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Pleural Mesothelioma

Pleural mesothelioma develops in the lung lining (pleura) and is the most common type of mesothelioma. Symptoms include chest pain, chronic cough, and shortness of breath. Treatments like surgery or chemotherapy can help you live longer and ease painful symptoms. Learn more about pleural mesothelioma and how our team can help you navigate your cancer journey.

Medically reviewed by: Mark Levin, MD

Last updated:

What Is Pleural Mesothelioma?

Malignant pleural mesothelioma is a type of cancer that develops in the pleura, the thin lining of tissue surrounding the lungs.

It is the most common form of malignant mesothelioma, accounting for about 80% of all cases.

Key Facts on Pleural Mesothelioma
  • Approximately 2,400 Americans are diagnosed with pleural mesothelioma each year.
  • Asbestos exposure is the only known cause.
  • Pleural mesothelioma is the only type of mesothelioma with its own formal staging system.
  • Men make up 80% of pleural mesothelioma patients, according to Cancer Therapy Advisor.
What Is Pleural Mesothelioma? Video Thumbnail

Pleural mesothelioma is the most common type of this cancer and accounts for about 80% of all cases. It forms in the pleura (lung lining) 10-50 years after asbestos exposure.

Duration: 1 min 00 sec

Learn more about pleural mesothelioma — and the most effective ways to treat it — in our Free Pleural Mesothelioma Guide.

Mesothelioma Guide Images
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  • Symptoms & staging
  • Average prognosis
  • Life-extending treatments

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Pleural Mesothelioma Symptoms

Pleural mesothelioma symptoms often don’t show up until 10-50 years after initial asbestos exposure.

 Common warning signs of this cancer include:

  • Chest pain
  • Difficulty breathing and shortness of breath
  • Dry, chronic cough
  • Fatigue
  • Fever
  • Night sweats
  • Pain or tightness in the chest
  • Pleural effusion (excess fluid around the lung)
  • Unexplained weight loss

Symptoms of mesothelioma tend to worsen as the cancer spreads through the body.

Pleural Mesothelioma
Pleura
Lining of lungs
Asbestos Fibers
Mesothelioma Cell
A person may develop pleural mesothelioma after breathing in asbestos fibers. Pleural mesothelioma causes symptoms like shortness of breath and chest pain.

Talk to your doctor if you are experiencing symptoms, even if you don’t know if you were ever exposed to asbestos. Early detection is the best way to treat malignant pleural mesothelioma before it spreads.

Doctors can also help address painful or uncomfortable symptoms through various methods, including pain management, tumor reduction, or draining excess fluid around your lungs.

The right doctor will help you develop a holistic treatment approach to reduce your cancer symptoms and help you feel more like yourself. Use our Free Doctor Match to find an experienced pleural mesothelioma specialist near you.

Mesothelioma doctor talking with an older couple
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Pleural Mesothelioma Causes

The only known cause of this cancer is asbestos exposure. Asbestos is a naturally occurring mineral once used in many construction and manufacturing products from the 1930s to the early 1980s.

Multiple industries, including the U.S. military, used asbestos extensively until it became widely known as a cancer-causing substance (carcinogen).

How Asbestos Causes Pleural Mesothelioma

  1. Exposure: Someone inhales or swallows airborne asbestos fibers through direct or secondhand exposure.
  2. Buildup: Microscopic asbestos fibers become stuck in the lining of the lungs since they are too small to cough up and too tough to dissolve.
  3. Damage: Over time, asbestos fibers cause inflammation, scarring, and genetic damage to nearby cells.
  4. Cancer: After 10-50 years, irritation from the fibers causes pleural cells to mutate and grow at an out-of-control rate. The first symptoms of cancer then start to develop.

Malignant Pleural Mesothelioma Risk Factors

Pleural mesothelioma mainly affects older men with working-class and/or military backgrounds. That said, anyone who has been exposed to asbestos may be at risk.

 High-risk groups include:

Understanding your risk factors may help you identify your symptoms and guide your conversation with your doctor.

Diagnosing Mesothelioma of the Pleura

A mesothelioma diagnosis often starts with an appointment to address flu-like symptoms. The doctor may perform a basic exam, and then order additional tests to evaluate any troubling findings or persistent symptoms.

