What is pleural mesothelioma?
Pleural mesothelioma is a rare cancer that starts in the pleural cells on the surface of the lungs. It is different from lung cancer.
The lungs are in the chest, on either side of the heart. The lungs and the inside of the rib cage are covered with a filmy membrane called the pleura. Between the lungs and the ribcage is a space (pleural space) and a small amount of fluid (pleural fluid) that allow the lungs to move easily when we breathe. If the pleura or pleural fluid are damaged, breathing becomes difficult.
Causes pleural mesothelioma
Almost all cases of pleural mesothelioma are caused by workplace exposure to asbestos fibres. It is usually diagnosed 20 to 40 years after the first exposure to asbestos. All asbestos workers have an increased risk of developing mesothelioma, but workers in the shipbuilding and insulating trades have the highest risk. It may also occur in family members of asbestos workers, especially if their soiled work clothing was brought home.
Pleural tuberculosis or some chronic lung infections may also increase the risk of developing pleural mesothelioma.
Some people develop pleural mesothelioma without any of these risk factors.
Signs and symptoms of pleural mesothelioma
Having the following signs and symptoms does not necessarily mean that you have pleural mesothelioma. They could be caused by other problems, so see your doctor to be sure.
- shortness of breath
- pain in the chest
- weight loss
- cough
- weakness
- loss of appetite
- fever
- hoarseness
- difficulty swallowing
- superior vena cava syndrome (compression or obstruction of the vein that empties into the heart) causing:
- shortness of breath
- a sensation of fullness in the head
- facial swelling
- arm swelling
- cough
- trouble swallowing
Your doctor may have suspected pleural mesothelioma after talking with you about your health and completing a physical examination. Perhaps you had a routine chest x-ray or were part of a screening program for asbestos workers. A number of special tests are usually necessary to confirm a pleural mesothelioma diagnosis. They include:
Imaging StudiesX-rays, ultrasound, CT (computerized axial tomography) scans, MRIs (magnetic resonance imaging) and bone scans allow organs, tissues and bones to be examined in more detail. They may be uncomfortable but are usually painless.
BiopsyA biopsy is usually necessary to make a definite diagnosis of cancer. Cells or tissues are removed from the body and checked under a microscope. If the cells are cancerous, they may be studied further to see how fast they are growing.
To diagnose pleural mesothelioma, your doctor may arrange for:
- Pleuroscopy: This is also called an endoscopy. A flexible telescope is used to see inside the chest. In some cases, it can take photographs as well as a biopsy. Pleuroscopy usually needs a mild anesthetic and may require a small incision in the chest wall.
- Thoracotomy: Using general anesthetic, a surgeon opens the chest cavity to remove part or all of the tumour. Nearby tissues and lymph nodes may be examined and removed.
Once your doctors know the type and stage of your cancer, they will decide which treatment will work best for your type of cancer, and any other health issues you may have.
You will be encouraged to help make the final treatment choices.
As cancer patients often have a combination of treatments, your treatment may include:
- surgery
- radiation therapy
- chemotherapy
- photodynamic therapy
Your doctor will recommend regular visits to check your general health, but will want you to make an appointment right away if you notice anything unusual or worrying.
In some provinces, there are special services or benefits to help workers (and their families) who have developed mesothelioma from workplace exposure to asbestos. Ask your doctor about these programs or check with the workers’ compensation or insurance agency in your province.
