What Is Mesothelioma Cancer?

The survival rate for mesothelioma patients ranges from 18 to 31 months with treatment. Recent cancer treatments have improved a patient’s quality of life and overall survival. Common forms of treatment for mesothelioma include traditional cancer therapies such as chemotherapy, surgery, radiation, as well as newer methods like immunotherapy (to enhance the immune system).

Life expectancy after diagnosis (commonly referenced as a five-year survival rate) is generally poor; about 46%patients are alive one year after being diagnosed. This also suggests why early detection is so important.

Mesothelioma Statistics

• Mesothelioma tumors can take 20 to 50 years to develop and cause noticeable health complications. Early signs of the disease often include symptoms such as chest pain, shortness of breath, and/or fluid buildup.
• Men make up the majority of cases due to their occupational exposure associated with asbestos in career fields such as construction.
• The average age of people diagnosed in the U.S. with pleural mesothelioma is 72 years old.

These journals also publish articles that undergo a rigorous peer-review process and discuss many of the topics and statistics we mentioned, so you can be confident that the information they contain is credible.

• Nature https://www.nature.com/
• Science https://www.science.org/
• American Cancer Society https://www.cancer.org/
• FDA https://www.fda.gov/
• OSHA https://www.osha.gov/asbestos/

Symptoms of Mesothelioma

The early symptoms of mesothelioma are often the same as less severe disease processes and can take 10 to 50 years to present after the initial exposure to asbestos. Additionally, most patients diagnosed 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 usually mild. Studies show that early symptoms include chest or abdominal pain and fluid buildup leading to swelling and/or bloating. Other warning signs 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

These symptoms often present as less severe illnesses such as the common cold or pneumonia. Additionally, malignant tumors can produce mild symptoms, and patients will only recognize key symptoms as their disease becomes more severe. This suggests that most patients diagnosed with mesothelioma may have had symptoms for several months prior to seeking medical care and testing.

Therefore, if you or a loved one is believed to have a history of asbestos exposure, it can be very helpful to disclose this information to a doctor. This could lead to an earlier diagnosis and a less involved treatment plan. Mesothelioma early detection can often improve a patient’s cancer prognosis and quality of life.

Mental Effects and Anxiety in Mesothelioma Patients

Mesothelioma patients often develop anxiety in response to their signs/symptoms and cancer diagnosis. When the body is sick, the immune system releases stress hormones and other key chemicals that might negatively impact a patient’s mental health. Anxiety, the feeling of nervousness and concern, is a natural emotion the body undergoes in response to harm or a threat. There are two forms of anxiety: acute and chronic. While living with mesothelioma, a patient may experience continued anxiety, which can be triggered from:

• Difficulty performing everyday activities
• Physical treatment side effects
• Lack of social or spiritual satisfaction
• Predisposition for stress or other mental health complications

Persistent Dry Cough

Pleural mesothelioma grows in the lining of the lungs. Many patients diagnosed with pleural mesothelioma develop symptoms associated with the chest region. A key common symptom is an unusual dry cough. Patients often experience dry coughs during stages 1 and/or 2. As the cancer progresses, the dry cough tends to become more aggressive and painful. In the latter stages of cancer (stages 3 and 4), tumor growth can cause pressure on the lungs, leading to a more frequent dry cough.

Fever and Night Sweats

Other potential symptoms include 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 will regulate its temperature to fight illnesses such as tumor growth, infections, autoimmune disorders, and many other medical conditions.

Pain Management in Malignant Malignant Mesothelioma

Tumors often cause pain in patients as they continue to grow and push against arteries, veins, nerves, and other body organs. As the cancer progresses, fluid buildup can also cause pain with breathing, coughing, and eating. Over 60% of pleural mesothelioma patients experience chest pain, and 30% to 50% of peritoneal patients have abdominal pain. Additionally, cancer treatment can also cause discomfort and pain in many patients.

