Pleural Mesothelioma

This is a type of cancer that develops in the tissue that covers the lungs and chest wall. It is called pleural mesothelioma, and it often occurs due to prolonged exposure to Asbestos. This is a mineral that was used as a building material. However, it was banned in 1989. Unfortunately, there is no way to cure this type of cancer, but doctors can recommend some treatments to relieve the symptoms and improve your quality of life. They often prescribe radiation therapy, chemotherapy, immunotherapy, surgery, and other treatments.

In other words, this type of cancer is also known as malignant pleural mesothelioma, and it affects the pleura (the membrane) that lines the walls of the chest and lungs. It is a lining that protects the internal organs. One of the most common causes of this cancer is prolonged exposure to Asbestos, but it may also occur due to other causes. Healthcare providers identified a connection between this mineral and mesothelioma in the 1960s. Thereafter, the government agencies and manufacturers in the United States have taken multiple steps to reduce exposure to this dangerous mineral.

Generally, this type of cancer occurs quite rarely, but pleural mesothelioma continues to be the most common type of this disease. Moreover, about 3,300 people get this type of cancer in the U.S. each year. About 80% of them are pleural mesothelioma. However, the number of people who develop pleural mesothelioma is lower compared to the 2000s.

Types of Pleural Mesothelioma

The World Health Organization (WHO) divided this disorder into 3 categories in 2015. The following groups are based on the type of cells in the mesothelium (also known as mesothelial cells), where the abnormal cells begin to develop. These include:

Epithelioid mesothelioma – This type of pleural mesothelioma is the most common form and the easiest type to treat at the same time. It affects 60% to 80% of all diagnosed cases.
Sarcomatoid mesothelioma – While it occurs very rarely (about 10% of cases), it grows faster and is more difficult to treat.
Biphasic mesothelioma – This type also occurs in rare cases, but it affects up to 15% of all diagnosed cases. It also contains a mix of epithelioid and sarcomatoid cell types.

Symptoms

Usually, the symptoms of this type of cancer appear gradually. Sometimes, it can take up to 50 years of exposure to Asbestos to develop pleural mesothelioma. However, the primary symptoms of this cancer can cause discomfort, but are easy to dismiss. In most cases, people who develop pleural mesothelioma delay until the advanced stages of the cancer. While the main symptoms are chest pain and shortness of breath (dyspnea), it can also cause other symptoms. These include:

Persistent cough
Hoarseness
Dysphagia (swallowing problems)
Low back pain
Swollen face and arms
Unusual weight loss
Night sweats
Fatigue (extreme tiredness)
Fever

If any of the previous symptoms occur, immediately contact your healthcare professional.

Causes

Long-term exposure to Asbestos causes about 70% of all pleural mesotheliomas. While healthcare providers know for sure this is the exact cause of cancer, the exact number can be higher. In general, this mineral causes cancer because it consists of fibers that are small, airborne fibers. When you inhale them, they settle in the lungs. In general, the body can destroy these particles, but quite difficult. Over time, Asbestos causes inflammation and scarring in the lungs, which leads to changes that cause cancer. Moreover, intact materials that contain Asbestos are safe, but they become dangerous when they are released into the air. However, some research has shown that there are other possible causes of pleural mesothelioma that are not related to Asbestos. Check below some examples:

Previous radiation therapy that was directed at the chest
Genetic changes (mutations) that run in families (such as the missing BAP1 gene)
Prolonged exposure to carbon nanotubes (this is a building material that is used to reinforce structures), which is often found in vehicles, sports equipment, and other products.

Nowadays, more research is needed to understand how this type of cancer develops when Asbestos is not the cause.

Risk Factors

While it is not always possible to determine the exact cause of pleural mesothelioma, doctors have identified some factors that may elevate your risk of developing it. In general, there are some professions that are at increased risk for Asbestos exposure. For example:

Firefighters
Plumbers
Miners
Automotive, factory, and railway workers
Building renovators and demolition crews
Navy service members
Construction workers and builders (including shipbuilding)

Furthermore, your risk of Asbestos exposure remains high if you live with someone who works around this mineral and brings the particles home on their clothes, or you live near an Asbestos mine or a demolition site with buildings that contain it.

What Are The Possible Complications of Pleural Mesothelioma?

