Mesothelioma Types, Risks, Diagnosis, and Treatment

Mesothelioma is a rare type of lung cancer; it affects fewer than 20,000 people per year in the United States. It begins in cells that line the heart, lungs, and abdomen.

Pleural mesothelioma forms in the lining of the lungs. Peritoneal mesothelioma begins in the lining of the abdomen.

Mesothelioma is extremely aggressive and hard to treat effectively.

The Mesothelioma Specialty Care Center at UPMC Hillman Cancer Center provides a comprehensive treatment approach to this challenging disease.

The center brings together experts in:

  • Thoracic surgical oncology
  • Pulmonology
  • Pathology
  • Radiology
  • Pain management
  • Medical and radiation oncology

Types of Mesothelioma

There are three main types of mesothelioma, classified by the type of cells where they originate:

  • Epithelioid mesothelioma accounts for about 70 percent of all cases. It's the most easily treated type. It usually begins when a person’s healthy epithelioid cells have exposure to asbestos. This form of lung cancer develops quickly, because epithelial cells divide quickly. But, because epithelial cells tend to stick together, this type of mesothelioma is less prone to spread. Symptoms can include chest pain, trouble breathing, and fluid build-up in the lungs.
  • Sarcomatoid mesothelioma is a very rare form of this disease, accounting for just 10 to 15 percent of all cases. It's the most difficult to treat. Sarcomatoid mesothelioma is also more prone to spread than other types. Symptoms can include problems breathing, fatigue, and weight loss.
  • Mixed mesothelioma is a combination of epithelioid and sarcomatoid mesothelioma involving both types of cells. Prognosis depends on the percentages of each type of cell. Cases with more epithelioid cells tend to grow more quickly, but their spread is slower. Cases with more sarcomatoid cells spread much faster. Symptoms can include chest pain, problems breathing, and fluid build-up in the lungs.

Mesothelioma Risk Factors

Factors that may increase your risk for mesothelioma include:

  • Age — adults ages 45 and older are at the highest risk of getting mesothelioma.
  • Asbestos exposure — at one time, asbestos was a common material in the construction and chemical industries. Exposure to asbestos can increase a person's risk for lung cancer. Data shows that the lifetime risk of getting mesothelioma among asbestos workers can be as high as 10 percent.

Mesothelioma Diagnosis

Doctors diagnose the type of mesothelioma based on the cells involved.

Before your care team can arrive at a diagnosis, pathologists must study the affected cells.

The pathologist identifies cells by the types of proteins they contain. He or she uses a process called immunohistochemistry.

This involves staining the tissue sample with a substance that changes color when a certain type of protein is present. The substance acts as a dye to make the proteins inside the cells easier to detect and differentiate under the microscope.

Your oncologist will need to perform a biopsy to get a tissue sample.

Mesothelioma Treatment

UPMC Hillman Cancer Center's care team works closely to create a comprehensive treatment plan for your type and stage of lung cancer.

Treatments for mesothelioma may include:

Surgical Oncology for Mesothelioma

To improve your quality of life and prolong your survival, UPMC Hillman Cancer Center surgeons are pioneering a chemoperfusion treatment involving a pleurectomy.

For pleural mesothelioma:

  • Hyperthermic chemoperfusion (HIPEC) involves applying concentrated heated chemotherapy directly into the tumor.
  • Pleurectomy surgery involves removing part of the pleura.
  • Pneumonectomy is surgery to remove all or part of the lung.

For peritoneal mesothelioma:

  • HIPEC directs concentrated heated chemo into the affected area.
  • Peritonectomy surgery removes the cancerous part of the abdominal lining.
  • Resection is surgery to remove as much of the tumor as possible.

Chemotherapy for Mesothelioma

Medical oncologists specializing in mesothelioma offer a full range of chemo and biologic therapies.

You also have access to clinical trials through the UPMC Hillman Cancer Center. We are western Pennsylvania's only National Cancer Institute-designated Comprehensive Cancer Center.

Radiation Therapy for Mesothelioma

Your care team may suggest radiation therapy as an additional treatment option after surgery. If you're not a candidate for surgery, radiation may be the best course of treatment.

Our radiation oncologists have extensive skill in using leading-edge approaches to treat mesothelioma, including:

Contact Us About Mesothelioma Care

To learn more about mesothelioma or other forms of lung cancer, contact UPMC Hillman Cancer Center at 412-623-LUNG (5864).