What Is Mesothelioma?
Mesothelioma is a rare and aggressive cancer caused by inhaling or swallowing airborne asbestos fibers. This aggressive cancer is identified by tumors that develop in the mesothelium, a layer of the protective lining that covers the majority of internal organs.
Malignant mesotheliomas are cancers that primarily start in the mesothelium of the pleura (chest cavity), peritoneum (abdominal cavity), pericardium (heart cavity). There are four primary types of mesothelioma: pleural, peritoneal, pericardial, and testicular.
Mesothelioma cancer only has one known cause of the condition – asbestos. Asbestos is a fibrous mineral that was used throughout the country for decades. When inhaled or ingested, the fibers often lodge within the lining of internal organs, causing tumors to develop.
The survival rate for mesothelioma patients ranges from 18 to 31 months with treatment. Cancer treatment can improve a patient’s quality of life and survival. Common forms of treatment for mesothelioma include traditional cancer therapies such as chemotherapy, surgery, and radiation, as well as newer methods like immunotherapy.
Life expectancy after diagnosis (commonly referenced as a five-year survival rate) is generally poor; about 46 percent of patients are alive one year after being diagnosed. This is why early detection is so important.
- Mesothelioma tumors can take 20 to 50 years to develop and cause noticeable health complications. Early signs of the disease often include symptoms like chest pain, shortness of breath, and/or fluid buildup.
- Pleural mesothelioma affecting the lining of the chest cavity is the most common type – accounting for up to 85 percent of mesothelioma cases.
- Men make up the majority of cases due to occupational exposure to asbestos in fields like construction.
- The average age of people diagnosed with pleural mesothelioma in the U.S. is 72 years old.
Symptoms of Mesothelioma
The early symptoms of mesothelioma are often the same as less-severe diseases and can take 10 to 50 years to present after the initial exposure to asbestos. Additionally, most patients diagnosed with mesotheliomas had symptoms for several months prior to seeing a doctor for testing.
What are the Early Warning Signs of Mesothelioma?
Early signs of mesothelioma can be difficult to detect as they are mild. Studies show that early symptoms include chest or abdominal pain and fluid buildup in the form of swelling or bloating. Other warning signs of mesothelioma include anxiety, dry cough, fever, pain, and fatigue.
|Location of Mesotheliomas||Symptoms|
|Pleural mesothelioma||Chest pain or lower back pain, shortness of breath, persistent cough, difficulty swallowing, hoarse voice, swelling of the face and/or arms|
|Peritoneal mesothelioma||Swollen belly, abdominal pain, nausea, vomiting, constipation|
|Pericardial mesothelioma||Chest pain, irregular heartbeat, heart murmur, shortness of breath|
When these symptoms do appear, patients and doctors often misdiagnose them for different, less severe illnesses such as the flu or pneumonia. Additionally, malignant tumors often produce mild symptoms, and it is not until patients are very sick that they notice their symptoms are more severe. This means most patients diagnosed with mesothelioma had symptoms for several months prior to seeing a doctor for testing.
If you or a loved one believe to have a history of asbestos exposure, it can be helpful to disclose this information to a doctor. This could lead to an earlier, better diagnosis and treatment plan. Mesothelioma early detection often improves a cancer prognosis.
Anxiety in Mesothelioma Patients
Mesothelioma patients often develop anxiety in response to their symptoms or diagnosis. Additionally, when the body is sick, the immune system releases stress hormones and other chemicals that might negatively impact a patient’s mental health. Anxiety, the feeling of nervousness or concern, is a natural emotion the body produces in response to harm or threat. There are two forms of anxiety: acute and chronic. While living with mesothelioma, a patient may experience continued anxiety triggers from:
- Difficulty performing everyday activities
- Physical treatment side effects
- Lack of social or spiritual satisfaction
- Predisposition for stress or other mental health complications
Mesothelioma Dry Cough
Pleural mesothelioma grows in the lining of the lungs. Many patients diagnosed with pleural mesothelioma develop symptoms associated with the chest. A common symptom is a dry cough. Patients often begin to experience dry cough during stage 1 or stage 2. As cancer progresses, the dry cough tends to become more aggressive and painful. In the latter stages of cancer, tumor growth can extend pressure on the lungs, leading to frequent dry cough.
