Pleural Mesothelioma Question & Answers

What is malignant pleural mesothelioma?

Malignant pleural mesothelioma is caused when asbestos fibers or dust is inhaled and sticks in the pleura tissue that coats the lungs and chest cavity.

These fibers can cause irritation in the tissue, resulting in pleural plaques, diffuse pleural thickening, pleural effusion, and other conditions.

Malignant pleural mesothelioma does not typically develop until 15 to 60 years after a person was exposed to asbestos.

Why is malignant pleural mesothelioma the most common type of mesothelioma?

Most people are exposed to asbestos when fibers from asbestos-containing materials become airborne. This could happen when cutting, sanding, drilling, filing, or otherwise disturbing these dangerous materials. In the past, some workers also were exposed to raw asbestos, which was mixed with other materials to form products such as asbestos cement.

Airborne asbestos fibers could easily drift across an entire worksite, putting everyone in the vicinity at risk, not just those who were working directly with the material. This widespread exposure risk makes pleural mesothelioma the most common type of the disease.

Is the stage assigned to my pleural mesothelioma important?

Yes. An accurate staging of your disease is needed to determine your prognosis and most effective treatment(s).

The treatment options are typically based on the extent of the cancer, which is determined by staging.  A localized cancer would be identified as Stage 1, for example, and can involve a surgically removable tumor.  Once the cancer cells have spread beyond that original location, and a higher stage level is designated, the mesothelioma is considered advanced and surgery is often no longer an option.

The most popular staging system used for pleural mesothelioma is the TNM System developed by the International Mesothelioma Interest Group. The letters TNM stand for Tumor, lymph Node, and Metastasis. This system is similar to the staging systems used for other cancers and can be summarized as follows:

• Stage I. In Stage I mesothelioma, one side of the chest’s pleural lining (the pleura) has tumors. The cancer has spread to the outer lining of the lungs, but it is minimal. Cancer has not spread to the lymph nodes.
• Stage II. Stage II mesothelioma is characterized by tumors on one side of the pleura. Tumors have spread to the outer lung lining, the diaphragm, or the lung itself.
• Stage III. In Stage III mesothelioma one side of the pleura has tumors, and tumors have spread to the first layer of the chest wall, a single spot in the chest wall, the chest’s fatty parts, the heart‘s outer layer, or any lymph nodes on the same side of the chest as the primary cancer.
• Stage IV. Stage IV mesothelioma is found on one side of the pleura in addition to any of the following areas: the pleura on the other side of the chest, the chest wall, chest organs or any other organs in the body, the diaphragm, blood vessels, the spine, the nerves leading to the arm, or the lymph nodes on the opposite side of the primary cancer site.

Although the stage of the cancer is important in determining a patient’s prognosis, additional factors are also important when assessing life expectancy. The patient‘s age at disease diagnosis, status as a smoker or non-smoker, mesothelioma type, the length of time between asbestos exposure and the onset of symptoms, a patient‘s overall health, and other factors all play a role in patient outlook.

What is pleural effusion?

Pleural effusion is the accumulation of fluid around the lungs. When the fluid contains cancer cells, it is known as malignant pleural effusion.

Fluid buildup restricts the natural movement of the lung, resulting in shortness of breath, a feeling of tightness in the chest, and pain. Pleural effusion is not a disease; it is a complication of an underlying disorder.

Most pleural mesothelioma patients have pleural effusion. To treat the buildup of fluid, a procedure called thoracentesis is performed. This must be done before further treatment can be administered. Draining fluid from the pleural cavity usually provides immediate relief of unpleasant symptoms.