Mesothelioma of the pleura - Pleural Mesothelioma

Malignant pleural mesothelioma is a type of mesothelioma cancer affecting the lining of the lungs. Contrary to popular misconception, pleural mesothelioma is different from lung cancer, which refers to any type of malignant tumor that originates in the lungs.

The pleura is a type of serous tissue that lines and protects the lungs. There are two pleura. These can be called pleural membranes. The gap between them is called the pleural space.

The pleura are fibrous sheets which help to protect the lungs. They produce a lubricating fluid that fills the gap between the two pleura. This helps the lungs to move smoothly in the chest when they are inflating and deflating as we breathe.

Pleural mesothelioma is a cancer of the cells that make up the pleura or lining around the outside of the lungs and inside of the ribs.

Its only known cause in the U.S. is previous exposure to asbestos fibers, including chrysotile, amosite, or crocidolite. This exposure is likely to have happened twenty or more years before the disease becomes evident, since it takes many years for the disease to "incubate."

It is the most common type of mesothelioma, accounting for about 75% of all cases.

Pleural Mesothelioma Symptoms

There are a number of varying symptoms of pleural mesothelioma that can alert sufferers to the presence of the rare asbestos disease. In general, the clinical presentation of pleural mesothelioma may include the following:

1. Cough Shortness of breath,
2. difficulty breathing
3. Difficulty sleeping
4. Pain in the chest and abdominal regions, which is generally unresponsive to analgesics
5. Progressive loss of appetite and weight loss
6. Pleural effusions (fluid in the chest cavity)

Management of pleural mesothelioma depends largely on the staging of the tumor.

An early pleural mesothelioma diagnosis and surgical intervention may lengthen life expectancy. However, surgery may not be a viable option depending on the age and physical condition of the patient (in addition to the location of the tumor itself). In addition to surgical options, radiation treatment and chemotherapy may be helpful in the overall therapeutic program for treating pleural mesothelioma.

Pleural mesothelioma is of two kinds:

(1) diffuse and malignant (cancerous), and (2) localized and benign (non-cancerous).

Benign pleural mesothelioma can often be removed surgically, is generally not life-threatening, and is not usually related to asbestos exposure.  Malignant pleural mesothelioma, however, is very serious.

Fortunately, malignant pleural mesothelioma is a rare disease - about two thousand people are diagnosed with pleural mesothelioma in the United States each year.

Pleural Mesothelioma Diagnosis

The first step in detecting pleural mesothelioma is, typically, a chest x-ray or CT scan.  This is often followed by a bronchoscopy, using a viewing scope to look inside the lungs.  A definitive diagnosis of pleural mesothelioma usually requires obtaining a section of suspect tissue through a biopsy.  This can be done with a needle biopsy, an open biopsy, or through a tube with a camera (thoracoscopy or chest scope).  If an abnormality is seen through the camera then a tissue sample can be taken at the same time, using the same tube.  The spread of the tumor over the pleura causes pleural thickening. This can reduce the flexibility of the pleura and encase the lungs in an increasingly restrictive girdle that makes breathing more and more difficult.

There is no known cure for malignant pleural mesothelioma.  A given mesothelioma prognosis depends on various factors, including the size and stage of the tumor, the extent of the tumor, the cell type, and whether or not the tumor responds to treatment.  Many patients live for five- to ten-years after diagnosis, most of them in good health for a majority of those years.  However, some pleural mesothelioma victims succumb within a few months.  The average survival time is about a year.