Diagnostic tests for malignant pleural mesothelioma may include:

  • Imaging tests: X-rays, magnetic resonance imaging (MRI) scans, and computerized tomography (CT) scans can help doctors look for signs of cancer in and around the lungs.
  • Biopsies: If imaging tests show signs of cancer, biopsies are ordered to extract tissue and/or fluid to test for cancer cells.

A biopsy is the only way to confirm a pleural mesothelioma diagnosis.

Getting an early diagnosis is the best way to improve your health outlook. If you’re diagnosed before the cancer spreads, you’ll have more treatment options and may be able to live longer.

Until you receive a diagnosis, you won’t know which treatments will be available in your case. Knowledge is power, and help is available no matter what your previous risk factors or diagnosis may be.

Get help guiding your conversation with your doctor with our free Checklist of Questions to Ask. Download your copy now so you can go into your initial appointment prepared.

Pleural Mesothelioma Misdiagnosis

Doctors sometimes misdiagnose pleural mesothelioma as more common and less severe conditions like pneumonia. This happens more often when patients visit a general physician, who may not have experience diagnosing and treating mesothelioma.

Because of this, it’s helpful to get a second opinion from an experienced mesothelioma specialist.

Not only can they confirm a pleural mesothelioma diagnosis, but they can accurately determine other important factors like cell type and stage to develop the best treatment plan for you.

Pleural Mesothelioma Cell Types

During a biopsy, your doctor will determine the type of mesothelioma cell(s) that make up the tumor or tumors. The three mesothelioma cell types are epithelioid, sarcomatoid, and biphasic (when tumors have both of the other cell types).

Pleural Mesothelioma Stages

There are four stages of pleural mesothelioma. Each stage refers to how much cancer is in your body and how far it has spread. The stage of your cancer can impact which treatments your doctor recommends.

Doctors typically use the tumor-node-metastasis (TNM) staging system to classify the stages of pleural mesothelioma.

Stage 1
Description

The earliest stage. Cancer is only in the pleura.

Treatment

Treatments like surgery may improve life expectancy by several months or years.

Median Life Expectancy

21 months

Learn More About Stage 1 Mesothelioma
Stage 2
Description

The cancer has spread just past the pleura and may have reached nearby lymph nodes. It has not reached the other side of the chest.

Treatment

Patients still have many treatment options to increase life expectancy.

Median Life Expectancy

19 months

Learn More About Stage 2 Mesothelioma
Stage 3
Description

The cancer has reached nearby tissues, organs, or lymph nodes.

Treatment

Some patients can get life-extending treatments, but others will only qualify for pain-relieving care.

Median Life Expectancy

16 months

Learn More About Stage 3 Mesothelioma
Stage 4
Description

The final stage. Cancer has reached distant areas of the chest and the rest of the body.

Treatment

Treatments are focused exclusively on easing pain.

Median Life Expectancy

12 months

Learn More About Stage 4 Mesothelioma

Read about the different treatments for each stage in our Free Pleural Mesothelioma Guide.

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Malignant Pleural Mesothelioma Prognosis

A prognosis is the projected outcome of a disease. Mesothelioma prognosis is typically measured using survival rate (percentage of patients still alive after a set period of time) and life expectancy (average length of time people live after a diagnosis, usually measured in months).

The average mesothelioma prognosis is not as encouraging as that of other cancers, but you are not a statistic. Your experience will be different from anyone else’s, and general survival rates are based on large population groups that may not have anything in common with your health or situation. Regardless of your prognosis, there is always hope.

“Getting a mesothelioma diagnosis can be very scary. So many people go on Google and find either misinformation or information that doesn’t apply to their individual situation. Mesothelioma is not a guaranteed death sentence — there are options that you have.

- Quote from Dr. Raja Flores, pleural mesothelioma specialist and researcher

Pleural Mesothelioma Life Expectancy

Pleural mesothelioma patients have an average life expectancy of 18 months after diagnosis. However, this is just an average. Many patients go on to live far longer and with a better quality of life thanks to the right treatment and support.

One mesothelioma survivor, Art Putt, received a grim prognosis with his pleural mesothelioma diagnosis in 2018. Today, he’s living a full and happy life.

“Originally, the doctor said he would have possibly six months to a year, and that was six years ago. I still got him.”
— Jan Putt, wife of pleural mesothelioma survivor Art Putt

What Is the Survival Rate of Pleural Mesothelioma?

The survival rate for pleural mesothelioma varies based on the stage of the disease, the patient’s age, the type of treatment received, and other factors.

