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Pleural Mesothelioma

Definition

The pleura is a membrane. It lines the outside of the lungs and the inside of the chest cavity. Pleural mesothelioma is cancer of the pleura.
Pleura of the Lungs
Pleura of the Lungs
Copyright © Nucleus Medical Media, Inc.

Causes

Asbestos is a fibrous mineral that is known to cause cancer. This type of cancer is almost always caused by exposure to it. Even a small amount of exposure can be a risk.Other fibers can cause mesothelioma.

Risk Factors

Factors that increase your chances of getting pleural mesothelioma include:
  • Repeated exposure to asbestos fibers
  • Living with a person who works near exposed asbestos fibers
  • Exposure to other fibers (erionite, fluoro-edenite, and refractory ceramic)
  • Exposure to ionizing radiation

Symptoms

This cancer can take up to 20-40 years to develop. Early signs of pleural mesothelioma include:
  • Trouble breathing
  • Long-lasting cough
  • Pain under the rib cage or in the abdomen
  • Pain while breathing
  • Weight loss and fatigue
Many people do not have symptoms for a long period of time.

Diagnosis

Your doctor ask about your symptoms and medical history. A physical exam will be done. You may be referred to a doctor who specializes in lung problems or cancer. A pulmonologist focuses on the lungs. An oncologist focuses on cancer.
Sometimes, it is hard to tell the difference between this and other, more common types of lung cancer.
Images may be taken of your bodily structures. This can be done with:
Your bodily fluids and tissues may be tested. This can be done with:
These same tests and others may also be used to find out if cancer has spread outside the pleura. It is important to know whether and how far the cancer has spread to plan treatment. This step is called the staging process. It helps determine the level of treatment.

Treatment

Pleural mesothelioma is usually treated with:
  • Chemotherapy—use of drugs to kill cancer cells
  • Radiation—use of radiation to kill cancer cells and shrink tumors
  • Surgery—to remove tumor and some surrounding tissue,
  • Combinations of these three treatments may work the best

Prevention

The only known way to prevent this cancer is to avoid asbestos or other fibers. People who could be exposed to asbestos at work include:
  • Miners
  • Factory workers
  • Insulation workers
  • Railroad workers
  • Ship builders
  • Makers of gas masks
  • Construction workers
Family members of workers can also be at risk for this cancer. The asbestos fibers can be brought home on clothing. This type of exposure is just as dangerous.
Asbestos can also be found in old building insulation, roofing materials, and tiles.
To avoid exposure to asbestos:
  • Workers should use proper safety equipment and precautions.
  • Workers should use safety measures to avoid bringing asbestos dust home on their clothing.
  • Areas of exposed asbestos must be checked by experts. This may be old public buildings and homes with asbestos shingles, tiles, or insulation.
  • Exposed areas must be removed by proper means or sealed off.
  • A homeowner untrained in asbestos abatement should never attempt to remove asbestos material.

RESOURCES

American Lung Association http://www.lungusa.org

National Cancer Institute http://www.cancer.gov

CANADIAN RESOURCES

Canadian Cancer Society http://www.cancer.ca

Cancer Care Ontario http://www.cancercare.on.ca

References

Antunes G, Neville E, Duffy J, Ali N on behalf of the BTS Pleural Disease Group. BTS guidelines for the management of malignant pleural effusions. Thorax . 2003;58:ii29

Cugell DW, Kamp DW. Asbestos and the pleura: a review. Chest . 2004;125:1103-1117.

General information about malignant mesothelioma. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/patient. Accessed May 29, 2013.

Nishimura SL, Broaddus VC. Asbestos-induced pleural disease. Clin Chest Med . 1998;19:311-329.

Occupational lung disease. American Lung Association website. Available at: http://www.lung.org/assets/documents/publications/solddc-chapters/occupational.pdf. Published 2010. Accessed May 29, 2013.

Roberts JR. Surgical treatment of mesothelioma: pleurectomy. Chest . 1999;116(6 Suppl):446S-449S.

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