Malignant mesothelioma
Mesothelioma - malignant; Malignant pleura mesothelioma (MPM)Malignant mesothelioma is an uncommon cancerous tumor. It mainly affects the lining of the lung and chest cavity (pleura) or lining of the abdomen (peritoneum). It is due to long-term asbestos exposure.
Tumor
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).
Causes
Long-term exposure to asbestos is the biggest risk factor. Asbestos is a fire-resistant material. It was once commonly found in insulation, ceiling and roofing vinyls, cement, and car brakes. Even though many asbestos workers smoked, experts do not believe smoking itself is a cause of this condition.
Older veterans make up 30% of the cases of mesothelioma due to exposure in the military ship, vehicle, and plane industry.
Men are affected more often than women. The average age at diagnosis is 60 years. Most people seem to develop the condition about 30 years after being in contact with the asbestos.
Symptoms
Symptoms may not appear until 20 to 40 years or longer after exposure to asbestos, and may include:
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Abdominal bloating
Abdominal bloating
Abdominal bloating is a condition in which the belly (abdomen) feels full and tight. Your belly may look swollen (distended).
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Abdominal pain
Abdominal pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
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Chest pain, especially when taking a deep breath
Chest pain
Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.
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- Fatigue
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Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough air
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- Fever and sweating
Exams and Tests
Your health care provider will do an exam and ask you the person about your symptoms and medical history. Tests that may be done include:
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Chest CT scan
Chest CT scan
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
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Cytology of pleural fluid
Cytology of pleural fluid
A cytology exam of pleural fluid is a laboratory test to detect cancer cells and certain other cells in the fluid from the area that surrounds the lu...
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Open lung biopsy
Open lung biopsy
An open lung biopsy is surgery to remove a small piece of tissue from the lung. The sample is then examined for cancer, infection, or lung disease....
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Pleural biopsy
Pleural biopsy
Pleural biopsy is a procedure to remove a sample of the pleura. This is the thin tissue that lines the chest cavity and surrounds the lungs. The bi...
Mesothelioma is often hard to diagnose. Under the microscope, it can be hard to tell this disease apart from similar conditions and tumors.
Treatment
Malignant mesothelioma is a difficult cancer to treat.
There is usually no cure, unless the disease is found very early and the tumor can be completely removed with surgery. Most of the time, when the disease is diagnosed, it is too advanced for surgery. Chemotherapy or radiation may be used to reduce symptoms. Combining certain chemotherapy medicines may help decrease symptoms, but it will not cure the cancer.
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Untreated, most people survive about 9 months.
Participating in a clinical trial (test of new treatments), may give the person more treatment options.
Pain relief, oxygen, and other supportive treatments may also help relieve symptoms.
Support Groups
You can ease the stress of illness by joining a support group where members share common experiences and problems.
Support group
The following organizations are good resources for information on cancer:American Cancer Society. Support and online communities. www. cancer. org/...
Outlook (Prognosis)
The survival time varies greatly from several months to several years. The outlook depends on:
- The location of the mesothelioma
- The cell type of the mesothelioma
- The stage of the tumor
- The person's age and general health
- Whether surgery is an option
- The person's response to treatment
You and your family may want to start thinking about end-of-life planning, such as:
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Palliative care
Palliative care
Palliative care helps people with serious illnesses feel better by preventing or treating symptoms and side effects of disease and treatment....
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Hospice care
Hospice care
Hospice care helps people with illnesses that cannot be cured and who may be nearing death. The goal is to give comfort and peace instead of a cure....
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Advance care directives
Advance care directives
When you are very ill or injured, you may not be able to make health care choices for yourself. If you are unable to speak for yourself, your health...
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Possible Complications
Complications of malignant mesothelioma may include:
- Side effects of chemotherapy or radiation
- Continued spread of cancer to other organs
When to Contact a Medical Professional
Make an appointment with your provider if you have symptoms of malignant mesothelioma.
Prevention
Avoid exposure to asbestos.
References
Baas P, Hassan R, Nowak AK, Rice D. Malignant mesothelioma. In: Pass HI, Ball D, Scagliotti GV, eds. IASLC Thoracic Oncology. 2nd ed. Philadelphia, PA: Elsevier; 2018:chap 53.
Davies HE, Sterman D, Gary Lee YC. Pleural malignancy. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 114.
McCool FD. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 86.
National Cancer Institute website. Malignant mesothelioma treatment (adult) (PDQ) -- Health professional version. www.cancer.gov/types/mesothelioma/hp/mesothelioma-treatment-pdq. Updated April 24, 2024. Accessed July 8, 2024.
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Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
Review Date: 6/17/2024
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.