Understanding Mesothelioma Cancer: Causes, Symptoms, and Treatment

Mesothelioma Cancer
Mesothelioma Cancer. (source: khcc.jo)

Mesothelioma cancer is a rare and aggressive form of cancer that primarily affects the lining of the lungs, abdomen, heart, or testicles.

This devastating disease is predominantly caused by exposure to asbestos, a naturally occurring mineral that was commonly used in construction and manufacturing until its health risks became widely known.

In this article, we will delve into what mesothelioma cancer is, its causes, symptoms, and available treatment options.

What is Mesothelioma Cancer?

Mesothelioma cancer originates in the mesothelium, a protective membrane that covers and surrounds various organs in the body.

The mesothelium consists of two layers: the visceral layer, which covers the organ, and the parietal layer, which lines the chest, abdomen, or other cavities.

Mesothelioma can develop in any of these layers, but the most common types are pleural mesothelioma (affecting the lining of the lungs) and peritoneal mesothelioma (affecting the lining of the abdomen).

Causes of Mesothelioma Cancer

The primary cause of mesothelioma is asbestos exposure. Asbestos is a mineral that was extensively used in various industries for its heat-resistant and insulating properties.

When asbestos fibers are disturbed or damaged, they can become airborne and inhaled or ingested, leading to long-term health risks. Asbestos exposure may occur in the following settings:

1. Occupational Exposure

Many workers in industries such as construction, shipbuilding, manufacturing, and mining were exposed to asbestos on a daily basis.

2. Secondary Exposure

Family members of asbestos-exposed workers may also be at risk through the transfer of asbestos fibers on clothing or equipment.

3. Environmental Exposure

Individuals living near asbestos mines or asbestos-containing materials may have been exposed through airborne asbestos fibers.

Symptoms of Mesothelioma Cancer

Mesothelioma symptoms often do not appear until the disease has reached an advanced stage, making early detection challenging. Common symptoms include:

  • Shortness of breath
  • Chest pain or discomfort
  • Persistent cough
  • Fatigue
  • Unexplained weight loss
  • Abdominal pain and swelling (in peritoneal mesothelioma)
  • Changes in bowel habits (in peritoneal mesothelioma)

Diagnosis and Treatment

Early diagnosis is crucial for effective mesothelioma treatment. Diagnostic methods may include imaging tests like X-rays, CT scans, and MRIs, as well as biopsy to confirm the presence of cancer cells.

Treatment options for mesothelioma depend on several factors, including the stage of the disease, the location of the tumor, and the patient’s overall health. Common treatment modalities include:

1. Surgery

Surgery is one of the treatment options for mesothelioma cancer, especially for patients in the early stages of the disease.

The goal of surgery in mesothelioma treatment is to remove as much of the cancerous tissue as possible, alleviate symptoms, and potentially improve the patient’s prognosis.

However, the feasibility of surgery depends on various factors, including the stage of the disease, the patient’s overall health, and the tumor’s location.

Here are some common surgical procedures used in the treatment of mesothelioma:

Extrapleural Pneumonectomy (EPP)

This surgical procedure is typically performed for patients with pleural mesothelioma, which affects the lining of the lungs. During an EPP, the surgeon removes the affected lung, the pleura (lining of the lung), the diaphragm, and nearby lymph nodes. This aggressive surgery aims to remove all visible tumor tissue within the chest cavity.

Pleurectomy/Decortication (P/D)

Unlike an EPP, a pleurectomy/decortication surgery preserves the affected lung while removing the pleura and any visible tumor growth. This procedure is often considered for patients in earlier stages of pleural mesothelioma or those who may not be suitable candidates for an EPP.

Cytoreductive Surgery (CRS) with HIPEC

This surgical approach is primarily used for peritoneal mesothelioma, which affects the lining of the abdomen. During CRS, the surgeon removes visible tumors and heated intraperitoneal chemotherapy (HIPEC) is administered directly into the abdominal cavity to target any remaining cancer cells. HIPEC helps to kill cancer cells and prevent recurrence.