Fever and Night Sweats
Other potential symptoms of mesothelioma are fever and night sweats. When the body’s temperature rises, causing a fever, the body begins to sweat excessively to cool itself down. The body tries to regulate its temperature to fight illness. These illnesses could include tumor growth, inflammation, and many other conditions.
Malignant Mesothelioma Pain Management
Tumors often cause pain in patients as they continue to grow and push against nerves and organs. As cancer progresses, fluid buildup can also cause pain with activities such as breathing, coughing, and eating. Over 60 percent of pleural mesothelioma patients experience chest pain and 30 to 50 percent of peritoneal patients have abdominal pain. Additionally, cancer treatment can cause discomfort and pain in patients.
Weakness and Fatigue
When a patient develops cancer and undergoes treatment, they may experience weakness and fatigue. Patients experiencing weakness and fatigue may show signs of a decrease in strength and difficulty moving. Those enduring fatigue often describe themselves as feeling “exhausted” and having trouble staying awake. Over 80 percent of mesothelioma patients experience weakness and fatigue. Asbestos causes latent mesothelioma. Think you were exposed? Request a case evaluation to pinpoint the cause and who’s responsible.
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Asbestos causes latent mesothelioma. Think you were exposed? Request a case evaluation to pinpoint the cause and who’s responsible.
Causes of Mesothelioma
Cancerous cells form when the DNA of healthy cells is damaged. While the exact mechanisms that cause mesothelioma are not yet clear to cancer researchers, asbestos exposure is recognized as the primary cause of pleural mesothelioma. Approximately 80 percent of people diagnosed with mesothelioma have been exposed to asbestos at some time in their lives.
When asbestos enters the body (often in the form of dust from loose fibers), the small particles travel deep into the ends of respiratory pathways. There, the particles become lodged in the pleura surrounding the lungs, causing inflammation and tissue scarring. If swallowed, the toxins can travel through the digestive system into the peritoneum lining the abdominal cavity.
Radiation therapy has been studied as another possible cause of certain types of mesothelioma. Even the kinds of radiation used in cancer treatments can lead to mutations in cells’ DNA. Eventually, these mutations may spread, resulting in cancer.
What Mesothelioma Does to Your Body
When someone faces asbestos exposure, minuscule fibers can enter the body through a variety of ways. People can either inhale or ingest asbestos fibers, allowing them to enter the body and bloodstream. Asbestos fibers then settles in the abdominal, heart, lung, and/or testicular lining. Over time, these fibers cause the tissue lining to inflame, leading to scar tissue developing on the surface of the lining. Within the scar tissue, cancerous tumors form, leading to mesothelioma.
Who Is at Risk for Developing Mesothelioma
About three of every four mesothelioma diagnoses are linked to asbestos exposure, most of which are related to occupational risks from previous employment. People who are most at risk of being diagnosed with mesothelioma include occupations such as:
- Construction and demolition workers
- First responders and firefighters
- U.S. military and veterans
The attacks on September 11, 2001, in New York also put many people at risk. Thousands of residents, Manhattan workers, and first responders inhaled massive amounts of asbestos dust that had been released from the fallen buildings.
Types of Mesothelioma
Mesothelioma is a rare type of cancer that begins in mesothelial cells in different parts of the body. Mesothelial cells can be found in the lining of the chest, heart, and abdominal cavities. These cells are also located in the mesothelium of the testicles.
1) Pleural Mesothelioma
Pleural cancer refers to tumors developing in the lining of the lungs, or the pleura. This type of mesothelioma is the most common, accounting for up to 80 percent or approximately 2,500 to 3,000 cases each year.
Patients with cancer in the pleura typically experience symptoms related to the chest and lungs. The symptoms typically begin with persistent chest pain or cough. Patients may experience chest lumps, shortness of breath, fatigue, or unexplained weight loss.
