Of the three major types of the disease, pleural mesothelioma is by far the most common. It accounts for 65-70% of all new diagnoses today. Many of the information documents you’ll see on mesothelioma will focus solely on the pleural variant of the disease.
What is the Pleura?
The pleura consists of two sections of the mesothelium, a membrane that covers many of the organs in the body and provides a lining for both the chest wall and the abdominal wall. The visceral pleura is the membrane that wraps around the outer surface of the lungs. The parietal pleura lines the chest wall opposite the lungs. Under normal circumstances there is a thin film of fluid between these two membranes that lubricates the action of the lungs as they inhale and exhale. When that fluid is absent the lungs rubbing against the chest can be very painful.
Is Pleural Mesothelioma Lung Cancer?
No it is not. Pleural mesothelioma forms on the membrane lining the outer surface of the lungs, whereas lung cancer develops within the lung itself. It is true that lung cancer and pleural mesothelioma share several common symptoms: shortness of breath, a persistent dry cough, chest pain or chest pressure, and coughing up blood. But the malignant tissue found with pleural mesothelioma is located on the surface that lines the outer lungs, or on the chest wall, or both. Asbestos can cause lung cancer, but pleural mesothelioma is a different form of malignancy altogether.
One of the causes for chest pain and shortness of breath is the gradual thickening of the pleura that takes place as the disease matures. Pleural thickening in combination with pleural effusion, an excess of pleural fluid, puts substantial pressure on the lungs and their ability to function properly.
Pleural Mesothelioma Treatments
As with most cancers, pleural mesothelioma has three standard treatment modalities: chemotherapy, radiation, and surgery. The best scenario for a patient with this disease is a diagnosis made early enough that surgery is feasible. If that is the case, the surgeon will remove most or all of the malignant portion of the mesothelium. That may mean removing the chest wall lining as well as a portion of the lining for the outer lungs. It is not unusual for a surgeon to also remove one or more of the lung lobes on the side of the body where the mesothelioma is located. If pleural mesothelioma is going to metastasize, moving into the lung occurs early in the process. A section of the lung may be removed as a precautionary measure.
Chemotherapy is the most effective of the externally applied therapy options. Radiation has a modest impact on most cases of mesothelioma; chemotherapy can have substantial impact if the drugs that are used successfully target the malignant cells on the pleura. There are several variations for the cellular structure of pleural mesothelioma; different cancer cells respond to different chemotherapy drugs. There is also a new approach to chemotherapy utilized in the operating room while the patient is still on the table. Heated chemotherapy drugs are applied directly to the impacted area, providing a much more direct, targeted use of this treatment modality. Intraoperative chemotherapy is followed up with the standard post-operative applications of radiation and chemo.
Legal Rights for Pleural Mesothelioma Patients
In the twentieth century millions of workers were exposed to hazardous asbestos products while at work. The huge majority of all mesothelioma cases have developed as the result of on-the-job exposure. Hundreds of thousands of lawsuits have been filed against corporations that made or used asbestos products resulting in nearly $79 billion in settlements. If you or a family member has pleural mesothelioma you may be eligible for compensation.
Malignant Mesothelioma, American Cancer Society
Mesothelioma, National Cancer Institute
Surgery for Malignant Pleural Mesothelioma, Medscape, Dr. Paul Sugarbaker