What is Mesothelioma?
Mesothelioma is a rare but aggressive cancer caused by asbestos exposure. Unlike other cancers that originate in a single organ, mesothelioma develops in the protective linings of various body cavities, leading to four primary types:
- Pleural mesothelioma (lungs)
- Peritoneal mesothelioma (abdomen)
- Pericardial mesothelioma (heart)
- Testicular mesothelioma (testes)
Each type has distinct symptoms and treatment options. Understanding the differences can help patients and their families make informed decisions.
Common & Rare Mesothelioma Types
Here’s an overview of the types of mesothelioma.
Common Types of Mesothelioma by Cell Type and Location:
- Pleural Mesothelioma – Forms in the lung lining.
- Peritoneal Mesothelioma – Forms in the abdominal lining.
- Epithelioid Mesothelioma – Cancer made up of epithelial cells.
- Biphasic Mesothelioma – Contains both epithelial and sarcomatoid cells.
Rare Types of Mesothelioma by Cell Type and Location:
- Pericardial Mesothelioma – Forms in the heart lining.
- Testicular Mesothelioma – Develops in the tunica vaginalis (testicular lining).
- Sarcomatoid Mesothelioma – Composed of aggressive sarcomatoid cells.
Additionally, there are other rare cell subtypes such as well-differentiated papillary cells, deciduoid, small cell, cystic, desmoplastic, adenomatoid, and heterologous cells.
Overview of Mesothelioma Types
Now let’s take a closer look at these types of mesothelioma.
1. Pleural Mesothelioma: Causes, Symptoms & Treatment
Pleural mesothelioma accounts for 70-75% of cases and develops in the pleura (the thin lining around the lungs).
Symptoms of Pleural Mesothelioma
- Early Signs: Persistent cough, chest pain, and shortness of breath.
- Advanced Symptoms: Fatigue, weight loss, and fluid buildup in the lungs (pleural effusion).
Diagnosis
- Imaging Tests: X-rays, CT scans, and MRIs to detect abnormalities.
- Biopsy: A pleural biopsy confirms the presence of mesothelioma cells.
Treatment Options
- Surgery: Pleurectomy/decortication (P/D) or extrapleural pneumonectomy (EPP).
- Chemotherapy & Radiation Therapy: Slows tumor growth and eases symptoms.
- Immunotherapy: Boosts the body’s immune response to cancer.
Patient Story: John R., a 64-year-old construction worker, was diagnosed with pleural mesothelioma. After undergoing a combination of chemotherapy and radiation, he has been able to manage his symptoms and maintain an active lifestyle.
2. Peritoneal Mesothelioma: Causes, Symptoms & Treatment
Peritoneal mesothelioma affects 10-20% of mesothelioma patients and forms in the peritoneum (lining of the abdomen).
Symptoms of Peritoneal Mesothelioma
- Bloating and abdominal pain
- Unexplained weight loss
- Loss of appetite
- Changes in bowel movements
Diagnosis
- Imaging Tests: CT scans and PET scans to identify tumors.
- Biopsy: Tissue sampling from the peritoneum for confirmation.
Treatment Options
- Cytoreductive Surgery (CRS) + Heated Chemotherapy (HIPEC): Increases survival rates.
- Chemotherapy: Used when surgery isn’t an option.
- Clinical Trials: Experimental treatments are available for eligible patients.
Patient Story: Maria L., a 52-year-old teacher, underwent HIPEC surgery and has been cancer-free for over three years.
3. Pericardial Mesothelioma: Causes, Symptoms & Treatment
Pericardial mesothelioma is extremely rare, occurring in less than 1% of cases. It forms in the pericardium (the sac around the heart).
Symptoms of Pericardial Mesothelioma
- Irregular heartbeat (arrhythmia)
- Shortness of breath
- Chest pain and fluid buildup around the heart (pericardial effusion)
Diagnosis & Treatment
- Echocardiogram & MRI: Used to detect abnormalities.
- Surgical Removal: Pericardiectomy is performed in select cases.
- Chemotherapy & Palliative Care: Helps manage pain and prolong life.
Patient Story: James T., a 58-year-old mechanic, was diagnosed at an advanced stage. Palliative treatments helped him manage his symptoms, extending his life expectancy beyond initial predictions.
4. Testicular Mesothelioma: Causes, Symptoms & Treatment
Testicular mesothelioma is the rarest form of mesothelioma, with fewer than 100 reported cases worldwide.
