chest X-rays and computer tomography scans (CT scans) cannot exclusively confirm a mesothelioma diagnosis.

Biopsies

If imaging scans reveal signs of pleural mesothelioma, a pathologist will perform a biopsy, which is a procedure that removes a small fluid or tissue sample from a patient’s body to test it for a disease.

A biopsy is the only way to confirm a pleural mesothelioma diagnosis.

Getting a Second Opinion

Many patients with pleural mesothelioma are misdiagnosed because this type of cancer is usually difficult to tell apart from other lung-related illnesses, even with diagnostic tests.

For this reason, it is important for patients to get a second opinion from an experienced pleural mesothelioma doctor to confirm their diagnosis. An accurate diagnosis for a patient’s cancer type and stage often leads to more effective treatment options.

Pleural Mesothelioma Stages

Doctors recognize 4 pleural mesothelioma stages, which describe how far the cancer has spread and help doctors determine the best treatment plan for a patient.

Pleural mesothelioma is the only mesothelioma type to have an official staging system (the TNM system).

Stage 1 Mesothelioma Lungs

Stage 1

Stage 1 pleural mesothelioma (earliest stage) typically has the best prognosis because the majority of patients qualify for life-extending surgery.

Median Life Expectancy = 21.2 months

Stage 2 Mesothelioma Lungs

Stage 2

Pleural mesothelioma patients diagnosed during stage 2 are usually good surgery candidates.

Median Life Expectancy = 18.9 months

Stage 3 Mesothelioma Lungs

Stage 3

Most pleural mesothelioma patients are diagnosed during stage 3, when their symptoms start to become more obvious. Generally, the cancer has spread too far for surgeons to remove all of it.

Median Life Expectancy = 14.3 months

Stage 4 Mesothelioma Lungs

Stage 4

During stage 4 pleural mesothelioma (final stage), patients usually no longer benefit from life-extending surgery. Instead, treatment is focused on reducing pain and increasing comfort.

Median Life Expectancy = 10 months

Pleural Mesothelioma Prognosis

Pleural mesothelioma patients generally have a poor prognosis, which is the expected progression of their cancer.

The median survival for a pleural mesothelioma patient is around 1 year. That said, every patient’s prognosis is different and is dependent on their disease stage, cell type, age, and overall health.

The 3 main cell types for pleural mesothelioma are epithelioid (most common type), sarcomatoid, and biphasic.

Pleural Mesothelioma Treatment

Pleural mesothelioma is usually treated with a combination of surgery, chemotherapy, and radiation therapy (multimodal treatment). Those eligible for surgery usually have the best survival rates.

Surgery

Curative surgery is the most effective treatment for pleural mesothelioma. The goal of this treatment option is to remove as many visible tumors from a patient’s chest cavity as possible.

The 2 main surgeries for pleural mesothelioma are:

  • Extrapleural pneumonectomy (EPP)
  • Pleurectomy/decortication (P/D)

In most cases, only patients with early-stage (stages 1 and 2) cancer who are in good health can undergo surgery.

Chemotherapy

Pleural mesothelioma chemotherapy uses cancer-killing drugs (usually a combination of cisplatin and pemetrexed) to limit the spread of cancer cells and tumor growth.

Chemotherapy can be administered before, during, or after surgery to improve the survival time of pleural mesothelioma patients. However, this treatment commonly causes side effects like nausea and hair loss.

Radiation

Pleural mesothelioma radiation therapy uses painless high-energy beams to destroy mesothelioma tumors in the chest. Although radiation may be an effective way to slow cancer growth and manage painful symptoms, it may also damage healthy lung tissue.

Clinical Trials

Pleural mesothelioma patients may be able to access promising new treatments like immunotherapy, targeted therapy, or photodynamic therapy by participating in a clinical trial.

For help locating a clinical trial near you, contact our support team today.

Palliative Treatment

Patients ineligible for surgery can still receive palliative care to help minimize discomfort and manage the symptoms of mesothelioma.

Palliative treatments for pleural mesothelioma include:

  • Thoracentesis: Drains pleural effusions to relieve shortness of breath and chest pain
  • PleurX™ Catheter: Allows patients to drain pleural effusions by themselves at home instead of going to the hospital
  • Video-Assisted Thoracoscopic Surgery (VATs) and talc pleurodesis: Stops repeated pleural effusions by sealing the two layers of the pleura with talc

Pleural Mesothelioma FAQ

Who are the top pleural mesothelioma specialists?

