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Mesothelioma is a rare cancer that starts in the mesothelium, a layer of tissue that lines the outside of the lungs, called the pleura, and the inside of the chest wall and abdominal cavity.
While many tumors have clear, defined edges, mesothelioma does not. Instead, it can surround organs and fill in the chest and abdominal cavity, compressing the lungs.
Types of mesothelioma
Most cases of mesothelioma start in the pleura. This type of mesothelioma also is called malignant pleural mesothelioma.
A rarer type of mesothelioma starts in the abdomen and is called malignant peritoneal mesothelioma.
Mesothelioma is also categorized by the type of mesothelial cells where the disease starts. These types of mesothelioma are:
- Epithelioid: This accounts for 60% to 70% of mesothelioma cases. It usually has the best outcomes.
- Sarcomatoid: About 10% to 15% of cases are sarcomatoid mesothelioma. It is more aggressive than epithelioid mesothelioma.
- Biphasic or mixed: This type of mesothelioma has both epithelioid and sarcomatoid cells. Between 10% and 15% of cases fall into this category. This is an extremely aggressive form of the disease.
Mesothelioma can begin in he pleura, the layer of tissue that lines the chest wall. Surgical treatments include pleurectomy/decortication and extrapleural pneumonectomy. Visit the meseothelioma symptoms page to learn about these procedures.
Mesothelioma causes
Mesothelioma usually is caused by past exposure to asbestos.
Asbestos is a fibrous mineral that was used in several industries in the past. These include construction, automotive, military, marine and manufacturing.
When tiny particles of asbestos are made or disturbed, they can float in the air. People can breathe in or swallow these particles.
Asbestos fibers can remain in the body for decades. In some cases, these fibers cause genetic changes to mesothelial cells, leading to mesothelioma. The disease typically occurs 30 to 50 years after a person has come in contact with asbestos. Often patients will not be aware of this past asbestos exposure.
Asbestos can cause serious health conditions other than mesothelioma. These include cancers of the lung, larynx and kidney. It also can cause asbestosis, a non-cancerous, chronic lung disease.
Who gets mesothelioma?
Most mesothelioma cases are caused by exposure to asbestos that took place decades before the diagnosis. Asbestos was commonly used in manufacturing and construction, into the 1980s, so people who worked in those fields prior to that time are often diagnosed with the disease. People who worked in buildings that contained asbestos may also have an increased risk.
Symptoms
Mesothelioma symptoms include shortness of breath and constant, uninterrupted pain in the chest or abdomen. Lean more, including other possible diagnoses and who should get screened, on our mesothelioma symptoms page.
Diagnosis
Mesothelioma is diagnosed by studying suspected cancer tissue under a microscope. Doctors also rely on imaging exams to understand each patient’s condition. Read more on the mesothelioma diagnosis page.
Treatment
Mesothelioma patients usually get a combination of treatments, including surgery, cancer drugs and radiation therapy. Clinical trials are also available. Find more information, including types of surgery and treatment side effects, on the mesothelioma treatment page.
Mesothelioma survival rates
The five-year survival rate for pleural mesothelioma is around 15%, though that number can change depending on the patient’s specific subtype. People diagnosed when the disease is confined to the pleura have a slightly higher survival rate, while those diagnosed after it has spread have a lower survival rate.
These figures do not include people diagnosed in the past few years, who may benefit from newer treatments.
Mesothelioma risk factors
Anything that increases your chance of getting mesothelioma is a risk factor. The risk factors for mesothelioma are:
- Asbestos exposure: Asbestos exposure accounts for most cases of mesothelioma. Exposure usually occurred decades before the disease is diagnosed.
- Gender: Mesothelioma is more common in men. This is likely due to more men than women working in industries that frequently used asbestos, such as construction and manufacturing.
- Radiation exposure: People who have received radiation for other cancers may later develop mesothelioma. This is not a major risk factor, and the benefits of radiation therapy as a cancer treatment far outweigh the risks.
Not everyone with risk factors gets mesothelioma. However, if you have been exposed to asbestos, it’s a good idea to tell your doctor.
Is mesothelioma hereditary?
A small percentage of mesothelioma cases are connected to a mutation in the BAP1 gene. Doctors believe this mutation increases the chances of developing mesothelioma in people exposed to asbestos. This mutation can be passed down from parent to child. Visit the Family History section to learn more about hereditary cancer and genetic counseling.
Asbestos exposure and cancer: 8 things to know
Most cases of mesothelioma are caused by exposure to a substance called asbestos. This rare cancer develops in the mesothelial cells, the thin layer of tissue that lines the chest cavity and is also known as the pleura.
But what is asbestos? How might you be exposed to it? And, is there anything you should do to lower your risk of developing asbestos-related cancers?
We spoke with , vice president and head of Cancer Prevention and Population Sciences. He’s what he shared.??
What is asbestos, and how might the average person be exposed to it?
Asbestos is a group of six naturally occurring mineral fibers that have special properties, such as being fire resistant and good insulators. They are found in certain types of rock and extracted through mining. Their names are:
- Actinolite?
