Mesothelioma is a rare, aggressive form of cancer that develops in the linings of the lungs, abdomen, heart or testes. The only known cause of malignant mesothelioma is asbestos, though there are other potential risk factors. Due to a long latency period, symptoms may take 10 – 50 years to develop after exposure.
According to the most recent data, around 3,000 new cases of mesothelioma are diagnosed in the United States each year. The average life expectancy for mesothelioma patients is 12 – 21 months, but will vary based on tumor location, cell type, staging and patient characteristics. Currently there is no cure for the cancer, but surgery, chemotherapy, radiation therapy and clinical trials can improve patient prognosis.
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The only known cause of malignant mesothelioma is asbestos exposure. When asbestos is disturbed, microscopic fibers are released into the air and inhaled or ingested. Fibers can then lodge themselves into the lining of organs, including the lungs, heart, abdomen and testes, causing inflammation and leading to the development of mesothelioma. Though asbestos use has declined, it was used frequently prior to the 1980s and is still not fully banned, continuing to put people at risk.
Research studies have shown that there may be other causes of mesothelioma, though none of them have been proven, including zeolites, radiation exposure, simian virus 40 and high aspect ratio nanoparticles. Case studies have also found other potential risk factors for developing mesothelioma, like poor overall health and a history of smoking.
Types of Mesothelioma
Mesothelioma type is determined by tumor location. Mesothelioma cancer develops in the linings of certain organs or spaces within the body, known as the mesothelium.
There are four primary types of mesothelioma, including malignant pleural mesothelioma, peritoneal mesothelioma, pericardial mesothelioma and testicular mesothelioma. Pleural mesothelioma involves tumors within the pleura (lung linings). Peritoneal tumors develop in the peritoneum (abdominal linings), while pericardial tumors develop within the pericardium (heart linings), and testicular mesothelioma develops in the tunica vaginalis testis (testes linings). Pleural mesothelioma is the most common, followed by peritoneal, pericardial and testicular mesothelioma.
The most common type, pleural mesothelioma is caused by the inhalation of asbestos fibers.
Inhaled or swallowed asbestos fibers can become trapped in the lining of the abdomen (the peritoneum).
In rare cases, asbestos fibers can get lodged in the pericardium, the lining around the heart cavity.
Mesothelioma Cell Types
Mesothelioma types can be further broken down into cell types, including epithelial, sarcomatoid and biphasic. There are also rare cell types that have emerged in limited cases. Epithelioid mesothelioma is the most common, with cells that are slow to spread and responsive to cancer treatments. Sarcomatoid mesothelioma is the least common with cells that spread quickly and are less responsive to treatment. Biphasic mesothelioma involves a combination of both epithelial and sarcomatoid cells with varying growth patterns and responsiveness to treatment depending on which cell type is more dominant.
Diagnosing Mesothelioma Symptoms
Malignant mesothelioma has a long latency period of 10 – 50 years, meaning it can take decades for symptoms to emerge after exposure to asbestos, the only known cause of mesothelioma. When disturbed, asbestos fibers are inhaled and become lodged in the linings of organs, leading to development of the cancer.
Mesothelioma symptoms are nonspecific and often mimic other more common diseases, frequently leading to misdiagnoses like lung cancer. Symptoms may vary for mesothelioma patients based on type, cell type and staging, however, there are common symptoms that patients and physicians can look out for.
Common Mesothelioma Symptoms
Abdominal and chest pain and swelling
Difficulty breathing (dyspnea)
Fever and night sweats
Fluid buildup (pleural effusion or peritoneal effusion)
Loss of appetite
Unexplained weight loss
The best way to improve mesothelioma prognosis is through early detection. Patients who exhibit mesothelioma symptoms should seek medical care immediately to begin the diagnostic process. A mesothelioma diagnosis typically involves the following:
Imaging scans: X-rays, MRI scans, CT scans, PET scans and ultrasounds are used to look for tumors and abnormalities.
Blood tests and biomarkers: Various blood tests may be able to detect certain biomarkers in the blood that suggest the presence of mesothelioma, show mesothelioma symptoms or reveal a history of asbestos exposure.
Biopsies: A biopsy is the only definitive way to diagnose mesothelioma, as a tissue or fluid sample is taken to determine malignancy, cancer type, cell type and staging through a study known as pathology.
Stages of Mesothelioma
Staging mesothelioma involves a doctor categorizing the disease into one of four stages. Pleural mesothelioma is the only type with its own staging systems, including the Butchart staging system, Brigham staging system and TNM staging system. The TNM system (tumor, lymph nodes and metastasis) is the most commonly used, as it’s frequently updated with recent case studies and advancements in mesothelioma research. Other types of mesothelioma are staged by using more general cancer and mesothelioma characteristics.
Staging will help provide patients and physicians with a better understanding of how the disease will progress, what symptoms can be expected, prognosis and what treatment options are viable.
Stage 1 Mesothelioma
During stage 1, the mesothelioma tumor is localized to one area of the body without distant metastasis. Symptoms can be unrecognizable or are very limited. Treatment options typically can be aggressive, and a multimodal approach is common with surgery, chemotherapy and radiation therapy.
Stage 2 Mesothelioma
Mesothelioma cancer may have spreading to nearby tissues, organs or lymph nodes, but there is no distant metastasis. Aggressive treatments may still be an option, including a multimodal approach.
Stage 3 Mesothelioma
Tumors have typically spread beyond the local area to several nearby locations and to the lymph nodes. Treatment options may be limited during this stage, and curative surgery usually isn’t an option. Many patients undergo palliative treatment to reduce symptoms, and they may be eligible for clinical trials.
