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Pleural Mesothelioma

Pronounced: Plur-al mehz- oh-thel-ee- oh -ma

Definition

The pleura is a membrane. It lines the outside of the lungs and the inside of the chest cavity. Pleural mesothelioma is cancer of the pleura.

Pleura of the Lungs

Pleura of the Lungs
Copyright © Nucleus Medical Media, Inc.

Causes    TOP

Cancer occurs when cells in the body divide without control or order. If cells keep dividing uncontrollably, a mass of tissue forms. This is called a growth or tumor. The term cancer refers to malignant tumors. They can invade nearby tissue and spread to other parts of the body.

Mesothelioma is type of cancer is almost always caused by exposure to asbestos. It is a fibrous mineral that is used to be present in many construction materials and car parts. Even a small amount of exposure can be a risk. Other fibers can cause mesothelioma.

Risk Factors    TOP

Factors that may increase your chance of getting pleural mesothelioma include:

  • Repeated exposure to asbestos fibers, usually work related
  • Living with a person who works near exposed asbestos fibers
  • Exposure to other fibers (erionite, fluoro-edenite, mineral wool, and refractory ceramic)
  • Exposure to ionizing radiation

Symptoms    TOP

This cancer can take up to 20-40 years to develop. Early signs of pleural mesothelioma include:

  • Pain or trouble breathing
  • Long-lasting cough
  • Pain under the rib cage or in the abdomen
  • Weight loss, sweats, and fatigue

Symptoms may not start until a long time after the tumor develops.

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a doctor who specializes in lung problems or cancer. A pulmonologist focuses on the lungs. An oncologist focuses on cancer.

Sometimes, it is hard to tell the difference between this and other, more common types of lung cancer.

Your bodily fluids and tissues will be tested. This can be done with:

  • Blood tests—may show chemicals produced by the tumor
  • Examination of pleural fluid for tumor cells
  • Biopsy—needed to confirm the diagnosis

Pulmonary function tests may be done to see if your breathing is effected

Images may be taken of your bodily structures. This can be done with:

These same tests and others may also be used to find out if cancer has spread outside the pleura. It is important to know whether and how far the cancer has spread in order to plan treatment. This step is called the staging process. It helps determine the level of treatment.

Treatment    TOP

Pleural mesothelioma is usually treated with combinations of:

  • Chemotherapy—use of drugs to kill cancer cells
  • Radiation therapy—use of radiation to kill cancer cells and shrink tumors
  • Surgery—to remove tumor and some surrounding tissue

Pleural fluid caused by the tumor will be removed. This is repeated as needed.

Prevention    TOP

The only known way to prevent this cancer is to avoid asbestos or other fibers. People who could be exposed to asbestos at work include:

  • Miners
  • Factory workers
  • Insulation workers
  • Railroad workers
  • Ship builders
  • Makers of gas masks
  • Construction workers

Family members of workers can also be at risk for this cancer. The asbestos fibers can be brought home on clothing. This type of exposure is just as dangerous.

Asbestos can also be found in old building insulation, roofing materials, and tiles.

To avoid exposure to asbestos:

  • Workers should use safety equipment and precautions appropriate for their job.
  • Workers should use safety measures to avoid bringing asbestos dust home on their clothing.
  • Areas of exposed asbestos must be checked by experts. There may be old public buildings and homes with asbestos shingles, tiles, or insulation.
  • Exposed areas must be removed by proper means or sealed off.
  • A homeowner untrained in asbestos abatement should never attempt to remove asbestos material.

RESOURCES:

American Lung Association
http://www.lung.org
National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca
Cancer Care Ontario
http://www.cancercare.on.ca

References:

Antunes G, Neville E, Duffy J, Ali N on behalf of the BTS Pleural Disease Group. BTS guidelines for the management of malignant pleural effusions. Thorax. 2003;58:ii29
Cugell DW, Kamp DW. Asbestos and the pleura: A review. Chest. 2004;125(3):1103-1117.
General information about malignant mesothelioma. National Cancer Institute website. Available at:
...(Click grey area to select URL)
Updated September 4, 2015. Accessed May 11, 2016.
Mesothelioma. American Lung Association website. Available at:
...(Click grey area to select URL)
Accessed May 11, 2016.
Mesothelioma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116096/Mesothelioma. Updated August 21, 2015. Accessed May 11, 2016.
Last reviewed June 2016 by Michael Woods, MD
Last Updated: 6/20/2013

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