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CancerICD-10: C45.0Approximately 3,000 new cases are diagnosed annually in the United States

Mesothelioma

Also known as: Malignant Mesothelioma, Asbestos Cancer, Pleural Mesothelioma

Mesothelioma is an aggressive and often fatal cancer that develops in the mesothelium, the thin layer of tissue lining the lungs (pleural mesothelioma), abdomen (peritoneal mesothelioma), or heart (pericardial mesothelioma), and is strongly associated with asbestos exposure. The disease typically has a long latency period of 20-50 years between asbestos exposure and symptom onset, and is often diagnosed at an advanced stage when treatment options are limited. Despite advances in surgery, chemotherapy, and immunotherapy, the prognosis remains challenging, with a median survival of 12-21 months after diagnosis.

Symptoms

Shortness of breath and difficulty breathing
Chest pain or tightness under the rib cage
Persistent dry cough
Unexplained weight loss and fatigue
Pleural effusion (fluid buildup around the lungs)
Abdominal pain and swelling (peritoneal mesothelioma)
Lumps of tissue under the skin of the chest
Night sweats and fever

Causes

  • Inhalation or ingestion of asbestos fibers
  • Chronic inflammation and cellular damage from embedded asbestos fibers
  • Genetic mutations in mesothelial cells triggered by asbestos exposure
  • Rarely, exposure to erionite (a naturally occurring mineral) or radiation therapy to the chest

Risk Factors

  • Occupational asbestos exposure (construction, shipbuilding, mining, manufacturing)
  • Living with someone who works with asbestos (secondhand exposure on clothing)
  • Living near asbestos mines or contaminated sites
  • Age over 65 (most diagnoses occur between 65 and 75)
  • Male sex (4-5 times more common in men due to occupational exposure patterns)
  • History of radiation therapy to the chest

Diagnosis

  • Chest X-ray and CT scan showing pleural thickening or effusion
  • PET scan to assess cancer extent and detect distant metastases
  • Thoracoscopic or laparoscopic biopsy for definitive tissue diagnosis
  • Immunohistochemistry staining to distinguish mesothelioma from other cancers
  • Pulmonary function tests to evaluate respiratory capacity

Treatment

  • Multimodal therapy combining surgery, chemotherapy, and radiation
  • Extrapleural pneumonectomy (EPP) or pleurectomy/decortication for operable cases
  • Pemetrexed and cisplatin/carboplatin chemotherapy as first-line treatment
  • Immunotherapy with nivolumab and ipilimumab for unresectable disease
  • Tumor treating fields (TTFields) in combination with chemotherapy
  • Palliative care including pleural drainage and pain management

Prevention

  • Avoid exposure to asbestos in occupational and environmental settings
  • Follow OSHA regulations and use proper protective equipment when working with asbestos
  • Have older buildings inspected for asbestos before renovation or demolition
  • Do not disturb asbestos-containing materials; hire licensed professionals for removal
  • Seek regular medical monitoring if you have a history of asbestos exposure

When to See a Doctor

  • You have a history of asbestos exposure and develop persistent cough or shortness of breath
  • You experience unexplained chest or abdominal pain with weight loss
  • You notice increasing shortness of breath or difficulty breathing
  • You have known asbestos exposure and want screening evaluation

Frequently Asked Questions

Related Conditions

Chronic Obstructive Pulmonary Disease

Respiratory

Asthma

Respiratory

Pneumonia

Respiratory

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

Content reviewed against peer-reviewed medical literature and clinical guidelines. Read our editorial standards.