Pleural mesothelioma is a rare cancer often diagnosed in people who have been exposed to high levels of asbestos. The malignancy affects the pleura, a thin membrane of lubricating cells that lines the lungs and chest wall.
It sometimes takes ten years or more for changes to appear that are indicative of pleural disease, and even longer for symptoms to manifest. These differences can include a thickening or calcification of the pleural lining—a condition commonly diagnosed as pleural plaques. Conditions like pleural calcification or the development of pleural plaques often serve as precursors to mesothelioma.
Pleural mesothelioma accounts for about 75 percent of all mesothelioma cases. Like other types of mesothelioma, this particular form of the disease gets its name because of where it is formed — in the pleura, a soft tissue that surrounds the lungs. In almost all cases, pleural mesothelioma is caused by asbestos exposure.
The first symptoms of pleural mesothelioma typically include chest pain and shortness of breath. You may experience no symptoms at all in the first few stages of the cancer’s progression.
The life expectancy of someone with pleural mesothelioma is less than 18 months, but some patients live much longer. It often takes decades (20 to 50 years) for mesothelioma to develop after someone is first exposed to asbestos. This lag time — called a latency period — explains why the disease usually affects older people.
In most instances, pleural disease is not considered fatal but it can cause diminished lung function and may confirm that a person has sustained significant asbestos exposure. Patients diagnosed with pleural conditions are generally considered to be at a higher risk for developing the more severe pleural mesothelioma.
Pleural mesothelioma originates in the pleura but can quickly spread to the outer chest wall, abdomen, and heart. Pleural mesothelioma is typically fatal within one year of diagnosis. However, understanding and recognizing key risk factors, like asbestos exposure, will typically lead to early detection of the cancer. Those individuals who are fortunate to receive an early diagnosis are likely to be more eligible for life-sustaining treatments such as surgical resection of the cancer. This type of treatment can extend a patient’s life years beyond that of a typical mesothelioma patient.
While there is no cure for pleural mesothelioma, treatment options do exist for this type of cancer. There are ways for patients to control the disease through tumor management including traditional radiation and chemotherapy methods. These methods can ease symptoms of the disease and make a patient more comfortable. In patients where a diagnosis is made of early stage disease, mesothelioma surgery can extend the survival rate far beyond previous levels in untreated disease.
Symptoms of pleural mesothelioma include persistent dry or raspy cough, coughing up blood (hemoptysis), shortness of breath (dyspnea), and difficulty swallowing (dysphagia). There are four stages of mesothelioma that doctors use to describe how far the cancer has progressed. For many people, unfortunately, symptoms are not noticeable until the cancer is in a later stage — stage III or IV.
Pleural mesothelioma is known only be caused by exposure to asbestos. Asbestos is a naturally occurring and microscopic mineral that was used for hundreds of years in a number of different industrial compounds. Asbestos fibers are extremely durable, but also extremely difficult to expel from the body once introduced to the internal tissue.
Upon inhalation, asbestos fibers will lodge on the outer layers of the lung tissue and within the pleura, a thin membrane of mesothelial cells which lines the chest cavity. This lining allows for the free movement of the body’s internal body structures because it provides a special lubrication to the surface of these structures. The pleura, like other mesothelial membranes, is a delicate structure and microscopic asbestos fibers can cause pleural plaques to form on its surface. Pleural plaques may eventually develop into pleural mesothelioma tumor cells. Generally, it takes many years between asbestos exposure and the development of adverse health complications, as the fibers will slowly irritate and inflame the internal tissue over time until symptoms appear.
Asbestos fibers can cause excess fluid to build up between the two layers of the pleura, a condition called pleural effusion. While a little fluid in your pleural space is important, too much can make breathing difficult. The extra fluid puts pressure on the lungs, causing chest pain that gets worse when you cough or take deep breaths.