There are several thoracic surgeons across the nation who specialize in diagnosing and treating pleural mesothelioma. A few of the top mesothelioma doctors are Dr. Abraham Lebenthal, Dr. Jacques Fontaine, and Dr. Robert B. Cameron.

For help connecting with a pleural mesothelioma specialist, contact Sokolove Law.

Is pleural mesothelioma curable?

There is no cure for pleural mesothelioma. However, some treatment options can increase a patient’s life expectancy by several months to a few years.

Can a chest X-ray show mesothelioma?

Only a biopsy can confirm a pleural mesothelioma diagnosis. However, doctors sometimes use chest X-rays to help look for pleural thickening and pleural effusions, which are signs of this cancer.

Take Control of Your Pleural Mesothelioma Diagnosis

A pleural mesothelioma diagnosis can be very stressful for families. The shock of a diagnosis and the associated costs of treatment can bring problems without easy answers.

For this reason, Sokolove Law is dedicated to helping victims of mesothelioma access financial compensation. Our firm has over 40 years of experience in pursuing legal claims against major asbestos companies on behalf of families like yours.

To learn if you may be able to access compensation, get a free legal case review now.

Author:Sokolove Law Team
Sokolove Law Team

Contributing Authors

The Sokolove Law Content Team is made up of writers, editors, and journalists. We work with case managers and mesothelioma attorneys to keep site information up to date and accurate. Our site has a wealth of resources available for victims of mesothelioma and their families.

Last modified: July 22, 2020

View 14 Sources
  1. Aziz, F. (2009). Radiological findings in a case of advance staged mesothelioma. Journal of Thoracic Disease, 1(1), 46-47.

  2. Bibby, A. C., Tsim, S., Kanellakis, N., Ball, H., Talbot, D. C., Blyth, K. G., & Psallidas, I. (2016). Malignant pleural mesothelioma: An update on investigation, diagnosis and treatment. European Respiratory Review : An Official Journal of the European Respiratory Society, 25(142), 472-486.

  3. Chemotherapy. (n.d.). Retrieved May 30, 2020 from https://www.mayoclinic.org/tests-procedures/chemotherapy/about/pac-20385033

  4. Hasegawa, S. (2014). Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma. General Thoracic and Cardiovascular Surgery, 62(9), 516-521.

  5. How Is Malignant Mesothelioma Diagnosed? (n.d.). Retrieved May 30, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/how-diagnosed.html

  6. Malignant Mesothelioma Imaging. (2019, November 09). Retrieved May 30, 2020, from https://emedicine.medscape.com/article/359470-overview?pa=9V5hp7frfzbp7cv7rIfsNowbILvj1hXyMyxFeEcwjaUifaDkNvr5EeRl3d%2BZVybDLxY8ILgX%2Fhmc1eVgnkUOUON5lPYw%2FtQ7Z8WOOzpssmw

  7. Mesothelioma: Diagnosis. (n.d.). Retrieved May 21, 2020 from https://www.cancer.net/cancer-types/mesothelioma/diagnosis

  8. Mesothelioma: Risk Factors (n.d.). Retrieved May 30, 2020 from https://www.cancer.net/cancer-types/mesothelioma/risk-factors

  9. Mesothelioma: Statistics (n.d.). Retrieved May 30, 2020 from https://www.cancer.net/cancer-types/mesothelioma/statistics

  10. Mesothelioma: Types of Treatment. (n.d.). Retrieved May 30, 2020 from https://www.cancer.net/cancer-types/mesothelioma/types-treatment

  11. Rusch, V. W., MD. (2017). Pleurectomy and decortication: How I teach it. Annals of Thoracic Surgery, 103(5), 1374-1377.

  12. Stages of pleural mesothelioma. (n.d.). Retrieved May 30, 2020 from https://www.cancer.ca/en/cancer-information/cancer-type/mesothelioma/staging/?region=bc

  13. Survival Rates for Mesothelioma (n.d.). Retrieved May 30, 2020 from https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/survival-statistics.html

  14. Williams, L. A., Whisenant, M. S., Mendoza, T. R., Haq, S., Keating, K. N., Cuffel, B., & Cleeland, C. S. (2018). Modification of existing patient-reported outcome measures: Qualitative development of the MD anderson symptom inventory for malignant pleural mesothelioma (MDASI-MPM). Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 27(12), 3229-3241