BHC home - health and medical information for consumers

Health and medical information for consumers, quality assured by the Victorian government (Australia).

24 November, 2009

Home > Fact sheets by category > Diseases and conditions > Cancer > Specific cancers > Mesothelioma.

Health information

Resources and tools

Healthy eating

Find help

Mesothelioma

Mesothelioma is a rare type of cancer. Malignant (cancerous) cells develop in the mesothelium, the protective sac that covers most of the body’s internal organs. Mesothelioma generally starts in the outer membrane of the lungs (pleura), but can also occur in the lining of the abdominal cavity (peritoneum). Uncommonly, the heart or reproductive organs may be affected. Treatment depends on where the cancer is found and whether it has spread.

Currently there is no cure for mesothelioma unless it can be removed by surgery. Unfortunately, by the time mesothelioma is diagnosed, it has usually already spread beyond the point where it could be removed by an operation. In this case, treatment aims to prolong life and keep the person as comfortable as possible.

Mesothelioma is almost always caused by exposure to asbestos and can develop decades after the exposure. Asbestos is a group of minerals that was once widely used for its fire-resistant and insulating properties. It is no longer mined or processed in Australia because of the health risks.

How it spreads
Malignant (cancerous) cells develop in the mesothelium. This protective sac has different names, depending on its location in the body. Those most commonly affected by mesothelioma are:

Visceral pleura – the membrane that surrounds the lungs.
Parietal pleura – the membrane that lines the chest wall.
Peritoneum – the membrane that forms the lining of the abdominal and pelvic cavities.

Mesothelioma most often starts in the pleura. Normally, the two pleura touch and slide across each other while we breathe, lubricated by a slick of fluid. In cases of pleural mesothelioma, the pleura make more fluid than necessary, which presses on the lung (pleural effusion). Mesothelioma usually develops in only one lung. The tumour tends to grow across the lung until the entire organ is encased.

In about 10 per cent of mesothelioma cases, asbestos fibres that have been swallowed can move through the stomach wall and cause cancer cells to develop in the peritoneum (peritoneal mesothelioma).

Sometimes cancer cells migrate to lymph nodes and other areas of the body (such as the unaffected lung) via the lymphatic system. Uncommonly, the heart or reproductive organs may be affected.

Symptoms of mesothelioma – lungs
Symptoms of pleural mesothelioma include:

Breathlessness
Dry cough
Pain.

Symptoms of mesothelioma – peritoneum
Symptoms of peritoneal mesothelioma include:

Painful abdomen
Swollen abdomen
High temperature
Nausea and vomiting
Bowel problems
Urinary problems.

Symptoms in the later stages
Symptoms in the later stages of the disease include:

Sudden and unexplained weight loss
Spitting up sputum
Spitting up blood
Swallowing problems
Hoarseness.

High-risk groups
The primary risk factor for mesothelioma is asbestos exposure. The disease is rarely seen in young people. Since mesothelioma can take as long as 40 years to develop, the incidence tends to rise following middle age. High-risk groups include anyone who has worked with asbestos – in jobs such as asbestos mining, milling and manufacture or in the construction, power and shipbuilding industries – and their close family or household members: for example, those who washed their work clothes.

Smoking greatly increases the risk of lung cancer in a person who has been exposed to asbestos. Most asbestos-related lung cancers are attributable to the combined effects of asbestos and tobacco smoke.

Diagnosis
The symptoms of mesothelioma may be caused by this condition or may be due to other, less serious conditions. It is important to see a doctor about any symptoms. Only a doctor can make a diagnosis.

Diagnosis of mesothelioma may include:

Medical history, including history of asbestos exposure
Physical examination
Blood tests
Chest x-rays
CT scans
Drainage and laboratory analysis of the pleural fluid
Tissue sample (biopsy) to help differentiate mesothelioma from another condition known as ‘benign asbestos related pleural disease’.

Treatment
Treatment depends on the type of mesothelioma, the stage (extent) of disease and the person’s preference. Options may include:

Pleurectomy – surgery to remove the affected tissue. The affected lung may also be removed in whole (pneumonectomy) or in part (lobectomy). Usually only small tumours are treated with surgery. A person’s life span may be prolonged for a few months or years.
Phototherapy – a procedure sometimes used during pleurectomy. Stray cancer cells within the chest are highlighted with special dye and killed by laser.
Thoracentesis – a procedure that removes fluid from the pleural cavity through a needle inserted between the ribs.
Pleurodesis – a special powder is inserted between the pleural layers to cause inflammation and stop production of excess fluid. This is performed using a slender instrument (endoscope) inserted into the chest.
Paracentesis – a procedure in which a thin needle or tube is put into the abdomen to remove fluid from the peritoneal cavity (the space within the abdomen that contains the intestines, the stomach and the liver).
Peritoneal surgery – surgery to remove tumours in the abdominal cavity. Bowel symptoms can often improve following this procedure.
Chemotherapy – the use of cancer-killing drugs that can shrink the cancer and ease symptoms. Chemotherapy is often recommended if the cancer has returned following other treatment or if other treatments are inappropriate.
Radiotherapy – x-ray treatment to kill cancer cells. Only small areas can be treated or else the healthy cells of the lungs, heart and liver may be damaged. Radiotherapy is often used to ease pain and breathlessness.

The role of asbestos
Asbestos is the name of a group of minerals that was once widely used for its fire-resistant and insulating properties. Due to health risks, it is no longer mined, milled or manufactured in Australia. All uses of asbestos in new products are now banned in Australia and no asbestos products may be imported. Strict precautions also govern the removal and disposal of asbestos and asbestos-containing materials.

Where to get help

Your doctor
Asbestos Diseases Foundation of Australia Tel. (02) 9637 8759
Asbestos Diseases Society of Australia Tel. 1800 646 690
Cancer Council Victoria, Cancer Council Helpline Tel. 13 11 20
Multilingual Cancer Information Line, Victoria - see the CCV website for contact details
Peter McCallum Cancer Centre Tel. (03) 9656 1111
WorkSafe Victoria Tel. (03) 9641 1444 or 1800 136 089
Environment Protection Authority Victoria Tel. (03) 9695 2722
Department of Human Services, Environmental Health Unit Tel. 1300 761 874
Asbestos Victims Association SA Tel. (08) 8212 6008 or 1800 665 395 (SA country only)
Asbestos Diseases Society of Victoria – Information, Support and Counselling Service Tel. (03) 9329 9584 or 1300 659 226

Things to remember

Mesothelioma is a rare type of cancer that can develop decades after exposure to asbestos.
Mesothelioma usually targets the outer membrane of the lungs (pleura) but can also occur in the membrane lining of the abdominal cavity (peritoneum). Uncommonly, the heart or reproductive organs may be affected.
Unless surgical removal is an option there is no cure – treatment aims to prolong life and keep the person as comfortable as possible.

You might also be interested in:
Asbestos and your health.
Asbestos in the home.
Cancer.
Cancer and asbestos.
Cancer pain management.
Cancer treatments - chemotherapy.
Cancer treatments - radiotherapy.
Palliative care explained.
Pleurisy explained.
Respiratory system.

Want to know more?
Go to More information for support groups, related links and references.

This page has been produced in consultation with and approved by:

(Logo links to further information)