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Malignant Mesothelioma

Malignant mesothelioma is a type of cancer that is both rare and aggressive. It is most often caused by repeated exposure to asbestos, although not everyone exposed to it will develop this type of cancer. The most common form of mesothelioma is called pleural and it attacks the lining of the lungs. Other types are less common, but may be just as deadly.

All types of malignant mesothelioma are cancers of the mesothelium, a thin, double layer of tissue that covers most organs in the body. In addition to the pleura, this kind of cancer may attack the peritoneum, which lines the organs in the abdominal cavity; the pericardium, which lines the heart; and most rare of all it may attack the lining of the testicles. While there are treatment options available, malignant mesothelioma is often caught late and when it is not curable.

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Asbestos and Malignant Mesothelioma

Asbestos is the leading risk factor for malignant mesothelioma. It has been used for thousands of years, but only in large quantities in the last couple of centuries.

Asbestos has been used to insulate homes, to strengthen materials like cement and glue, and in many applications in shipping. Asbestos is made up of small fibers, which can easily be inhaled if they become airborne. When asbestos is well-contained within a material, it poses no danger. When it becomes disturbed, however, the fibers can come loose from the bulk of the material and cause harm.

Anyone who spent a career working around or with asbestos is at risk for malignant mesothelioma. Inhaling the fibers causes them to become lodged in tissues where they cause damage. Over many years this can lead to cancer and other illnesses. In most cases the damage accumulates, without any apparent symptoms for decades. Misdiagnosis and late diagnosis is common.

Types of Mesothelioma

Malignant mesothelioma can be one of a few different types, all affecting the tissue called the mesothelium. All types are difficult to diagnose and most often impossible to cure. Treatments are focused on extending life and giving patients relief from symptoms.

  • Pleural Mesothelioma.
    This type of malignant cancer affects the pleura around the lungs and is the most common form of mesothelioma. It is most common because exposure to asbestos mostly occurs through inhalation. When breathed in, the fibers get embedded in the pleura and cause damage and eventually cancer.
  • Peritoneal Mesothelioma. This is the second most common type of malignant mesothelioma and it impacts the lining of the abdomen. Inhaled particles of asbestos may travel to the abdomen, but it is also possible that fibers settle as dust and get accidentally ingested.
  • Pericardial Mesothelioma.
    The pericardium is the lining around the heart and if asbestos fibers migrate to this part of the chest cavity, a rare type of mesothelioma may develop. There are only about 200 known cases of pericardial mesothelioma.
  • Testicular Mesothelioma.
    The rarest of all types of mesothelioma occurs when the malignancy begins in the lining around the testicles. Although it is a malignant tumor, this type is much more treatable than any other type of mesothelioma. Surgery is usually curative for patients.

Symptoms

One reason malignant mesothelioma is so deadly is that early symptoms of the cancer are mild and similar to symptoms of more common illnesses. It often takes decades for someone with this type of cancer to be diagnosed because of the symptoms, which vary by type of mesothelioma.

Pleural mesothelioma is characterized by:

  • A persistent cough.
  • Chest pains.
  • Wheezing.
  • Shortness of breath.

Symptoms of pericardial mesothelioma are similar to those of the pleural form, while peritoneal mesothelioma causes:

  • Swelling.
  • Abdominal pain.
  • A feeling of fullness and distension.
  • Bowel obstructions.
  • Constipation.

Testicular mesothelioma most often causes a lump that is the typical first sign of the illness. Because there have only ever been about 100 cases of this type, there is no comprehensive list of typical symptoms.

Diagnosis

Diagnosis of malignant mesothelioma often comes too late for treating the cancer effectively. A person may experience mild symptoms for years without realizing it is cancer or may be misdiagnosed with something like chronic obstructive pulmonary disorder, heart disease, or irritable bowel syndrome.

After a general physical exam and medical history, a doctor will most likely try to rule out these more common illnesses. If cancer is suspected, the next step is typically to have imaging scans done to look for the presence of tumors. CT scans, MRIs, PET scans, and X-rays can all be used for this purpose, alone or in combination.

If tumors are found, the next steps in diagnosing the type of cancer is to biopsy it and remove a sample of cells. These can then be examined to determine the origin of the tumor and whether it is mesothelioma or another type of cancer. This is not always accurate, and misdiagnoses can still be made at this stage.

A part of diagnosing malignant mesothelioma is staging. Staging is a way to describe the progression of cancer and it allows doctors to plan the appropriate treatments. Unfortunately mesothelioma is often diagnosed in the later stages, when it has spread throughout the chest cavity or even out to further locations in the body.

