Understanding Pleural Mesothelioma

It is estimated that 3,000 are diagnosed every year in the United States. The average age for a pleural mesothelioma diagnosis is 72. Unfortunately, the disease masks itself and its symptoms for decades. Medical experts cite the latency period of pleural mesothelioma to be around 20-50 years making it very difficult to treat once diagnosis does occur.

What is Pleural Mesothelioma?

Pleural mesothelioma is cancer in the protective lining of the lungs, the pleura.

Of the four types of mesothelioma, pleural mesothelioma is the most common. 75% of all mesothelioma cases are diagnosed as pleural mesothelioma.

Common Symptoms of Pleural Mesothelioma

  • Shortness of Breath
  • Chest Pain
  • Coughing Up Blood
  • Difficulty Swallowing
  • Pain in the Lower Back
  • Night Sweats
  • Lumps Under the Skin on the Chest
  • Unexplained Weight Loss
  • Fatigue
  • Persistent, Dry or Raspy cough

What is Pleural Effusion?

This is a common medical condition associated with the presence of malignant pleural mesothelioma patients. In medical language, pleural effusion is a condition where built up fluid has collected in or around the lining and layers of the lungs. The pleura is a thin membrane that lines and protects the lung cavity. Their function is to lubricate and facilitate breathing. In common speak, it is known as “water on the lungs”. Pleural effusion is treatable in most cases.


Asbestos exposure is the chief culprit responsible for most mesothelioma cases. Clinical studies in both humans and animals conclude asbestos increases risk for cancer. The studies are so conclusive to the development of cancer and other adverse health conditions that government agencies (WHO, EPA, IARC) have classified asbestos as a dangerous banned substance that is “carcinogenic to humans”

What is Asbestos?

Asbestos is a group of minerals that take shape as long fibrous bundles that are thin and malleable. They are found primarily in rocks located in various parts of the world. The fibers are used mainly in construction and ship yard environments for insulation purposes.

Asbestos at one time was hailed as a miracle fiber due to the fact it is flame retardant. There are two main types of asbestos: one is known as Chrysotile or White asbestos. This type of asbestos is most often used in ships and industrial parks. The other is Amphibole and is a brown or blue colored asbestos with straight sharp needle like fibers.

How does Asbestos Exposure Occur?

When asbestos fibers are disturbed, they can float freely through the air making it very easy to inhale them without really being aware. Consequently, the tiny fibers travel into the lower lungs, into other areas of the chest cavity or abdomen. The asbestos fibers can even become swallowed by drinking contaminated liquids.

Asbestos fibers can stick in the mucous lining the throat and trachea thus allowing for further damage and irritation. This irritation causes inflammation and cell damage which leads to the development of mesothelioma or other adverse health conditions, such as pleural effusion, asbestosis, and/or other types of cancers. Those who have worked with asbestos or near it for long periods of time are the people most often diagnosed with pleural mesothelioma.

How is Pleural Mesothelioma Diagnosed?

Getting to the Doctor: When presenting with the symptoms listed above, the first thing your doctor may want to do is order a chest x-ray. A physical exam is also quite common where they will look for lumps in the chest or other signs of trauma or disease. They will be checking for fluid build-up or other signs related to a more serious condition.

Advanced Testing and Biopsy: It is not uncommon to be referred to a specialist for an additional battery of tests which may include advanced imaging scans such as a CT scan. A biopsy may also be performed. A biopsy is where a tiny bit of issue is extracted and then analyzed under a microscope for the presence of malignant cancerous cells.

Staging and Treatment Planning: After confirming diagnosis of pleural mesothelioma, the next thing to expect is a discussion regarding how advanced the cancer is. Staging is applied to try to explain the reach of the cancer in the body. For example: Stage 1 would be indication that the tumor has not left the original location and spread to other areas of the body. Cancer stages are commonly given a numerical assignment of stage 1 -4, with stage 4 being the worst. Treatment planning has many variable and are largely dependent upon on age, cancer progression, and health at time of the mesothelioma diagnosis.

Treatment Options for Pleural Mesothelioma


  • EPP – Extra pleural pneumonectomy, a common surgery for pleural mesothelioma that is the removal of a lung. This procedure is known to prolong life.
  • P/D – Spares the lung during a two-part procedure and opens the chest cavity and involves removing the lining of the diseased lung and any obvious tumors.

Prognosis for Patients Diagnosed with Pleural Mesothelioma

Because of the latency period associated with pleural mesothelioma, the prognosis can sometimes be grim. However, with early treatments there is hope of survival and prolonged life. Experts suggest the average life expectancy varies with cell type, stage, and complications during time of illness.


Chemotherapy, often referred to as “chemo” is the most common type of cancer treatment. Most forms of chemotherapy are administered intravenously. However, there are oral forms. Chemotherapy works by introducing a chemical into the body that lyses (kills) cancer cells.

Palliative Care

Palliative care is the care given to a patient when all other measures have been exhausted or the patient is not a qualified candidate for advanced measures. This type of treatment is about giving the best quality of life available for the last stages of life including pain control, medical assistance, supportive home assistance, help understanding the medical system, and emotional support.

Alternative and Complimentary Care

Traditional medicine practices work well when complimented with other holistic type of therapies such as acupuncture, herbs/diet, massage, cryotherapy, yoga, and meditation. Many times patients benefit from a more comprehensive approach and find that it enhances quality of life.


HITHOC stands for hypothermic intrathoracic chemotherapy and involves delivering heated chemotherapy drugs directly into the chest cavity following a pneumonectomy and decortication.

Radiation Therapy

Radiation therapy is delivered right to the site of mesothelioma. Most often, radiation is administered in patients after they have had surgery to remove the malignant tumor. This is known as part of a multimodal therapeutic intervention, whereas a patient undergoes several types of treatment to increase odds of survival and improved quality of life. The goal of radiation therapy is to kill off the remaining cancer cells. Radiation works by emitting a beam of energy from a machine held outside of the body directly onto the affected area. The light is comprised of waves or particles of energy that is able to lyse cancer cells.

Pleural Mesothelioma Facts

-Occupations with Increased Risk for Asbestos

  • Construction
  • Firefighting
  • Manufacturing
  • Chemical refining
  • Power generation
  • Shipbuilding
  • Military service


-Smoking is not associated with pleural mesothelioma.

-Men are more often diagnosed with mesothelioma due to women mainly because the professions associated with asbestos exposure are primarily men.

-White males account for 90% of all diagnosed mesothelioma cases.

-Risk for developing mesothelioma is higher for those over 60 as opposed to someone 40 years or younger due to the latency period.

-From 1999 to 2015, a total of 45,221 Americans died from mesothelioma

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