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Pleural Mesothelioma

Pleural mesothelioma is a rare form of cancer. It develops in the lungs—specifically in the pleura, which is a thin layer of tissue that lines the lungs. The only known cause of pleural mesothelioma is exposure to asbestos. Pleural mesothelioma occurs when asbestos fibers become airborne. These fibers are inhaled and become trapped in the lungs. 75% of mesothelioma patients have this type of the disease.


  • Shortness of breath
  • Chest pain
  • Painful coughing
  • General fatigue
  • Fever
  • Unusual lumps of tissue under the skin on your chest
  • Unexplained weight loss
  • Fluid around the lungs
  • Difficulty swallowing


For many patients, the most important question is “When will I get better?” Unfortunately, the answer is not so clear. Every outcome is unique. On a positive note, patients living with pleural mesothelioma have better survival rates than those with other types of mesothelioma.

For pleural mesothelioma patients, the prognosis (chance of recovery) depends on several factors:

  1. Stage of the disease – The earlier the disease is diagnosed and treated, the better the chance for survival.
  2. The type of cell within the tumor – There are 3 cell types for mesothelioma tumors. Each type responds differently to treatment. Find out more here.
  3. Metastasis – The more the tumor has spread beyond its original site, the more difficult it is to treat.


As is the case with other cancers, mesothelioma is measured in stages. Before your doctor decides the best treatment option for you, he or she will likely evaluate your illness using the TNM staging system, a tool developed by the American Joint Committee on Cancer. The stage number depends on the size of your tumor (T), whether the cancer has spread to nearby lymph nodes (N), and whether the tumor has metastasized (M) or spread to other parts of the body. Pleural mesothelioma is classified into 4 stages:

Stages 1 and 2 – Mesothelioma is confined to the pleura (the lining) of one lung.
Stage 3 – Mesothelioma has spread to the mediastinum (the membranes area between the lungs) and/or the lymph nodes.
Stage 4 – Mesothelioma has invaded the chest wall or has spread to other areas of the body.


Medical treatment for pleural mesothelioma typically includes 3 options: surgery, chemotherapy, or radiation. Many doctors have found that the best results come from combining and customizing any of these treatments to meet the specific needs of each patient. This combination approach is called “multimodal therapy.”

Surgery Options for Pleural Mesothelioma Patients

Surgery may be an option for you, depending on the stage of the illness and your general health. Your doctor will evaluate these factors and recommend the most appropriate treatment. Typically, there are 2 surgical options for pleural mesothelioma patients:

  1. Extrapleural pneumonectomy (EPP)
    • Aggressive surgery
    • Patient must be in otherwise good health to qualify for surgery
    • Removal of the affected lung, part of the chest lining, the diaphragm, and lining of the sac that surrounds the heart
    • Likely outcomes: increased life expectancy, pain relief
  2. Pleurectomy/decortication (P/D)
    • Very complicated and invasive
    • Removal of the membrane coating of the affected lung, the membranes between the lungs called the mediastinum, the diaphragm, and the lining of the chest wall
    • Likely outcomes: potential pain relief, better quality of life

Chemotherapy Treatment

Chemotherapy, also known as “chemo,” is commonly used to treat many forms of cancer. Chemotherapy drugs aggressively and effectively attack cancer cells, but unfortunately, healthy cells are often affected as well. You should be prepared for uncomfortable side effects such as hair loss, loss of appetite, mouth sores, and nausea. The reduction of red and white blood cells may also cause fatigue and increase your chance of infection. Fortunately, these difficult side effects typically fade away when you have completed treatment.

Radiation Therapy

This therapy targets cancer cells directly using high-energy forms of radiation. It is not always a preferred treatment option for mesothelioma patients because it usually works best when the radiation is aimed at specific tumors, and mesothelioma tends to be more widespread. This therapy is still sometimes used after surgery to “clean up” any cancer cells that were missed, or to help ease some of the more painful mesothelioma symptoms, such as shortness of breath or difficulty swallowing.

Managing Symptoms of Pleural Mesothelioma

One of the first symptoms pleural mesothelioma patients notice is a shortness of breath. This is caused by a buildup of fluid around the lung called “pleural effusion.” Your doctor may be able to perform a procedure called a “thoracentesis” to drain this fluid and give you much-needed relief.

Life Expectancy and Survival

  • Pleural mesothelioma – Patients usually survive about 4-18 months after diagnosis. Some people, however, have lived more than 10 years.
  • Survival rate – In general, about 10% of pleural patients live 5 years after diagnosis.