What Is Mesothelioma?

Mesothelioma, frequently referred to as malignant mesothelioma, is a rare and aggressive cancer with a very poor prognosis. Although there is no known cure for mesothelioma, treatment therapies and techniques have greatly improved over the last several decades, offering hope to those diagnosed.

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Causes of Mesothelioma

The only known cause of mesothelioma cancer is exposure to asbestos, but there are a variety of other risk factors that can increase the likelihood of developing the disease. If someone is in the presence of airborne asbestos fibers, the fibers can be inhaled or swallowed, becoming embedded in the lining of the lungs, abdomen or heart. They then irritate the organs’ delicate linings, leading to scarring and inflammation which can potentially mutate over time and result in the growth of harmful tumors.

Asbestos Exposure Prevention

Asbestos exposure has most commonly occurred in the workplace, especially for industrial jobs like construction sites, factories, power plants, shipyards, and oil refineries. Workers in these occupations tend to have a much higher risk of developing mesothelioma than others.

The harmful material has also been found in dorm buildings, homes, schools, and everyday products. Take caution when handling any known products that contain asbestos, and contact a certified asbestos contractor to safely handle any removal or cleanup.

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Mesothelioma can take many years to develop, leaving patients without any noticeable symptoms until about 20 – 50 years after exposure to asbestos. This long latency period can complicate diagnosis, especially if patients don’t know whether or not they were exposed to the cancer-causing material.

Diagnosing Mesothelioma

Since early symptoms are nonspecific, mesothelioma patients are often misdiagnosed with other diseases and conditions. For example, many malignant pleural mesothelioma patients are told they have pneumonia based on similar symptoms.

Types of Mesothelioma and Common Mesothelioma Symptoms

Although symptoms may not be a clear indication of what type of mesothelioma a patient has, they can help guide medical care providers towards diagnosis. There are three types of mesothelioma, each different in location and common symptoms. Pleural mesothelioma is the most common, and therefore has a higher rate of diagnosis. While all types of mesothelioma are rare, peritoneal and pericardial mesothelioma have a very small number of diagnosed cases and often are mistaken for other diseases and conditions. Early detection of symptoms is key to ensuring accurate diagnosis, a wide range of treatment options and longer life expectancy.

Mesothelioma Symptoms by Type

Pleural MesotheliomaPeritoneal MesotheliomaPericardial Mesothelioma
Location: lung linings

Symptoms:

  • Chest pains or achiness
  • A persistent cough
  • Fluid buildup in the lungs (pleural effusion)
  • Difficulty swallowing
  • Sudden or unexplained weight loss
  • Extreme tiredness or ongoing fatigue
  • Fever and night sweats
Location: abdominal lining

Symptoms:

  • Abdominal pain and/or swelling
  • Unexpected or unexplained weight loss
  • Bowel obstruction
  • Buildup of fluid around the abdomen (ascites)
  • Anorexia or loss of appetite
  • Iron deficiency/anemia (most common in women)
  • Nausea
  • Fever
Location: heart lining

Symptoms:

  • Heart murmur, irregular heartbeat, or palpitations
  • Buildup of fluid around the heart (effusion)
  • Difficulty breathing/extreme shortness of breath (dyspnea)
  • Tightness or pain in the chest
  • Fever and night sweats

Mesothelioma Diagnostic Tests

In order to pinpoint if a patient has mesothelioma, there are a variety of diagnostic tests that he or she must go through, including imaging tests, blood tests and biopsies. Biopsies in particular are crucial, as the only way to definitively diagnose mesothelioma cancer, paving the way to determining stage and best treatment options.

  • Imaging tests: Visual insight from X-rays, MRI scans, CT scans, and PET scans
  • Blood tests: Test for biomarkers Mesothelin, Osteopontin, N-ERC/Mesothelin, HMGB1, and Fibulin-2
  • Biopsies: Examination of body tissues via fine-needle aspiration, minimally invasive biopsy or open surgery biopsy

Stages of Mesothelioma

As part of the diagnosis, doctors will determine the stage of mesothelioma, which can help patients get a better understanding of what to expect with symptoms, treatment options and general life expectancy. Staging is determined by whether or not the cancer has already spread or metastasized and how distant the spreading has become.

Mesothelioma Stage Characteristics

Stage 1
  • Disease is localized
  • Lymph nodes unaffected
  • No metastases
  • Best options for treatment, including surgery
  • Average life expectancy: 21+ months
Stage 2
  • Disease is localized
  • Lymph nodes unaffected
  • No metastases
  • Tumor has grown deeper into pleural surfaces, and into the diaphragm or lung
  • Potential for surgery and other treatment options
  • Average life expectancy: 19 months
Stage 3
  • Disease is no longer localized
  • Lymph nodes on the side of origin could be affected
  • No metastases
  • Tumor has grown into the deeper pleural surfaces
  • Potential tumor growth in chest wall, thoracic fascia, sac surrounding the heart or in mediastinal fat
  • Limited treatment options
  • Average life expectancy: 16 months
Stage 4
  • Disease has spread
  • Tumor cannot be addressed with surgery
  • Lymph nodes on opposite side of origin are affected or distant metastasis has occurred
  • Average life expectancy: around 12 months

Mesothelioma Survival Rate and Life Expectancy

9%
of patients face a life expectancy of 5 years or longer.

Mesothelioma has a very poor prognosis, with most patients facing a life expectancy of only about 1 year, and only 9% of patients expected to survive 5 years or longer. There are many factors that impact survival rate, including the stage classification, cancer location, cell type, and patient characteristics.