Testicular Mesothelioma Surgery

In cases of testicular mesothelioma, which is extremely rare, surgical removal of the affected testicle (radical inguinal orchiectomy) is typically the primary treatment.

It’s essential to note that surgery for mesothelioma is often accompanied by other treatments, such as chemotherapy and radiation therapy, to target any remaining cancer cells and improve the chances of success.

The choice of surgical procedure and the overall treatment plan will be determined by the patient’s specific circumstances and the expertise of the medical team.

It is crucial for patients diagnosed with mesothelioma to consult with a specialized mesothelioma treatment center or oncologist experienced in treating this rare cancer.

They can help determine the most appropriate treatment plan, including whether surgery is a viable option, and provide guidance on potential risks and benefits.

Each case of mesothelioma is unique, and treatment decisions should be made on an individual basis to maximize the patient’s chances of a favorable outcome.

2. Chemotherapy

Chemotherapy is a commonly used treatment for mesothelioma cancer. It involves the use of powerful drugs to kill or slow the growth of cancer cells.

Mesothelioma is often diagnosed at an advanced stage, and chemotherapy is typically employed as part of a multimodal treatment approach, which may also include surgery and radiation therapy.

Here’s an overview of chemotherapy for mesothelioma:

Systemic Chemotherapy

In most cases, chemotherapy drugs are administered systemically, which means they are introduced into the bloodstream and circulated throughout the body. The drugs can target cancer cells not only at the primary tumor site but also at any potential metastases (spread of cancer to other parts of the body).

Combination Chemotherapy

Mesothelioma is known for being resistant to many chemotherapy drugs when used alone. Therefore, combination chemotherapy is often preferred. Two or more drugs with different mechanisms of action are used together to improve the treatment’s effectiveness. Commonly used chemotherapy drugs for mesothelioma include pemetrexed and cisplatin or carboplatin.

Intraperitoneal Chemotherapy

For peritoneal mesothelioma (which affects the lining of the abdomen), chemotherapy drugs can be delivered directly into the abdominal cavity during surgery (intraperitoneal chemotherapy). This approach helps to target any remaining cancer cells in the area.

Intrapleural Chemotherapy

Intrapleural chemotherapy involves delivering chemotherapy drugs directly into the chest cavity, specifically for pleural mesothelioma. This can be done through a chest tube or a surgically implanted catheter.

Neoadjuvant and Adjuvant Chemotherapy

Neoadjuvant chemotherapy is given before surgery to shrink tumors, making them easier to remove. Adjuvant chemotherapy is administered after surgery to kill any remaining cancer cells and reduce the risk of recurrence.

Palliative Chemotherapy

In cases where the mesothelioma is advanced and surgery is not an option, chemotherapy may be used as a palliative treatment to alleviate symptoms, improve the patient’s quality of life, and slow the progression of the disease.

Chemotherapy for mesothelioma can be associated with side effects, which can vary depending on the specific drugs used and the individual’s response.

Common side effects may include nausea, vomiting, fatigue, hair loss, anemia, and decreased blood cell counts.

Patients receiving chemotherapy will be closely monitored by their medical team, and supportive care measures can help manage these side effects.

The choice of chemotherapy regimen and treatment duration will depend on the patient’s overall health, the stage of the disease, and the oncologist’s recommendations.

Mesothelioma treatment plans are typically personalized to best address the individual’s specific circumstances.

Patients are encouraged to discuss their treatment options, potential side effects, and expectations with their healthcare providers to make informed decisions about their care.

3. Radiation Therapy

Radiation therapy, also known as radiotherapy, is one of the treatment options for mesothelioma cancer. It uses high-energy radiation beams to target and destroy cancer cells or shrink tumors.

Radiation therapy can be used in various ways to manage mesothelioma, but its role is often limited compared to surgery and chemotherapy.

