Pleural mesothelioma is the most common form of mesothelioma, accounting for roughly 75-80% of all cases. It develops in the pleura — the thin membrane lining the lungs and chest cavity — after asbestos fibers reach and irritate that lining over decades.

Cause

Pleural mesothelioma is caused by inhaling asbestos fibers. The fibers travel to the pleura, where they cause chronic inflammation and cellular damage that can, 20 to 50 years later, develop into cancer. Workers in insulation, construction, shipbuilding, the Navy, power generation, and industrial trades — and their family members exposed secondhand — are among the most affected.

Symptoms

  • Shortness of breath (often from fluid buildup, or pleural effusion)
  • Chest pain or tightness
  • Persistent cough
  • Fatigue and unexplained weight loss
  • Low-grade fever or night sweats

See the full symptoms guide for detail.

Diagnosis

Diagnosis typically involves imaging (chest X-ray, CT, PET, or MRI), analysis of pleural fluid, and a biopsy to confirm the cancer and determine its cell type (epithelioid, sarcomatoid, or biphasic), which affects treatment and prognosis.

Treatment

Treatment depends on the stage, cell type, and the patient’s health, and is usually multimodal:

  • Surgery (such as pleurectomy/decortication or extrapleural pneumonectomy) for eligible patients
  • Chemotherapy
  • Radiation therapy
  • Immunotherapy, which has become an important option in recent years
  • Clinical trials offering access to emerging treatments

A multidisciplinary team — thoracic surgeons, oncologists, and pulmonologists — guides treatment planning.

Prognosis

Prognosis varies widely by stage, cell type, and treatment. See the life expectancy and prognosis guide and stages guide for more.

If you were diagnosed with pleural mesothelioma and were exposed to asbestos at work, in the military, or in a building, you may be entitled to significant compensation through asbestos trust funds and civil litigation.

This information is educational, drawn from sources such as the American Cancer Society and National Cancer Institute, and is not medical advice. Consult your own physician about diagnosis and treatment.