Mesothelioma of Pleura Unknown Facts, Line of Treatment, Causes & More

Mesothelioma of Pleura: Pleural mesothelioma refers to a form of lung lining cancer known as the pleura, typically triggered by the inhalation of asbestos fibers. Around 80-90% of mesothelioma cases are diagnosed as malignant pleural mesothelioma.

mesothelioma of pleura

Some of the most common indicators of this condition encompass difficulties in breathing, a persistent dry cough, and chest discomfort. Please note that mesothelioma of pleura is the same as pleural mesothelioma.



What Is Pleural Mesothelioma?

Malignant pleural mesothelioma represents an uncommon form of cancer affecting the lining encasing the lungs, known as the pleura.

This condition arises from exposure to asbestos fibers. Upon inhalation, these fibers can penetrate the pleura, provoking inflammation and tissue scarring. Gradually, this sequence of events may culminate in the formation of mesothelioma tumors.

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Pleural Mesothelioma Facts

  • Malignant pleural mesothelioma stands as the most prevalent form of mesothelioma cancer.
  • Symptoms include chest pain, dry cough, fatigue, and shortness of breath.
  • While some patients have experienced extended survival post-aggressive treatment, it's not considered curable.
  • Prognosis varies per individual, with an average life expectancy of approximately 18 months.
  • Around 2,500 people receive mesothelioma of pleura diagnosis annually.
  • Diagnosis involves various tests such as scans and biopsies.
  • Treatment often combines chemotherapy, surgery, radiation therapy, and immunotherapy.


Mesothelioma of Pleura Prognosis

The prognosis for mesothelioma of pleura hinges on several factors, much like other forms of this cancer. Without treatment, the median survival time is typically around six months. However, certain treatments, like a combination of surgery and chemotherapy, have shown potential to enhance life expectancy.

Survival rates for mesothelioma of pleura at various intervals post-diagnosis are as follows:

1 year after diagnosis: 73%

3 years after diagnosis: 23%

5 years after diagnosis: 12%

10 years after diagnosis: 4.7%


The key prognosis factors for pleural malignant mesothelioma patients include:

Cell Type (Histopathology): The most common cell type diagnosed in pleural mesothelioma is epithelioid, which tends to form solid sheets or cord arrangements and responds better to treatment. Patients with this cell type typically survive around 19 months.

Stage of Mesothelioma: Staging plays a crucial role in determining prognosis, with early stages often offering more treatment options and better outcomes compared to advanced stages.

Patient’s Gender and Age: Gender and age can also influence prognosis, although the impact varies among individuals.

The epithelioid cell type generally shows better responsiveness to treatment compared to sarcomatoid and biphasic types. Sarcomatoid mesothelioma tends to be more resistant to treatment, leading to a prognosis of about eight months, while biphasic mesothelioma outcomes depend on the dominant cell type.

Recent data indicates improved survival rates for malignant pleural mesothelioma patients due to advancements in treatments and diagnostics. Long-term survivors, like Heather Von St. James, diagnosed in 2005 with a 15-month prognosis, have defied expectations due to tailored treatments and care, with some achieving more than a decade and a half of survival.


What Causes Pleural Mesothelioma?

pathways that result in DNA damage, potentially leading to the formation of mesothelioma tumors.

In addition to asbestos exposure, other factors that might contribute to mesothelioma development include:

Erionite Exposure: Similar to asbestos, erionite—a natural mineral—has been associated with mesothelioma and lung cancer due to its carcinogenic properties.

Radiation Exposure: Previous radiation therapy for cancer treatment, while targeting cancer cells, may inadvertently damage healthy cells and potentially increase the risk of developing mesothelioma, although this connection is not fully established.


What Are the Symptoms of Pleural Mesothelioma?

Following asbestos exposure, it can take anywhere from 10 to 50 years before symptoms of pleural mesothelioma manifest. These symptoms typically initiate within the chest cavity and respiratory system.

Symptoms of Pleural Mesothelioma include:

  • Chest pain
  • Coughing up blood
  • Difficulty swallowing
  • Dry cough
  • Fatigue
  • Fever
  • Presence of fluid in the lung (pleural effusion)
  • Night sweats
  • Shortness of breath (dyspnea)
  • Weight loss

As the disease progresses, additional and exacerbated symptoms may emerge. For instance, at stage 4, symptoms could encompass coughing up blood and swallowing difficulties.

Moreover, individuals diagnosed with pleural malignant mesothelioma may also present with concurrent asbestos-related conditions, potentially influencing the onset and severity of symptoms.


Pleural Effusion

Pleural effusion occurs when an abnormal amount of fluid collects in between the two layers of the pleura. This fluid can compress the lungs, making it difficult to breathe. Pleural effusion and associated breathing problems are common symptoms in pleural mesothelioma.


Pleural Plaques

Pleural plaques are areas of thickened tissue on the surface of the pleura. Pleural plaques often do not cause symptoms. This condition is one of the most common side effects of asbestos exposure. Asbestos-exposed individuals with pleural plaques may have an elevated risk of developing mesothelioma.

Pleural Thickening

Pleural thickening is a condition in which scar tissue thickens the pleura. Pleural thickening can be benign or malignant. It is caused by asbestos exposure and other conditions that cause inflammation. According to one study, the majority of pleural mesothelioma patients experience pleural thickening. 


