Mesothelioma of the Pleura

Writer : Dr. Cristine Naskan

Mesothelioma of the Pleura, The lining of the lungs can develop cancer called pleural mesothelioma. Asbestos exposure is the primary cause of this condition. Shortness of breath, pain in the chest, cough, and fluid in the lungs are some of the symptoms. Approximately 75% of mesothelioma cases are malignant pleural mesothelioma.

What Is Mesothelioma of the Pleura?

As the thin membrane that encircles and protects the lungs, the pleura, is vulnerable to malignant mesothelioma. Asbestos fibers can cause inflammation and scarring in the lining of the lungs if they become lodged there. Pleural mesothelioma is the name given to the tumors that form in the pleura.

Information on Pleural Mesothelioma

  • In terms of mesothelioma, pleural mesothelioma is the most common form of the disease.
  • Anxiety and exhaustion are common signs and symptoms of pleural mesothelioma.
  • Mesothelioma of the pleura is incurable. Fortunately, cancer treatment can extend life expectancy while also easing the discomforts that come with the disease.
  • Pleural mesothelioma has a five-year survival rate of 10% and an average life expectancy of four to 18 months.

Pleural mesothelioma is a cancer that is diagnosed in approximately 3,000 people each year in the United States.

Pleural Mesothelioma Is Caused By What?

Pleural mesothelioma is a cancer of the lining of the lungs caused by inhaling asbestos fibers. Mineral fibers with a pointed shape enter the lungs and gradually migrate into the pleural lining after they've been inhaled.

These fibers, when inhaled for an extended period of time, can cause irritation, chronic inflammation, and mutations in the DNA that can lead to cancer in otherwise healthy pleural cells. Malignant pleural mesothelioma usually develops 20 to 50 years after the initial exposure to asbestos. The disease usually affects people over the age of 75 as a result of this latency period.

There are two pleural layers in the lungs: the pericardium and the pericardium.

  • Under the ribs, the outer layer covers the entire chest cavity.
  • In the lungs, the inner layer acts as a barrier and shield.

On either layer, a cancerous tumor can form and then spread to the other. tumor masses form around an affected lung as nodules on the pleural surface begin to grow. Pleural fluid can build up in the chest cavity as a result of tumors.

There is an increase in chest pressure and breathing difficulties when there is a tumor mass on the lung and fluid accumulation in the pleural cavity.

Non-tumor forming malignant cells can spread through the blood and lymphatic system and form new tumors on distant organs if left untreated.

Pleural Mesothelioma symptoms

Symptoms of pleural mesothelioma include shortness of breath, pain in the chest, as well as a dry, raspy cough and swallowing difficulties. Many people with mesothelioma don't notice any symptoms until the cancer has progressed to a more advanced stage.

Some of the symptoms of pleural mesothelioma include:

  • Breathlessness
  • Pain in the chest or difficulty in breathing
  • Chronic dry or raspy sneezing
  • I'm having trouble swallowing
  • discomfort in the lower back or ribs
  • Fatigue and unexplained weight loss
  • Facial and arm edema
  • Fever or sweaty nights
  • On the chest, there are bumps under the skin.
  • The lungs are filled with fluid.

Most patients don't bring up issues like losing weight or feeling tired when they first see their doctor. Advanced cancer is the only possible cause of these signs and symptoms. Pain in the back or nerves can also be experienced by some patients, as well as swelling of the face or arms.

A history of asbestos exposure and the possibility of a mesothelioma diagnosis can be indicated by a number of pleural cancer symptoms and conditions. Pleural plaques, pleural effusions, and pleural thickening are all included in this category.

Pleural Plaques

Asbestos exposure can cause pleural thickening, which is the most common sign. In the absence of any symptoms, pleural plaques may indicate an increased risk of cancer.

Pleural Effusion

Excess fluid can accumulate between the pleura's two layers as a result of irritation from asbestos fibers. Pleural effusion is a common complication of pleural mesothelioma. Having a small amount of fluid between the pleural layers is a good thing. Chest pain that gets worse when you cough or take deep breaths can be caused by having too much pressure on the lungs.

Pleural Thickening

It can be difficult and painful to breathe if large areas of the pleura are stiffened by scarring. It is common for both lungs to become pleural thickened as a result of asbestos exposure. Pleural thickening can worsen as scar tissue accumulates from repeated episodes of pleural effusion.


Toxic exposure to asbestos can cause scarring of the lungs that progresses over time. As far as we know, the pleural lining is unaffected by this disease. Asbestos-related lung cancer is more common in people with asbestosis, but pleural mesothelioma has been documented in the medical literature.