Time After DiagnosisSurvival Rate
1 year73%
3 years23%
5 years12%
10 years5%
Source: Moffitt Cancer Center

These survival rates may not seem the most optimistic, but it is possible to become a pleural mesothelioma survivor.

John Stahl was diagnosed with stage 4 pleural mesothelioma in 2019 but is still alive today thanks to chemotherapy treatments. Watch John’s survival story below, and read more about John and other survivors in our Free Survivors Guide.

Pleural Mesothelioma Survivor John Stahl Video Thumbnail

Mesothelioma survivor John Stahl was diagnosed with stage 4 pleural mesothelioma in 2019. More than four years later, he's still enjoying his golden years with his wife, Dee. Call us today at (866) 608-8933 to get the medical help you need to become a survivor. View Transcript.

Duration: 2 min 59 sec

Dee Stahl:
The day started out fine. We got up and John, which is unusual for him, just came out of the bedroom and just sat down, and he said, “I just don’t feel good.” And I knew something was wrong because John doesn’t complain. And I said, “Well, I think we should probably go to the ER.” They found out that there was over two liters of fluid on his left lung, and they were amazed that he was even able to breathe, period. They did a CAT scan, and that’s when he just said, “You have stage four mesothelioma, John.”

John Stahl:
I was kind of blank. I didn’t know what to think. I didn’t realize that my job had exposed me to this.

Dee Stahl:
We’re the Stahls. I’m Dee, and this is my husband, John.

John Stahl:
My name is John Stahl. I was first exposed to asbestos poisoning through the construction business, through Sheetrock®, through gaskets, and piping all through my career. And I worked 43 years in the construction business. If you don’t work, you don’t get paid. The first treatment was with chemotherapy, and I went every two weeks. It didn’t take long, an hour or so, but it would take me seven to 10 days to recover. That was hard for me because I’m a pretty active person. At first, it didn’t really sink in. The longer I thought about it, it’s gonna end my life eventually, but I’m gonna live it…as well as I can.

Dee Stahl:
Being with John through this, I’m glad I was here for him. He’s got a lot of support. He’s got a lot of friends and family that really care for him. But to be there, John made it easy because he was so positive. I’m just glad I was here for him. He held me up, really.

John Stahl:
Having Dee with me going through this was indescribable. It’s important for people to understand that there’s help and there’s people that are willing to help them.

Dee Stahl:
I think John’s positive attitude has kept him going like he has, having John so halfway healthy. I mean, he’s able to do things and be happy. John’s a very positive guy. He makes you happy.

Pleural Mesothelioma Treatment

Mesothelioma treatment aims to increase life expectancy, manage symptoms, and kill cancer cells.

Commonly used treatments for pleural mesothelioma include surgery, chemotherapy, radiation, and immunotherapy. Treatments may also focus on relieving pain and symptoms, known as palliative care.

An experienced mesothelioma doctor may recommend a multimodal treatment approach, using a combination of several treatments to target different aspects of your cancer.

Art Putt Headshot
Point of Hope

Pleural mesothelioma survivor Art Putt underwent chemotherapy and immunotherapy following his diagnosis in 2018. In addition to the standard treatments he did under his doctor’s care, Art prioritized nutrition and wellness to help his body fight the disease and manage side effects from chemo. Read Art’s full story here.

We can help find the best mesothelioma treatments for you or a loved one. Call (866) 608-8933 now.

Pleural Mesothelioma Surgery

Pleural mesothelioma surgery is one of the most effective ways to treat this cancer.

The two most common types of surgeries include:

  • Extrapleural pneumonectomy (EPP): An EPP removes the lung closest to the mesothelioma tumors and the lung lining. Patients live for over 35 months on average with this surgery.
  • Pleurectomy with decortication (P/D): A P/D leaves the lungs intact but removes the lung lining and tumors. Patients treated with this surgery live for 34 months on average. They usually have a lower risk of complications and shorter recovery times when compared to those treated with an EPP.
Did You Know?

According to a 2023 study published in Cancer Medicine, patients treated with surgery live for nearly 1 year longer on average than those who do not.

Your oncology doctor will look at your health situation to determine whether surgery is best for you.

Chemotherapy

Chemotherapy circulates through the body and destroys cancer cells. The most common chemotherapy drugs used to treat pleural mesothelioma are cisplatin and pemetrexed.