One of the most common complications in people with this type of cancer is pleural effusion. About 95% of people who are diagnosed with pleural mesothelioma develop this complication. This is a serious health condition in which fluid builds up between the chest wall and lungs. One of the most common symptoms of pleural effusion is shortness of breath (dyspnea). However, people with this type of cancer can also experience other complications. Check below some examples:

Lung collapse
Breathing problems
Chest pain
Metastasis
Infections
Arrhythmia (irregular heart rhythm)
Abnormal connections between the esophagus and other chest organs

The previous list does not contain all possible complications of pleural mesothelioma. In any case, you can consult with your doctor about ways to reduce the risk or even prevent them.

How to Prevent Pleural Mesothelioma?

There are some tips that may help reduce the risk of Asbestos exposure. These include:

It is usually recommended to have an Asbestos abatement expert check your home for the presence of this mineral before remodeling it.
You should also hire an Asbestos company before removing a wall or drilling into a surface that may contain it.
Always wear protective gear to prevent breathing in Asbestos.

Diagnosis

First, doctors perform a physical examination to check for irregularities associated with this disease. They may also ask some questions about the symptoms and family history to get more clues about the condition. However, to confirm or rule out this type of cancer, doctors often perform the following tests. Examples include:

Imaging tests – The following tests are used to get detailed images of different structures and organs in the body. Physicians typically perform MRI (magnetic resonance imaging), CT (computed tomography), or PET (positron emission tomography) scans.
Blood tests – These tests are often done to check for substances linked with mesothelioma (including fibulin-3 and soluble mesothelin-related peptides).
Thoracentesis – During this procedure, doctors will take a sample of fluid from around the lungs to check for cancerous cells. It also helps reduce pressure in the chest.
Biopsy – This test also involves a small sample of the tumor for testing to check for malignant cells. Usually, doctors take this sample through the following procedures. These include bronchoscopy, thoracoscopy, and VATS (video-assisted thoracic) surgery.

In addition, after doctors confirm the diagnosis, they can also perform additional tests to determine the stage (extent) of the cancer. It helps make the best treatment plan for you.

Treatment

In most cases, it is challenging to treat this type of cancer because it easily spreads along the nerves, blood vessels, and other tissues. That’s why doctors often recommend a combination of treatments for people with pleural mesothelioma. Check below some of them:

Surgery – During this procedure, surgeons will remove the tumor and some healthy tissue that surrounds it. Usually, physicians recommend this treatment when the tumor is small (in the early stages of cancer). The procedures may include extrapleural pneumonectomy (EPP) or pleurectomy with decortication (P/D). Sometimes, oncologists can recommend radiation therapy or chemotherapy after surgery to destroy cancerous cells that may remain even after a successful surgery.
Radiation therapy – This therapy involves powerful energy beams that are delivered directly to the tumor to destroy cancerous cells. The energy often comes from X-rays, protons, or other sources.
Chemotherapy – It involves strong medicines that are often given intravenously (IV) to destroy cancer cells throughout the body. However, a pill form is also available. Doctors often recommend Pemetrexed, Carboplatin, and Cisplatin.
Immunotherapy – This treatment option is often prescribed by doctors when other treatments do not work or a person has pleural mesothelioma in an advanced stage. It involves medicines that boost the immune system to find and destroy cancerous cells. Moreover, almost all cancerous cells produce certain chemicals that help them hide from the immune system.
Palliative care – In general, the goal of this treatment is to get rid of cancer. They can also ease the symptoms and improve your quality of life.

Frequently Asked Questions

Is pleural mesothelioma curable?

Unfortunately, there is no way to cure this type of cancer. That’s why the treatment goal is to reduce the symptoms and prevent serious complications.

When should I call the doctor?

It is recommended to see a healthcare professional if any of the following symptoms occur. Examples include:

Back or chest pain
Chronic cough
Hoarseness
Problems with breathing or swallowing
Facial swelling
Unusual weight loss

What is the life expectancy of a person with pleural mesothelioma?

This is a serious type of cancer that causes serious health problems. That’s why the average survival is about 18 months with treatment. In general, there are some factors that could influence the prognosis. For example, the type and severity of the cancer, the patient’s response to treatment, age, and overall health. Ask your healthcare provider if you have additional questions.