Pleural mesothelioma is a malignant cancer that develops on the lining of the lungs called the pleura. It is the most common type of mesothelioma. Although the prognosis is typically poor, finding a pleural cancer specialist can diversify your treatment options and help improve your prognosis.
Pleural mesothelioma accounts for about 75 percent of all mesothelioma cases. Like other types of mesothelioma, this particular form of the disease gets its name because of where it is formed — in the pleura, a soft tissue that surrounds the lungs. In almost all cases, pleural mesothelioma is caused by asbestos exposure.
The first symptoms of pleural mesothelioma typically include chest pain and shortness of breath. You may experience no symptoms at all in the first few stages of the cancer’s progression.
The life expectancy of someone with pleural mesothelioma is less than 18 months, but some patients live much longer. It often takes decades (20 to 50 years) for mesothelioma to develop after someone is first exposed to asbestos. This lag time — called a latency period — explains why the disease usually affects older people.
Pleural mesothelioma accounts for about 75 percent of all mesothelioma cases. Like other types of mesothelioma, this particular form of the disease gets its name because of where it is formed — in the pleura, a soft tissue that surrounds the lungs. In almost all cases, pleural mesothelioma is caused by asbestos exposure.
The first symptoms of pleural mesothelioma typically include chest pain and shortness of breath. You may experience no symptoms at all in the first few stages of the cancer’s progression.
The life expectancy of someone with pleural mesothelioma is less than 18 months, but some patients live much longer. It often takes decades (20 to 50 years) for mesothelioma to develop after someone is first exposed to asbestos. This lag time — called a latency period — explains why the disease usually affects older people.
What Are Pleural Mesothelioma Symptoms?
Symptoms of pleural mesothelioma include persistent dry or raspy cough, coughing up blood (hemoptysis), shortness of breath (dyspnea), and difficulty swallowing (dysphagia). There are four stages of mesothelioma that doctors use to describe how far the cancer has progressed. For many people, unfortunately, symptoms are not noticeable until the cancer is in a later stage — stage III or IV.
Asbestos fibers can cause excess fluid to build up between the two layers of the pleura, a condition called pleural effusion. While a little fluid in your pleural space is important, too much can make breathing difficult. The extra fluid puts pressure on the lungs, causing chest pain that gets worse when you cough or take deep breaths.
In their first meeting with a doctor, a majority of pleural mesothelioma patients report chest pain and shortness of breath. Patients rarely mention weight loss and fatigue during their initial doctor visit, but these symptoms may be present if the cancer is in a later stage.
Diagnosis
Two layers of tissue make up the pleura. These tissues protect and support the lungs and other important structures of the chest. They also produce lubricating fluid between to help the lungs move smoothly as we breathe. The outer layer, the parietal pleura, lines the entire inside of the chest cavity. The inner layer, or visceral pleura, covers the lungs.
Mesothelioma commonly affects both layers of the pleura. The cancer generally forms in one layer of the pleura and rapidly invades the other pleural layer, diaphragm, chest wall or lung. If the cancer reaches nearby glands called lymph nodes, it can metastasize, or spread, to other parts of the body.
Non-cancerous conditions like pleural plaques and atelactasis can develop on the surface of the pleura as a result of asbestos exposure and these conditions are not associated with pleural mesothelioma. They don’t develop into cancer and they don’t increase the risk of developing lung cancer or pleural mesothelioma.
Diagram of Healthy Lung vs Diseased Lung
Pleural mesothelioma can be difficult to diagnose, since symptoms usually do not arise until long after the first exposure to asbestos. Since many diseases of the lungs and respiratory system have the same symptoms as pleural mesothelioma, doctors may mistake it for the flu or pneumonia.
Difficult to Confirm a Diagnosis
It is challenging for doctors to tell the difference between pleural mesothelioma and lung cancer. While doctors may suspect mesothelioma based on a patient's symptoms, history of asbestos exposure and irregular imaging scan results, these signs are not enough to confirm a diagnosis.
Reliable Ways to Diagnose
More reliable ways to diagnose the disease include thoracoscopy, which allows doctors to view the patient's chest through a small camera and collect a tissue biopsy, which doctors use to test tissue and fluid samples for cancerous cells.
With the introduction of the PET scan in the early 1960s, doctors could better distinguish between cancerous and non-cancerous growths on the pleura. While imaging plays an important role in staging mesothelioma and guiding treatment, it cannot be used to diagnose the cancer on its own.
