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Pleural Mesothelioma

Also known as malignant pleural mesothelioma or MPM, pleural mesothelioma is a form of cancer that affects the mesothelium or the membranes that line the lungs and chest cavity. Pleural mesothelioma is the most common form of this disease. MPM affects 70 percent of the 3,000 patients who are diagnosed with mesothelioma every year. Shortness of breath caused by fluid accumulations between the lungs and the chest wall is one of the most common symptoms of MPM. This devastating disease is difficult to diagnose due to its vague symptoms and delayed onset. Nearly all cases of pleural mesothelioma are linked to asbestos exposure at work or through consumer products made with this dangerous mineral. Approximately 80 percent of all mesothelioma cases are found in men, and roughly three-quarters of all mesothelioma cases in men and women affect smokers.

In recent years, screening procedures and standards for diagnostic staging have improved. To estimate the stage of a patient's pleural mesothelioma progression, oncologists use a TNM staging system that is based on the size and extent of the tumor growth, the N-factor, which indicates whether there is lymph node involvement, and the M-factor, which indicates whether the cancer has metastasized and spread to neighboring areas. Using the TNM staging standard as a foundation, the International Mesothelioma Interest Group (IMIG) system designates each stage with a numerical value ranging from one to four. Stage four diagnoses are the most advanced and typically mean that the cancer has spread and is inoperable or untreatable. For patients, stage one diagnoses generally mean the best prognosis, the largest variety of treatment options and superior life expectancy rates. The current life expectancy for pleural mesothelioma is generally between one to five years. Today, approximately 40 percent of patients reach the one-year life expectancy mark, 20 percent of patients reach the two-year mark and 10 percent reach the three-year mark. Only eight percent of patients are long-term survivors living more than five years after their diagnosis, but this could be changing as diagnostic techniques improve and new treatment methods increase survival rates.

Mesothelioma Treatment Options

Current treatment methods for pleural mesothelioma patients revolve around a trimodality or multimodality approach that uses multiple methods and pharmaceutical agents to attack tumors on the pleura. Trimodality treatments typically include radical lung surgery to remove tumors and cancerous tissue. Surgical procedures are generally preceded or followed by radiation therapy and chemotherapy to destroy as many cancer cells as possible. Researchers from the Brigham and Women's Hospital in Boston also see surgical treatment as an opportunity for scientists to study and analyze the characteristics and effects of different cell types, lymph node involvement, surgical margins, reoccurrences and a variety of different variables. In this study, scientists concluded that refinements in the knowledge of pleural mesothelioma will improve over the next five years as doctors learn more about the pathology and molecular staging of the disease and use these details to improve patient selection and develop more effective adjuvant therapies.

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