The 2023 Cancer Medicine study revealed that pleural mesothelioma patients treated with chemotherapy live for an average of 14 months. Patients lived for nearly 22 months when chemotherapy was combined with surgery.

Patients can get chemotherapy alone or combined with other treatments like surgery and immunotherapy.

Radiation

Radiation therapy treats mesothelioma with intense beams of energy. It is often used to reduce the symptoms of late-stage pleural mesothelioma. It may also be used alongside chemotherapy or surgery to kill cancer cells and extend a patient’s life.

The average pleural mesothelioma life expectancy with radiation is 12 months, according to a report in Cancer Medicine.

There are multiple treatment options that may be available to you, and it’s important to talk with your care team to determine the best choice. Our Free Checklist of 14 Questions to Ask Your Doctor can help guide your conversation and ensure you are fully informed going into treatment.

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Immunotherapy

Immunotherapy boosts the body’s immune response to mesothelioma. Mesothelioma cells sometimes escape detection by the immune system, and as a result, grow and spread rapidly.

Cancer Medicine noted that pleural mesothelioma patients treated with immunotherapy had an average life expectancy of nearly 16 months. However, every patient will be different — for some, immunotherapy has made a big impact on their quality and length of life compared to other treatments.

The U.S. Food and Drug Administration (FDA) has approved two immunotherapy drugs — Opdivo® and Yervoy® — to treat pleural mesothelioma. Additional immunotherapy medications are currently being tested in clinical trials and may be approved as standard mesothelioma treatments in the future.

Learn more about how immunotherapy may be able to help you in our Free Immunotherapy Guide.

TTFields

Tumor treating fields (TTFields) help stop or slow the spread of mesothelioma. Pads attached to the patient’s chest produce a low-grade electrical field that disrupts the division of cancer cells without any side effects.

The FDA approved TTFields to treat pleural mesothelioma in 2019. All patients using TTFields also receive chemotherapy.

Emerging Treatments

Medical professionals are developing and studying many new mesothelioma treatment options in clinical trials.

Examples of emerging treatments include:

These and other promising treatments offered in clinical trials can bring hope to patients whose cancer has stopped responding to standard therapies.

Palliative Care for Pleural Mesothelioma Patients

Late-stage pleural mesothelioma patients who cannot undergo life-extending treatments can still access therapies called palliative care to reduce pain and discomfort.

Palliative care options include:

  • Partial pleurectomy: This prevents fluid buildup and relieves symptoms by removing part of the pleura.
  • PleurX™ catheter: This device helps patients drain pleural effusions at home.
  • Talc pleurodesis: Doctors insert medical grade-talc into the pleura using video-assisted thoracoscopic surgery (VATS) to prevent fluid buildup.
  • Thoracentesis: This removes extra fluid from the pleura to make breathing easier.

Tell your doctor about all the symptoms you’re facing so they can help determine the right palliative care options for you. The goal is to find ways to help you maintain your quality of life and enjoy each moment as much as possible.

Top Pleural Mesothelioma Doctors

Doctors around the country specialize in pleural mesothelioma, making it their life’s work to understand how to treat this disease.

Top doctors who treat this type of mesothelioma include:

Chairman of the Department of Thoracic Surgery at Mount Sinai Medical Center in New York

Dr. Raja Flores

Dr. Raja Flores

New York, NY

Chief of Thoracic Surgery at Mount Sinai Hospital in New York

Dr. Anne Tsao

Dr. Anne Tsao

Houston, TX

Director of the Mesothelioma Program at the University of Texas MD Anderson Cancer Center

Director of the Mesothelioma Treatment Center at Baylor College of Medicine’s Lung Institute in Houston

Get help finding top specialists near you using our Free Doctor Match.

Financial Assistance for Pleural Mesothelioma Cancer

When you or your loved one is diagnosed with pleural mesothelioma, your priority is to get the right treatment to maximize your length and quality of life.

Sadly, as many as 50% of cancer patients and their families struggle with financial toxicity after a diagnosis. One estimate puts the total cost of mesothelioma treatment at over $500,000.

Thankfully, however, there are many options for financial support that can help you pay for everything from immunotherapy drugs to traveling for treatment to buying a wig if you lose your hair during chemo.

Our team can help you pursue mesothelioma compensation from the asbestos companies that might have caused you or a loved one to develop this cancer. We can also help you find travel grants for treatment, understand your health insurance, and apply for VA benefits if you served in the military.

