Pleural Mesothelioma Causes, Symptoms and Treatments

Quick Summary

Pleural mesothelioma is a rare and aggressive type of cancer caused by asbestos exposure. It affects the lungs' protective tissue lining and causes painful respiratory symptoms. While there is no known cure for pleural mesothelioma, treatment combinations can slow disease progression, improve quality of life and possibly extend survival.


If you’ve been diagnosed with pleural mesothelioma or suspect you might have it, here is what you need to know about this cancer type and how it affects your prognosis:

  • Only 3,000 new cases of mesothelioma diagnosed per year
  • Most common form of mesothelioma (80% of cases)
  • Is typically diagnosed in advanced stages
  • Doctors diagnose by stages from 1 to 4 based on how far it has spread
  • Combination treatments of surgery, chemotherapy, and radiation are the best way to control and treat pleural mesothelioma
  • Dozens of the world’s top medical specialists are available to help you now
  • Learn about all this and more in our FREE Mesothelioma Help Guide

What Is Pleural Mesothelioma?

Pleural mesothelioma is a cancer that forms in the tissue lining that covers and protects the lungs and chest cavity. It activates after someone has been exposed to asbestos and has inhaled the fibers into their lungs.

Mesothelioma has a long latency period, meaning the onset of symptoms doesn’t occur until 10-50 years after asbestos exposure.

Though there are only 3,000 cases of mesothelioma every year, pleural accounts for the vast majority of cases at 80%. These rates are significantly higher compared to other mesothelioma types that form in the peritoneum (abdomen) or the pericardium (heart).

Life Expectancy and Survival

The median life expectancy of pleural mesothelioma patients is 12-21 months but can improve significantly with treatment.

Nearly 40% of patients live longer than one year. Longer survival is largely attributed to high-quality, aggressive treatments and early intervention.


Asbestos is the only known cause of pleural mesothelioma. A toxic substance that was used extensively during the 20th century, asbestos is a fibrous material that releases microscopic shards into the air when disturbed. Anyone who handled asbestos at work, home or in school is at risk of having breathed in fibers.

Pleural Mesothelioma Update

Inhaled asbestos fibers travel down the airway and into the lungs where they lodge themselves into the pleura—the protective tissue lining that covers the lungs. Once inside, fibers can never be expelled. They remain trapped in the pleura, causing irritation and inflammation to healthy cells.

After 10-50 years of irritation, healthy pleural cells mutate into mesothelioma cells that grow and divide at unchecked rates. As they continue to divide rapidly, mesothelioma cells eventually form a mass (tumor). When pleural tumors grow large enough, they cause fluid buildup in the lungs (pleural effusions).

What Happens When Mesothelioma Tumors Spread?

Tumors metastasize (spread) and eventually reach the lymph nodes—the immune system’s filtration points. When the lymphatic system becomes compromised by mesothelioma cells, the immune system can no longer protect the body.

With the right treatment, doctors can limit mesothelioma tumors from spreading to these distant sites and extend a patient’s life.


Pleural mesothelioma forms in the lungs, so initially a person will experience symptoms of impaired breathing. Mesothelioma causes fluid and pressure to accumulate in the lungs, which causes other symptoms as well.

Common stage 1 and 2 symptoms include:

  • Chest pain
  • Difficulty breathing
  • Persistent, dry cough
  • Tightness in the chest
  • Unexplained weight loss

Mesothelioma Symptoms Update

Since mesothelioma is so rare, most family doctors are not familiar with screening for mesothelioma and can easily overlook early symptoms. That’s why knowing your history of asbestos exposure is key to linking your symptoms to a mesothelioma diagnosis so you can get life-extending treatment as early as possible.

As the disease progresses to stages 3 and 4, more severe symptoms will appear, including:

  • Audible fluid in the lungs when breathing
  • Back and shoulder pain
  • Coughing up blood
  • Fever and night sweats
  • Noticeable lumps under the skin in the chest area
  • Swelling of the face and arms

Initially, symptoms may be easy to confuse with other conditions like a cough or bronchitis. These vague, early-stage symptoms are what make this disease so difficult to detect.

What Treatments Are Right for Your Mesothelioma Diagnosis?

Mesothelioma is a complex disease requiring specialized treatments. The Mesothelioma Help Guide will explain your diagnosis and provide treatment options to improve prognosis.

Request Your Free Mesothelioma Help Guide Now

Disease Stages

Unlike other forms of mesothelioma (peritoneal and pericardial), pleural mesothelioma has an official staging system. Doctors use staging systems to identify how far the mesothelioma has spread. The disease stage informs specialists on how to best approach treatment so that the patient will get the most benefit.