Malignant Mesothelioma Treatment

After a diagnosis a patient will have to make treatment choices as guided by a medical team. Treatment options depend on the type of mesothelioma, location and spread of tumors, the state, and overall patient health. A typical strategy is to use some combination of surgery, chemotherapy and radiation therapy.

Few patients diagnosed with malignant mesothelioma will benefit from a curative treatment, such as surgery. Because it is so often advanced when diagnosed the cancer is usually treated with slowing the spread in mind, not a cure. Relieving symptoms and extending life span are the typical goals of treatment.

Prognosis for Malignant Mesothelioma

Multiple factors play a role in determining a prognosis for a patient with mesothelioma. The stage of the disease, the location in the body, the extent of the tumor, and even lifestyle habits of the patient will affect the outcome. Most patients with mesothelioma will not get a very positive prognosis. The cancer tends to spread aggressively and many patients will be given a life expectancy in months rather than years.

Finding the Best Treatment

Malignant mesothelioma is a rare type of cancer, and not even a great cancer center will have an expert in mesothelioma. If you suspect you may have this type of cancer, start with your regular doctor or internist. If your doctor can rule out more common illnesses you may then need to see a specialist.

With a diagnosis of mesothelioma you should seek out a specialty treatment center or a specialist in mesothelioma. Before you settle on one make sure you ask questions and get the answers that make you feel comfortable. If you ever get a diagnosis or treatment plan that you are unsure of, get a second opinion.

There are several cancer centers in the U.S. that specialize in mesothelioma research and treatment, and you may have to travel to get access to them. But, at these facilities you will get the best experts in malignant mesothelioma, as well as cutting edge treatments. Many of these cancer centers participate in clinical trials. This means you may have the chance to try the latest and most innovative treatments. These come with risks, but the benefits could be great.

Malignant Mesothelioma Lawsuits, Trust Funds, and Settlements

Getting a diagnosis of malignant mesothelioma is devastating. Thousands of people will find out they have this type of cancer and that they never realized they were being exposed to dangerous asbestos at work. The shortened life expectancy is bad enough, mesothelioma patients also face major expenses for treatment.

If you are facing mesothelioma treatment and you think your workplace was the cause of asbestos exposure, you have options for seeking compensation to help with treatment and other expenses.

Many companies have set up asbestos trust funds to help fund new cases of mesothelioma as they are diagnosed. You may also be able to start a lawsuit if your employer does not have a trust fund, or if you think the manufacturer of a product you worked with is to blame. Many people have received generous settlements for malignant mesothelioma and have gotten the money they need to pay for treatment and end-of-life care.

Veterans and Mesothelioma

Some of the people most affected by asbestos exposure and this malignant mesothelioma are U.S. military veterans, especially those that served in the U.S. Navy. Ships built up to the mid-1970s used asbestos heavily and in many materials. Many sailors were exposed.  Veterans getting a diagnosis today of malignant mesothelioma have options for treatment and benefits.

Veterans may seek care at Veterans Affairs hospitals, including the hospital in Los Angeles that partners with the Pacific Mesothelioma Center. Here there are experts in mesothelioma treatment that can help affected veterans. Veterans also have access to monetary benefits, including special monthly compensation, dependency and indemnity compensation, and disability compensation.

If you have been diagnosed with malignant mesothelioma, you were probably exposed to asbestos. Someone, like an employer or asbestos material manufacturer, may be to blame for that. Whether you were in construction, worked on ships, or worked in another industry, you probably didn’t realize that you were at risk for this terrible type of cancer. Let a mesothelioma lawyer help guide you and figure out what your next steps should be.

Page Edited by Dave Foster

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Dave has been a mesothelioma Patient Advocate for over 10 years. He consistently attends all major national and international mesothelioma meetings. In doing so, he is able to stay on top of the latest treatments, clinical trials, and research results. He also personally meets with mesothelioma patients and their families and connects them with the best medical specialists and legal representatives available. Connect with Patient Advocate Dave Foster

Page Medically Reviewed and Edited by
Luis Argote-Greene, MD

Luis Marcelo Argote-Greene, MD
Luis Argote-Greene is an internationally recognized thoracic surgeon. He has trained and worked with some of the most prominently known thoracic surgeons in the United States and Mexico, including pioneering mesothelioma surgeon Dr. David Sugarbaker. He is professionally affiliated with University Hospitals (UH). His areas of interest and expertise are mesothelioma, mediastinal tumors, thoracic malignancies, lung cancer, lung transplantation, esophageal cancer, experimental surgery, and lung volume reduction. Dr. Argote-Greene has also done pioneering work with video-assisted thoracoscopic surgery (VATS), as well as robotic assisted minimally invasive surgery. He has taught the procedures to other surgeons both nationally and internationally.

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