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This information was reviewed and approved by Jeffrey Kern, MD, Bronwyn Long, DNP, MBA, ACHPN, AOCNS, ACNS-BC, Laurie L. Carr, MD (3/31/2014).

Mesothelioma is a type of cancer where the tumor grows on the mesothelium, which is a lining inside a body cavity. Pleural mesothelioma starts in a part of the chest called the pleura, which is the lining that surrounds the lungs and internal chest wall. It separates the lung from the chest wall.

Pleural mesothelioma is different from lung cancer, which grows inside the lung. Pleural mesothelioma grows in the lining of the lung.

 

How is it caused?



Pleural mesothelioma is known to be caused by breathing asbestos fibers. Your exposure may have occurred many years ago. Asbestos was a popular form of insulation at one time and was used commonly in homes and buildings. Other agents may also cause pleural mesotheliomas but are not known.

 

How is it treated?



Pleural mesothelioma may be treated with surgery, chemotherapy, radiotherapy or a combination of the three.

  • Chemotherapy: The first-line chemotherapy treatment is a combination of Cisplatin and Pemetrexed, given every 21 days, usually for 4-6 cycles.

  • Surgery: Surgery may be an extra-pleural pneumonectomy. In this procedure, the pleura with the mesothelioma is removed from the chest wall, diaphragm and lung. In addition, the entire lung is removed at the same time, trying to keep the pleura and lung together as one piece will keep the mesothelioma as contained as possible.

  • Radiotherapy: Radiotherapy may be given to kill any remaining mesothelioma.

Pleural effusions are often a part of the pleural mesothelioma. The fluid that collects around the lung in the chest cavity can lead to shortness of breath. The fluid can be removed by a procedure called a thoracentesis or "tap." If the fluid comes back, a pleuredesis is performed. This glues the lung to the chest wall to prevent any further fluid accumulation.

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Christopher B. Jones

Christopher B. Jones, MD