Pleural Mesothelioma | Symptoms, Stages, Prognosis & More

Patients experiencing any of these symptoms should talk to their doctor about any possible exposures to asbestos in the past. Even if it happened years ago, no amount of exposure is considered safe, and it can help your doctor test for mesothelioma or other asbestos-related diseases.

With these nonspecific symptoms and the long latency period associated with all forms of mesothelioma, some patients have to wait weeks or even months before receiving a proper pleural mesothelioma diagnosis. Though a diagnosis will generally begin with a variety of imaging tests like CT scans and x-rays to determine the presence of cancer, a biopsy is currently the only method to confirm pleural mesothelioma.

The biopsy will consist of taking samples of pleural tissue for testing. The doctor may also perform a thoracentesis, or a pleural tap, which is a slightly invasive procedure that removes fluid from the pleura for analysis. A pathologist will determine if the cells are malignant, and if pleural mesothelioma is confirmed they will also be able to decipher the cell type.

Unlike the other forms of mesothelioma, pleural mesothelioma has several staging systems that oncologists rely on to determine the progression of the disease. The most widely used and accepted, however, is the TNM Staging System, which stands for Tumor, Nodule, and Metastasis. Doctors will use the system to score an area for each category, which will collectively make up the stage.

Refers to disease which is confined to the primary site, or site of origin. The lymph nodes are free of disease and there are no metastases present. Most often, treatment for stage I mesothelioma consists of surgical resection, or removal, of the disease.

Refers to disease which is confined to one site. While the lymph nodes are still free of disease and there are no metastases present, the tumor extends into the deeper pleural surfaces on the same side as the tumor as well as at least one of the following: the diaphragm or the lung.

Refers to disease which either has spread to lymph nodes on the same side as the tumor; or, a tumor which is extensive and involves the deeper pleural surfaces as well as at least one of the following: chest wall, thoracic fascia, sac around the heart, or mediastinal fat. The tumor is still considered resectable by surgery. There is no metastasis present.

Refers to disease in which one of the following occurs: the tumor is too extensive for surgery, there is distant lymph node involvement on the opposite side from the tumor, or there is distant metastasis present.

Doctors may also use the Brigham staging system, which focuses on a tumors ability to be surgically removed, or the Butchart system, which focuses on the extent of the primary tumor and in general is viewed as more limiting. Regardless of the staging system used, the stage of pleural mesothelioma has a large impact in determining what treatments a patient is eligible for and their prognosis. A stage 1 patient, for instance, will have more treatment options like curative surgery, compared to a stage 4 patient whose malignant mesothelioma has likely spread to other parts of the body or the tumors are too extensive for removal.

Learn More About Mesothelioma Stages

Like the other types of mesothelioma, pleural mesothelioma patients also face a poor prognosis. Though it is the most common and most researched, doctors still face difficulties in diagnosing and treating the disease. Advancements in treatment and ongoing clinical trials have provided hope in finding new, effective treatments like immunotherapy, which has already shown promise in extending survival for some patients. On average, pleural mesothelioma patients have a life expectancy of about one year, though a number of factors can influence an individuals prognosis like stage, cell type, and the patients age.

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Pleural Mesothelioma | Symptoms, Stages, Prognosis & More

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