Here is an overview of radiation therapy for mesothelioma:

External Beam Radiation Therapy (EBRT)

This is the most common type of radiation therapy used for mesothelioma. During EBRT, a machine outside the body directs precisely targeted radiation beams at the tumor site. The radiation damages the DNA of cancer cells, preventing them from growing and dividing.

Intensity-Modulated Radiation Therapy (IMRT)

IMRT is a more advanced form of EBRT that allows for more precise targeting of the tumor while sparing nearby healthy tissues. This technique can reduce radiation-related side effects.

Palliative Radiation Therapy

In some cases, radiation therapy is used as a palliative treatment to relieve symptoms and improve the quality of life for patients with advanced mesothelioma. It can help reduce pain, discomfort, and the size of tumors that are causing symptoms.

Adjuvant Radiation Therapy

Adjuvant radiation therapy is administered after surgery (e.g., after pleurectomy/decortication or extrapleural pneumonectomy) to target any remaining cancer cells and reduce the risk of recurrence.

Intraoperative Radiation Therapy (IORT)

IORT involves delivering radiation therapy directly to the tumor site during surgery. It is used in some specialized centers to enhance the effectiveness of treatment.


Brachytherapy involves the placement of radioactive sources directly into or near the tumor. It is less commonly used in mesothelioma but may be considered in specific situations.

It’s important to note that radiation therapy for mesothelioma is often used in combination with other treatments, such as surgery and chemotherapy, to provide the most effective approach to managing the disease.

The choice of radiation therapy and the specific treatment plan depend on several factors, including the stage of the disease, the patient’s overall health, and the goals of treatment.

Radiation therapy can have side effects, which may include fatigue, skin irritation at the treatment site, nausea, and lung or heart problems, particularly if the radiation is directed toward the chest area.

The radiation oncology team works closely with the patient to manage these side effects and ensure the treatment is as comfortable as possible.

Patients with mesothelioma should discuss their treatment options, including radiation therapy, with their medical team.

Treatment plans are typically tailored to the individual’s specific condition and needs, and the goal is to provide the best possible outcome while minimizing side effects.

4. Immunotherapy

Immunotherapy has emerged as a promising treatment option for mesothelioma cancer, offering a new approach to harness the body’s immune system to fight the disease.

While mesothelioma has traditionally been challenging to treat, immunotherapy has shown potential in providing durable responses in some patients.

Here’s an overview of immunotherapy for mesothelioma:

Immune Checkpoint Inhibitors

Immune checkpoint inhibitors are a class of drugs that block certain proteins on the surface of immune cells, such as PD-1 or PD-L1, that inhibit the immune system’s ability to recognize and attack cancer cells. By blocking these checkpoints, immune checkpoint inhibitors can enhance the body’s immune response against mesothelioma.

Pembrolizumab (Keytruda) and nivolumab (Opdivo) are two immune checkpoint inhibitors that have shown promise in clinical trials for mesothelioma. They are typically used in advanced cases of mesothelioma, either alone or in combination with chemotherapy.

Clinical Trials

Many ongoing clinical trials are exploring various immunotherapy approaches for mesothelioma, including novel checkpoint inhibitors, cancer vaccines, and adoptive cell therapy. Participation in clinical trials can provide access to cutting-edge treatments that may offer better outcomes.

Cancer Vaccines

Some experimental therapies involve the use of cancer vaccines to stimulate the immune system to recognize and attack mesothelioma cells. One such vaccine is CRS-207, which has been tested in clinical trials for mesothelioma treatment.

CAR T-Cell Therapy

While not as commonly used for mesothelioma as other cancer types, CAR T-cell therapy is an emerging immunotherapy approach. It involves modifying a patient’s own T cells to target specific proteins on the surface of mesothelioma cells.

