pleural mesothelioma

 pleural mesothelioma 

What Is Pleural Mesothelioma?

Malignant pleural mesothelioma (MPM) is a cancer that develops in the lungs. Almost 75% of diagnosed mesothelioma cases form in the pleura, making it the most common of the four types.

The cause of pleural mesothelioma is exposure to asbestos fibers, which are inhaled into the lungs. It usually takes from 20 to 50 years for mesothelioma to develop after a person’s first exposure to asbestos. Because of this latency period, the disease usually affects people older than 75.

The average life expectancy for pleural mesothelioma is often less than 18 months, but it depends on many factors.

Although there is no cure for mesothelioma, some patients live much longer with treatments. Combining several treatments, such as surgery, chemotherapy and radiation therapy, has helped some people live for years. Clinical trials offer access to new treatments such as immunotherapy.

Pleural Mesothelioma Facts

Most common type of mesothelioma

• Forms on soft tissue covering the lungs

• Symptoms: Shortness of breath, chest pain, dry cough and fatigue

• Diagnostic Tools: Imaging scans and tissue biopsies

• Treatments: Chemotherapy, surgery, radiation therapy, immunotherapy and experimental therapies

• Life Expectancy: About 40% live at least one year

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What Causes Pleural Mesothelioma?

Asbestos causes pleural mesothelioma. After inhaling the mineral’s needle-like fibers, they tend to lodge in the lungs and gradually migrate into the pleural lining.

Over a long period of time, these fibers cause irritation, chronic inflammation and genetic changes that turn cells cancerous.

These cancerous cells grow fast and uncontrollably, threatening the organs around them.

Two layers make up the pleural lining. The outer layer lines the entire inside of the chest cavity (inside the ribs), and the inner layer covers the lungs.

A malignant tumor can develop on either layer and quickly spread to the other layer. As tumors develop on the pleural surface, they grow to form a mass around the affected lung. They also cause pleural fluid to accumulate in the chest cavity.

The combination of tumor mass on the lung and collection of pleural fluid prevents the lung from expanding, which causes breathing difficulties.

Symptoms of Pleural Mesothelioma

For many people, mesothelioma symptoms are not noticeable until the cancer is in a later stage.

• Shortness of breath

• Chest pain or painful breathing

• Persistent dry or raspy cough

• Coughing up blood

• Difficulty swallowing

• Pain in the lower back or rib area

• Unexplained weight loss and fatigue

• Swelling of the face or arms

• Night sweats or fever

• Lumps under the skin on the chest

Patients rarely mention weight loss and fatigue during their initial doctor visit. These symptoms may show if the cancer is advanced. Some patients develop swelling of the face or arms, back pain or nerve pain.

Pleural Mesothelioma Treatment Options

Standard pleural mesothelioma treatment options can include surgery, radiation therapy and chemotherapy.

Chemotherapy is the most common type of pleural treatment. A combination of treatments can be used, which is known as multimodal therapy, if a patient is diagnosed early. These treatments can improve symptoms, such as chest pain and breathing difficulties, and improve survival.

Patients can access these therapies at top cancer centers across the nation that specialize in pleural mesothelioma treatment.

Chemotherapy

The most common pleural mesothelioma treatment is chemotherapy. It uses one or more drugs, usually a combination of cisplatin or carboplatin and pemetrexed (Alimta), to kill cancer cells or prevent them from reproducing. Recent advances have improved how well patients respond to chemotherapy, but success rates remain low overall.

Surgery

Pleural mesothelioma patients diagnosed in the early stages benefit the most from surgery. The goal of surgery is to remove the cancer and prevent it from recurring as long as possible.

The two most common surgeries for pleural mesothelioma are the extrapleural pneumonectomy and pleurectomy and decortication. A pleural mesothelioma specialist can determine if you are eligible for surgery and advise you on which procedure may be the best option for your diagnosis.

Extrapleural Pneumonectomy

A more aggressive surgical option, the extrapleural pneumonectomy removes the pleura, the entire cancerous lung, the diaphragm and the heart sac (pericardium).

Pleurectomy and Decortication

A pleurectomy and decortication, or radical pleurectomy, involves removing the tumors and affected pleura (lining of the lung).

Radiation Therapy

Targeted radiation can destroy cancer cells and decrease tumor size. Radiation therapy cannot cure pleural mesothelioma, but it is an effective way to manage chest pain. Radiation can also help prevent cancer recurrence after surgery.

External beam radiation therapy is the most common form of radiation therapy for pleural mesothelioma. Sessions are fast, painless and only take a few minutes.

Emerging Treatments

Emerging treatments include the use of immunotherapy, gene therapy and photodynamic therapy to treat pleural mesothelioma. These treatments are designed to fight cancer more effectively, while causing fewer side effects for the patient.

You may be able to receive an experimental therapy through a pleural mesothelioma clinical trial. Some patients may be eligible for immunotherapy drugs and other emerging treatments through compassionate use programs.

Pleural mesothelioma is a cancer of the lining of the lungs, known as the pleura. It is caused by inhaling asbestos fibers. Malignant pleural mesothelioma accounts for 80 – 90% of all mesothelioma diagnoses. Symptoms of pleural mesothelioma include shortness of breath, dry cough and chest pain. 

What Is Pleural Mesothelioma?

Pleural mesothelioma is a type of cancer caused by asbestos fibers becoming embedded in the lining of the lungs. Over time, the fibers may cause inflammation and scarring. As the scarring worsens, it may develop into mesothelioma tumors.

Pleural malignant mesothelioma is the most common form of mesothelioma cancer.

Each year, about 2,500 people are diagnosed with the disease.

Symptoms of the cancer commonly include shortness of breath, chest pain, dry cough and fatigue.

Diagnosis typically consists of multiple tests, including scans and biopsies.

Pleural mesothelioma is often treated with chemotherapy, surgery, radiation therapy and immunotherapy.

A patient’s prognosis will vary depending on their individual case, with an average life expectancy of six to twelve months.

02. PROGNOSIS

What Is the Prognosis for Pleural Mesothelioma?

As with all types of malignant mesothelioma, prognosis for pleural malignant mesothelioma is poor. For patients who do not receive treatment, the median survival time is six months. However, certain types of treatment can improve life expectancy, such as surgery combined with chemotherapy.

Pleural Mesothelioma Survival Rates

1 year after diagnosis 73%

3 years after diagnosis 23%

5 years after diagnosis 12%

10 years after diagnosis 4.7%

The most important factors affecting the prognosis of pleural malignant mesothelioma patients are:

Cell type (histopathology)

Stage of the cancer

Patient’s gender and age

Most pleural mesothelioma patients are diagnosed with the epithelioid cell type, which is the most common. Epithelioid cells typically form in solid sheets or cord arrangements, meaning they adhere closely together and don’t metastasize as quickly. They are also the most responsive to treatment. Typically, pleural mesothelioma patients with the epithelioid cell type survive 19 months.