Malignant Mesothelioma

Malignant mesothelioma develops from the pleural lining surrounding the lungs and is strongly linked to asbestos exposure.

It progresses insidiously, often presenting decades after exposure.

Treatment requires a multidisciplinary approach with surgery, chemotherapy, and immunotherapy to control disease and symptoms.

Overview And Clinical Background

Asbestos exposure and pathophysiology

Asbestos fibers, when inhaled, lodge in the pleura causing chronic inflammation and genetic damage leading to mesothelial cell transformation.

The disease is aggressive and often diagnosed at an advanced stage.

Common typePleural mesothelioma affecting lung lining; peritoneal and pericardial forms are rarer.

LatencySymptoms appear 20–40 years post-exposure.

Risk groupOccupational exposure in construction, insulation, and shipyard workers.

Symptoms, Signs And Presentation

Symptoms include progressive shortness of breath, chest pain, dry cough, and weight loss.

Pleural effusion (fluid around lungs) is common and often the first finding.

Respiratory distressBreathlessness due to pleural effusion or tumor encasement.

Chest painPersistent dull pain or heaviness on the affected side.

Systemic effectsFatigue, loss of appetite, and night sweats.

Diagnosis Methods And Investigations

Imaging and tissue confirmation

Chest CT, PET-CT, and thoracoscopy are used for diagnosis.

Biopsy from pleural nodules confirms malignancy, supported by immunohistochemistry markers such as calretinin and WT-1.

Pleural imagingCT chest or MRI shows pleural thickening and effusion.

ThoracoscopyAllows direct visualization and biopsy of pleural lesions.

HistopathologyConfirms mesothelial origin and rules out metastatic carcinoma.

Treatment Options And Surgical Techniques

Treatment involves multimodal therapy combining surgery, chemotherapy, and immunotherapy.

Surgery options include pleurectomy/decortication (lung-sparing) or extrapleural pneumonectomy for selected patients.

SurgeryPleurectomy with decortication or extrapleural pneumonectomy in early stages.

ChemotherapyPemetrexed and cisplatin remain the standard first-line regimen.

ImmunotherapyCheckpoint inhibitors (nivolumab, pembrolizumab) show promise in advanced disease.

Recovery, Risks And Prognosis

Mesothelioma has a guarded prognosis, with median survival of 12–24 months.

Supportive care for symptom relief and pleural effusion drainage is crucial alongside active treatment.

Why Choose Us

CureU Healthcare provides integrated mesothelioma management — early diagnostic evaluation, expert thoracic surgery, systemic therapy access, and dedicated palliative care for comfort and function.

Conclusion

Malignant mesothelioma remains challenging but treatable.

Timely diagnosis, asbestos exposure awareness, and access to modern multimodal therapy offer patients better outcomes and comfort.