Mesothelioma Cancer: Symptoms, Causes, and Treatment Options

Mesothelioma is a rare but aggressive form of cancer that affects the mesothelium, a thin layer of tissue that covers most of the internal organs. This type of cancer is caused by exposure to asbestos, a naturally occurring mineral that was widely used in construction and manufacturing until the 1980s. Despite being banned in many countries, asbestos is still present in many older buildings and products, making Mesothelioma a continuing concern.

The symptoms of Mesothelioma can take decades to appear, and they can be easily mistaken for other conditions. Common symptoms include chest pain, shortness of breath, coughing, and fatigue. Unfortunately, by the time these symptoms appear, the cancer is often in an advanced stage, making treatment more challenging. However, early detection and treatment can improve the chances of survival, making it essential to be aware of the risks and symptoms of Mesothelioma.

where mesothelioma develops diagram

What is Mesothelioma Cancer?

Mesothelioma is a rare and aggressive form of cancer that develops in the mesothelium, a thin layer of tissue that lines the lungs, chest wall, abdomen, and other internal organs. This cancer is caused by exposure to asbestos, a naturally occurring mineral that was commonly used in construction materials, insulation, and other products until the 1970s.

Mesothelioma Stages

The stage of mesothelioma cancer describes its location since tumors first started developing, how large the tumors are, and whether they have spread to other areas of the body. Cancers are typically staged from I (1) to IV (4), with lower numbers representing earlier-stage cancers. Unfortunately, most mesothelioma patients are diagnosed in the advanced stages of the disease.

The staging for mesothelioma is based on the American Joint Committee on Cancer (AJCC) TNM system. However, pleural mesothelioma is the only type with established staging as the other types are so rare. The TNM system utilized three primary pieces of information:

  • Tumor (T): The extent and size of the primary tumor
  • Nodes (N): The spread to nearby lymph nodes
  • Metastasis (M): The spread or metastasis of tumors to distant sites

The stages for mesotheliomas in the chest (i.e., tumors in the pleural lining) are different than the staging of mesotheliomas in the abdomen (tumors in the peritoneum), and mesotheliomas in the heart (tumors in the pericardium).

Stage of Mesothelioma

Description

Stage I

Cancerous cells can be found in the pleura surrounding one lung on one side of the body.

Stage Ia

Cancerous cells can be found in the outer layer of the pleura (i.e., parietal pleura) surrounding one lung on one side of the body.

Stage Ib

Cancerous cells can be found in the innermost layer of the pleura (i.e. visceral pleura) surrounding one lung on one side of the body.

Stage II

Cancerous cells can be found on both layers of the pleura, but only on one lung. Masses of cells have increased to the size of notable tumors and may have started to spread to nearby diaphragm muscles or lung tissues.

Stage III

Tumors have spread to the chest wall, nearby lymph nodes, or the pericardium (i.e., the layer of tissue surrounding the heart), but may be small enough to remove via surgery.

Stage IV

Tumors are larger and have spread throughout different parts of the body (the chest wall, diaphragm, peritoneum, the other lung, other organs in the chest, lymph nodes, above the collarbone, etc.). Surgery is no longer an option for treatment.

Other types of mesothelioma (including peritoneal and pericardial) are too rare even among mesotheliomas to have an established staging system. Regardless, many doctors may still refer to the above staging system when talking about the spread of mesothelioma tumors.

Stage 1 – Is Stage 1 Mesothelioma Cancer Curable?

Mesothelioma is at the least advanced state during stage 1 and carries the best prognosis. During stage 1 mesothelioma, cancer tumors are localized, meaning they have not spread to other parts of the body. Although cancer caught at stage 1 is often curable, many people are not diagnosed during this early stage. Stage 1 characteristics often include:

  • Localized to one side of the body
  • No metastasis to lymph nodes or other organs
  • No or few symptoms
  • Potentially curative treatment options
  • Best prognosis

Stage 2 – How Long can you Live With Stage 2 Mesothelioma?

Following stage 1, stage 2 mesothelioma has the best curative treatment and prognosis. More people are diagnosed during stage 2 than stage 1 as symptoms often become more prevalent and persistent. Mesothelioma during this stage can often be treated with curative measures like chemotherapy, surgery, radiation, and immunotherapy. Stage 2 characteristics often include:

  • Localized to one side of the body
  • Some metastasis to lymph nodes or nearby organs
  • Mild symptoms that are often mistaken for other illnesses
  • Potentially curative treatment options
  • Fair prognosis

Stage 3 – Is Stage 3 a Terminal Cancer?