Symptoms of Testicular Mesothelioma
- Painless testicular lump
- Swelling in the scrotum
Diagnosis & Treatment
- Ultrasound & Biopsy: Used for diagnosis.
- Surgical Removal (Orchiectomy): The most effective treatment.
- Chemotherapy: Often recommended post-surgery.
Patient Story: Michael S., a 45-year-old factory worker, successfully underwent surgery and chemotherapy, maintaining a good quality of life post-treatment.
Types of Mesothelioma Cells
There are three cell varieties of mesothelioma:
1. Epithelial Mesothelioma
- Most common type (70-75%)
- Better response to treatment
2. Sarcomatoid Mesothelioma
- More aggressive and harder to treat
- Accounts for 10-20% of cases
3. Biphasic Mesothelioma
- A mix of epithelial and sarcomatoid cells
- Treatment effectiveness depends on the cell ratio
These cell types can be identified under a microscope.
Each of these types responds differently to treatment. Epithelial cells are the most responsive to treatment, and sarcomatoid cells are more resistant, meaning that biphasic (being a mix of those) varies in its response to treatment. These differences are taken into account by medical professionals when they are determining a treatment plan.
Epithelial Cell Mesothelioma
Being the most common mesothelioma cell type, epithelial cell mesothelioma makes up approximately 70-75% of all asbestos-related cancer. Approximately 50% of pleural mesothelioma is epithelioid, and roughly 75% of peritoneal tumors are comprised of epithelial cells.
Epithelial cells have the best prognosis and are the most responsive to treatment. They are less aggressive and don’t spread as quickly.
Sarcomatoid Cell Mesothelioma
The least common mesothelioma cell type is sarcomatoid mesothelioma (also called sarcomatous, spindle, or diffuse malignant fibrous mesothelioma), and it is the most aggressive and difficult to treat. 10-20% of all mesothelioma diagnoses are sarcomatoid. Approximately 20% of pleural tumors are sarcomatoid and a small 1% of peritoneal mesothelioma cases are.
Biphasic Cell Mesothelioma
Biphasic cell mesothelioma cases are dependent on which cell (epithelial or sarcomatoid) dominates the tumor. Typically, the presence of more epithelial cells indicates a better prognosis, while the presence of sarcomatoid cells usually indicates it will be harder to treat and an individual’s prognosis won’t be as good. Approximately 30% of pleural mesothelioma cases are biphasic and 25% of peritoneal tumors are as well.
Rare Mesothelioma Cell Types
The rare mesothelioma cell types are usually subtypes of the three cell types we covered above. They can be more difficult to diagnose and have characteristics that can affect a patient’s prognosis. Here’s an overview:
- Well-differentiated papillary cells: Commonly occur in peritoneal mesothelioma, with a very low amount of cases being reported elsewhere.
- Small cell: Occurs most commonly in the abdomen.
- Deciduoid: A little over half of deciduoid cases occur in the abdomen and the rest in the lung lining.
- Cystic cells: More common in peritoneal mesothelioma.
- Desmoplastic and lymphohistiocytic cells: More common in pleural mesothelioma cases.
- Adenomatoid cells: Occur in both benign and malignant mesothelioma cases.
- Heterologous cells: Found in tumors that may also contain cartilage, bone, and soft tissue.
Mesothelioma Symptoms by Type
Unfortunately, many of the early signs of mesothelioma can disguise themselves as minor ailments. Most patients with mesothelioma don’t receive a mesothelioma diagnosis until months after their first symptoms arise. If you have any combination of these symptoms, you should see a doctor right away.
