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Pleural Mesothelioma

Of the many varieties of asbestos cancers, pleural mesothelioma accounts for up to 80 percent of all diagnoses, or about 2,000 patients a year. This form of the disease attacks the pleural membrane, which is the covering that protects and lubricates the lungs and chest cavity.

Mesothelioma, also known as asbestos cancer, is a rare form of cancer with no known cure. There is a growing body of research into the disease and new treatments. This means that patients who are diagnosed today have a much better chance at recovery than those who were diagnosed decades ago.


The first symptoms for many patients are a cough that won’t go away, a low-grade fever and general malaise. Often, many patients will see their general practitioner at first for answers. Typically, the first diagnosis may be bronchitis or pneumonia. When the antibiotics don’t work, many patients will move to a specialist with more experience in advanced lung disease. After the first chest X-ray, the doctors usually see the build up of fluid in the lungs, called a pleural effusion, and order more advanced tests.

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When any advanced lung disease is suspected, doctors will run a battery of tests. These tests include CT scans, MRIs and PET scans. Each of these non-invasive tests give doctors a better view of the cancer and the types of cells involved. Doctors may also use a biopsy to remove cell samples and determine the advancement of the disease.


When compared to other types of asbestos-related cancers, pleural mesothelioma patients generally have a better prognosis. That’s because pleural mesothelioma is the most common of the mesothelioma varieties. That means that more research and funding is put into the disease and more doctors specialize in its cure. There are also other factors that make a pleural mesothelioma prognosis more positive:

  • Cell Type - Epithelial cell types account for more than 50 percent of pleural mesothelioma cases. Epithelial cells are known to be uniform in size, shape and configuration, allowing for easier treatment.
  • Disease Stage - Disease Stage - When pleural mesothelioma is diagnosed in the early stages (stages I and II), doctors are able to perform more radical life-saving techniques. Advanced stage disease, including stages III and IV, are more difficult to treat and eradicate.
  • Overall Health of the Patient - Patients who are generally healthy, younger and do not have other medical conditions are better able to undergo pleural mesothelioma treatment.


In most mesothelioma cases, doctors recommend the conventional treatments, which is chemotherapy, surgery or radiation, or a combination of these treatments. In some cases, these are used to eradicate the disease and in other cases they are used to relieve pain, or for palliative measures.

There are also progressive treatments that have been used with great success:

  • Extrapleural pneumonectomy - Pioneered by Dr. David Sugarbaker, this procedure removes the damaged lung, lining around the lung and heart and surrounding lymph nodes. This procedure is known to control tumor growth and can improve a patient’s life expectancy by months or years. In some cases, it has been curative. Some doctors say the procedure is too radical.
  • Pneumonectomy - In this procedure, only the damaged lung isremoved. This can help control or prevent the spread of cancerous cells.
  • Pleurodesis - Used to treat pleural effusion, which is a build upof excess fluids in the chest, this is not meant to be a curative treatment. It can help relieve symptoms that include chest pain and shortness of breath. The procedure closes the space between the linings of the lungs, closing the area where fluids accumulate.

In addition, there are several treatments that are considered new and emerging:

  • Immunotherapy - This uses the body’s defenses to attack cancer cells by enhancing the immune system. It is only available through clinical trials.
  • Photodynamic therapy - After patients are injected with a photosensitizing drug, doctors use a specialized light to kill reactive cancer cells. In clinical trials, this has been found to improve the life expectancy of pleural mesothelioma patients.
  • Cryotherapy - This allows doctors to selectively freeze anddestroy tumors while leaving surrounding healthy tissue undamaged.

It’s important to ask your doctor about all available treatments and clinical trials. They will give you the best chance of success.


Brigham and Women’s Hospital. International Mesothelioma Program. Retrieved from http://www.brighamandwomens.org/Departments_and_Services/surgery/services/thoracicsurgery/Services/mesothelioma/Default.aspx

Sugarbaker, David., et al. “Surgery for malignant pleural mesothelioma. U.S. National Library of Medical National Institute of Health. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20524919