Mesothelioma (mez´-o-thee´-lee-oh´-muh) is a rare but aggressive cancer that affects the thin layer of tissue (mesothelium) that lines your lungs, abdomen, heart, and other organs. Mesothelioma most often affects the tissue that surrounds the lungs (pleura).
About 3,000 cases of mesothelioma are diagnosed in the United States each year, according to the American Cancer Society.
In the US, the disease is more common in men, whites, and Hispanics/Latinos. Mesothelioma is typically diagnosed when the patient is between the ages of 50 and 70.
The main cause of mesothelioma is believed to be repeated exposure to asbestos, a naturally occurring group of minerals that is made up of tiny fibers and is found in soil and rocks around the world. When asbestos fibers are in the air and you breathe them in, they can get caught in your lungs. It usually takes 20 years for mesothelioma to develop after exposure.
Asbestos was previously used to make fireproof materials, such as theater curtains, insulation, flooring, and workers’ gloves. Although the use of asbestos has dramatically decreased over the past few decades, it is still used in some products. People at the highest risk for asbestos exposure in the workplace include miners, factory workers, plumbers, and construction workers.
Living with a person who works near asbestos is also a risk factor for malignant mesothelioma because asbestos fibers some times are brought home on clothes.
Some research has found a link between mesothelioma and a monkey virus in a polio vaccine that was given between 1955 and 1963.
Pleural mesothelioma affects the lining of the lungs (pleura). Symptoms include:
For people with known exposure to asbestos, some doctors recommend initial screening with blood tests and imaging tests, such as chest radiography (X-rays) and computed tomography (CT scans).
Chest x-ray showing a benign fibrous tumor of the pleura
CT scan revealing a pleural tumor
If these tests indicate mesothelioma is likely, the only way to confirm the disease is through a biopsy, which involves the removal of fluid or tissue that will be examined under a microscope.
Depending on what area of your body is affected, your doctor will select the right biopsy procedure for you. Options include:
Once mesothelioma is diagnosed, your doctor will order additional tests—likely more imaging tests such magnetic resonance imaging (MRIs) and/or positron emission tomography (PET scans)—to determine the extent, or stage, of the cancer.
There currently is no cure for advanced stage mesothelioma.
Your treatment will vary depending on the type of mesothelioma you have and how much it has progressed. If your disease is caught early, you will have a better chance for survival. If your disease is in an advanced stage, the 5-year survival rate is only about 10%. Based on these factors, your treatment options may include surgery, radiation therapy, and/or chemotherapy.
If surgery is recommended, a cardiothoracic surgeon may perform one of the following procedures to either remove all of the disease or ease the symptoms.
Surgery to remove one lung, the affected chest lining, the diaphragm, and the lining of the heart. The diaphragm and heart lining are then reconstructed with man-made materials.
Surgery to remove the lining of the chest cavity and one lung, as well as part of the lung surface. This preserves the lung.
A surgical procedure that is similar to a P/D, but removes less tissue and still preserves the lung.
As with any surgical procedure, operations used to treat mesothelioma can have serious risks and side effects, although these depend on the extent of the surgery and the person’s health beforehand.
Serious complications of any of the surgeries can include bleeding, blood clots, wound infections, changes in heart rhythm, pneumonia, fluid buildup in the chest, and loss of lung function.
Most of these symptoms are less common with less extensive operations.
Because the surgeon must often spread the ribs during surgery, the incision will hurt for some time afterward. Your activity may be limited for at least a few months if not more.