What is mesothelioma?
Mesothelioma is a rare type of cancer that starts in mesothelial cells, which make up the lining around certain body parts. Also known as malignant mesothelioma, this cancer usually occurs in people exposed to asbestos, but symptoms may not develop until 10-50 years later.
The most common type of mesothelioma is pleural mesothelioma, which affects the tissue in the lining of the lungs. But the cancer can develop in other areas of the body, too. There are only about 3,000 cases of mesothelioma diagnosed each year in the United States.
Types of mesothelioma
There are four main types of mesothelioma—based on where in the body the cancer first starts to form. Pleural mesothelioma makes up more than 80% of all mesothelioma cases. Mesothelioma can also develop in the peritoneum (lining of the abdomen), pericardium (the lining of the heart) or the lining of the testicles.
What are mesothelioma symptoms?
Mesothelioma symptoms can vary depending on where in the body the cancer starts to grow, and it may take a long time for symptoms to appear after asbestos exposure. At first, your symptoms may be similar to other common conditions, like flu or pneumonia. One common symptom of mesothelioma is pleural effusion, fluid buildup in the pleural lining of the chest. You may also have symptoms that affect the whole body, such as fatigue.
Common mesothelioma symptoms
As mesothelioma starts to grow, it can affect nearby organs, causing many different symptoms:
- Shortness of breath or trouble breathing
- Fluid around the lungs, abdomen, heart or testicles
- Chest, back, rib, abdomen or testicular pain
- Dry cough and hoarseness
- Loss of appetite and weight loss
- Fatigue
- Digestive problems
- Swelling in the face, arms or legs
- Irregular heartbeat or palpitations
When to see a doctor
If you have a history of asbestos exposure, it’s important to pay attention to any signs of mesothelioma. Symptoms such as chest pain, shortness of breath, abdominal pain or frequent infections could be caused by mesothelioma. If you have any ongoing symptoms or something feels off, schedule a visit with your doctor.
Mesothelioma causes
Mesothelioma occurs when abnormal cells in the lining of the lungs, heart, abdomen or testes start to grow rapidly. We don’t fully understand why this happens with mesothelioma, but doctors know some factors that may put you more at risk.
The majority of mesothelioma cases—about 80% —are linked to asbestos exposure. But other factors like your environment, health history, lifestyle or genetics could also play a role in causing mesothelioma.
Mesothelioma risk factors
Knowing your risk of mesothelioma and its symptoms means that you and your healthcare team can be proactive in detecting any signs of the disease. While some risk factors may be out of your control, there are steps you can take to protect yourself.
How is mesothelioma diagnosed?
If you’re having any symptoms of mesothelioma, especially if you’ve been exposed to asbestos, your doctor has several tools to help diagnose your condition. You’ll likely have imaging or blood tests to give your team more information. A biopsy will take tissue samples to diagnose mesothelioma.
If mesothelioma is found through your biopsy, your care team will also classify your condition based on the specific type of cells involved. The most common cell type in mesothelioma is epithelioid cells—found in about 70% of cases. Another less common type is sarcomatoid cells. If you have both types of cells, it’s called biphasic mesothelioma.
Medical history and physical exam
Your care starts with a visit to the doctor, where you'll discuss your medical history and any risk factors for mesothelioma, such as asbestos exposure. During your exam, your doctor will listen to your heart and lungs, tap your abdomen or chest and look for signs of fluid buildup.
If you have symptoms of pleural mesothelioma, you may also have a pulmonary function test to check how your lungs are working. As mesothelioma shares symptoms with many other conditions, your doctor may order additional tests after your exam to help with diagnosis.
Mesothelioma stages
When you're diagnosed with mesothelioma, your care team will place your cancer into one of four stages. Your cancer stage is important in your mesothelioma care because it helps you and your team make informed choices about the right treatment options for you. Stages 1 and 2 are considered early-stage cancer. Stages 3 and 4 are more advanced.
Stage 1
Stage 1 mesothelioma is still localized and hasn't spread. You may have more treatment options during this stage, such as surgery.
Stage 2
Stage 2 mesothelioma has spread into nearby tissues or lymph nodes. Sometimes, surgery is still an option.
Stage 3
Stage 3 mesothelioma has started to spread further away from its original location. At this stage, you may have fewer treatment options.
Stage 4
Stage 4 mesothelioma has spread to distant areas of the body. Care plans at this stage often focus on managing symptoms.
Treatment for mesothelioma
When it comes to treatment for mesothelioma, this rare type of cancer requires a specialized, team approach. You may visit multiple doctors who will work together to create a plan for your needs and specific stage of cancer.
Surgery is a standard treatment option in the earlier stages of mesothelioma. Your treatment could also include chemotherapy, radiation therapy, immunotherapy, targeted therapies, pain management or palliative care. Often, you’ll have a combination of treatments.
Surgery
Surgery can be used to treat mesothelioma to remove as much of the cancer as possible. Though often, mesothelioma can’t be completely removed with surgery. The type of surgery that your care team recommends will depend on the location of your cancer and how much your mesothelioma has spread.
- Extrapleural pneumonectomy: This extensive and complex surgery aims to remove all the areas of cancer caused by pleural mesothelioma, like a pneumonectomy, where your surgeon will remove one of your lungs. An extrapleural pneumonectomy also removes the lining in the chest on that same side, part of your diaphragm, lymph nodes and, in some cases, the sac around your heart.
- Pleurectomy and decortication: During this surgery, known as P/D, your doctor removes the lining around the affected lung and the pleural coating around your lung and diaphragm on that side of the body.
- Debulking: Debulking surgery removes as many areas of cancer as possible in the lining of the lungs or abdomen, while leaving as much healthy tissue in place as possible. When used in the lining of the lungs, it may be called a partial pleurectomy.
- Pleurodesis: Pleurodesis is a procedure that removes fluid buildup and then uses chemicals to make scar tissue in the lining of the lungs. This process prevents any additional fluid from building up in the space.
Finding specialized mesothelioma cancer treatment

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