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Man describing chest pain from mesothelioma

Mesothelioma is an aggressive cancer that’s caused by prolonged exposure to asbestos—a set of naturally occurring, heat-resistant fibrous minerals that were used in the construction of many commercial and residential buildings prior to the 1980s. Government legislation has significantly reduced the likelihood of long-term workplace asbestos exposure, although some degree of risk may still remain for employees in the construction, electrical, mining, firefighting, military and shipbuilding industries.

There are multiple types of mesothelioma, which are categorized by where they originate in the body and the cancer’s cellular makeup.

Mesothelioma types by location

There are two primary types of mesothelioma: pleural mesothelioma and peritoneal mesothelioma. Two additional types, pericardial mesothelioma and testicular mesothelioma, are far less common.

Pleural mesothelioma

Pleural mesothelioma is a slow-growing cancer that develops in the protective lining of the lungs called the pleura. The most common form of mesothelioma, it accounts for about 75% of all cases.

The symptoms of pleural mesothelioma are often vague or frequently associated with less serious conditions. Common symptoms include:

  • Low back pain
  • Shortness of breath
  • A dry, sharp cough
  • Fever
  • Excessive sweating
  • Unexplained weight loss
  • Coughing up blood
  • Swelling in the face or arms
  • Lumps of tissue around the chest

Robust treatment of pleural mesothelioma can help patients maintain a positive quality of life and survive for five or more years after diagnosis.

Peritoneal mesothelioma

Peritoneal mesothelioma develops in the lining of the abdomen (the peritoneum) and accounts for 15% to 20% of all mesothelioma diagnoses. It responds more favorably to treatment than other types of mesothelioma, although less research is available on this subtype.

Symptoms of peritoneal mesothelioma may include:

  • Abdominal pain and swelling
  • Bloating
  • Changes in bowel habits
  • Loss of appetite

Pericardial mesothelioma

Pericardial mesothelioma develops in the protective lining of the heart (the pericardium) and accounts for just 1% to 2% of mesothelioma diagnoses. This type of mesothelioma is especially aggressive and is associated with the following symptoms:

  • Trouble breathing
  • Chest pain
  • Irregular heartbeat
  • Cough

Testicular mesothelioma

Testicular mesothelioma develops in the membrane that lines the testes (the tunica vaginalis) and is the rarest type of mesothelioma, accounting for less than 1% of all mesothelioma diagnoses. Approximately 100 total cases have ever been recorded in medical literature.

Mesothelioma cell types

Once the primary type of mesothelioma has been established, physicians will look at a tissue sample under a microscope to determine its histological (cell) type. Because cell types can influence the way a tumor behaves and responds to treatment, it’s important to consider this information when creating a treatment plan.

Epithelial mesothelioma

The most common histological type, epithelial mesothelioma affects the epithelial cells in the pleura, which are the membranes that line the chest cavity and surround the lungs. There are several subtypes of epithelial cells, which can influence treatment decisions.

In its early stages, epithelial mesothelioma tends to produce nonspecific symptoms that mimic those of less severe respiratory conditions, such as asthma and pneumonia. In many cases, a persistent cough is the first symptom that prompts a visit with a physician. The coughing may be accompanied by:

  • Shortness of breath
  • Chest wall pain
  • Unexplained weight loss
  • Fatigue

In general, many patients receive a combination of chemotherapy, radiation therapy and surgery. Treatment for epithelial mesothelioma can vary depending on the subtype and stage of the cancer. Overall, epithelial cells tend to respond more favorably to treatment than other types of mesothelioma cells.

Sarcomatoid mesothelioma

Sarcomatoid mesothelioma is a rapidly-dividing cell type that tends to spread quickly and is challenging to treat. Also referred to as spindle cell mesothelioma due to its shape, sarcomatoid mesothelioma accounts for 10% to 20% of all mesothelioma cases.

Biphasic mesothelioma

Biphasic (mixed) mesothelioma involves both epithelial and sarcomatoid cells and makes up around 10% to 20% of mesothelioma cases. Its prognosis and recommended course of treatment will depend on which mesothelioma cell type is dominant.

There is currently no cure for any type mesothelioma, but multiple ambitious research initiatives are focused on improving treatments and outcomes for patients with this cancer. The goal of mesothelioma treatment is to reduce symptoms and slow the progression of the disease, usually through a combination of chemotherapy, radiation therapy and surgery.

Moffitt’s approach to mesothelioma

Moffitt Cancer Center’s Mesothelioma Research and Treatment Center offers the latest advances in treatment and supportive care to patients with all types mesothelioma. As a National Cancer Institute-designated Comprehensive Cancer Center, we stand at the forefront of mesothelioma research and offer a robust clinical trial program that gives eligible patients access to breakthrough treatments before those options are made widely available. Moffitt is the first NCI-designated Comprehensive Cancer Center based in Florida and is the No.1 cancer hospital in the state.

Call 1-888-663-3488 or submit a new patient registration form online if you would like to consult a mesothelioma specialist at Moffitt. We welcome patients with or without referrals and connect them to specialists as soon as possible.

References Types of Mesothelioma Types of Mesothelioma