Financial assistance options for mesothelioma include:

  • Asbestos Trust Funds

    Many asbestos companies declared bankruptcy to avoid being sued. However, the U.S. court system forced these companies to put money in trust funds to help victims. More than $30 billion is available in asbestos trust funds right now.

  • Mesothelioma Lawsuits

    Mesothelioma patients or their families can file a lawsuit to pursue financial compensation. Mesothelioma lawsuits typically pay out $1 million or more.

  • VA Benefits and Health Care

    Military veterans with mesothelioma can file for benefits offered by the U.S. Department of Veterans Affairs (VA). These benefits include monthly payouts worth nearly $4,000 a month in many cases and medical care from the VA health care system.

“We filed a mesothelioma lawsuit to hold companies accountable. … I don’t know how these people slept at night, knowing people were being exposed to asbestos, poisoning their bodies. They need to pay anyone who’s been affected by this.”

- Quote from John Stahl, 4+ year pleural mesothelioma survivor

Get Help for Pleural Mesothelioma Today

If you or your loved one has recently been diagnosed with pleural mesothelioma, there’s a lot to consider — and it can be hard to know where to start. Our compassionate, experienced team of Patient Advocates is here to make this journey easier and less overwhelming.

We can help you:

  • Understand your diagnosis and pathology report
  • Find a specialist for treatment
  • Navigate your options for financial assistance
  • Connect with a support group or peer mentor

It’s always free to speak with our team. Call us at (866) 608-8933 or fill out our contact form to get personalized guidance and support now.

Pleural Mesothelioma FAQs

What is the life expectancy of someone with pleural mesothelioma?

Pleural mesothelioma patients have an average life expectancy of 18 months after diagnosis. But life expectancy will vary depending on your individual diagnosis and prognosis. With the right treatment, you may be able to become a long-term survivor.

Treatments like surgery, chemotherapy, immunotherapy, and radiation can help improve your prognosis and allow you to spend more time with the people you love.

What are the symptoms of pleural mesothelioma?

Common signs and symptoms of pleural mesothelioma include difficulty breathing, dry coughing, chest tightness, shortness of breath, and fluid buildup in the lungs.

These symptoms are associated with other respiratory illnesses, so it is important to be seen by a doctor to get a correct diagnosis.

How is pleural mesothelioma diagnosed?

Pleural mesothelioma is diagnosed by assessing a patient’s symptoms and asbestos exposure history, and then ordering diagnostic tests.

According to the American Cancer Society (ACS), doctors will often order a chest X-ray to look for signs of pleural mesothelioma in the lungs, lung lining, and chest wall. Other imaging tests like mesothelioma CT scans may also be used depending on the patient.

Doctors will then order biopsies to test tissue/fluid to see if there are cancerous cells present. Only a biopsy can confirm a pleural mesothelioma diagnosis.

Is pleural mesothelioma curable?

No, but some mesothelioma patients may live for 20 years or more after being diagnosed with this cancer. The key is to get medical care from top mesothelioma doctors.

Patients also have a better chance of living longer if they’re diagnosed before the cancer spreads.

Where does pleural mesothelioma spread to?

Pleural mesothelioma starts in the lining of the lungs, called the pleura. If the cancer is not treated, it may metastasize, or spread to other parts of the body.

In stage four pleural mesothelioma, the cancer may have spread to the bones, liver, diaphragm, heart, and central nervous system, according to the Cleveland Clinic.

Is pleural mesothelioma painful?

It can be. In early stages, it often starts as a dull, diffuse pain in the chest. As the cancer progresses, the pain can worsen.

Pain can be caused by either the tumors themselves or surgeries used to diagnose and treat the disease, according to one study on pain management in pleural mesothelioma patients.

There are many pharmaceutical, surgical, and alternative/holistic methods to address your pain. Talk to your doctor to understand your options and get relief for the pain.

How rare is pleural mesothelioma?

According to the National Institutes of Health, less than 3,000 people per year are diagnosed with pleural mesothelioma in the United States. For context, there are about 333 million people in the U.S.

Because pleural mesothelioma is so rare, it’s important to find the right doctor and a personal support team that understands every aspect of this cancer and knows what you’re going through.

Call our team at (866) 608-8933 to get the help you need to navigate mesothelioma.

Dr. Mark LevinReviewed by:Mark Levin, MD

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD, has over 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

  • Board Certified Oncologist
  • 30+ Years Experience
  • Published Medical Author
Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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References
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