Weakness and Fatigue

When a patient develops cancer and undergoes treatment, they may experience weakness and fatigue. Patients experiencing weakness and fatigue may also have a decrease in strength and difficulty moving. Those experiencing fatigue often feel “exhausted” and have trouble staying awake. Over 80% of mesothelioma patients experience weakness and fatigue.

General 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% of people diagnosed with mesothelioma have been exposed to asbestos at some point in their lives and not necessarily due to their work environments.

When asbestos enters the body (often in the form of dust from loose fibers), the small particles travel deep into the respiratory pathways. The particles become lodged into the pleura surrounding the lungs, causing inflammation and tissue scarring. This makes certain occupations, such as miners and those who deal with asbestos physically, liable for asbestosis and mesothelioma. If swallowed, the toxins can travel throughout the digestive system and into the peritoneum lining within the abdominal cavity.

Radiation therapy has also been studied as another possible cause of mesothelioma. Even the various types of radiation used in cancer treatments can lead to mutations within a cell’s DNA. Eventually, these mutations may spread and result in cancer development.

What Can Mesothelioma Do to Your Body

When someone faces asbestos exposure, very fine 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 settle in the abdominal, heart, lung, and/or testicular lining. Over time, these fibers can cause the tissue lining to become inflamed, leading to scar tissue developing on the surface of the lining. Within the scar tissue, cancerous tumors can form, ultimately leading to mesothelioma.

Who Is at Risk for Developing Mesothelioma

About three of every four mesothelioma diagnoses are linked to asbestos exposure, and most of which can be related to an occupational risk from previous employment. The people who are most at risk of being diagnosed with mesothelioma include occupations such as:

• Construction and demolition workers
• First responders and firefighters
• Teachers
• U.S. military and veterans

The attacks on September 11, 2001, in New York also put many people at risk for mesothelioma. Thousands of residents, Manhattan workers, and first responders inhaled massive amounts of asbestos dust that had been released from the fallen Twin Tower buildings.

Different 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% or approximately 2,500 to 3,000 cases yearly.

Patients with cancer in the pleura typically experience symptoms related to the chest and lungs. The symptoms typically begin with persistent chest pain and/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%of cancer diagnoses yearly.

Peritoneal cancer symptoms often include swelling in the belly and stomach pains caused by growing tumors. Lumps in the abdomen and unexplained weight loss are key signs 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 1% of cases are associated with the pericardium. Symptoms of pericardial mesothelioma include frequent chest pain, shortness of breath, a persistent cough, and/or heart palpitations, aka fast or irregular heartbeat (speedy heart rate).

4) Testicular Mesothelioma

The rarest type of mesothelioma is testicular mesothelioma, with only a few hundred cases diagnosed in the U.S. Due to its rarity, signs and symptoms of testicular mesothelioma are quite hard to determine. The most common signs among patients diagnosed with the testicular form are lumps on the scrotum that don’t cause pain.

How to Diagnose Mesothelioma

Doctors use a combination of physical exams and tests to locate and diagnose tumors. A doctor may ask about your occupation and medical history while examining 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 chest x-rays), though they may not be entirely effective in identifying cancer early. CT scans, PET scans, MRIs, and echocardiograms may also 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, which are then analyzed under a microscope.

Common Tests for Diagnosing Mesothelioma

After a person develops mesothelioma, they may begin to notice signs and symptoms. Generally, patients begin their diagnostic process by going 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.

Imaging Scans to Locate Tumors

Doctors often utilize imaging tests to begin the diagnosis process. They usually begin with a low-resolution test and work up to a high-resolution test when necessary. Common imaging scan tests include X-rays, CT scans, and PET scans.

An X-ray is a low-resolution, low-radiation image test that gives doctors 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 an abnormal growth or a fluid collection around the lungs is detected, doctors will recommend a more detailed imaging scan such as a PET, CT, or MRI.

Blood Tests

After a doctor completes an imaging test, they may perform a series of blood tests. Doctors’ primary blood tests for 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® received 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 within the body.