Stage 4 Mesothelioma
Distant metastasis is present as cancer has spread to nearby and distant organs, tissues and lymph nodes. Most treatment plans for stage 4 patients consist of primarily palliative treatments to reduce symptoms and improve quality of life.
Mesothelioma Prognosis and Survival
After a doctor confirms a mesothelioma diagnosis and determines the stage of the disease, they will be able to provide a prognosis and life expectancy estimate. Prognosis can vary greatly based on mesothelioma staging at the time of diagnosis. Patients diagnosed in the earlier stages generally have a much better prognosis than those diagnosed at later stages. However, prognosis is also affected by mesothelioma type and cell type, as well as patient characteristics like age, gender and overall health. Patients should discuss their individual case with a mesothelioma specialist to better understand their prognosis.
How a disease will progress. A prognosis can be good or bad and may have a survival time estimate.
MORE Life Expectancy
How long a patient can expect to survive. This may change with treatment and other developments.
MORE Survival Rate
A statistic (percentage or ratio) indicating how many people live a certain amount of time after diagnosis.
Treatment for mesothelioma is similar to other types of cancer. The most common treatment is a multimodal approach of surgery, chemotherapy and radiation, though these treatments may be used individually as well. In some cases, treatment can improve a patient’s prognosis, sometimes improving life expectancy to five years or more.
Surgery: Aims to remove as much of the cancer as possible, but can also be used palliatively to reduce tumor size or remove fluid buildup to alleviate pressure and relieve associated symptoms.
Chemotherapy: Aims to kill fast-growing cancer cells or to kill remaining mesothelioma cells after surgery.
Radiation therapy: Aims to damage cancer cells to hinder growth and reduce symptoms.
Newer treatments like immunotherapy are being studied as part of clinical trials and may be available for some patients who do not respond to conventional therapies. Palliative treatments can also be used at any time to reduce pain and discomfort caused by the symptoms or side effects of mesothelioma treatment.
Since malignant mesothelioma is rare, not many doctors have experience with the disease. However, there are mesothelioma specialists around the country who have expertise in diagnosing and treating the disease, as well as lead research studies and conduct clinical trials to improve diagnostic tools and develop new treatments. A mesothelioma specialist can provide patients with a better understanding of how the disease will progress, what their treatment options are and what emerging clinical trials may be available to help improve their prognosis.
Top Mesothelioma Doctors in the Country
James Pingpank, M.D.
James Pingpank, M.D.
Map Marker UPMC Hillman Cancer Center
Raphael Bueno, M.D.
Raphael Bueno, M.D.
Chief, Division of Thoracic Surgery; Co-Director, The Lung Center
Map Marker Brigham and Women’s Hospital
Mesothelioma Cancer Clinics
There are mesothelioma clinics and cancer centers around the country that are dedicated to providing mesothelioma patients with specialized care during their treatment journey. These centers are equipped with the latest technology and treatment techniques available, along with specialists that have experiencing dealing with the cancer. Patients and their loved ones should locate a mesothelioma clinic to explore medical care specialized for their diagnosis.
Heather Von St. James – Mesothelioma Survivor
Watch Heather’s Story
Heather Von St. James is a 13-year pleural mesothelioma survivor, who has become an inspiration and source of hope for other mesothelioma patients, as well as a spokeswoman for mesothelioma awareness and the need for an asbestos ban. Heather works with newly diagnosed patients to mentor and advocate for them, also helping them to understand treatment and legal options.
Heather experienced an aggressive, life-saving surgery (extrapleural pneumonectomy) that removed one of her lungs, a hugely successful treatment by Dr. David Sugarbaker. Her treatment has allowed her to offer valuable insight to others exploring treatment options, while also sharing her unique perspective and story with the mesothelioma community. Click here to connect with Heather.
Mesothelioma survivors also help raise awareness of the rare cancer and offer hope to those newly diagnosed. While there is no cure for the disease, there are survivors that share their successful treatment journeys. With the support of survivors, members of the mesothelioma community, friends and family members, patients are never alone. If you have a loved one that has recently been diagnosed, offering comfort and support to them can make a huge difference during their treatment journey.
Support & Resources for Mesothelioma Patients
Read warrior stories from mesothelioma survivors
Learn more about Heather Von St. James’ journey
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Mesothelioma Legal Rights
Before the 1980s, asbestos was used frequently in many different industries, leading to occupational exposure of millions of workers each year and secondhand exposure among workers’ loved ones. Asbestos companies produced many asbestos products, from construction materials to consumer goods, that individuals came into contact with on a daily basis, heightening their risk of developing mesothelioma and other asbestos cancers. Even after the risks of asbestos were recognized, companies continued to put people at risk, leading to many of today’s cancer diagnoses and mesothelioma lawsuits.
There are many costs associated with a mesothelioma diagnosis, including diagnostic and treatment expenses, travel and lodging expenses and lost wages. Because of the asbestos companies’ negligence, mesothelioma patients and their loved ones have legal rights that may entitle them to compensation to help cover these expenses. A mesothelioma lawyer can offer specialized insight into what options are available and answer all questions regarding eligibility, especially for patients diagnosed decades after exposure to asbestos.
Financial assistance may include the following:
Legal Settlements: Victims of asbestos exposure can recover money from companies that produced, made and distributed asbestos products.
Veteran Benefits: Individuals exposed to asbestos while serving in the military can receive help through the Veterans Administration.
Asbestos Trust Funds: Trust funds have been established by former asbestos companies to pay for asbestos-related medical expenses.
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