Knowing how doctors stage the disease will help you better understand your diagnosis and how this disease progresses.

Pleural mesothelioma has 4 disease stages:

  • Stage 1: Mesothelioma is contained in the first layer of the pleura in one lung only. In stage 1, mesothelioma may also spread into the second layer of the pleura, which is the inner layer, closer inward to the lung.
  • Stage 2: Mesothelioma is still fairly localized in stage 2, but may have also spread out to the walls of the chest cavity or into the diaphragm, which is nearby. It may have also spread into the lung itself.
  • Stage 3: Mesothelioma has spread to the chest, the pericardium (heart covering) and/or nearby lymph nodes. Stage 3 pleural mesothelioma may still be resectable (removable by surgery) depending on the patient and their overall health level.
  • Stage 4: The most advanced stage, mesothelioma has spread throughout the chest, into the peritoneum (abdomen), or to the other lung. In stage 4, mesothelioma may also spread into the lymph nodes located in the collarbone or to other distant sites. Stage 4 is almost never considered removable by surgery.


Pleural mesothelioma has standard treatments available at any disease stage. No two cases of pleural mesothelioma are the same, and despite there being standard treatments, what’s most effective for the patient can vary in each case.

It’s essential for patients to be treated by a mesothelioma specialist who can put you on a specialized plan tailored to you.


Chemotherapy is a standard treatment given to patients in most treatment plans.

If you’ve been prescribed chemotherapy, here’s what you need to know about how this treatment option works:

  • Chemotherapy is a cancer-killing drug
  • Administered to patients in regular doses over multiple weeks
  • Circulates through the body and kills cancer cells in its path
  • Prevents mesothelioma from spreading to distant sites

Chemotherapy is an essential treatment component in multimodal therapy and is given to virtually every patient.

All patients should be aware of the serious and common side effects of chemotherapy that include hair loss and nausea. Different chemotherapy medications cause different side effects, and doctors may change your prescription based on how you react to treatment.


Radiation is another standard therapy part of most treatment plans. Radiation therapy is considered a non-invasive treatment method that helps protect healthy tissues while killing cancerous ones.

Radiation therapy uses high-energy rays that target and destroy cancer cells to shrink tumors. It helps control the growth and spread of mesothelioma.

Radiation therapy can also help alleviate painful symptoms caused by tumors and is often administered as a palliative treatment for end-stage patients.

Thoracic Surgeries

There are 2 different thoracic (chest) surgical procedures:

  1. Extrapleural Pneumonectomy: The EPP is a surgical procedure that removes the diseased lung entirely. During EPP, the surgeon also removes part of the diaphragm, the pericardium (heart covering) and the pleura from the chest wall. The goal is to remove all visible tumors and to stop the mesothelioma from spreading to distant sites by removing vulnerable tissues and organs.
  2. Pleurectomy With Decortication: The P/D procedure is a lung-saving operation whereby the surgeon removes the diseased pleura entirely. Compared to the EPP, the P/D is considered less radical because the patient is able to keep their lung.

Different mesothelioma specialists have their own views on which surgical procedure is most beneficial to the patient. Ultimately, it’s up to you and your medical team to decide which approach is best for you.

Both surgeries generally include neoadjuvant (preoperative) chemotherapy or radiation therapy as well as multiple weeks of adjuvant (postoperative) chemotherapy following the surgery.

Find the Right Specialist for Your Diagnosis

Pleural mesothelioma doctors across the country are accepting new mesothelioma patients now. Our Doctor Match Program connects you with a nearby specialist.

Connect With A Mesothelioma Doctor Now

Why Choose a Specialist?

As a rare and complex cancer, mesothelioma can best be treated by a specialist as opposed to a general oncologist. Pleural specialists are thoracic surgeons with specialized oncological experience who know how to properly diagnose and treat the disease.

Mesothelioma specialists all over the country are accepting new patients and can place you on a personalized treatment plan as soon as possible.

Some of the top specialists include:

If you have been diagnosed with pleural mesothelioma or suspect you may have symptoms of it, contact Mesothelioma Help Now and speak with our Patient Advocates. Call us at (800) 584-4151 or receive a FREE Mesothelioma Help Guide to understand the most effective treatments.

View Author and Sources

  1. American Cancer Society, “Malignant Mesothelioma Treatment” Retrieved from: Accessed on December 11, 2017.
  2. Cancer Research UK, “Mesothelioma—Stages” Retrieved from: Accessed on December 11, 2017.
  3. UCSF Thoracic Surgery Department, “Extrapleural Pneumonectomy” Retrieved from: Accessed on December 11, 2017.

Last modified: January 24, 2019