Pleural mesothelioma affects the lung lining.

Do not confuse it with lung cancer, as many people tend to. This disease only affects the lining of the lung (pleura). The pleura is a thin membrane that surrounds the lungs, and it is responsible for the secretion of the special lubrication that facilitates the expansion and contraction of the lungs during respiration. 

Pleural mesothelioma is the most common of mesothelioma cancers, accounting for 75% of cases (and is a virtually untreatable disease). There are two types of pleural mesothelioma; diffuse and malignant (which is cancerous), and localized & benign (non-cancerous). The latter is usually removed surgically and has no link to asbestos exposure. Due to this it is generally not life-threatening if you're diagnosed with the localized & benign pleural mesothelioma. If you have malignant mesothelioma there is definately cause for alarm as this is a deadly form of cancer. About 2000 individuals in the United States are diagnosed with malignant mesothelioma. (There is also peritoneal mesothelioma.)

Like all mesotheliomas, it is caused by the inhalation of asbestos fibres. These lodge themselves in the lung pleura. As time progresses the fibres lead to chronic inflammation. This in turn causes the growth of cancerous tumors.

Pleural mesotheliomas normally affects two particular surfaces of the pleura. These are known as the parietal surface and the visceral surface. The former is closer to the lung whilst the latter is on the outside. Usually it is the right lung that is affected the most due to its larger surface area, and hence, larger pleural surface area. During diagnosis large tumor growths are seen in the pleura, which can completely obliterate the lung cavity in the later stages of the disease. From the pleura the disease can spread onto other vital organs such as the heart. It can also invade the lymph nodes and the blood system. As it spreads it can compress the lungs, invading the chest wall and ribs, making it extremely painfull. As it spreads over the pleura is causes it (pleura) to thicken. This encases the lungs and tend to make them 'smaller'. This in turn makes breathing quite a laborious task. The affected person may become breathless even while resting as the lung fucntion diminishes - due to its decrease in size.

When it comes to the symptoms of pleural mesothelioma, they are somewhat similar to those of peritoneal mesothelioma, with patients experiencing chest pains. However, this pain is usually felt in the upper abdomen or even the shoulders. It is also worth noting that some of the symptoms are also like those of the flu or pneumonia, making it even more difficult to diagnose in the first place. Other symptoms include persistent coughing, weight loss, blood clots, lower-back pain and even anorexia, believe it or not ! Patients can also experience shortness of breath.

The tumors grow quickly and cause the pleural space to enlarge, filling it with fluid. This is known as a pleural effusion and is usually detected during the intial tests used to diagnose the disease. This can usually be seen in a normal chest x-ray and also heard during a physical examination. It is this fluid that leads to the discomfort and pain felt by patients. Following the chest x-ray (or CAT scan) a bronchoscopy is performed.

In order to ascertain oneself of the presence of mesothelioma a biopsy has to be performed. During this procedure a piece of tissue is obtained. This is done by either a needle biopsy, and open biopsy, or via a thoracoscopy (tube with a camera). If an abnormality is spotted then a tissue sample is extracted then and there. A pathologist performs the biopsy with local anaesthetic. This is usually a painless procedure.

Unfortunately, the survival rate of patients who are diagnosed with pleural mesothelioma is low. The median (survival) rate is only 242 days. There are three different cell types when mesotheliomais concerned. These are known as sarcomatoid, epitheloid, and biphasic. It is the patients with the biphasic type that usually have the lowest life expectancy. You might as well say that it is a type of cancer that is virtually 100% fatal. The treatments just ease the symptoms and extend your life expectancy by a few months.

Treatment options for mesothelioma as a whole have improved over the years. Scientists are conducting trials on alternative methods such as gene therapy, immunotherapy, and angiogenesis inhibitors. Treatments that reduce the pain and increase the lung functions are showing signs of increased success but the total cure for mesothelioma cancer is still non-existent. The cure for pleural mesothelioma (and many other cancers for that matter) is as elusive as that of the HIV virus.