This information will help you understand mesothelioma, including risk factors, diagnosis, surgery, and treatment. 

Mesothelioma is a rare form of cancer of the tissue that lines the body's internal organs. The most common type of mesothelioma affects the sac that protects the lungs, called the pleura. This type of mesothelioma is called pleural mesothelioma. Mesothelioma may also affect the peritoneal membrane, which is the tissue that surrounds the abdominal organs. This type of mesothelioma is called peritoneal mesothelioma. In rare cases, mesothelioma can also affect the intestines or heart.

Risk Factors

The main known risk factor for mesothelioma is exposure to asbestos, a mineral fiber that was commonly used in building construction. People who work in mining, milling, construction, plumbing, heating, insulation, and carpentry, as well as those who do electrical and shipyard work, generally have had greater exposure to asbestos than those in other fields. Therefore, they are at higher risk of developing mesothelioma. Family members of these workers are also at higher risk than others because they may have been exposed to asbestos in the clothes and hair of the workers.

Although asbestos is the most common risk factor for mesothelioma, people can develop it without being exposed to asbestos.

Diagnosis

To see if you have mesothelioma, you will have a biopsy. A biopsy involves removing a small amount of tissue from the area where the cancer may be located. The tissue will be looked at under a microscope by a pathologist. A biopsy is usually done by thoracentesis, video-assisted thoracic surgery, or open lung biopsy. Your surgeon will discuss with you which approach is best for you.

Thoracentesis

Thoracentesis is a procedure in which a needle is used to remove fluid from your pleura (the space between your chest wall and your lung). It can be done in your doctor's office or in a hospital.

Video-assisted thoracic surgery

Video-assisted thoracic surgery (VATS) is done in an operating room. A thin telescope attached to a video camera is inserted into your stomach through a small incision (surgical cut). Additional incisions are made and a surgical instrument is used to remove tissue.

Open lung biopsy

Open lung biopsy is done in an operating room. Your surgeon will make a small incision between your ribs. A surgical instrument is then used to remove a piece of your pleura.

Other tests

Your doctor may want you to have other tests, such as a computed tomography (CT) scan, a positron emission tomography (PET) scan, a stress test, a pulmonary function test (PFT), and a ventilation perfusion scan to see if the cancer has spread to other areas in your body and to test how your lungs are working. If you need to have any other tests, your doctor will discuss this with you.

Staging

Staging a cancer is a way of describing its location, whether it has spread, and whether it affects other organs. Staging will help your doctor make the best treatment choice for you.

  • Stage I mesothelioma is when tumors are confined to the pleura.
  • Stage II mesothelioma is when tumors have spread from the pleura to 1 lung.
  • Stage III mesothelioma is when tumors have spread into the chest wall or involves the lymph nodes.
  • Stage IV mesothelioma is when tumors have invaded the chest wall or have spread to other sites in the body.

Treatment

Your treatment may include surgery, radiation therapy, and chemotherapy. Your healthcare team will make a treatment recommendation based on the stage of your cancer, how well your lungs are functioning, and your overall health.

Surgery

Surgery is the most common treatment for mesothelioma. The goal of surgery is to remove all of the cancer. Depending on your surgery, you may have part or all of your pleura, lung, and linings of your diaphragm and pericardium (the sac surrounding your heart) removed.

Some patients may have a pleural effusion, which is when there is a buildup of fluid between the walls of the pleura. This can limit how much your lungs can expand, and can make you feel short of breath. Your doctor may do a procedure called a to help you breathe and feel more comfortable.

Radiation therapy

Radiation is the use of high energy x-rays to kill cancer cells and to help reduce the risk of recurrence (the cancer coming back). Your healthcare team will go over radiation planning, treatment, and possible side effects with you.

Chemotherapy

Chemotherapy is a medication or a combination of medications that is used to treat cancer. The most commonly used chemotherapy to treat mesothelioma includes 2 medications: pemetrexed (Alimta®) and cisplatin. Your healthcare team will discuss the benefits and risks of chemotherapy with you.

Your doctor may also recommend other medications or the possibility of joining a clinical trial. 

Emotional Support

The diagnosis and treatment of cancer can be a very stressful and overwhelming event. You may feel depressed, anxious, confused, afraid, or angry. You may have strong feelings about any permanent changes. These changes can have an impact on your emotional well-being. Help is available for you at any time. If you would like counseling, your nurse can give you a referral to see a social worker, psychiatrist, or counselor.

The Memorial Sloan Kettering Cancer Center (MSK) Resources for Life After Cancer (RLAC) Program provides support services after your treatment is finished. To learn more about these services, call (646) 888-4740.

Also, you may find it comforting to speak with a cancer survivor or caregiver who has been through a similar treatment. Through our Patient-to-Patient Support Program, you have a chance to speak with former patients and caregivers. To learn more about this service, call (212) 639-5007.

External Resources

National Cancer Institute
 

For additional online information, visit LIBGUIDES on MSKCC's library website at http://library.mskcc.org or the mesothelioma cancer section of www.mskcc.org. You can also contact the library reference staff at (212) 639-7439 for help.