2) Peritoneal Mesothelioma
Tumors that develop in the peritoneum, or the abdominal lining, are referred to as peritoneal mesothelioma. It is the second-most common type of mesothelioma, making up between 15 and 20 percent of diagnoses yearly.
Peritoneal cancer symptoms often include swelling in the belly and stomach pain caused by growing tumors. Lumps in the abdomen and unexplained weight loss are symptoms of advanced cancer.
3) Pericardial Mesothelioma
Mesothelioma can also occur in the tissue sac covering the heart, known as the pericardium. Pericardial mesothelioma is extremely rare, only one percent of cases begin in the pericardium.
Symptoms of pericardial mesothelioma include frequent chest pain, shortness of breath, a persistent cough, and/or heart palpitations.
4) Testicular Mesothelioma
The rarest type of mesothelioma is testicular mesothelioma, with only a few hundred cases ever diagnosed in the U.S.
Due to its rarity, symptoms of testicular mesotheliomas are hard to determine. The most common symptoms among patients diagnosed with the testicular form are lumps on the scrotum that don’t cause any pain.
When making a diagnosis, doctors look at a sample of the types of cells from the affected area. The three main types of mesothelioma cells include:
|Cell Type||Shape||Cell Description|
|Epithelioid||square||The most common cell type as well as the easiest to identify. This type is usually easier to remove via surgery, giving patients better prognoses.|
|Fibrous sarcomatoid||oval||Sarcomatoid cells account for about 15 to 20 percent of cases. This type is often more aggressive and spreads faster, resulting in poorer prognoses.|
|Biphasic||Mix of cell types||A mixture of epithelioid and sarcomatoid cells making up between 20 and 30 percent of cases. This type is harder to treat than epithelioid.|
Diagnosing Mesothelioma – Is Mesothelioma Difficult to Diagnose?
Doctors use a combination of physical exams and tests to locate and diagnose tumors. Because mesothelioma is rare among cancers, a doctor may ask about your occupation and medical history during an examination of symptoms. If your doctor believes you’re at risk, they may order a round of diagnostic tests.
Malignant mesothelioma doesn’t have a recommended screening test for those without symptoms or who are at a high risk of the disease. If you were exposed to asbestos on the job, doctors recommend regular imaging tests (such as X-rays), though they may not be entirely effective in catching cancer early. CT scans, PET scans, MRIs, and echocardiograms may be used to determine whether suspicious lumps or swelling are linked to cancerous tumors. While imaging scans can indicate the presence of cancer, biopsies are needed to make specific diagnoses of cancer cell types. Currently, a biopsy test is the only way to diagnose mesothelioma. A biopsy uses a needle to remove a sample of cells to analyze beneath a microscope.
Common Tests for Diagnosing Mesothelioma
After a person develops mesothelioma, they may begin to notice symptoms. Generally, a patient begins their diagnosis process with a trip to their doctor and undergoing a thorough physical examination. After initial testing, a medical professional may request imaging tests for the patient. Common tests that identify mesothelioma include imaging scans, blood tests, and biopsies.
To begin the diagnosis process, doctors often utilize imaging tests. They often begin with the lowest resolution scans and work up when necessary. Common imaging scan tests include X-rays, CT scans, and PET scans.
An X-ray is a low-resolution, low-radiation image that provides doctors with a two-dimensional look at the body. When an X-ray looks abnormal, they often move to higher-resolution tests. Most people initially undergo a basic chest X-ray to check for any abnormalities. If abnormal growth or fluid around the lung is detected, doctors will recommend a more detailed imaging scan such as a PET, CT, or MRI.
After a doctor completes an imaging test, they may perform a series of blood tests. Doctors’ primary blood tests when diagnosing mesothelioma include the Cancer Antigen (CA 125) and the MesoMark®.
The CA 125 is a protein biomarker found in large concentrations of cancer cells. This blood test measures how much of the protein is present in a patient’s blood. This test can help doctors determine the presence, staging, and potential treatment options for cancers.