The third stage is when most people notice symptoms of mesothelioma. However, once people are diagnosed during this stage, tumors have oftentimes spread to other parts of the body, presenting a poor prognosis. Stage 3 characteristics include:

  • Localized to one side of the body
  • Metastasis to lymph nodes and nearby organs
  • Worsening symptoms
  • Palliative treatment options
  • Poor prognosis

Stage 4 – What Happens in the Final Stages of Mesothelioma?

Mesothelioma has the worst prognosis and symptoms during stage 4. In this stage, tumors have likely metastasized to other parts of the body, making it more difficult to treat. During this stage, doctors may choose to utilize palliative treatment instead of curative methods to ease symptoms. Characteristics of stage 4 include:

  • Spread to both sides of the body
  • Metastasis to lymph nodes and organs throughout the body
  • Severe symptoms
  • Palliative treatment options
  • Poorest prognosis

Mesothelioma Prognosis

Overall, the mesothelioma prognosis for all types of this cancer is poor. Most people with mesothelioma only learn of their illness after it has metastasized to other organs, lymph nodes, and/or bones. Mesothelioma treatment options during the later stages are few and there are no options for a cure.

Cancer survival timelines are most often measured by five-year survival rates. The rate is an average of all surviving patients five years after being diagnosed with mesothelioma. The average mesothelioma survival rate is 4-18 months after diagnosis, but there are some that lived longer than 10 years. The current 5-year survival rate is 10 percent.

The American Cancer Society utilizes information from the Surveillance, Epidemiology, and End Results (SEER) database. The SEER staging system breaks down into three parts:

  • Localized: Size and extent of the primary tumor
  • Regional: Metastasis of primary tumor to lymph nodes
  • Distant: Metastasis of primary tumor to distant parts of the body

TNM Stage

5-Year Average Survival Rate

Localized

20%

Regional

16%

Distant

8%

All SEER Stages Combined

12%

Mesothelioma Treatment Options

Mesothelioma is a difficult disease to treat, even when caught in its early stages because tumors grow in multiples and spread quickly to nearby tissues. The stage of cancer is typically the main factor in determining the course of treatment, followed by the patient’s overall health and ability to recover from treatment.

Stage I and II mesothelioma may be treated with surgery followed (or precipitated) by a round of chemotherapy or radiation. Advanced-stage mesothelioma that has spread to other parts of the body may be treated with emerging treatments like targeted therapy and immunotherapy. For all cancer patients, doctors often prescribe some form of palliative specialist treatment.

Deciding on a treatment plan that prioritizes your overall well-being while achieving treatment goals is important. You may need to seek a second opinion or travel to other cities for more mesothelioma treatment options.

Chemotherapy Treatments

Chemotherapy treatment utilizes cancer drugs to limit the growth of cells. Cytotoxic chemical substances either kill the cancer cells or prevent them from dividing. However, these chemicals harm both cancerous and healthy cells. Chemotherapy can also be used in conjunction with other treatments such as radiation and surgery.

Types of Mesothelioma

There are four primary types of mesothelioma, which are classified based on the location and type of mesothelial cells affected:

  • Pleural Mesothelioma: This is the most common type of mesothelioma, accounting for about 75% of cases. It develops in the lining of the lungs and chest cavity and can cause chest pain, difficulty breathing, and other respiratory symptoms.
  • Peritoneal Mesothelioma: This type of mesothelioma affects the lining of the abdomen and can cause abdominal pain, swelling, and digestive problems.
  • Pericardial Mesothelioma: This rare form of mesothelioma affects the lining of the heart and can cause chest pain, heart palpitations, and other cardiac symptoms.
  • Testicular Mesothelioma: This is the rarest form of mesothelioma and affects the lining of the testicles.

Causes of Mesothelioma

The primary cause of mesothelioma is exposure to asbestos, which can occur through inhalation or ingestion of asbestos fibers. When these fibers enter the body, they can become lodged in the mesothelial tissue and cause inflammation and scarring over time, which can lead to the development of cancer.

Other risk factors for mesothelioma include:

  • Age: Mesothelioma typically affects people over the age of 65, although it can develop in younger individuals as well.
  • Gender: Men are more likely to develop mesothelioma than women, likely due to higher rates of occupational exposure to asbestos.
  • Genetics: Some studies suggest that certain genetic mutations may increase the risk of developing mesothelioma.

Symptoms of Mesothelioma

The symptoms of mesothelioma can vary depending on the type and stage of cancer, but may include:

  • Chest pain or tightness
  • Shortness of breath or difficulty breathing
  • Persistent cough or wheezing
  • Fatigue or weakness
  • Abdominal pain or swelling
  • Nausea or vomiting
  • Unexplained weight loss

It is important to note that these symptoms can also be caused by other conditions, so it is important to see a doctor if you experience any of these symptoms, especially if you have a history of asbestos exposure.

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