- Amosite?
- Anthophyllite?
- Chrysotile?
- Crocidolite
- Tremolite
Until the 1970s, asbestos was used a lot in manufacturing. It could be found in everything from roof shingles and brake pads to flooring and insulation. Once asbestos was identified as a carcinogen, though, government agencies stepped in to start limiting its use. They also developed strict protocols on how materials containing asbestos could be handled, removed and disposed of.
Asbestos exposure is not considered as much of an issue today because its use has declined so much in the past 50 years.?
Is there anything I should do to reduce my risk of asbestos exposure?
For the most part, no. Asbestos finds its way inside our bodies primarily through respiration. In other words, we breathe in the fibers and dust when we’re exposed to ore or other materials containing asbestos, and they get caught inside our lungs.
Small amounts of asbestos are still used in some products and industries today. But the average person probably won’t encounter it in high enough concentrations to increase their risk of developing a related cancer.?
Prolonged, repeated exposure to asbestos is required for cancer to become an issue. That’s why people who lived or worked close to Ground Zero after the 9/11 World Trade Center attacks are at increased risk. And, anyone involved in the renovation or demolition of older residential or commercial structures could also be exposed to asbestos.
But unless you’re a miner, auto mechanic, roofer or construction laborer who worked in those industries mostly before about 1970, your risk is pretty low.
Which cancers are caused by asbestos exposure??
Mesothelioma is by far the most common. But asbestos exposure has also been linked to lung cancer, laryngeal cancer, ovarian cancer and even some gastrointestinal cancers.?
Interestingly, asbestos was a factor in the recent lawsuits linking talcum powder to ovarian cancer, too. I’ve often wondered how something that's primarily inhaled can get so far inside the body. Maybe that connection will someday become clearer.
Are there any warning signs or symptoms of asbestos exposure?
No. That’s one of the challenges. There weren’t any screening tests to look for asbestos-related cancers in otherwise healthy individuals back in the 1970s. There still aren’t today. That’s why these cancers tend to be found in more advanced stages.?
How are asbestos-related cancers usually diagnosed?
Mesothelioma and lung cancers caused by asbestos exposure are normally diagnosed with a chest X-ray in someone who complains of shortness of breath, trouble breathing, persistent coughing or other symptoms.
Why does asbestos exposure cause cancer?
There are currently three theories:
- Chronic inflammation
- Changes in cell signaling, or how our cells communicate with one another
- Free radicals, or highly unstable oxygen molecules that can damage cell DNA?
But none of these offers a really satisfying explanation. So, it’s still a bit of a mystery.?
Are there any unique features to help identify asbestos-related cancers?
No. I’ve seen reports that researchers are exploring potential blood markers. But it’s all still very experimental, so there’s nothing definitive yet. And, there are no distinctive, signature mutations related to asbestos exposure that I know of.
Even when we find actual asbestos particles in a biopsy specimen and can infer that it played a major part in causing a cancer, it doesn’t really influence treatment, as there is no treatment tailored to it.
What’s the most important thing to know about asbestos and cancer?
This is one instance in which government regulation has been really helpful. There’s always a bit of second-guessing involved at the beginning of that process, when you wonder, “Are we overdoing this?”
But there’s no doubt now that asbestos regulation has significantly decreased the incidence of all exposure-related diseases, including cancer. Recognizing the link between asbestos and cancer — and then acting on it by removing the source of exposure — has proven to be a highly effective prevention strategy.
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Why choose UT MD Anderson for mesothelioma treatment?
Mesothelioma is both rare and serious. With just a few thousand cases diagnosed in the United States each year, it is important to find a team with experience treating this disease.
At UT MD Anderson, you will be cared for by a team of doctors and other care providers with special expertise in treating mesothelioma. This team includes medical oncologists, surgeons, radiation oncologists, pulmonologists, pathologists and more. All are experts in their fields and in mesothelioma. They work together closely to customize the best treatment for you.
Groundbreaking research
As a top-ranked cancer center, UT MD Anderson's researchers are pioneering remarkable advances to give you the best chance for fighting mesothelioma. These include:
- Immunotherapy drugs designed to recruit the body’s own immune system in the fight against mesothelioma.
- Advanced surgical techniques that can improve outcomes while shortening hospital stays and recovery times.
- Targeted radiation therapy that focuses on cancer cells while minimizing damage to healthy nearby tissue.
Many clinical trials at UT MD Anderson are not available at other cancer centers. In fact, we offer clinical trials for patients at all stages of mesothelioma, including treatments for mesothelioma in its early stages, mesothelioma that has spread to other parts of the body, and mesothelioma that has returned or recurred.
And, at UT MD Anderson you're surrounded by the strength of one of the nation's foremost comprehensive cancer centers. We have all the support and wellness services needed to treat the whole person – not just the disease.
We're here to meet our patients where they are and journey with them.
Treatment at UT MD Anderson
UT MD Anderson mesothelioma patients can get treatment at the following locations.
UT MD Anderson's Thoracic Center