The MesoMark® earned FDA approval in 2007 and was the first blood test used to diagnose and monitor mesothelioma. MesoMark® works by measuring levels of soluble mesothelin-related proteins released by diseased cells, allowing doctors to assess the severity of mesothelioma present in the body.
A biopsy is the highest-resolution imaging test to diagnose mesothelioma. This test removes fluid or tissue to determine the disease’s presence or extent. In cancer patients, biopsies allow doctors to determine whether tumors have spread and, if so, to what extent.
The stage of mesothelioma cancer describes its location since tumors first started developing, how large the tumors are, and whether they have spread to other areas of the body. Cancers are typically staged from I (1) to IV (4), with lower numbers representing earlier-stage cancers. Unfortunately, most mesothelioma patients are diagnosed in the advanced stages of the disease.
The staging for mesothelioma is based on the American Joint Committee on Cancer (AJCC) TNM system. However, pleural mesothelioma is the only type with established staging as the other types are so rare. The TNM system utilized three primary pieces of information:
- Tumor (T): The extent and size of the primary tumor
- Nodes (N): The spread to nearby lymph nodes
- Metastasis (M): The spread or metastasis of tumors to distant sites
The stages for mesotheliomas in the chest (i.e., tumors in the pleural lining) are different than the staging of mesotheliomas in the abdomen (tumors in the peritoneum), and mesotheliomas in the heart (tumors in the pericardium).
|Stage of Mesothelioma||Description|
|Stage I||Cancerous cells can be found in the pleura surrounding one lung on one side of the body.|
|Stage Ia||Cancerous cells can be found in the outer layer of the pleura (i.e., parietal pleura) surrounding one lung on one side of the body.|
|Stage Ib||Cancerous cells can be found in the innermost layer of the pleura (i.e. visceral pleura) surrounding one lung on one side of the body.|
|Stage II||Cancerous cells can be found on both layers of the pleura, but only on one lung. Masses of cells have increased to the size of notable tumors and may have started to spread to nearby diaphragm muscles or lung tissues.|
|Stage III||Tumors have spread to the chest wall, nearby lymph nodes, or the pericardium (i.e., the layer of tissue surrounding the heart), but may be small enough to remove via surgery.|
|Stage IV||Tumors are larger and have spread throughout different parts of the body (the chest wall, diaphragm, peritoneum, the other lung, other organs in the chest, lymph nodes, above the collarbone, etc.). Surgery is no longer an option for treatment.|
Other types of mesothelioma (including peritoneal and pericardial) are too rare even among mesotheliomas to have an established staging system. Regardless, many doctors may still refer to the above staging system when talking about the spread of mesothelioma tumors.
Stage 1 – Is Stage 1 Mesothelioma Cancer Curable?
Mesothelioma is at the least advanced state during stage 1 and carries the best prognosis. During stage 1 mesothelioma, cancer tumors are localized, meaning they have not spread to other parts of the body. Although cancer caught at stage 1 is often curable, many people are not diagnosed during this early stage. Stage 1 characteristics often include:
- Localized to one side of the body
- No metastasis to lymph nodes or other organs
- No or few symptoms
- Potentially curative treatment options
- Best prognosis
Stage 2 – How Long can you Live With Stage 2 Mesothelioma?
Following stage 1, stage 2 mesothelioma has the best curative treatment and prognosis. More people are diagnosed during stage 2 than stage 1 as symptoms often become more prevalent and persistent. Mesothelioma during this stage can often be treated with curative measures like chemotherapy, surgery, radiation, and immunotherapy. Stage 2 characteristics often include:
- Localized to one side of the body
- Some metastasis to lymph nodes or nearby organs
- Mild symptoms that are often mistaken for other illnesses
- Potentially curative treatment options
- Fair prognosis
Stage 3 – Is Stage 3 a Terminal Cancer?
