Symptoms

Signs and symptoms of mesothelioma vary depending on where the cancer occurs.

Pleural mesothelioma, which affects the tissue that surrounds the lungs, causes signs and symptoms that may include:

• Chest pain
• Painful coughing
• Shortness of breath
• Unusual lumps of tissue under the skin on your chest
• Unexplained weight loss

Peritoneal mesothelioma, which occurs in tissue in the abdomen, causes signs and symptoms that may include:

• Abdominal pain
• Abdominal swelling
• Nausea
• Unexplained weight loss

Treatment Offered

If you have signs and symptoms that might indicate mesothelioma, your doctor will conduct a physical exam to check for any lumps or other unusual signs.

Your doctor may order imaging scans, such as a chest X-ray and a computerized tomography (CT) scan of your chest or abdomen, to look for abnormalities.

Based on the findings, you may undergo further testing to determine whether mesothelioma or another disease is causing your symptoms.

Biopsy

Biopsy, a procedure to remove a small portion of tissue for laboratory examination, is the only way to determine whether you have mesothelioma. Depending on what area of your body is affected, your doctor selects the right biopsy procedure for you.

Options include:

• Inserting a needle through the skin. The doctor might remove fluid or a piece of tissue with a thin needle inserted through the skin on your chest or abdomen.
• Collecting a sample of tissue during surgery. A fluid or tissue sample might be collected during an operation. The surgeon might make a small incision and insert a tube with a video camera to see inside your chest or abdomen. Special tools can be passed through the tube to collect a tissue sample.

Treatment

What treatment you undergo for mesothelioma depends on your health and certain aspects of your cancer, such as its stage and location.

Unfortunately, mesothelioma often is an aggressive disease and for most people a cure isn’t possible. Mesothelioma is usually diagnosed at an advanced stage — when it isn’t possible to remove the cancer through an operation. Instead, your doctor may work to control your cancer to make you more comfortable.

Discuss treatment goals with your doctor. Some people want to do everything they can to treat their cancer, even if that means enduring side effects for a small chance of an improvement. Others prefer treatments that make them comfortable so that they can live their remaining time as symptom-free as possible.

Surgery

Surgeons work to remove mesothelioma when it’s diagnosed at an early stage. In some cases this may cure the cancer.

Most of the time, it isn’t possible to remove all of the cancer. In this situation, surgery may help to reduce the signs and symptoms caused by mesothelioma spreading in your body.

Surgical options may include:

• Surgery to decrease fluid buildup.Pleural mesothelioma may cause fluid to build up in your chest, causing difficulty breathing. Surgeons insert a tube or catheter into your chest to drain the fluid. Doctors may also inject medicine into your chest to prevent fluid from returning (pleurodesis).
• Surgery to remove the tissue around the lungs.Surgeons may remove the tissue lining the ribs and the lungs (pleurectomy). This procedure won’t cure mesothelioma, but may relieve signs and symptoms.
• Surgery to remove a lung and the surrounding tissue.Removing the affected lung and the tissue that surrounds it may relieve signs and symptoms of pleural mesothelioma. If you’ll be receiving radiation therapy to the chest after surgery, this procedure also allows doctors to use higher doses, since they won’t need to worry about protecting your lung from damaging radiation.
• Surgery for peritoneal mesothelioma.Peritoneal mesothelioma is sometimes treated with surgery to remove as much of the cancer as possible. Chemotherapy may be used before or after surgery.

Chemotherapy

Chemotherapy uses chemicals to kill cancer cells. Systemic chemotherapy travels throughout the body and may shrink or slow the growth of a mesothelioma that can’t be removed using surgery. Chemotherapy may also be used before surgery (neoadjuvant chemotherapy) to make an operation easier or after surgery (adjuvant chemotherapy) to reduce the chance that cancer will return.

Chemotherapy drugs may also be heated and administered directly into the abdominal cavity (intraperitoneal chemotherapy), in the case of peritoneal mesothelioma.

Other treatments

In certain situations, other treatments might be used to treat mesothelioma. Other treatments include:

• Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process. This treatment might be an option if other treatments aren’t working.
• Targeted therapy.Targeted therapy uses drugs that attack specific vulnerabilities in cancer cells. These drugs aren’t commonly used for treating mesothelioma, but your doctor might recommend targeted therapy based on the results of tumor DNA testing.

Clinical trials

Clinical trials are studies of new mesothelioma treatment methods. People with mesothelioma may opt for a clinical trial for a chance to try new types of treatment. However, a cure isn’t guaranteed. Carefully consider your treatment options and talk to your doctor about what clinical trials are open to you. Your participation in a clinical trial may help doctors better understand how to treat mesothelioma in the future.

Clinical trials are currently investigating a number of new approaches to mesothelioma treatment, including new targeted therapy drugs and new approaches to immunotherapy.