Pleural Mesothelioma Pleural mesothelioma is cancer that affects the mesothelium around the pleura, or walls surrounding the lungs. 2000 – 3000 mesothelioma cases are diagnosed each year. Out of all mesothelioma cases, approximately 75% begin in the pleural mesothelium. How does Pleural Mesothelioma Form? Over time, asbestos fibers inhaled during asbestos exposure can migrate outward into the pleura and mesothelium. Once there, they cause changes to the cells that eventually become cancer. Pleural mesothelioma has a long latency period. This means that many years can pass between the asbestos exposure and the diagnosis of the cancer. Diagnosis & Treatment Pleural mesothelioma is rarely detected early. There are several reasons for this: Some victims don’t know they were exposed to asbestos, or it was so long ago they forgot about it. Many victims don’t know that asbestos causes mesothelioma, and/or are unaware of the symptoms. Early symptoms often mimic other less dangerous conditions. Mesothelioma is rare and many doctors have little or no experience diagnosing it. Because of these reasons, most mesothelioma diagnosis occur when the patient is in more advanced stages of the disease and few treatment options are available. Symptoms The symptoms of pleural mesothelioma may include some or all of these: Breathing difficulties, shortness of breath, persistent cough, coughing up blood, hoarse voice Unexplained weight loss Night sweats or fever Back pain Fluid in the chest between the chest wall and lungs. This is called pleural effusion. Facial swelling Fatigue Diagnosis Most often, a mesothelioma diagnosis occurs after a patient has seen their primary care or family physician several times for their symptoms, but the prescribed treatments have not helped. At that point, the doctor may order x-rays, MRI or another diagnostic procedure. Symptoms, such as pleural effusion, may be evident from these procedures and then a specialist will conduct a biopsy (removal and examination of tissue). When the biopsy indicates the presence of cancer in the mesothelium of the pleura, pleural mesothelioma is the diagnosis. Treatment Treatment depends on the stage at which the diagnosis is made, the patient’s overall health, the advice of the physician and the preference of the patient and their family. Tragically, most diagnoses occur when the disease is in advanced stages and few treatment options are available. At this time, there is no cure for pleural mesothelioma. There are three main types of treatment currently being used: Palliative treatment - the main purpose of palliative treatments is to make the patient more comfortable. These may include surgeries to reduce fluid build up or remove large tumors. Medication to help with the pain is often prescribed. Some patients also choose to participate in alternative palliative therapies such as meditation, prayer, taking herbs or supplements, or eating a special diet. Some believe these alternatives may help reduce pain and anxiety or even cure the disease. Unfortunately, there is no scientific evidence that alternative therapies cure or slow the spread of the disease. But some may find them comforting or helpful in other ways. Curative treatment - since there is no cure for pleural mesothelioma, "curative” therapies don’t cure the disease. Instead, they try to reduce the amount of cancer in the body, slow its spread, or increase the survival time. The three main curative treatments used for pleural mesothelioma are surgery, chemotherapy, and/or radiation. Experimental therapies - these are new treatments that are being explored in research and clinical trials. As yet, none have been shown to cure pleural mesothelioma, but several offer hope of a cure in the future. Several clinical trials for pleural mesothelioma include: immunotherapy, photodynamic therapy, gene therapy and anti-angiogenesis therapy. Survival The survival rates for those diagnosed with pleural mesothelioma average one year after diagnosis. This number is an average, so some people live much less, and some live much longer, up to five years.