Pleural Mesothelioma

Pleural mesothelioma is one of the three main forms of mesothelioma. Pleural mesothelioma is a rare malignant cancer. The only known cause of Pleural mesothelioma is asbestos exposure. Victims inhale asbestos fibers into their lungs which triggers the development of mesothelioma cancer. This is the most typical form of the cancer as almost 75 percent of mesothelioma diagnoses are Pleural mesothelioma.

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Defining Pleural Mesothelioma

What is Pleural Mesothelioma?

Pleural mesothelioma is a disease that originates and grows in the cells that line the lungs and inner lining of the chest cavities. This form of mesothelioma and all other forms of this cancer are named by the location they originate from.

When individuals inhale asbestos fibers, potential risks for the development of pleural mesothelioma can become a growing concern. When these fibers penetrate the protective lining of the lungs, also known as pleura, they can cause genetic mutations in the surrounding cells–in some cases, this could lead to pleural mesothelioma.

Pleural Mesothelioma is one of the most common types of mesothelioma, specialists have more opportunities to develop new treatments and/or new treatment strategies for the disease. New promising treatments are being tested every day in the hope of helping patients and one day discovering a cure. You can check out new mesothelioma treatment options on our website.

Why is your diagnosis significant?

Apart from telling patients what is causing their symptoms, it is important to make a correct diagnosis when considering treatment options. Treatment options may be affected as cell type and stage vary in pleural mesothelioma.

What treatments are obtainable?

Typically, many patients with pleural mesothelioma are prescribed and recommended chemotherapy and/or radiation therapy in order to slow the spread of aggressive mesothelioma cells. However, in some cases the best chance for an extended prognosis involves surgical options such as a pleurectomy.

What is the prognosis for Pleural Mesothelioma?

A patient’s overall health and stage at which they had been diagnosed at are important factors that a prognosis can be dependant on. Most patients live for just over a year after diagnosis, but due to new treatments, there are patients who have lived with the disease for years.

Pleural Mesothelioma Symptoms

Symptoms of Pleural Mesothelioma

Pleural mesothelioma symptoms mainly affect the respiratory system, including the airway, breathing muscles, and lung. As a result of pleural effusion (excess fluids) within the lining of the lungs, the beginning signs a patient may experience is a persistent cough and/or shortness of breath.

Patients may also experience the following additional symptoms of pleural mesothelioma:

  • Chest pains
  • Dry cough
  • Shortness of breath
  • Weight loss
Stage 4 Mesothelioma
Pleural Mesothelioma Diagnosis

Diagnosing Pleural Mesothelioma

Due to its nonspecific symptoms – which is a symptom that is shared between other medical conditions – pleural mesothelioma can be difficult to diagnose. Similar symptoms include those of common respiratory conditions such as chronic obstructive pulmonary disease (COPD) or pneumonia.

It is also difficult for doctors to distinguish pleural mesothelioma from other cancers under a microscope. Therefore, doctors typically run tests and perform special stainings on biopsy samples to confirm the cell type, stage of cancer, and location of the mesothelioma.

It is important to note that a patient’s diagnosis can impact the type of treatment they may be able to receive. For instance, doctors are less likely to perform an operation on a patient that is entering and in later stages. Getting another physicians’ second opinion can however sometimes provide a different diagnosis and open up additional treatment options.

Where is Pleural Mesothelioma?

Location of Pleural Mesothelioma

Pleural mesothelioma arises in the membrane which surrounds the lung, called the pleura. Pleural mesothelioma is the most common form of this deadly cancer.

Defining Stage 2 Mesothelioma
Diagnostic Tests for Pleural Mesothelioma

Pleural Mesothelioma Diagnostic Imaging Tests

To locate abnormal-looking growths and/or masses, the chest area is examined with a diagnostic imaging test such as CT or x-ray. Although these imaging scans require a patient to remain still for a long period of time they are painless and can show the stage and location of the tumor.

To begin a diagnosis, doctors will commonly use the following imaging tests:

  • Computerized tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan
  • X-ray


A biopsy may be pursued depending on the results from an imaging test. A biopsy requires a small sample of fluid or tissue; it provides important information to confirm a diagnosis and determine mesothelioma cell type. Doctors use the pathology results to create a treatment plan that is most effective for a patient.

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Treatment Options for Pleural Mesothelioma

Pleural Mesothelioma Treatment Options

The standard treatments options that are available to mesothelioma patients include surgery, chemotherapy, and radiation therapy. When a doctor combines two or more of these treatments, the multimodal therapy approach has been known to significantly improve a patient with mesothelioma life expectancy.

Extrapleural Pneumonectomy for Pleural Mesothelioma (EPP)

Some patients with pleural mesothelioma have an extrapleural pneumonectomy, or EPP performed – one of the most effective surgeries available. It was developed by Dr. David Sugarbaker, the world-renowned mesothelioma surgeon.

During the operation a surgeon removes:

  • Fragments of the protective lining of the chest, heart, and lung.
  • Fragments or the entire diaphragm.
  • Nearby lymph nodes.
  • The whole lung that has been affected by mesothelioma.

It is believed that the EPP offers the best chance of removing mesothelioma from the body by many specialists. However, a doctor will only suggest an EPP if a patient is in good health as this procedure is invasive and requires a strong recovery. Despite its risk, researchers have shown the efficacy of the EPP in several studies. In fact, one study reported that the median survival rate for EPP patients was 27 months – that is twice the average mesothelioma survival rate.

