Malignant mesothelioma is a rare form of cancer that can originate in several areas of the body, but most commonly within the lung. The cancer cells start in the lining of the lung (pleura) or of the abdomen (peritoneum). It has been strongly linked to people who have worked in jobs where asbestos has been inhaled.

Malignant mesothelioma is difficult to diagnose and difficult to cure. The most common presenting symptoms include pain in the chest wall and trouble breathing (shortness of breath). Asbestos exposure is the primary cause of this type of lung cancer. Often exposure to the asbestos occurs 30-40 years before the cancer develops. At this time, early detection and surgery for stage I mesothelioma, offers the best chance for cure.

Staging
As in non-small cell and small cell lung cancer, tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the cancer to plan treatment.

• Localized malignant mesothelioma
  Stage I – The cancer is found in the lining of the chest cavity near the lung and heart or in the diaphragm or the lung.
• Advanced malignant mesothelioma
  Stage II – The cancer has spread beyond the lining of the chest to lymph nodes in the chest.
  Stage III – Cancer has spread into the chest wall, center of the chest, heart, through the diaphragm, or abdominal lining, and in some cases into nearby lymph nodes.
  Stage IV – Cancer has spread to distant organs or tissues.

Treatment of Mesothelioma

• Surgery is the treatment of choice if the mesothelioma is caught in the early stages. The pleural lining is peeled away from the chest wall, called decortication.
• Photodynamic Therapy (PDT) can be used during surgery to remove the tumor. Photofrin is injected into a vein through an IV 2 days before the procedure. During the surgery the chest cavity is exposed to a light source needed to destroy the cancer cells.
• Chemotherapy and radiation therapy can also be used in mesothelioma, but the likelihood of cure is rare. The chemotherapy and radiation are used more to palliate the symptoms, prolong life and improve the quality of life.
• Researchers are currently studying a new drug called Pemetrexed (Alimta™) in combination with standard chemotherapy agents in the fight against mesothelioma.