What Is Mesothelioma?
Mesothelioma is a cancer of the mesothelium — the thin protective lining surrounding the lungs, abdomen, and heart. When asbestos fibers are inhaled or swallowed, they embed in this lining and cause cellular mutations over decades. The disease is almost exclusively caused by asbestos exposure, though symptoms typically don’t appear until 20–50 years after exposure occurred.
Types of Mesothelioma
| Type | Location | % of Cases | Key Treatment |
|---|---|---|---|
| Pleural | Lining of the lungs | 75–80% | EPP or P/D surgery, chemo, immunotherapy |
| Peritoneal | Lining of the abdomen | 15–20% | CRS + HIPEC; best survival outcomes |
| Pericardial | Lining of the heart | <1% | Pericardectomy; extremely rare |
| Testicular | Lining of the testes | <1% | Orchiectomy; best prognosis due to early detection |
Symptoms
Pleural mesothelioma symptoms include shortness of breath, chest pain, dry cough, pleural effusion (fluid around the lungs), and unexplained weight loss. Peritoneal mesothelioma causes abdominal pain, distension, nausea, and ascites. Symptoms typically appear 20–50 years after asbestos exposure and are often mistaken for more common conditions.
Former industrial workers who notice these symptoms should inform their doctor of their asbestos exposure history immediately. Diagnosis requires tissue biopsy — imaging alone is insufficient.
Prognosis & Survival
| Stage | Median Survival | Surgical Candidate? |
|---|---|---|
| Stage I | 21–24 months | Yes |
| Stage II | 18–20 months | Often |
| Stage III | 15–16 months | Sometimes |
| Stage IV | 12–14 months | Rarely |
| Peritoneal (HIPEC) | 40–92+ months | Yes (specialized) |
Treatment Options
Mesothelioma treatment depends on type, stage, cell type (epithelioid, sarcomatoid, biphasic), and patient fitness. The standard approaches are:
- Surgery — EPP (extrapleural pneumonectomy) or P/D (pleurectomy/decortication) for pleural; CRS + HIPEC for peritoneal. Surgery guide ›
- Chemotherapy — Cisplatin + pemetrexed (Alimta) is first-line for pleural; ~40% response rate. Chemotherapy guide ›
- Immunotherapy — Nivolumab + ipilimumab (FDA-approved 2020, CheckMate 743). Immunotherapy guide ›
- Clinical trials — CAR-T, TTFields, mesothelin-targeted therapies. Clinical trials guide ›
After a Diagnosis: Your Next Steps
- Confirm the diagnosis — get pathology slides reviewed by a mesothelioma specialist at an NCI-designated cancer center
- Contact a mesothelioma attorney — free consultation, no obligation; preserves your right to compensation before filing deadlines pass
- Document your asbestos exposure history — employment records, union cards, Social Security earnings statement
- Apply for VA benefits if a veteran — no filing deadline; can be pursued simultaneously with a lawsuit
- Apply for SSDI — mesothelioma is on the SSA Compassionate Allowances list; approval in 2–4 weeks