Specific Tests During the Diagnostic Process

When navigating the diagnostic process, these procedures may be spoken about or suggested, and it’s important to know the differences so you know exactly what you’re getting into. Additionally, people with mesothelioma may encounter terms like:

• Fine Needle Aspiration (FNA): A minimally invasive procedure using a thin needle to collect cells from a suspicious lump for microscopic examination.
• Thoracoscopy: A procedure where a thin, lighted tube is inserted through a small incision in the chest wall to visualize the internal organs and potentially collect tissue samples.
• Laparoscopy: Similar to thoracoscopy, but performed in the abdomen through a small incision for examining abdominal organs and collecting tissue samples.
• Thoracotomy: A surgical procedure involving an incision in the chest wall to directly access the lungs and surrounding tissues for diagnosis or treatment.
• Laparotomy: A surgical procedure involving an incision in the abdomen to access the abdominal organs for diagnosis or treatment directly.

Tissue Biopsies and Cell Types

A tissue biopsy is the highest-resolution (gold-standard) test for diagnosing mesothelioma or any other cancer. The test involves removing fluid or tissue to determine the disease’s presence. In cancer patients, biopsies allow a pathologist to determine the tumor type and whether it has moved to other regions of the body. When making a diagnosis, doctors will perform a biopsy to collect 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 a better prognosis.
Fibrous sarcomatoid	oval	Sarcomatoid cells account for about 15% to 20% of cases. This type is often more aggressive and spreads faster, resulting in a poorer prognosis.
Biphasic	Mix of tissue cell types	Between 20% and 30% of cases involve a mixture of epithelioid and sarcomatoid cells, which are much harder to treat than epithelioid cells.

The Stages of Mesothelioma

Mesothelioma cancer stages describes its initial location, the size of the tumors, and whether they have spread to other areas of the body. Cancers are typically staged from I to IV. Stage I represents the earlier stages of cancer. Unfortunately, most mesothelioma patients are diagnosed in the more 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 information as the other types are quite rare. The TNM system utilizes 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 staging process for mesothelioma in the chest (i.e., tumors in the pleural lining) is different from that for mesothelioma in the abdomen (tumors in the peritoneum) and mesothelioma 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 mesotheliomas (including peritoneal and pericardial) are very rare, even among cancers with an established staging system. Regardless, many doctors may still refer to the above staging system when discussing the spread of mesothelioma tumors.

Stage 1 – Can This Stage of Mesothelioma be Curable

Mesothelioma is the least advanced state during this stage 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 identified at this stage 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
• Very few symptoms are present
• There is a potentially curative treatment options given
• This stage has the 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. During this stage can often be treated with curative measures also, like chemotherapy, surgery, radiation, and immunotherapy. Stage 2 characteristics often include:

• Localized to one side of the body
• Some metastases to lymph nodes or nearby organs
• Mild symptoms that are often mistaken for other diseases
• Potentially curative treatment options are available
• The patient usually has a fair prognosis

Stage 3 – Can Stage 3 be a Terminal Cancer?

The third stage is when most people notice symptoms of mesothelioma. However, once people are diagnosed during this stage, tumors have usually spread to other parts of the body. This provides the patient with 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

Mesothelioma Prognosis

Overall, the prognosis for all types of this cancer is poor. Most people who are diagnosed only learn of their illness after it has metastasized to other organs, lymph nodes, and/or bones. Mesothelioma treatment options during the later stages (III and IV) are few, and there are no cure options.

Five-year survival rates measure cancer survival timelines. The rate is an average of all surviving patients five years after being diagnosed with mesothelioma. The average survival rate is 4-18 months after diagnosis, but there are some that lived longer than 10 years. The current 5-year survival rate for mesothelioma is 10%.

The American Cancer Society utilizes the Surveillance, Epidemiology, and End Results (SEER) database information. The SEER staging system is broken 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
Localized	20%
Regional	16%
Distant	8%
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 cancer stage 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 stages that have 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 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 innovative treatment options.

