Mesothelioma is a rare cancer most often associated with asbestos exposure. Explore the different types of mesothelioma, common symptoms, diagnostic methods, treatment approaches, and support resources available to patients and families.

What Is Mesothelioma?

Although mesothelioma is relatively uncommon compared to other cancers, it continues to affect thousands of Americans each year. According to the National Cancer Institute (NCI), approximately 3,000 new mesothelioma cases are diagnosed annually in the United States. 

What is mesothelioma? Most commonly linked to exposure to asbestos, this disease is a rare form of cancer that develops in the mesothelium, the thin layer of tissue that surrounds and protects many internal organs. 

Because mesothelioma can take decades to develop after exposure, many people are not diagnosed until years after they first encountered asbestos. Because of this, detecting the illness is quite difficult. In most cases, the manifest is very late, making treatment particularly challenging.

Types of Mesothelioma and Where the Cancer Forms

It is classified according to its origin and development, as well. Pleural mesothelioma tends to occur in the membrane surrounding the lungs and chest cavity and accounts for roughly 80 percent of all cases.

Peritoneal mesothelioma then starts to occur in the lining of the abdomen. There is also pericardial mesothelioma, which occurs in the area of the heart. Testicular mesothelioma, on the other hand, occurs in the testicles. These two, however, are so extremely rare that you rarely hear about them.

In the Cleveland Clinic mesothelioma overview, the five-year relative survival rate for pleural mesothelioma lands somewhere around 7 to 24%, and it depends on what stage it’s in. Peritoneal mesothelioma often has a slightly better outlook, since doctors can line up treatment more precisely with that subtype.

The type of cell is significant as well since it influences prognosis on its own, rather than just due to the location. Epithelioid cells generally have slower metastasis and are usually better at responding to therapy, leading to increased life expectancy.

Sarcomatoid cells, though, usually behave more aggressively, and they’re generally less responsive to therapy. Biphasic mesothelioma includes both cell types, so the final outlook relies on the mix, or how much of each portion there is.

The Latency Period: Why Mesothelioma Is Often Diagnosed Late

The biggest problem related to mesothelioma is the delay of 20 to 60 years between the first contact with the substance and the manifestation of the symptoms. The disease itself is merciless in its gradual and subtle nature. The delayed effect means that the worker who first comes into contact with the substance in the 1960s in a naval shipyard could be healthy until the 1980s or 1990s, even with less contact.

By the time symptoms become noticeable, the disease may have reached an advanced stage, meaning the surgical procedures available may not be as numerous as people might think. There are also studies released on a regular basis that suggest 22.6 percent of those suffering from mesothelioma receive an incorrect diagnosis to start, and that incorrect diagnosis is of an asbestos-related but lesser ailment.

That mislabel rate really hints at how closely mesothelioma mimics other problems, like respiratory or stomach-related issues. The National Cancer Institute’s mesothelioma information page also says that because this illness is pretty uncommon, a lot of clinicians don’t meet it all that often, and that can slow down recognition. 

When it’s caught early, pleural mesothelioma might appear as breathlessness or a cough that just won’t really quiet down. Your chest may feel a discomfort that tends to grow worse when taking a deep breath. 

Unfortunately, those signals could also be mistaken for pneumonia or chronic obstructive pulmonary disease. This makes the diagnosis get delayed or pushed back. In later-stage situations, a more classic pattern shows up with unexplained weight loss along with an ongoing, heavy fatigue. 

For peritoneal mesothelioma, some people first notice abdominal swelling, belly pain, and changes in bowel habits.

How Mesothelioma Is Diagnosed

Diagnosis is a sequence. Each step keeps shrinking the list of possibilities while also trying to actually show malignant cells. It usually goes something like this, not perfectly linear, but you know.

• Imaging. Chest X-rays, CT scans, and PET scans can show pleural thickening, fluid buildup, or some mass. Sure, these results make doctors suspicious, but on their own they can’t truly confirm mesothelioma.
• Fluid analysis. Mesothelioma often leads to pleural effusion, where extra fluid is collected around the lungs. Doctors may take a sample and analyze it for cancer cells. Still, pleural fluid cytology is not very reliable for mesothelioma, so it tends to need extra follow-up tests.
• Biopsy. For a definitive diagnosis, tissue has to be taken. Depending on where the disease is, they might use thoracoscopy, where a camera-guided tool reaches the chest cavity, or laparoscopy, for peritoneal cases. Then the tissue gets looked at under a microscope and it may be stained with immunohistochemical markers to tell mesothelioma apart from other cancers that look similar under basic histology.
• Specialist referral. Because mesothelioma is rare, and its cells can be tricky to categorize, a pathology review at a center that deals with mesothelioma a lot is often recommended. 

According to North Carolina mesothelioma lawyer William M. Graham, those diagnosed in very late stages may die within a few months; others have survived several years if the cancer was detected and treated in an early stage.

Treatment Options and What the Data Shows

Using a mix of surgery, chemotherapy and radiation has for a long time been the usual approach. When pleural mesothelioma is detected early enough to allow surgery in roughly 20% of patients, the results tend to be much better than for those who only receive chemotherapy and radiation. 

People diagnosed at stage 1 or 2 who go for a very aggressive lung-sparing procedure have, in newer studies, shown a median survival that comes in near 32 months, which is well over the general average. 

As Mayo Clinic oncologist Anastasios Dimou has also pointed out, mesothelioma is widely treated as noncurable for most people, and the typical survival is around 18 months after diagnosis even when therapy is given. If no treatment happens, life expectancy can drop to about 6–8 months.

Immunotherapy has in some cases changed the whole picture. Pembrolizumab (Keytruda), together with chemotherapy, got FDA approval for unresectable pleural mesothelioma, and the clinical findings seem to point toward better survival in certain histologic cell patterns. 

Sarcomatoid mesothelioma, which used to be the least favorable subtype overall, has shown immunotherapy responsiveness in a way that chemotherapy alone didn’t really make clear. 

Legal Rights and Compensation for Mesothelioma Patients

Mesothelioma is almost always caused by someone else’s failure to protect workers from a well-known hazard. Asbestos manufacturers, and also employers in asbestos-heavy industries, knew about the health dangers decades before anyone put in place real and adequate protections. 

Asbestos bankruptcy trusts, set up by former manufacturers who asked for Chapter 11 protection, now keep more than $30 billion sitting aside for people who may have claims now and later. Workers’ compensation claims and civil product liability actions against the companies that are still around are also other ways to pursue recovery. 

The Mesothelioma Applied Research Foundation steps in with resources for patients and families who are trying to manage both the medical side and the legal side of this disease. They offer details on specialized treatment centers, along with patient support programs and other guidance. 

And since mesothelioma has that long latency period, a diagnosis today can end up tracing back to workplace exposure that happened decades ago, so figuring out those past, historical exposures is where a legal claim really has to begin.

Disclaimer

The information provided in this article is for general informational and educational purposes only and should not be considered medical advice, diagnosis, or treatment. While every effort has been made to ensure the accuracy of the information presented, medical knowledge and treatment recommendations may change over time.

Mesothelioma is a serious medical condition that requires professional evaluation and care. Readers should consult a qualified healthcare professional regarding any symptoms, concerns, diagnosis, or treatment options and should not rely on this article as a substitute for professional medical advice.

If you have been diagnosed with mesothelioma or believe you may have been exposed to asbestos, seek guidance from an appropriately qualified medical specialist.