Combination Therapies

Researchers are exploring the potential benefits of combining immunotherapy with other treatments, such as chemotherapy, radiation therapy, or targeted therapy, to enhance the immune response and improve overall outcomes.

It’s essential to understand that not all patients with mesothelioma are candidates for immunotherapy, and the effectiveness of these treatments can vary from person to person.

The decision to use immunotherapy is based on factors such as the patient’s overall health, the stage and type of mesothelioma, and the presence of specific biomarkers.

Immunotherapy for mesothelioma is relatively new, and ongoing research continues to refine its use and identify which patients are most likely to benefit.

Patients diagnosed with mesothelioma should consult with a specialized mesothelioma treatment center or oncologist experienced in immunotherapy to determine the most appropriate treatment plan and whether immunotherapy is a suitable option for their specific case.

5. Clinical Trials

Clinical trials play a crucial role in advancing the treatment and understanding of mesothelioma cancer. They provide opportunities for patients to access innovative therapies and contribute to the development of new treatments and approaches.

Here’s an overview of clinical trials in mesothelioma:

Why Clinical Trials are Important

Clinical trials are research studies that involve patients to evaluate the safety and effectiveness of new treatments, drug combinations, therapies, and medical devices.

They help determine whether a new treatment is more effective than existing ones or if it offers benefits such as improved quality of life or fewer side effects.

Clinical trials also help researchers gather data on the long-term outcomes and potential risks associated with new treatments.

Types of Clinical Trials for Mesothelioma

Treatment Trials

These trials test new therapies or treatment combinations, such as chemotherapy, radiation therapy, immunotherapy, targeted therapy, or surgery. They aim to identify better treatment options for mesothelioma patients.

Prevention Trials

These trials focus on strategies to prevent mesothelioma, often by testing medications or interventions in individuals at high risk due to asbestos exposure.

Screening Trials

These trials investigate new methods for the early detection of mesothelioma, with the goal of diagnosing the disease at an earlier, more treatable stage.

Supportive Care Trials

These trials focus on improving the quality of life for mesothelioma patients by addressing symptoms, side effects, and supportive care measures.

Finding Clinical Trials

Patients interested in participating in clinical trials can consult with their oncologist or mesothelioma specialist to explore available options.

Research organizations, cancer centers, and clinical trial databases such as ClinicalTrials.gov can provide information on ongoing trials.

It’s important to consider factors such as eligibility criteria, location, and potential benefits and risks when selecting a clinical trial.

Benefits and Considerations

Participating in clinical trials can provide access to cutting-edge treatments that may not be available through standard care.

Patients in clinical trials receive close medical monitoring and follow-up care.

However, there are potential risks, including unknown side effects and the possibility that the new treatment may not be more effective than existing options.

Informed Consent

Before participating in a clinical trial, patients must go through an informed consent process. This process ensures that patients are fully informed about the trial’s purpose, procedures, potential risks, and benefits, and they have the opportunity to ask questions.

Ethical Considerations

Clinical trials are conducted following strict ethical guidelines to protect the rights and well-being of participants. Independent ethics committees review and approve trial protocols.

Future Impact

By participating in clinical trials, patients contribute to the advancement of mesothelioma research, potentially leading to improved treatments and outcomes for future patients.

In summary, clinical trials are a crucial component of mesothelioma research and treatment. They offer hope for patients seeking alternative therapies and contribute to the ongoing efforts to find more effective treatments and ultimately improve the prognosis for individuals with mesothelioma.

Patients and their healthcare teams should carefully consider the available clinical trial options to determine the best course of action for their specific situation.


Mesothelioma cancer is a rare and deadly disease primarily caused by asbestos exposure. Understanding the causes, symptoms, and available treatments is crucial for early detection and improving the prognosis for affected individuals.

If you or a loved one has been exposed to asbestos or is experiencing symptoms associated with mesothelioma, it is essential to consult with a medical professional for a proper evaluation and diagnosis. Early intervention can significantly impact treatment outcomes and quality of life.

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