Clapper, Patti, Schweizer and Mason

Symptoms of pleural malignancies, such as difficulty breathing, chest pain and weight loss, become the impetus that leads to a diagnosis and staging of mesothelioma.  Malignant pleural mesothelioma are highly symptomatic, have few effective therapeutic interventions, and, to date, no known cure.   Diagnosis usually reveals stage IV development.  Although pleural malignancies are rare, mesothelioma is the most common among them.

Pleural effusions are a common occurrence, causing dyspnea and great chest pain.  Treatments are purely palliative and not curative in intent, although some clinical trials are searching for more definitive methods.

Assessment usually begins with a thoracentesis if the patient shows signs of pleural effusion.  If any suspicion of prior asbestos exposure or malignancy is present, the treating clinician will then perform a surgical biopsy of the pleura.  This procedure is performed by an oncologist in a hospital under general anesthesia by making a small incision that allows a video thoracoscope to be inserted into the chest cavity for visual investigation, aspiration of any fluid buildup, and biopsies of the pleural lining.  The procedure is performed not only for the purpose of diagnosis but also to palliate fluid to relieve painful symptoms.  In instances where this type of biopsy is not possible, core needle and incisional biopsies may be performed.

Once a diagnosis of malignant pleural mesothelioma has been rendered, the health care team will create a treatment plan with a palliative approach in mind.  Palliative means relieving symptoms versus removing or curing the cancer completely.  Intent is to extend survival times with improved quality of life. 

If you are experiencing any symptoms of mesothelioma, consult with an oncologist immediately.  Increased treatment options exist with earliest possible diagnosis.  You can visit the National Cancer Institute for more information and for the latest listing of clinical trials being conducted in your area.