A Guide to Diagnosing and Treating Pleural Mesothelioma

The initial symptoms of pleural mesothelioma are evaluated by a doctor to begin the diagnostic process. A chest X-ray can reveal fluid buildup or tumors around a lung in the event of chest pain and breathing difficulties. When a patient needs additional testing, their primary care physician will refer them to a specialist.

To confirm a pleural mesothelioma diagnosis, specialists must use advanced imaging scans and tissue biopsies. Cancer stage and cell type must also be determined in order to develop an effective treatment plan.

Cell Types

Pleural mesothelioma tumors can be made up of three different cell types, and tissue biopsies help determine the best course of treatment. There are many epithelioid cells found in most malignant mesothelioma tumors, which can be used to diagnose the disease. Treatment for cancer works best on cells of this type.

It is the rarest form of the disease, with sarcomatoid mesothelioma being the most common. Most of these cases occur in patients with pleural effusions, which are difficult to treat.

Biphasic cells are a mixture of the two types. The ratio of cells determines how well it will respond to treatment. Epithelioid cells are better at responding to treatment than sarcomatoid cells.

Pleural plaques, pleural effusions, and pleural thickening are all symptoms of pleural cancer that could point to a mesothelioma diagnosis if the patient has a history of asbestos exposure.

A case of pleural mesothelioma was discovered in a 2020 study published in Case Reports after testing for metastatic gastric and colonic polyps found in imaging scans. The only indication that the patient had pleural mesothelioma was the presence of these polyps.

Stages of Mesothelioma of the Pleura

Doctors use pleural mesothelioma staging to determine how far the cancer has spread in a patient. The doctor's decision-making process is influenced by the stage.

The TNM staging system for pleural mesothelioma was developed by the International Mesothelioma Interest Group.

Localized tumors are found in stages 1 and 2 of the disease, which are considered the earliest stages. Later stages (stages 3 and 4) refer to tumors that have spread.

Pleural mesothelioma patients who are diagnosed in stages 1 or 2 have more treatment options, including surgery, which offers the best chance of a longer life. Since cancer has spread to other parts of the body, treatment options are limited in the later stages.

Surgeon-Eligible Patients with Stage I and II Malignant Mesothelioma




Stage 1

22.2 months

One lung's tissue lining and surrounding tumors remain tumor-free.

Stage 2

20.0 months

Nearby lymph nodes are being invaded by cancerous cells.

Stage 3

17.9 months

Lymph nodes in other parts of the body have also been affected by the cancer's spread.

Stage 4

14.9 months

Distant organs have been infected by the disease.

Pneumothorax Pleural Mesothelioma Treatment

Radiation therapy and chemotherapy are three of the most common forms of treatment for patients with pleural mesothelioma.

Most patients who have pleural effusions are treated with chemotherapeutic agents. Patients who are diagnosed early in the disease process are often prescribed a combination of medications known as multimodal therapy. Treatments like these can alleviate symptoms like heartburn and difficulty breathing while also increasing a patient's chance of survival.

Top cancer centers across the country offer these treatments to pleural mesothelioma patients.


Pleural mesothelioma patients typically receive chemotherapy as their primary mode of treatment. Cisplatin and pemetrexed (Alimta) are commonly used in combination to kill cancer cells or prevent them from re-proliferating. Recent developments have improved the way patients respond to chemotherapy, but overall success rates are still very low.

Heated intrathoracic chemotherapy, or HITHOC, is a new method of administering chemotherapy that is administered directly into the pleural cavity following surgery. They are heated before being circulated in the pleural cavity.


Surgeons use surgery to diagnose, treat, and remove tumors. To obtain tumor tissue samples for biopsy testing, thoracoscopy, a minimally invasive surgical procedure, is a common diagnostic surgery.

Surgeons may be able to alleviate symptoms in patients with advanced cancer. A thoracentesis is a minimally invasive surgery in which a tube is inserted through a small incision in the chest to remove fluid from the pleural cavity. A pleurodesis also removes pleural fluid, but it goes one step further by fusing the two layers of the pleura together to eliminate the pleural space. There is a risk of pleural effusion, a buildup of fluid in the lungs.

Patients with pleural mesothelioma who are diagnosed early are most likely to benefit from surgery to remove the tumor. Tumor-removal surgery aims to remove cancer while also minimizing the risk of a recurrence.

Extrapleural pneumonectomy and pleurectomy and decortication are the two most common procedures for removing tumors in pleural mesothelioma patients. If you have been diagnosed with pleural mesothelioma cancer, you should consult with a specialized surgeon who specializes in this type of cancer to see if surgery is an option for you.

Pneumonectomy Outside the Pleural Fossa

Pleural, diaphragm and heart sac are all removed in an extrapleural pneumonectomy procedure that is more aggressive surgically (pericardium).