The third stage is when most people notice symptoms of mesothelioma. However, once people are diagnosed during this stage, tumors have oftentimes spread to other parts of the body, presenting a poor prognosis. Stage 3 characteristics include:
- Localized to one side of the body
- Metastasis to lymph nodes and nearby organs
- Worsening symptoms
- Palliative treatment options
- Poor prognosis
Stage 4 – What Happens in the Final Stages of Mesothelioma?
Mesothelioma has the worst prognosis and symptoms during stage 4. In this stage, tumors have likely metastasized to other parts of the body, making it more difficult to treat. During this stage, doctors may choose to utilize palliative treatment instead of curative methods to ease symptoms. Characteristics of stage 4 include:
- Spread to both sides of the body
- Metastasis to lymph nodes and organs throughout the body
- Severe symptoms
- Palliative treatment options
- Poorest prognosis
Overall, the mesothelioma prognosis for all types of this cancer is poor. Most people with mesothelioma only learn of their illness after it has metastasized to other organs, lymph nodes, and/or bones. Mesothelioma treatment options during the later stages are few and there are no options for a cure.
Cancer survival timelines are most often measured by five-year survival rates. The rate is an average of all surviving patients five years after being diagnosed with mesothelioma. The average mesothelioma survival rate is 4-18 months after diagnosis, but there are some that lived longer than 10 years. The current 5-year survival rate is 10 percent.
The American Cancer Society utilizes information from the Surveillance, Epidemiology, and End Results (SEER) database. The SEER staging system breaks down into three parts:
- Localized: Size and extent of the primary tumor
- Regional: Metastasis of primary tumor to lymph nodes
- Distant: Metastasis of primary tumor to distant parts of the body
|TNM Stage||5-Year Average Survival Rate|
|All SEER Stages Combined||12%|
Mesothelioma Treatment Options
Mesothelioma is a difficult disease to treat, even when caught in its early stages because tumors grow in multiples and spread quickly to nearby tissues. The stage of cancer is typically the main factor in determining the course of treatment, followed by the patient’s overall health and ability to recover from treatment.
Stage I and II mesothelioma may be treated with surgery followed (or precipitated) by a round of chemotherapy or radiation. Advanced-stage mesothelioma that has spread to other parts of the body may be treated with emerging treatments like targeted therapy and immunotherapy. For all cancer patients, doctors often prescribe some form of palliative specialist treatment.
Deciding on a treatment plan that prioritizes your overall well-being while achieving treatment goals is important. You may need to seek a second opinion or travel to other cities for more mesothelioma treatment options.
Chemotherapy treatment utilizes cancer drugs to limit the growth of cells. Cytotoxic chemical substances either kill the cancer cells or prevent them from dividing. However, these chemicals harm both cancerous and healthy cells. Chemotherapy can also be used in conjunction with other treatments such as radiation and surgery.
In 2020, the FDA approved the first set of mesothelioma immunotherapy treatment drugs. Immunotherapy is a unique form of treatment that uses the patient’s own immune system to fight mesothelioma cells. The body is able to better recognize and, ultimately, eliminate cancer cells with immunotherapy.
Radiation therapy utilizes high-energy X-rays to damage the cancerous cells’ DNA. Unlike chemotherapy, radiation targets a specific part of the body. These X-rays shrink tumors and prevent cancer recurrence and spreading. Radiation provides many benefits to cancer patients.
Mesothelioma surgery removes cancerous tumors from the body. Medical professionals often perform surgery to diagnose cancer, rid the body of tumors, or improve a patient’s symptoms. There are two primary types of pleural mesothelioma surgery: extrapleural pneumonectomy and pleurectomy and decortication. Many consider surgery in combination with chemotherapy and radiation to be the best mesothelioma treatment.
Financial Assistance to Help with Cancer Treatment
There are many costs associated with cancer treatment. Those without health insurance have large sums of money to pay, and those with insurance still may not be able to afford treatment. However, those with a cancer diagnosis have access to financial assistance. There are numerous federal and state government programs that provide benefits to patients are their families. Additionally, many non-profit organizations provide financial assistance to help pay for co-payments, deductibles, and many other costs associated with cancer. Additionally, many people developed this form of cancer negligently and may be eligible for legal compensation.