Chemotherapy Treatments

Chemotherapy uses cancer drugs to limit cell growth. Cytotoxic chemical substances either kill 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.

Immunotherapy Treatments

In 2020, the FDA approved the first set of mesothelioma immunotherapy treatment drugs. Immunotherapy is a unique treatment that uses the patient’s immune system to fight mesothelioma cells. With immunotherapy, the body is able to recognize better and, ultimately, eliminate cancer cells.

Radiation Treatments

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 are used to shrink tumors and prevent cancer recurrence and spreading. Radiation can provide many benefits to cancer patients.

Surgical Treatments

Traditional surgery usually removes cancerous tumors from the body. Medical professionals often perform surgery to diagnose cancer, eliminate tumors, and/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 treatment option.

Financial Assistance to Help with Treatment

There are many costs associated with cancer treatment. Those without health insurance may incur large sums of medical costs, while those with health insurance may still be unable to afford treatment costs. However, those with a cancer diagnosis may have access to several forms of financial assistance. There are numerous federal and state government programs that provide benefits to patients and their families. Additionally, many non-profit organizations provide financial assistance to help pay for co-payments, deductibles, and many other costs associated with cancer. The people who have developed this form of cancer due to some form of workplace exposure may also be eligible to file for legal compensation.

Top Mesothelioma Treatment Centers

Because mesothelioma is a rare form of cancer, many doctors and oncologists have not diagnosed or treated this type of patient. Additionally, many hospitals across the country can’t offer a wide range of new treatment options (such as CAR T-cell therapy). You may need to travel to another city or state to meet with a mesothelioma specialist. You may also consider entering a clinical trial to receive the newest treatment options, which are still under investigation.

Top Mesothelioma Doctors and Specialists

Surgeons, oncologists, radiologists, pathologists, and other experts specializing in asbestos-related treatment are often called mesothelioma doctors. Patients often choose to receive care from these specialists as they receive the highest level of knowledge and options. A specialist could provide patients with a better prognosis, access to earlier diagnoses, better treatment options, and clinical trials.

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 the new information about prognosis, treatment options, and recovery. It can be difficult to make many medical decisions, but several options can help you financially and legally.

After receiving a mesothelioma diagnosis, the focus should be on managing symptoms and improving your or your family member’s quality of life. Many treatment options are available, and experimental clinical trials are sometimes available for those who meet certain requirements.

While mesothelioma is an aggressive but slow cancer, receiving immediate medical attention and following a treatment plan can help patients live longer and experience a better quality of life. Doctors are continually refining their treatment approaches to improve outcomes for mesothelioma patients. This includes focusing on palliative care to manage pain and other symptoms, ensuring patients can maintain a good quality of life for as long as possible. This also goes for life post-treatment for those fortunate enough to beat the disease.

Financial and Legal Options

People who have been diagnosed with mesothelioma did not develop the disease naturally and are entitlted to certain legal rights. If you’ve been diagnosed, it’s quite possible that you were exposed to asbestos while at work or in your home. Workers’ compensation laws protect people who become ill from exposure while in the workplace. Other regulations and trust funds are available to protect retired senior citizens.

Bringing legal action against a company (or companies) responsible for asbestos exposure may result in financial compensation to cover the costs of cancer treatment and/or punitive damages in cases of wrongful death. 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

Most Common Mesothelioma Questions

We understand the complications a cancer diagnosis presents. If you have further questions regarding mesothelioma, ask a mesothelioma lawyer. Mesothelioma Hub has a full page dedicated to common mesothelioma questions to ask your doctor.

• 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.

Finding Emotional Support and Legal Resources

The mental health effects of a cancer diagnosis can be severe for patients as well as their families. Seeking the help of support groups and medicolegal resources may benefit those who need help coping with grief, handling legal challenges, and/or keeping up with a functioning 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. Our patient advocates can help support you with both emotional support resources and legal options.