Decortication and a pleurectomy

To perform a P/D or radical pleurectomy, the tumors and affected pleura are surgically removed (lining of the lung).

Treatment by Radiation

It is possible to kill cancer cells and shrink tumors with targeted radiation. It's not possible to cure pleural mesothelioma with radiation therapy, but it is an effective treatment option for alleviating symptoms. Additionally, radiation therapy has been shown to reduce the risk of cancer recurrence following surgery.

Pleural mesothelioma patients most often receive treatment with external beam radiation therapy. The sessions are brief, quick, and painless.

"Finding a specialist is essential when dealing with this disease. To achieve the best results, you'll need someone who has a thorough understanding of the problem and knows how to attack it aggressively.

Treatments that are currently in development

Pleural mesothelioma patients can benefit from new treatments such as immunotherapy, gene therapy, and photodynamic therapy. Patients will benefit from these treatments as researchers work to improve their efficacy while also reducing side effects.

A pleural mesothelioma clinical trial may provide you with access to experimental treatment. Compassionate use programs may make immunotherapy drugs and other cutting-edge treatments available to some patients.

Pleural Mesothelioma's prognosis.

As the disease progresses quickly and is resistant to many of the currently available treatments, the average prognosis for pleural mesothelioma sufferers is bleak.

When it comes to pleural mesotheliomas, the average life expectancy is less than 18 months, but there are many variables to consider.

Accurate prognosis forecasting is difficult because this disease is so complex. Treatment has a variable effect on each individual.

Survival Rates for Pleural Mesothelioma by Year



1 year


3 years


5 years


10 years



Factors Affecting Your Chances of Recovery

  • Stage: In determining a mesothelioma prognosis, stage of the disease at diagnosis is the most critical. A person with cancer who is diagnosed early on has a better chance of surviving the disease for the long term.
  • Cell Type: Tumors from mesothelioma can vary greatly in terms of their cell type.
  • Age: Patients who are younger have a higher chance of living a longer life.
  • Gender: Women are more likely than men to survive the disease.
  • Pleural Fluid: Pleural fluid in the chest is associated with a lower survival rate.
  • Patient Activity Level: Active patients have a better chance of recovery.
  • Cancer Recurrence: A worse prognosis is associated with mesothelioma recurrence.

Increasing Your Chances of Success

Malignant pleural mesothelioma patients can extend their lives and improve their quality of life by taking proactive measures. After treatment, some patients even experience remission and go years without experiencing any signs or symptoms of cancer.

There are many ways to deal with cancer, as demonstrated by the inspiring stories of mesothelioma survivors. Many survivors, however, make the same basic decisions in order to improve their health.

Ways to Extend Your Quality of Life Despite Having Pleural Mesothelioma

If you follow your doctor's advice, including exercising and eating a mesothelioma-friendly diet, you can improve your prognosis and extend your life expectancy.

  • Consult with a mesothelioma expert for treatment.
  • Adopt a healthier lifestyle and participate in clinical trials to learn about the latest treatments available.
  • Use complementary and alternative medicine to enhance your well-being.

For a Mesothelioma Treatment

Pleural mesothelioma has no known cure. Patients' prognoses have improved thanks to a treatment regimen that includes surgery, chemotherapy, and radiation therapy. Experimental clinical trials and new treatments like immunotherapy are helping patients who aren't eligible for surgery live for years after their diagnosis.

In an effort to find better treatments for pleural mesothelioma and to detect it earlier, scientists from around the world have dedicated their careers to the cause.

  • After working as a registered nurse for 43 years, Emily Ward was diagnosed with breast cancer in 2012. She used her medical training to find the best mesothelioma specialists, including the late Dr. David Sugarbaker, to treat her cancer. The pleurectomy and decortication were followed by three rounds of chemotherapy and immunotherapy with Keytruda, Opdivo and Yervoy. She also had three rounds of radiotherapy. Ward continues to do many of the things she loved to do before she was diagnosed with breast cancer.
  • In 2019, Tim Crisler celebrated his 17th anniversary of beating pleural mesothelioma. He attributes his long-term survival to his lung-removal extrapleural pneumonectomy surgery. Since his diagnosis in 2002, he's managed to ride his beloved Harley-Davidson across the country despite the persistent pain. "I have no problems with mesothelioma cancer at this time," he declared. That had not happened to her in a long time, she reflected.
  • Sallie Morton was able to live with pleural mesothelioma for four years despite not receiving any conventional treatment for the cancer. When she was diagnosed in 2013 at the age of 87, she was ineligible for surgery, and she refused chemotherapy after seeing too many friends deal with the harsh side effects of the drugs. In the end, she went her own way, surprising those who doubted her, and hosting parties and events. When she talked about herself, she used the phrase, "She's a tough cookie."


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