Pleurectomy with Decortication (P/D)

Pleurectomy with Decortication for Pleural Mesothelioma

The lung-sparing, less invasive alternative to the EPP is known as a pleurectomy/decortication, or P/D. Dr. Robert Cameron, a mesothelioma specialist, reportedly developed the procedure in the belief that the EPP was unnecessarily radical.

The two surgical techniques of a P/D include:

Pleurectomy – the lung’s protective lining in which the tumor grows is removed by surgeons

Decortication – the visible tumors located around and on the diseased lung are removed by surgeons

Compared to the EPP, some research has shown that P/D can give rates equal to and sometimes better for survival.


Pleurodesis is a palliative surgery that can be used by doctors to relieve pain and pressure caused by fluid in the chest. This buildup of fluid is known as a pleural effusion. Pleural effusion build up occurs between the internal and external pleural linings which inhibits the expansion of the lung and the chest.

To relieve pressure in both the chest and lungs, a thoracentesis is performed by inserting a hollow tube into the chest wall, which drains the excess fluid then medication is put in through the tube to adher the two layers of pleura together closing the space for fluid to reoccur. This procedure makes it easier for patients to breathe and reduces overall chest pain.

Pleurectomy with Decortication for Pleural Mesothelioma
Pleural Mesothelioma Chemotherapy

Chemotherapy for Pleural Mesothelioma

A chemotherapy drug may be used by itself or in combination with other chemotherapy drugs as treatment for pleural mesothelioma. Alimta and Cisplatin are the first particularly successful combination of chemotherapy drugs for mesothelioma. The medicines together increased patients ‘ survival time by an average of three months.

Chemotherapy can also be combined with surgery. It has been shown that survival times can be increased when chemotherapy is prescribed before (neoadjuvant), during (intraoperative), or after (adjuvant) a procedure. A recent medical study indicated that compared to those who had only surgery survived for 22 months while patients who had undergone a combination of surgery and heated chemotherapy survived for 35 months.

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Pleural Mesothelioma Radiation Therapy

Radiation Therapy for Pleural Mesothelioma

To shrink pleural mesothelioma tumors, the doctor utilizes radiation therapy – which can be used as in combination with surgery and chemotherapy or as a palliative treatment.

A recent study has shown that the combination of radiation therapy with surgery and chemotherapy can have a positive effect on the average survival time of many pleural mesothelioma patients to 33 months – that is three times the average life expectancy of many pleural mesothelioma patients.

Stages of Pleural Mesothelioma

Pleural Mesothelioma Stages

A doctor will also determine the stage of mesothelioma as part of the diagnostic process, which determines the origin of the tumor in the lining of the lungs and describes how far it has spread from that point. This information is significant to doctors when determining potential treatment availabilities. Standard treatment options are more commonly available to patients with stage 1 or stage 2 compared to patients with the later 3 and 4 stages.

The following are the pleural mesothelioma stages:


Within Stage 1, the mesothelioma tumor is generally in one location, and the cancerous cells have not dispersed to lymph nodes or other body organs and tissues. In general, surgical treatment may be an option for eliminating the cancerous growth.




Within Stage 2, the mesothelioma tumor is larger and has probably intruded on surrounding organs, such as the lung or even diaphragm. Lymph nodes could additionally be included. In this case, surgical resection might still be feasible, however much more difficult depending on the scope of the growth.


Within Stage 3, mesothelioma cancer has infested a region or perhaps location. Cancer has progressively spread throughout one side of the chest, within the chest wall, esophagus, and additional lymph nodes. Surgical treatment is typically not an option as curative therapy, however various other treatment options may be attempted. 



Within Stage 4, the mesothelioma has dispersed to numerous locations, such as various other organs and tissues throughout the body. Surgical treatment is no longer an alternative, and most treatments at this stage concentrate on minimizing discomfort and pain.

Pleural Mesothelioma Prognosis

Prognosis of Pleural Mesothelioma

If pleural mesothelioma is diagnosed, you have a better prognosis than patients diagnosed with mesothelioma elsewhere.

The following factors are important to the prognosis:

  • Age
  • Cell Type
  • Type of Cancer
  • Overall health (heart, kidneys, lungs, etc.)

Although all of these factors are important, the cancer stage and cell type are most influential in a prognosis. For example, more treatment opportunities are available to a patient that has stage 1 or stage 2 pleural mesothelioma. Early-stage pleural mesothelioma has not experienced far-spreading from the lung lining, making it is easier for doctors to remove surgically.

Similarly, if a pleural mesothelioma patient is diagnosed with epithelioid cell type they will most likely have a more favorable prognosis as these cells react more positively and do not spread as quickly as other cells.

Prognosis of Pleural Mesothelioma
The Life Expectancy for Stage 2 Mesothelioma
Life expectancy options for Pleural Mesothelioma

Take Control of Your Pleural Mesothelioma Life Expectancy

No matter your diagnosis— the cell type, location of the mesothelioma, or stage of cancer — an experienced doctor’s specialized treatment will help you improve your prognosis and quality of life.

A mesothelioma diagnosis can be devastating; however, it does not mean it is an immediate death sentence. A proactive approach combined with a variety of treatments may help people live longer. If you or a loved one has been diagnosed with pleural mesothelioma, make it a mission to find the treatment(s) that provides the best odds in life extension. This can be done by locating a qualified specialist and/or receiving a second opinion if needed.