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Pleural Mesothelioma

The most common kind of mesothelioma is pleural mesothelioma.  This is when the cancer begins on the lining of the lung or on the lining of the chest cavity. These two linings provide lubrication for the lungs to expand normally when you breathe.

What is Pleural Mesothelioma?

It is believed that people who inhale asbestos dust are inhaling tiny needle-like fibers.  These fibers get trapped within the lungs and are difficult or impossible to fully cough up.  Over time, the needles migrate throughout the lungs.  They stay lodged in the lining of the lungs for many years — up to 60 years in some cases.

Over time, the fibers irritate the lining of the lung and scar tissue begins to build. It then grows in the lining of the lungs, creating a large tumor.  Parts of the tumor may break off and spread through the bloodstream and lymph system until the cancer is in several parts of the body.

Symptoms of Pleural Mesothelioma

Common symptoms of pleural mesothelioma include:

  • Persistent cough
  • Unexplained weight loss
  • Chest pain
  • Lumps noticed on the skin of the chest wall
  • Chronic shortness of breath

In pleural mesothelioma, you may think you just have a chest infection such as bronchitis, pleurisy, or pneumonia. If your symptoms do not go away after several weeks of coughing and chest pain or if you notice lumps beneath the skin of the chest area, you may need to get tested for mesothelioma.

Diagnosing Pleural Mesothelioma

An X-ray, CT scan or MRI scan of the chest can show thickening of the lining of the lungs in certain areas—an indication that you have asbestos plaques on your pleural tissue, some of which may now be cancerous.  To get a proper diagnosis, you may need to get a biopsy or tissue sample from the affected area.

If the Diagnosis of Mesothelioma is Positive

If you are diagnosed with pleural mesothelioma, you’ll want to see one of the top doctors who deal with mesothelioma all the time.  It might mean traveling to the VA medical centers in Los Angeles or Boston, seeing the best mesothelioma doctors in the country.  Some top pleural mesothelioma doctors to contact include:

  • Dr. Avi Lebenthal
  • Dr. Robert Cameron
  • Dr. David Sugarbaker

Facts about Pleural Mesothelioma

  • It is caused by the inhalation of asbestos fibers.
  • It occurs commonly in veterans exposed to asbestos in military construction and naval shipyards.
  • It is the most common type of mesothelioma.
  • Family members of asbestos workers can get mesothelioma, too.
  • Changes in the pleura of the lung don’t occur for at least ten years.
  • Calcium deposits are the first sign that asbestos has infiltrated the pleural membrane.
  • Pleural plaques of inflamed tissue put you at a higher risk of having mesothelioma later in life.
  • Pleural mesothelioma is aggressive, often metastasizing within one year after diagnosis.

Treating Pleural Mesothelioma

Surgery

Surgery is difficult to do in pleural mesothelioma because it has often metastasized (traveled) to other body areas by the time it is diagnosed. Common areas of metastasis are the lymph tissue and abdominal organs, although other vital organ may be affected.

If your mesothelioma specialist thinks that surgery will work for you, there are two major surgeries they may consider.  These include:

  • Extrapleural pneumonectomy (EPP). Patients with localized disease may be eligible for the extrapleural pneumonectomy (EPP), a radical surgery that removes cancerous tissue by removing the entire affected lung. During an EPP, parts of the pericardium, the diaphragm, and the pleural tissue are removed along with the cancerous lung.
  • Pleurectomy with decortication (P/D). During this procedure, the tumor is carefully removed along with any other areas of the lung affected by pleural plaques or pleural disease.  It is preferred by some mesothelioma specialists because it is less radical of a procedure than the EPP.

Chemotherapy

Chemotherapy is the most used treatment for mesothelioma because most people are not eligible for surgery. In many cases, the mesothelioma has already spread to other tissues at the time of diagnosis.

There have been many types of chemotherapy used in clinical studies but currently only a combination of Alimta (pemetrexed) and cisplatin are approved by the US Food and Drug administration to treat mesothelioma.  Going through chemotherapy can be difficult but the process has shown to shrink tumors caused by mesothelioma.

Radiation Therapy

Radiation therapy is used to treat some cases of pleural mesothelioma.  It is often combined with other treatments, like chemotherapy or surgery.  Radiation uses painless X-ray waves that destroy parts of the tumor.  Radiation can shrink the tumor but is not considered a curative measure.

Alternative Therapy

Alternative therapies have become popular in the treatment of mesothelioma pain and symptoms.  These include reflexology, acupuncture, or massage to help mesothelioma patients feel better and less anxious. Patients using alternative therapies  often tolerate the stress of having chemotherapy and radiation better than patients who do not.  Speak to your mesothelioma specialist about alternative therapies if you think they will help you.

Sources & Author Edited: September 1, 2015

About the Writer

Retired LCDR Carl Jewett

LCDR Carl Jewett is a retired Naval Officer, having served just under 24 years in the submarine force. He currently serves as a VA Accredited Claims Agent and as the Executive Director of the Veterans Assistance Network. He specializes in assisting veterans filing VA claims for asbestos-related disabilities such as mesothelioma and asbestos-related lung cancer.

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