Asbestosisis a chronic lung condition resulting from the inhalation of asbestos fibers, characterized by benign effects. It manifests as a type of pulmonary fibrosis, leading to the formation of scar tissue in the lungs. 

The scarring reduces lung flexibility, making breathing more challenging. Additionally, individuals with asbestosis might face an elevated likelihood of developing pleural mesothelioma.

It's important to note that these conditions related to asbestos exposure, such as asbestosis, can arise separately from pleural mesothelioma.


How Is Pleural Mesothelioma Diagnosed?

Diagnosing pleural mesothelioma typically involves a series of tests. Initially, imaging scans like X-rays or CT scans are conducted to detect tumors or signs of disease spread. If a tumor is identified, blood tests might be performed to detect specific biomarkers, aiding in distinguishing mesothelioma from other conditions.

Currently, a biopsy remains the definitive method to confirm a diagnosis of malignant pleural mesothelioma. Procedures like thoracentesis or thoracoscopy are employed to obtain tissue or fluid samples for analysis. Thoracentesis involves using a fine needle to extract fluid buildup in the chest.

Thoracoscopy, a more invasive procedure, involves inserting a thoracoscope into the chest to examine the lungs and pleura. Tissue samples or fluid can be collected for analysis during this process. Following the biopsy, a pathologist examines the cells to provide a conclusive diagnosis, determining the cell type and predicting the disease's progression.


Malignant Pleural Mesothelioma Stages

As part of the diagnostic process, a mesothelioma specialist evaluates the disease's stage, indicating its extent of spread, crucial for prognosis and treatment decisions.

Life Expectancy for Pleural Mesothelioma by Stage:

Stage 1: Approximately 21 months

Stage 2: Around 19 months

Stage 3: Roughly 16 months

Stage 4: About 12 months

The commonly used TNM staging system assesses the tumor's size, lymph node involvement, and distant organ metastasis. Stages 1 and 2 typically denote limited spreading, while advanced stages may involve metastasis to lymph nodes and other organs.

Once the stage is identified, the medical team can tailor an effective treatment plan for the individual's specific case.


Pleural Mesothelioma Treatment Options

Pleural mesothelioma treatment typically adopts a multimodal strategy, combining standard methods such as surgery, chemotherapy, and radiation. The specific treatment plan is determined based on factors like cell type and disease stage, although these plans are not primarily aimed to cure the disease.

Surgery is a common approach for pleural mesothelioma. It can be aggressive, aiming to extend life expectancy, or less aggressive, focused on alleviating symptoms.

For early-stage malignant pleural mesothelioma, surgery might be an option. One common surgical method is Pleurectomy/Decortication (P/D), which involves removing the lining of the lung and chest wall, along with affected tissues and organs.

Another option, Extrapleural Pneumonectomy (EPP), is a more aggressive procedure, involving the removal of the impacted lung, part of the diaphragm, and the linings of the heart and lungs. Recent trials have indicated that these surgeries, especially when combined with chemotherapy and/or radiation, can potentially extend life expectancy to approximately three years.

Doctors often advise chemotherapy as an adjunctive measure either before or after surgery or as the primary therapy for patients with advanced disease. The most common prescribed combination therapy involves pemetrexed (Alimta®) and cisplatin, although ongoing research explores novel combinations. Radiation therapy may also be recommended for specific patients to shrink tumors and alleviate symptoms.

Cost considerations are crucial when determining treatment for pleural mesothelioma. Reports indicate that a single course of Alimta® treatment may exceed $50,000, while surgeries such as a pneumonectomy can cost a minimum of $17,000.

Understanding treatment expenses alongside the potential risks and benefits of available therapies is pivotal for patients and their families as they navigate treatment decisions.

Dr. David Sugarbaker, Baylor College of Medicine, His Role towards

Treating Mesothelioma


Emerging and Experimental Treatments

Malignant pleural mesothelioma, being the predominant type, attracts the focus of experimental treatments. Immunotherapy, gene therapy, and photodynamic therapy have displayed early successes in various clinical trials, showing promise in extending life expectancy.

Advancements in standard treatments are also underway. For instance, a study tested pleurectomy/decortication or extrapleural pneumonectomy combined with heated chemotherapy washes.


Results revealed:

A median survival of 35.3 months

A median progression-free survival of 27.1 months

This approach notably enhanced both overall survival and progression-free survival compared to earlier studies.

Researchers persist in exploring treatment options for mesothelioma, aiming to reduce recurrence rates and stall disease progression for patients.



Pleural Mesothelioma FAQS

Is pleural mesothelioma curable?

While there's currently no cure for pleural mesothelioma, several treatment approaches exist that can potentially enhance life expectancy and manage symptoms.

How long do pleural mesothelioma patients live?

Yes, on average, the life expectancy for a pleural mesothelioma patient is approximately 18 months.

What are the symptoms of pleural mesothelioma?

The symptoms you've listed are indeed commonly associated with pleural mesothelioma. Recognizing these signs is crucial for early detection and timely medical intervention

What causes pleural mesothelioma?

Pleural mesothelioma is caused by the inhalation of asbestos fibers

Biphasic Mesothelioma Diagnosis, Cell Types, Treatment &



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