Top Mesothelioma Treatment Centers
Because mesothelioma is a rare type of cancer, many doctors and oncologists have not yet diagnosed or treated this type of patient. Additionally, many hospitals across the country can’t offer a wide range of treatments (such as CAR T-cell therapy).
You may need to travel to another city or state to meet with a mesothelioma doctor. You may consider entering a clinical trial to receive new treatments still being studied.
Top Mesothelioma Doctors and Specialists
Surgeons, oncologists, radiologists, and other experts that specialize in mesothelioma treatment are often referred to as mesothelioma doctors. Patients often choose to receive care from these specialists as they receive the highest level of knowledge and options. With access to earlier diagnoses, better treatment options, and clinical trials, a specialist could provide patients with a better prognosis.
Find a Specialist or Local Doctor Near You
There are many more specialists such as Marcelo DaSilva, MD, and Bruce Johnson, MD. A specialist at a cancer medical center can greatly improve a patient’s prognosis. Mesothelioma Hub can help you or a loved one connect with a doctor or medical center. Our patient advocate team can also help connect you with a doctor in your area.
What to Do After Being Diagnosed With Mesothelioma
After being diagnosed with mesothelioma, you may feel overwhelmed. With all of the new information about prognosis, treatments, and recovery, it can be difficult to make decisions. But, there are several options to help you financially as well as legally.
Financial and Legal Options
Many people who have been diagnosed with mesothelioma did not develop the disease naturally. If you’ve been diagnosed, it’s possible you were exposed to asbestos while at work or in your home. Workers’ compensation laws protect people who fall ill from exposure while working. Other regulations and trust funds are available to protect retired senior citizens.
Bringing legal action against a company (or companies) responsible may result in financial compensation to cover the costs of treatment or in cases of wrongful death. Mesothelioma patients and their families should consider the following legal options:
- Asbestos settlements
- Asbestos trust funds
- Class action lawsuits
- Personal injury lawsuits
- Workers’ compensation
- Wrongful death claims
Finding Support and Mesothelioma Resources
The mental health effects of a cancer diagnosis can be severe for patients as well as their families. Seeking support groups and resources may benefit those who need help coping with grief, handling legal challenges, and/or keeping up with a household.
The American Cancer Society maintains a database of support resources, including mesothelioma support groups, patient lodging programs, cancer treatment information call centers, rides to treatment, and more. Many of these programs and services are free or low-cost to patients and their loved ones.
Most Common Mesothelioma Questions
- What tests will I need to diagnose mesothelioma? Imaging tests may tell a doctor that cancers are present, but they require a biopsy to make a diagnosis.
- What complications does mesothelioma cause? The most common side effects of mesothelioma are respiratory complications (like shortness of breath) and swelling in the chest or abdomen.
- How do I know if my cancer is serious? Your doctor will inform you of your stage of cancer and how far it has spread. Typically, medical professionals consider stage III and IV advanced-stage cancer and are harder to treat. Remission and recurrence are also elements to consider.
- Will I need to have radiation or chemotherapy? Your treatment plan may include multiple rounds of radiation or chemotherapy, depending on your stage of cancer, your overall health, and how likely you are to recover from treatment.
- How do I find a clinical trial for mesothelioma? Visit the National Cancer Institute’s Treatment Clinical Trials for Mesothelioma page for ongoing clinical trials accepting new patients and studies that have already concluded. You can also ask your doctor about current clinical trials in your area.
- Should I take special vitamins or follow a new diet to help my cancer? Complementary therapies like herbal supplements, acupuncture, and meditation may improve a patient’s well-being but should not be substituted for medical treatment.
- Can I sue the company that exposed me to asbestos? You may be able to file a personal injury (or wrongful death lawsuit on behalf of a loved one) if you can prove the company was responsible for your illness. Speak with an experienced cancer attorney to learn more about your legal options.