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What is mesothelioma?

Mesothelioma is a rare form of cancer in which tumors form in the lining of the chest (pleural mesothelioma) or the abdomen (peritoneal mesothelioma). Rarely, it can affect the outside covering of the heart (pericardial mesothelioma).

What is pleural mesothelioma?

Pleural mesothelioma is cancer that affects the lining of the lungs and chest wall. It is rare, with about 3000 new cases diagnosed in the United States per year.


What are the symptoms of pleural mesothelioma?

Symptoms of pleural mesothelioma may include:

  • Shortness of breath
  • Chest wall pain
  • Cough
  • Fever
  • Sweating
  • Fatigue
  • Weight loss
  • Trouble swallowing
  • Hoarseness
  • Generalized weakness

What causes this type of cancer?

Exposure to asbestos is strongly linked to mesothelioma and is felt to be the primary cause in most cases of the cancer. This exposure can usually be linked to a patient’s work-place or home. Asbestos is a naturally occurring mineral that was once widely used as a component of insulation due to its remarkable fire and heat resistance. It was used in factories, shipyards, building construction, automobile brakes and clutches until it became clear that exposure to microscopic asbestos fibers could cause cancer.

Most asbestos use was discontinued in the United States in the 1970s and 1980s although some homes and buildings constructed before this time do still contain asbestos. Almost all cases of pleural mesothelioma can be linked to asbestos exposure. Family members of those who worked with asbestos are at risk due to secondhand exposure to asbestos fibers carried home on clothing. It can take decades between the initial exposure to asbestos and the development of mesothelioma.

How is mesothelioma diagnosed?

The diagnosis of mesothelioma begins with a thorough history and physical exam. During the physical exam, your doctor will look for signs of fluid accumulation within the chest which is common with pleural mesothelioma. If the history or physical suggests mesothelioma, imaging, blood tests as well as other procedures may be ordered.


  • Chest X-ray– A chest X-ray may show thickening or calcium deposits in the lung lining, fluid accumulation within the chest or changes to the lungs themselves secondary to asbestos or tumor growth
  • Computed tomography (CT) scan– This cross sectional X-ray of the chest gives a more detailed map of the location of the tumor and any potential regions of spread.
  • Positron emission tomography (PET) scan– This non-invasive test involves the injection of radioactive sugar into the blood. Because cancer cells take up more sugar when compared to normal cells, a special camera that picks up the radiation creates a picture of the area where cancer is located.
  • Magnetic resonance imaging (MRI) scan– MRI scans are non-invasive tests in which radio waves created by powerful magnets produce a detailed picture of the body. MRIs can clarify the extent and location of tumor.

Tests of Fluids and other Tissues

  • Cytology– Mesothelioma often causes irritation of the lining of the chest leading to fluid accumulation known as a pleural effusion. Your doctor may draw fluid out of your chest with a needle and look for cancer cells within this fluid. Examination of this fluid for cancer cells under the microscope is known as cytology.
  • Needle biopsy– Larger samples of tissue that line the chest can be drawn out using a needle that is guided using CT scan imaging. This tissue, known as a needle biopsy, is then examined under the microscope for cancer cells.
  • Surgical biopsy– In some cases, more tumor tissue must be obtained to make a diagnosis. This can typically be done minimally invasively using VATS (video-assisted thoracic surgery) and a single incision about 1 inch in length. Patients are typically discharged on the same day as surgery. Results of this biopsy are close to 100% accurate.

What treatments are available for mesothelioma?

Although there is not yet a known cure for mesothelioma, there are several treatment options available that are aimed at extending and improving a patient’s quality of life. These options vary dependent on the stage of the cancer (how advanced it is), a patient’s age and overall medical condition as well as the tumor’s histology (how aggressive the tumor appears under the microscope). Mesothelioma can be difficult to treat given the fact that it is often discovered after it has spread throughout the body. However, for patients with disease that is still localized within the chest, a combination of surgery, chemotherapy and radiation may be of benefit.

What treats mesothelioma?

Because mesothelioma is a rare disease, it is important that you choose a team of physicians with experience treating mesothelioma. The team at the Chest Cancer Research and Treatment Center has extensive experience in treating mesothelioma. This team is composed of medical oncologists (doctors specialized in diagnosing and treating cancers), radiation oncologists (doctor specialized in giving radiation treatments to kill cancer cells) and thoracic surgeons (doctors who specializes in operating on organs inside the chest), all with the most up to date techniques in treating this disease.

Surgery for mesothelioma

Surgery is most commonly performed when disease is in its earlier stages (localized to the chest). The purpose of surgery is to remove all cancer from the chest. Types of surgery include.

  • Pleurectomy – Complete removal of the covering of the lungs and the lining of the chest
  • Extrapleural pneumonectomy – Removal of one lung along with the lining of the chest, the diaphragm (muscle of breathing) and pericardium (outside covering of the heart).

Radiation or chemotherapy may be used as follow-up to surgery to kill any invisible cancer cells. This form of treatment is known as adjuvant therapy (given after surgery). Your chest surgery should be performed by a specialized thoracic (chest surgeon) with expertise treating pleural mesothelioma. All thoracic surgeons in the Department of Thoracic Surgery at Baylor University Medical Center have extensive experience in surgery for mesothelioma. Your thoracic surgeon will determine whether you are a candidate for surgery and whether tumor is removable. Some tumors cannot be removed due to their location or if the cancer has spread. If you are not a candidate for surgery, chemotherapy may be recommended or you may be offered a clinical trail through the Chest Cancer Research and Treatment Center.

Are there resources available?

See the following websites: