What Is Mesothelioma?
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Expert Take

Dr. Andrea Wolf: What is mesothelioma

Mesothelioma is a primary cancer of the lining of the lung and chest wall.

So the pleura is the lining of the chest wall and lung. In a healthy person, it's like a cellophane wrap around the chest wall, the middle compartment of the chest where the sac around the heart is, the diaphragm that separates the chest and the abdomen, and the entire surface of the lung, deep into the crevices of each of the individual sections. In mesothelioma, that cellophane becomes thickened with tumor, almost like a blanket.

Now this differs from other cancers that go to that lining. In fact, it is even more common for people to get other cancers such as breast, lung, or other organs that go to the lining of the lung. That's considered metastatic, or meaning cancer going from one location to another part of the body or another organ. And so mesothelioma is when the cancer starts in the pleura or that lining.

What Is Mesothelioma?

Mesothelioma develops when asbestos fibers become trapped in the mesothelium, the protective tissue lining your organs. These fibers cause chronic inflammation and DNA damage, transforming normal cells into cancer. However, early diagnosis and treatment by specialists significantly improve survival rates.

Mesothelioma developing in the lungs, abdomen and heart
Mesothelioma may develop in the lining around the lungs, abdomen or heart.

Key Points About Mesothelioma

  • Annual cases: About 3,000 people are diagnosed each year in the U.S.
  • Primary cause: Asbestos exposure (workplace, military, secondhand)
  • Cancer type: Malignant mesothelioma (aggressive cancer requiring specialist care)
  • Latency period: 20 to 60 years between exposure and symptoms
  • Who’s Most Affected: Men over age 65
  • Average survival: 12 months, but treatment extends life expectancy
  • Curability: Incurable but treatable with chemotherapy, immunotherapy and surgery

Early diagnosis is critical because it gives you more treatment options and better outcomes. Mesothelioma patients are living longer than before. Long-term mesothelioma survivors Kim Madril, Tamron Little and Michael Cole show that with specialized care and cutting-edge treatment, it’s possible to exceed average survival statistics.

“I saw my kid graduate from high school,” said Madril, who was diagnosed with pleural mesothelioma in 2019. “I’m so glad that I’m not suffering like I did initially…You’re almost grateful for what you have. I’m grateful that I am still here. I am so happy that I’m still here. Embrace the moment.”

Asbestos-Kim-Madril-Survivor-Story-Short

Survivor Story

Kim Madril: My Experience Facing Mesothelioma

My name is Kim Madril, and I’m 62 years old. I was diagnosed with pleural mesothelioma, in July of 2019, and I am a mesothelioma survivor.

I woke up one early morning at 3 a.m.

And I had this sharp shooting pain on the left side. And so my PCP finally said, Kim, let’s just get CAT scan. Okay?

And it was July of 2019 when I was definitively diagnosed.

I did run marathons. I was active. I climbed Mount Kilimanjaro.

It just didn’t seem real.

I think my mom having lost her husband at 55, you know. I think she thought, oh my gosh. Am I gonna lose my kid?

My surgery ended up being about 8 hours.

When I woke up, I remember thinking, I made it.

I made it. And, really, after that, I thought okay, you’re gonna be fine, Kim. You’re gonna be fine.

My advice for anyone currently battling mesothelioma is to be well educated. Know that there are resources out there that you’re not really alone. You really aren’t, even if you don’t have a husband, a wife, a partner, or children, or siblings.

There are people out there that will help you. Seek them out.

Types of Mesothelioma 

There are 4 main types of mesothelioma. Mesothelioma forms in the lining around the lungs (pleura), abdomen (peritoneum), heart (pericardium) or testes (tunica vaginalis).

Pleural Mesothelioma

  • Prevalence: 70% to 79% of all cases
  • Location: Pleura (tissue around lungs and chest wall)
  • Treatments: Immunotherapy, surgery, chemotherapy
  • 5-year survival rate: 7% to 22%, according to the American Cancer Society

Peritoneal Mesothelioma 

  • Prevalence: 10% to 30% of all cases, second most common type
  • Location: Peritoneum (abdominal cavity lining)
  • Treatments: HIPEC surgery is highly effective for this type
  • 5-year survival rate: 65% (significantly better than pleural)

Pericardial Mesothelioma 

  • Prevalence: About 1% of cases (very rare)
  • Location: Pericardium (sac around the heart)
  • Median survival: 2 to 6 months
  • Treatment challenges: Limited options because of heart proximity

Testicular Mesothelioma 

  • Prevalence: Less than 1% of cases, rarest form
  • Location: Tunica vaginalis (membrane around testes)
  • Common symptom: Testicular mass or swelling
  • Prognosis: Better than other types, 33% of patients live 10+ years

Mesothelioma can spread from one location to another as it progresses. In rare cases, a person may develop both pleural and peritoneal mesothelioma. Pleural and pericardial types often share symptoms like chest pain and difficulty breathing, which can complicate diagnosis.

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Symptoms of Mesothelioma

The most common symptoms of mesothelioma include fatigue, weight loss and fever. These symptoms develop slowly and often resemble common respiratory infections, such as pneumonia or bronchitis, making early diagnosis difficult.

Most Common Mesothelioma Symptoms by Type
Symptom Pleural (Lung) Peritoneal (Abdomen) Pericardial (Heart) Testicular (Testes)
Shortness of breath X X
Chest pain or tightness X X
Persistent dry cough X X
Abdominal pain X
Abdominal swelling X
Unexplained weight loss X X X
Fatigue or weakness X X X X
Fever or night sweats X X X
Loss of appetite X X
Nausea or vomiting X
Heart Palpitations X
Difficulty breathing when lying down X
Testicular mass or swelling X
Fluid buildup X X X X

If you have a history of asbestos exposure and experience persistent symptoms, see a mesothelioma specialist immediately.

Mesothelioma survivor Michael Cole

Experience From a Mesothelioma Survivor

My story begins at the end of April 2015, when I went to my general practitioner’s office because of a cough and an unusual lack of energy. I thought maybe I was coming down with a case of pneumonia.

Michael Cole, pleural mesothelioma survivor

What Is the Main Cause of Mesothelioma?

Asbestos exposure is the primary cause of mesothelioma. When people inhale or ingest microscopic asbestos fibers, the fibers become trapped in the mesothelium, the protective lining of organs. As Dr. Marcelo DaSilva, chief of thoracic surgery at AdventHealth Cancer Institute, explains, these inhaled fibers lead to inflammation, which can then cause cancer to develop.

Dr. DaSilva tells us, asbestos “causes chronic inflammation in the mesothelium. This can lead to genetic changes.” As this inflammation causes DNA changes in the cells, they can become mesothelioma cancer cells.

Asbestos is a toxic mineral once widely used in construction, shipbuilding, military equipment and industrial products. Most people with mesothelioma were exposed decades ago, often without knowing the dangers.

It takes decades after initial asbestos exposure for mesothelioma to develop, which is why most patients get diagnosed in their 60s or 70s.

Who Is Most at Risk?

People with occupational asbestos exposure face the highest risk of developing mesothelioma. Workers in construction, shipbuilding, manufacturing and the military were regularly exposed before asbestos regulations took effect in the 1970s and 1980s. 

High-Risk Occupations

  • Auto mechanics: Brake repair and clutch work released asbestos dust
  • Construction workers and demolition crews: Exposed through insulation, drywall and floor tiles
  • Electricians and HVAC technicians: Handled asbestos-containing wiring, panels and ductwork insulation
  • Industrial workers: Manufacturing facilities used asbestos in production processes
  • Insulation installers: Direct handling of asbestos products
  • Pipefitters and plumbers: Worked with asbestos pipe insulation and gaskets
  • Shipyard workers and Navy veterans: Especially those who served before 1980

Family members and people living near asbestos sites also face elevated risk. Secondhand exposure occurs when workers bring asbestos fibers home on clothing, skin or hair. Spouses who laundered work clothes and children who greeted parents after work shifts faced significant exposure.

“It started with me going down to the Oneida County Courthouse in Utica, New York, with my dad,” pleural mesothelioma survivor Carla Fasolo remembers about her asbestos exposure. “I would go down there with him, and it was very dusty in the boiler room. There would be chunks of gray, fibrous stuff down there. I didn’t know what it was, but I’d pick it up and play with it.”

Environmental Exposure and Genetic Risk Factors

Environmental exposure affects people living near asbestos mines, processing plants or contaminated sites. Communities near vermiculite mines in Libby, Montana, and shipyards in port cities experienced elevated mesothelioma rates even among residents who never worked with asbestos directly.

No amount of asbestos exposure is considered safe. Even brief or low-level exposure can cause mesothelioma decades later.

While asbestos is the primary cause of mesothelioma, family history and genetic mutations (like BAP1) may increase susceptibility. Smoking does not cause mesothelioma but significantly increases the risk of asbestos-related lung cancer.

If You’ve Been Exposed to Asbestos

Talk to your doctor about screening if you worked in high-risk occupations, served in the military (especially Navy), lived with someone who worked with asbestos or have a family history of mesothelioma. Screening options include chest X-rays, low-dose CT scans and regular monitoring for early detection. Mesothelioma requires care from medical oncologists, thoracic surgeons, pulmonologists and radiation oncologists. Learn about top mesothelioma doctors

Diagnosing and Staging Mesothelioma

Confirming a mesothelioma diagnosis requires multiple tests and expert analysis. Doctors use imaging scans, blood tests and biopsies to identify cancer cells and determine how far the disease has spread. A biopsy is the only definitive way to diagnose mesothelioma. Imaging and blood tests alone cannot confirm cancer.

If you have a history of asbestos exposure, tell your doctor immediately. This information helps them order the right diagnostic tests and avoid delays. Many patients are initially misdiagnosed with pneumonia, bronchitis or COPD because early symptoms overlap with common respiratory conditions.

Test to Diagnose Mesothelioma

  • Physical examination and medical history: Checks for lumps, fluid buildup and asbestos exposure history
  • Imaging tests: Chest X-rays, CT scans, MRIs and PET scans reveal abnormalities and tumor locations
  • Blood tests: Detect biomarkers like SMRP, fibulin-3 and osteopontin (elevated levels suggest mesothelioma)
  • Biopsy: The only definitive diagnostic test. Pathologists examine tissue samples under a microscope to confirm cancer cells.

Your diagnosis identifies three critical factors: mesothelioma type, cell type and stage. These details determine your treatment options and prognosis.

Cell Type Treatment Comparison
Cell Type Prevalence Median Survival Treatment Response
Epithelioid 50% to 70% of cases 14 to 24 months Best response
Sarcomatoid 10% to 20% of cases 8 to 12 months Limited response
Biphasic 20% to 30% of cases 10 to 13 months Variable

Cell type significantly impacts treatment response. Epithelioid mesothelioma responds best to chemotherapy and immunotherapy. Sarcomatoid and biphasic types are more resistant. Knowing your cell type helps your doctor select the most effective treatment approach for your specific case.

New in 2025: The American Society of Clinical Oncology now recommends genetic testing for mesothelioma. Testing identifies BAP1 gene mutations, found in 20% to 25% of patients. Research shows patients with BAP1 mutations respond better to chemotherapy and immunotherapy, with improved survival outcomes.

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Mesothelioma Stages

Mesothelioma staging describes how far the cancer has spread. Stages 1 and 2 are early stages, and stages 3 and 4 are late stages. Early stages offer more treatment options, while advanced stages offer fewer.

Percent of Patients Diagnosed by Stage and Gender
% of Total Diagnosed % of Men % of Women
Stage 1 18% 18% 24%
Stage 2 11% 11% 12%
Stage 3 23% 23% 20%
Stage 4 48% 48% 44%
Source: The Mesothelioma Center at Asbestos.com, 2025

Unfortunately, more than 70% of patients are diagnosed at stage 3 or 4, which limits treatment options. This is why screening is critical for anyone with asbestos exposure history.

The TNM staging system, which is used for pleural mesothelioma, describes:

  • T: Tumor size and extent (T1 to T4)
  • N: Lymph node involvement (N0 to N3)
  • M: Metastasis to distant organs (M0 or M1)

Your stage determines which treatments you’re eligible for, including curative-intent surgery for early-stage disease.

How Is Mesothelioma Treated?

Mesothelioma is treated with chemotherapy, immunotherapy, surgery and radiation therapy, often used in combination for better outcomes. While mesothelioma cannot be cured, these treatments can extend life, reduce symptoms and improve quality of life.

In 2025, the American Society of Clinical Oncology (ASCO) updated treatment guidelines for pleural mesothelioma. The new guidelines recommend chemotherapy alone versus the previous standard of combining chemotherapy with surgery for some patients. However, treatment decisions should be individualized. Your mesothelioma specialist will determine the best approach based on your specific case.

Common Treatment Options

  • Chemotherapy: Kills cancer cells throughout the body
  • Immunotherapy: FDA-approved for pleural mesothelioma
  • Surgery: Removes tumors and affected tissue (pleurectomy/decortication, HIPEC)
  • Radiation therapy: Targets localized tumors
  • Multimodal therapy: Combines multiple treatments for better results
  • Palliative care: Manages symptoms and improves quality of life

Peritoneal mesothelioma survivor Tamron Little shares with us her personal story of success with cytoreductive surgery with HIPEC. She tells us, “Studies show HIPEC drastically improves life expectancy in about 50% of the peritoneal mesothelioma patients who have the procedure. It definitely worked in my favor and was a success!”

Our 2026 survey of mesothelioma patients and their caregivers found 31% chose chemo as their primary treatment, 23% chose immunotherapy and about 19% chose surgery. Nearly 27% reported using other treatment options.

Pie chart showing treatment choices among mesothelioma patients: chemo 31.4%, immunotherapy 23.3%, surgery 18.7%, radiation 12.9%, no treatment 5.2%, other 8.5%
Our exclusive 2025 survey shows chemo is the most common treatment among patients.

Your Mesothelioma Treatment Team

Mesothelioma treatment requires coordination between multiple specialists working as a team:

  • Thoracic surgeons perform complex procedures like pleurectomy/decortication and HIPEC surgery. Leading mesothelioma surgeons include Dr. Jacques Fontaine at Moffitt Cancer Center in Tampa, Dr. Andrea Wolf who directs the New York Mesothelioma Program at Mount Sinai and Dr. Marcelo DaSilva at AdventHealth Cancer Institute in Orlando.
  • Medical oncologists manage chemotherapy and immunotherapy protocols. These specialists work closely with pulmonologists who treat breathing complications, drain pleural effusions, and monitor lung function during treatment.
  • Radiation oncologists like Dr. Rupesh Kotecha at Miami Cancer Institute deliver targeted radiation therapy to control tumor growth and relieve symptoms. Radiation is often used in combination with surgery or chemotherapy for better outcomes.
  • Palliative care specialists manage pain, breathing difficulty, and other symptoms throughout your treatment journey. Starting palliative care early improves quality of life and may extend survival.

Look for cancer centers with dedicated mesothelioma programs. These centers have specialists who collaborate on your case and typically achieve better outcomes than general hospitals. Centers that treat 50 or more mesothelioma patients annually have the most experience with this rare cancer.

How Long Can You Live With Mesothelioma?

Most people with mesothelioma live 12 to 18 months after diagnosis, but survival varies significantly by the type of mesothelioma you have, your treatment approach and the stage at which you are diagnosed. Early diagnosis and multimodal treatment can extend life expectancy. 

According to the American Cancer Society, the 5-year survival rate for pleural mesothelioma is 7% to 22%. The 5-year survival rate for peritoneal mesothelioma is 65%. Peritoneal mesothelioma has significantly better survival outcomes, especially when treated with HIPEC surgery, which combines surgery with a gentle, heated chemotherapy. 

Survival varies by stage at diagnosis. Early-stage patients have a better survival rate than late-stage patients.

Survival by Stage at Diagnosis
Stage Median Survival 5-Year Survival Rate
Stage 1 21 months 46%
Stage 2 19 months 30%
Stage 3 16 months 16%
Stage 4 12 months Less than 5%

Treatment and a healthy lifestyle may lead to partial remission. Vaccines can also help prevent serious lung infections that can impact your health. Talk to your doctor about ways to boost your prognosis.

Long-Term Survivors Exist

While statistics show average outcomes, many patients exceed expectations. Some survivors have lived 10 to nearly 20 years beyond the life expectancies given after their mesothelioma diagnosis. 

  • Epifanio Figueroa: Has survived nearly 10 years with peritoneal mesothelioma after HIPEC surgery
  • Kim Madril: Pleural mesothelioma survivor, diagnosed in 2019, continues thriving after surgery and treatment
  • Michael Cole: Living well with pleural mesothelioma since 2015 diagnosis
  • Tamron Little: Diagnosed with peritoneal mesothelioma in 2007, achieved remission with HIPEC surgery and remains cancer-free 18+ years later

Your individual prognosis depends on mesothelioma type, stage at diagnosis, cell type, age and overall health. Talk to your mesothelioma specialist about personalized survival estimates and treatment options.

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Your Next Steps After a Mesothelioma Diagnosis

A mesothelioma diagnosis can feel overwhelming for patients and caregivers. Taking these specific actions now can improve your treatment outcomes, connect you with support and help you access financial resources. Our Patient Advocates are available to guide you through each of these steps at no cost.

First Priority: Get the Right Medical Care

  • Find a mesothelioma specialist: General oncologists rarely treat this rare cancer. Specialists at experienced cancer centers have access to the latest treatments and clinical trials that may improve your prognosis.
  • Get a second opinion: Confirm your diagnosis, stage and cell type. A mesothelioma specialist can present treatment options you may not have considered.
  • Explore clinical trials: Many patients in clinical trials experience better outcomes than those receiving standard care alone.

Second Priority: Access Support and Financial Resources

  • Join a support group: Reduces anxiety and connects you with other patients navigating mesothelioma
  • Apply for financial assistance: Asbestos trust funds provide compensation; mesothelioma lawyers help file claims at no upfront cost
  • Access veteran benefits: VA medical centers offer specialized care, disability benefits and caregiver support
  • Adopt healthy habits: Light exercise, a balanced diet and stress management improve quality of life during treatment
  • Consider palliative care: Helps manage symptoms and side effects alongside cancer treatment

You can empower your family with knowledge, resources and hope. Peritoneal survivor Tamron Little tells us more resources would have helped her when she was first diagnosed.

“I would have looked for different mesothelioma resources, aid or even support groups,” Tamron shares. “That would have helped me while I was battling the disease.”

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Commonly Asked Questions About Mesothelioma

Can mesothelioma go into remission?

Yes, some mesothelioma patients achieve remission through treatment. Remission can be partial or complete. Peritoneal mesothelioma patients treated with HIPEC surgery have the highest remission rates, though ongoing monitoring is essential as mesothelioma can recur. 

Can mesothelioma be cured?

Mesothelioma is not curable, but it is treatable. Surgery, chemotherapy and immunotherapy can extend life and improve quality of life. 

How did I get mesothelioma?

Mesothelioma is caused by asbestos exposure. Most people are exposed at work in occupations like construction, shipbuilding, plumbing and electrical work. Military veterans, especially Navy personnel who served before 1980, also face elevated risk. Asbestos fibers become trapped in organ linings and cause cancer decades after initial exposure.

How long can you live with mesothelioma?

Survival varies significantly by type and treatment. Peritoneal mesothelioma has a 65% 5-year survival rate with treatment, while pleural mesothelioma has a 7% to 22% 5-year survival rate. Early diagnosis and specialist care can extend life expectancy beyond these statistics.

What’s the difference between mesothelioma and lung cancer?

Mesothelioma develops in the tissue lining around the lungs, while lung cancer grows in the lung tissue itself. They require different treatments and have different causes. Mesothelioma is almost always caused by asbestos exposure, while lung cancer is often caused by smoking.

What are the first signs of mesothelioma?

Pleural mesothelioma typically causes shortness of breath and chest pain from fluid buildup. Peritoneal mesothelioma causes abdominal pain or swelling. Symptoms usually appear 20 to 60 years after asbestos exposure.

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