In terms of patient characteristics, age, gender, genetics, overall health, a history of smoking and blood counts can all play a role in shortening or lengthening life expectancy. For instance, those diagnosed at a younger age have a longer rate of survival than elderly patients, and women also generally experience a longer life expectancy than men.

Treatment of Mesothelioma Cancer

There are three main types of conventional mesothelioma treatment. In many cases, multimodal treatment (using more than one type of therapy) is the most effective approach. The three common options include:

There is no simple answer for mesothelioma treatment, and many different factors must be considered when establishing a treatment plan, including age, overall health and staging. The patient’s medical team will use the patient’s history, diagnosis and current health information to advise towards the best possible treatment options and educate the patient’s decision of what, if any, treatment to pursue.

Conventional Treatments

The three traditional modes of mesothelioma treatment are surgery, chemotherapy and radiation. Mesothelioma surgery aims to remove as much of the cancer as possible, including tumors and affected organ tissues. This is usually only a viable option at early stages of the disease, before it has spread throughout the body (metastasized). Chemotherapy can be used in addition to surgery, or as a standalone treatment, killing fast-growing mesothelioma cells. The types of surgeries and chemotherapy drugs available will differ based on the diagnosed mesothelioma type.

Treatment Options by Mesothelioma Type

Pleural MesotheliomaPeritoneal MesotheliomaPericardial Mesothelioma
SURGERIES
  • Pleurectomy – Removal of lung lining (pleura)
  • Pneumonectomy – Removal of an entire lung
  • Extrapleural Pneumonectomy – Removal of an entire lung, plus some surrounding tissue
  • Peritonectomy – Removal of the abdominal lining (peritoneum)
  • Cytoreduction/Debulking – Removal of tumors from abdominal organs, including possible removal of certain organs altogether
  • Pericardiectomy – Removal of the heart lining (pericardium)
CHEMOTHERAPY
  • Avastin + Cisplatin – combination of drugs used to slow or stop cancer growth
  • HIPEC (Hyperthermic intraperitoneal chemotherapy) – heated chemo applied directly to cancer cells
  •  Avastin + Cisplatin – combination of drugs used to slow or stop cancer growth

Radiation is the third type of traditional treatment that is typically only used as part of multimodal treatment. Mesothelioma radiation therapy is localized, targeting a particular area of cancer cells to stop growth or shrink tumor size. This technique is dangerous with a potential to damage other vital parts of the human body, especially sensitive organs affected by mesothelioma. External beam radiation and internal radiation are the two traditional modes, while other, less common therapies, such as 3D-CRT, IMRT, and Intraoperative radiation may be options.

With all types of treatment, it’s important to note the wide range of potential side effects, including fatigue, change of appetite, nausea, vomiting, a decrease in white blood cells and many others. The patient’s health should always be taken into consideration with potential side effects.

Immunotherapy and Other Emerging Treatments

Some patients may not respond to traditional treatments and may be eligible to participate in clinical trials, experimenting with new treatment techniques with the aim to lengthen life expectancy.

In combination with chemotherapy or surgery, immunotherapy can greatly alleviate symptoms and increase survival rates for mesothelioma patients. This therapy boosts the patient’s immune system to fight the cancer. Immunotherapy is currently only available through clinical trials, but has shown success towards becoming a first-line treatment option. Bevacizumab (Avastin) and Pembrolizumab (Keytruda) in particular are two monoclonal antibodies that have helped pave a successful path for immunotherapy drugs, while many others also show promise.

Other popular treatments that are continuing to develop include gene therapy, p35 gene therapy, epigenetic therapy, photodynamic therapy, mesothelioma virotherapy and cryotherapy. With continued research towards finding a cure for mesothelioma, the list of emerging treatments grows.

Palliative Care

Physical therapy, massage, meditation, yoga, acupuncture and art therapy are all palliative treatment options that can be used in addition to other modes of treatment or on their own as alternative care methods. The goal of palliative care is to help manage the stressors and discomforts associated with cancer for those actively fighting the disease, or for those that have chosen to forgo treatment. Palliative care is also especially common for stage 4 mesothelioma patients, helping nurture their physical, emotional, mental and spiritual health needs.

Other Points for Mesothelioma Patients to Consider

If you or a loved one have recently been diagnosed with mesothelioma, there are a variety of other points to consider, aside from staging and treatment options.

Treatment and Care Costs

All forms of treatments and medical care come with a cost, and bills can pile up. From prescription medications to doctors’ bills and secondary costs of treatment like travel and lodging, mesothelioma patients often struggle financially. Understanding the cost of therapies, medications, copays, travel fees and home care can help patients plan accordingly.

Legal Assistance for Mesothelioma Patients and Their Families

Since mesothelioma is known to be caused by exposure to asbestos, patients may be able to take legal action and gain some type of compensation for their struggle, like taking action against a past employer allowing exposure to asbestos. Look into all of your legal options and get in touch with a professional that will ensure you get the help you deserve.

Support for Mesothelioma Patients

Mesothelioma can be a scary diagnosis for individuals, and if you’ve recently been diagnosed, know that you have a support system. There are medical professionals trained specifically for addressing the disease, and they can provide you with the best advice and treatment options available. Researchers, cancer centers and organizations such as the American Cancer Society and National Cancer Institute are also fighting to find a cure and raising awareness around the world. With these supports as well as the care of friends and family and hope from survivors, there are many resources patients can rely on as they go through their treatment journey

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