The types of symptoms you may have can vary depending on which type of mesothelioma you have, so we’ll break it down by the different types. But here are the general symptoms of mesothelioma:
- Fever
- Excessive sweating
- Fatigue
- Unexplained weight loss
- Blood clots
- Loss of appetite
Symptoms of Pleural Mesothelioma
Pleural mesothelioma, or mesothelioma of the chest, makes up 80% of mesothelioma cases and can produce the following symptoms:
- Low grade fever
- Fatigue
- Pain in the side of the chest or lower back
- Shortness of breath
- Dry Cough/Persistent Cough
- Lung fluid buildup (pleural effusion)
- Body aches
- Trouble swallowing (feeling like food gets stuck)
- Hoarseness
- Swelling of the face and arms
- Blood clots
Late-stage symptoms include:
- Night sweats
- Fever
- Anemia
- Difficulty swallowing
- Coughing up blood
- Face or arm swelling
- Hoarseness
Symptoms of Peritoneal Mesothelioma
Peritoneal mesothelioma, or mesothelioma of the abdomen, makes up about 20% of mesothelioma cases and can produce the following symptoms:
- Abdominal pain
- Abdominal swelling
- Fluid in the abdomen
- Nausea and vomiting
- Constipation or other bowel issues
- Intestinal obstruction
- Weight loss
- Loss of appetite
Symptoms of Pericardial Mesothelioma
Pericardial mesothelioma, or mesothelioma of the heart, makes up less than 1% of mesothelioma cases and can produce the following symptoms:
- Chest pain
- Irregular heart rhythm
- Irritation and thickening of the pericardium
- Heart murmur
- Pericardial effusions (fluid buildup in the pericardium)
- Pericardial bleeding
- Shortness of breath or difficulty breathing
Getting a Mesothelioma Diagnosis
If you are experiencing any of the symptoms above and were exposed to asbestos, talk to your doctor right away. They’ll use scans to detect abnormalities in your body and may require biopsies for definitive proof of mesothelioma.
After diagnosis, reach out to us. We could help get you compensation to cover your medical care and hold those responsible who negligently exposed you to the asbestos that caused your illness.
Your diagnosis will depend on your current stage of mesothelioma.
Staging of Mesothelioma
Doctors use three-staging systems to describe the spread of mesothelioma (not to be confused with the four stages of mesothelioma). These staging systems are typically used for identifying common lung cancers and can help the doctors determine how far the tumor has spread and which treatment options are available based on their findings.
These staging systems include:
TNM
(T) refers to the growth of the tumor, (N) refers to the extent the tumor has spread to nearby lymph nodes, and (M) refers to the tumors spread to other organs.
Brigham System
Doctors use this four-stage system to describe how the spread of the tumor affects their ability to surgically remove it.
Butchart System
The most common and oldest staging method, doctors use this four-stage method to describe the location of the main tumor.
Stages of Mesothelioma, All Types
There are four stages of mesothelioma that are used by medical professionals to determine the progression of it and the best course of treatment. These stages are based on the size of the tumor and how far it has spread. Stage 1 usually has the best prognosis, while stage 4 is known as the end-stage of mesothelioma with the shortest average life expectancy. One of the main reasons mesothelioma can be so hard to be diagnosed is that the first two stages have less noticeable symptoms, while stages 3 and 4 have symptoms that usually lead to a diagnosis.
Stage 1 of Mesothelioma
In stage 1, the tumor is localized and hasn’t spread. Most treatment options are available at this stage and a person’s life expectancy is significantly better than in the later stages. This is a difficult stage to catch cancer because an individual may not be experiencing very many symptoms.
Stage 2 of Mesothelioma
In stage 2, the cancer cells have begun to enter nearby lymph nodes. The tumors remain small enough that they could be removed surgically, which will positively affect the patient’s life expectancy.
Stage 3 of Mesothelioma
In stage 3, the tumor progression is evident in nearby organs and distant lymph nodes. Treatment options are more limited than in earlier stages, but certain therapies can help improve quality of life. If surgery is available, a patient could live many more years.
Stage 4 of Mesothelioma
In stage 4, the cancer cells have spread throughout the body cavity and to other organs. At this stage, most treatment options (including surgery) are no longer viable options, and palliative care is used to reduce the severity of symptoms. The median life expectancy for someone with stage 4 mesothelioma is typically 14 months or less.
This is the stage in which metastasis happens, where cancer has spread far from where it first developed. Unlike most other cancers, mesothelioma tends to only metastasize locally rather than distantly.
Treatment Options After Diagnosis
Depending on the stage that your mesothelioma is at, you may have the following available to you:
- Surgery (Available in Stages 1, 2, and rarely 3)
- Chemotherapy and Immunotherapy (Available in every stage)
- Radiation therapy (Available in every stage)
- Clinical trials (Dependent on your doctor)
It’s always important to talk to your doctor about your options and to keep an open mind. They should be able to give you a good treatment plan that fits your stage of mesothelioma and will hopefully care for you to the best of their ability.
Final Thoughts
Mesothelioma is a challenging disease, but early detection and tailored treatment plans can significantly improve prognosis. If you or a loved one has been exposed to asbestos and experience symptoms, consult a mesothelioma specialist immediately.