Pleural mesothelioma is a cancer that forms in tissue covering your lungs and chest wall. Most cases result from exposure to asbestos, a mineral used in building materials before it was banned in 1989. Pleural mesothelioma isn’t curable, but treatments like surgery, radiation therapy, chemotherapy and immunotherapy can potentially extend your life.
Pleural mesothelioma — or malignant pleural mesothelioma — is a rare cancer that grows in the membrane (pleura) that lines the walls of your chest and lungs. The condition gets its name from the mesothelium, a lining that protects your internal organs. Cancer that forms in any part of the mesothelium is called mesothelioma.
Prior asbestos exposure is the most common cause of pleural mesothelioma. Asbestos is a group of minerals once used in many industries, like building and manufacturing. Until the 1960s and 1970s, workers mined asbestos in the United States. Around this time, scientists discovered the link between exposure to airborne asbestos particles and mesothelioma.
Since then, government agencies and manufacturers in the U.S. have taken steps to reduce asbestos exposure to prevent people from developing mesothelioma.
In 2015, the World Health Organization (WHO) classified mesothelioma into three categories based on the types of cells in the mesothelium (mesothelial cells) where the cancer develops. Some cells lead to more aggressive (fast-growing) cancer than others.
The type of pleural mesothelioma you have will help your healthcare provider determine what treatments may work best and what your prognosis, or likely outcome, might be.
Mesothelioma is rare. Still, pleural mesothelioma is the most common type of mesothelioma. Approximately 3,300 people in the United States receive a mesothelioma diagnosis each year. Pleural mesothelioma accounts for about 80% of these diagnoses.
Widespread efforts to reduce asbestos exposure have led to a decline in cases in the U.S. since 2000.
The symptoms of pleural mesothelioma set on slowly. It can take up to 50 years for pleural mesothelioma to develop after asbestos exposure. Early signs of pleural mesothelioma can be bothersome, but easy to dismiss. Many people delay seeing their healthcare provider until their cancer’s more advanced.
Other symptoms include:
Asbestos exposure causes pleural mesothelioma in 70% of cases. And these are only the cases researchers know of for sure. The number may be higher. Asbestos consists of fibers that become tiny, airborne particles when disturbed. The particles settle in your lungs if you inhale them. They’re too tough for your body to break down. Over time, these particles can cause scarring and inflammation in your lungs. They also cause cell changes that lead to cancer.
Intact materials containing asbestos are safe. Asbestos only poses a health risk when disturbing the material releases asbestos particles into the air.
Scientists are researching potential causes of mesothelioma unrelated to asbestos exposure. Other causes may include:
More research is needed to understand how pleural mesothelioma develops when asbestos isn’t the clear cause.
Most people diagnosed with pleural mesothelioma have spent years working jobs that exposed them to large amounts of asbestos. Men and people assigned male at birth (AMAB) often work in these positions. Mesothelioma takes several years (15 to 50 years) to develop. Many people receiving diagnoses are retired (aged 65 and up) but worked around asbestos for years before it was regulated.
Professions most at risk for asbestos exposure include:
You’re also at risk of asbestos exposure if you:
Up to 95% of people with pleural mesothelioma also experience pleural effusion. This condition occurs when fluid builds up between your lungs and chest wall. Pleural effusion can make it harder to breathe.
You may also have signs and symptoms associated with other conditions that often (but not always) occur alongside pleural mesothelioma, including:
Your healthcare provider can recommend treatments to relieve symptoms like difficulty breathing or pressure on your chest.
A healthcare provider will perform a physical exam, review your medical history and assess risk factors. They may recommend:
Cancer staging allows your provider to plan treatments and determine how advanced the disease is. They stage pleural mesothelioma from one to four, with one being least advanced and four being most advanced.
Understanding your cancer stage can help your provider plan the most effective treatments for your health and well-being.
Pleural mesothelioma is difficult to treat because the cancer can spread along nerves, blood vessels and tissues. Often, healthcare providers who treat cancer, or oncologists, recommend a combination of treatments for pleural mesothelioma.
Treatments may include:
Ask your oncologist if they’d recommend you participate in a clinical trial.
There isn’t a cure for pleural mesothelioma. Still, treatments can help you live a longer life, relieve symptoms and help you stay more comfortable. Pleural mesothelioma is a serious disease, but new treatment approaches continue to improve the prognosis for people with this cancer.
The best way to prevent pleural mesothelioma is to avoid airborne asbestos particles. Since the late 1970s, the Environmental Protection Agency (EPA) has regulated the use of asbestos in building materials. Still, many homes, buildings, cars and products made before 1980 are likely to have it. To reduce your risk:
Most people with pleural mesothelioma have a life expectancy of one to four years after diagnosis. Without treatment, the life expectancy is about six months.
Still, your prognosis depends on several factors, including the type of pleural mesothelioma you have and your cancer stage. For example, epithelioid mesothelioma that’s in the early stages has a better prognosis than sarcomatoid mesothelioma in advanced stages. New therapies that can potentially prolong your life are continually under development. Ask your healthcare provider about your prognosis based on your diagnosis.
You should call your healthcare provider if there’s a chance you have a history of asbestos exposure and you experience:
You may want to ask your healthcare provider:
A note from Cleveland Clinic
Pleural mesothelioma isn’t curable, but it may be treatable depending on your cancer stage and the type of cancer cells you have. Surgery, chemotherapy and (more recently) immunotherapy can potentially extend your life. These treatment options can provide symptom relief that allows you to experience your life more fully. Ask your healthcare provider about your prognosis based on your unique cancer diagnosis. Have them talk you through the pros and cons of all available treatment options so you’re making confident, informed decisions about your care plan.
Last reviewed by a Cleveland Clinic medical professional on 12/16/2022.
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