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Mesothelioma Progression

The development of mesothelioma after asbestos exposure is a slow process that can take decades. However, once the condition does emerge, mesothelioma progression often occurs rapidly, resulting in a deterioration of health over a very short period and a significantly shortened lifespan.


Medically Reviewed By:
Patricia Shelton, M.D.

Patricia Shelton

Medically Reviewed By:Patricia Shelton, M.D.

Mesothelioma is an aggressive cancer that generally begins with vague symptoms, making it difficult to diagnose. As a result, the condition is often diagnosed at a later stage, after treatment options have become limited. Despite taking decades to emerge, mesothelioma often progresses quickly.

Mesothelioma treatment is aimed at slowing the progression of mesothelioma and easing symptoms. There is no cure for mesothelioma. Even with treatment, the prognosis is poor.

How Does Mesothelioma Start?

When a person inhales asbestos fibers, they enter the lungs. The body attempts to flush them out by creating mucous, which may induce coughing or the movement of the fibers to nearby tissues, including the linings surrounding the lungs and stomach. However, some fibers may remain and deeply embed themselves into the tissue. 

It’s believed that asbestos fibers cause cancer through the following mechanism:

  • Cells of the immune system attempt to remove the asbestos fibers, resulting in an inflammatory response. 
  • Because the mineral is so stable, the immune system cannot destroy it. 
  • The inflammatory response becomes sustained over a long period. 
  • Inflammation creates a variety of substances that can cause damage to cellular DNA. 
  • Certain types of DNA damage cause a cell to become cancerous.

In some cases, the membranes around the lungs thicken. This may occur widely throughout the pleura, which is known as pleural thickening, or it may occur in smaller areas, which are known as pleural plaques. These conditions are often asymptomatic. Thickening of the pleura may occur before mesothelioma develops, although some patients do not show pleural thickening or plaques.

In some cases, pleural abnormalities can lead to fluid buildup around the lungs. This is known as a pleural effusion. It often causes symptoms like shortness of breath or chest pain, but some pleural effusions may be asymptomatic.

Mesothelioma Diagnosis

The earliest stages of mesothelioma may be asymptomatic. It is possible for a patient not to notice any symptoms until after the cancer reaches an advanced stage. 

When they do occur, early mesothelioma symptoms tend to be nonspecific, which can result in a misdiagnosis or delayed diagnosis. The symptoms often mimic more common, less serious conditions, such as the following:

  • Influenza
  • Pneumonia
  • COPD (emphysema)
  • Gastrointestinal infection, or “stomach flu”
  • Crohn’s disease
  • Irritable bowel syndrome
  • Celiac disease

However, as symptoms worsen, it becomes clear that the initial diagnosis was incorrect. This leads to additional testing to determine the correct diagnosis. Diagnosing mesothelioma generally involves a combination of imaging tests and a biopsy.

How Quickly Does Mesothelioma Progress?

The progression of mesothelioma is generally rapid compared to other forms of cancer. Without treatment, the life expectancy of mesothelioma is less than a year for all types of mesothelioma. Even with treatment, the life expectancy is often less than two years.

Approximately 65.8 percent of pericardial mesothelioma patients survive for just two months after diagnosis, with or without treatment. Patients with peritoneal mesothelioma who do not seek treatment survive an average of just four months. The most common form of mesothelioma, pleural mesothelioma, has an average overall survival of 21 months with treatment and 10 months without it.

These short survival times result from the rapid growth of mesothelioma tumors and their rapid spread from the tissues where they begin to the surrounding tissues, lymph nodes, and distant organs throughout the body.

Factors that Affect the Progression of Mesothelioma

The most important factors that influence the speed of mesothelioma progression include the following:

  • The stage at which the cancer is diagnosed and treatment is initiated
  • The treatment options that are available
  • The type of mesothelioma with which you are diagnosed
  • The mesothelioma cell type

Earlier Diagnosis

Diagnosis at an earlier stage allows for more treatment options, including surgery, which can significantly slow down the spread of the illness. A combination of surgery with systemic options, such as chemotherapy and immunotherapy, is often recommended in order to slow the progression to the fullest extent possible.

Patients with an early diagnosis of peritoneal mesothelioma may be eligible to undergo hyperthermic intraperitoneal chemotherapy (HIPEC), which involves filling the abdominal cavity with heated chemotherapy drugs. This procedure is performed during a surgical procedure after the surgeon removes all visible tumors from the abdomen.

This procedure can drastically increase life expectancy to as long as 34 to 92 months. Without treatment, peritoneal mesothelioma spreads very quickly.

The Mesothelioma Cell Type

The various cell types are important determinants of how quickly mesothelioma progresses. The primary cell types are as follows:

  • Epithelial mesothelioma
  • Sarcomatoid mesothelioma
  • Biphasic mesothelioma

Epithelial mesothelioma is less aggressive and responds better to treatment than other cell types. The sarcomatoid cell type is the most aggressive and is the most resistant to treatment. Biphasic mesothelioma is a combination of both of these cell types. The progression of biphasic mesothelioma will vary depending on the percentage of epithelial cells versus sarcomatoid cells.

Sarcomatoid cases, as well as biphasic ones with a high percentage of sarcomatoid cells, are generally considered inoperable. This means that patients are limited to systemic therapies, such as chemotherapy. While systemic therapies can slow the progression of mesothelioma and prolong life, they are often less effective without the addition of surgery.

What is Metastasis?

Metastasis is the development of additional tumors in areas of the body separate from the location of the primary tumor. Mesothelioma begins in the lining around the lungs, stomach, heart, or testicles. In most cases, it initially spreads to the organs in the immediate vicinity of the primary tumor.

The cancer cells may enter the lymphatic system, which collects excess fluid from the tissues. From there, they can enter surrounding lymph nodes, and may later spread through the lymphatic system to other organs, where new tumors form. Cancer cells can also spread to distant organs through the bloodstream. The tumors then grow in these areas, causing symptoms such as pain and preventing essential organs from functioning as they should.

Pleural Mesothelioma Stages

Official staging of mesothelioma is generally only used in cases of pleural mesothelioma, which impacts the lining surrounding the lungs. Staging is a means to denote how much mesothelioma has progressed. It is generally measured by the following:

  • The size of the original tumor
  • Whether the cancer has spread
  • How far the cancer has spread

Stage 1

Pleural mesothelioma begins as a small tumor affecting only the pleura, which is the membrane around the lungs. However, it is still classified as a stage 1 cancer even after it spreads to certain adjacent tissues, including the lung, chest wall, diaphragm, and pericardium (the lining around the heart).

Some patients do not experience symptoms during this stage of mesothelioma. For those that do, symptoms may include any combination of the following:

  • Shortness of breath
  • Coughing
  • Chest pain
  • Hoarseness
  • Difficulty swallowing

Initial symptoms, if any, may be bothersome but are usually not severe. Patients often assume that they are suffering from a common cold or flu. However, the tumor grows quickly without treatment, and the symptoms will steadily worsen. 

Patients whose cancer is diagnosed during this stage have the most treatment options and the best prognosis because the tumor is still localized. Unfortunately, mesothelioma is rarely diagnosed during stage 1.  

Treatment options during this stage include surgery, chemotherapy, and radiation therapy. This can slow the progression of the disease. The life expectancy for patients diagnosed with stage 1 pleural mesothelioma is 21 to 30 months with treatment.

Stage 2

Pleural mesothelioma is classified as stage 2 when it has spread to the lymph nodes on the same side of the chest. Symptoms during this stage may be very persistent, and by this time, many patients are aware that they have some type of chronic lung condition, even if they have not yet received a diagnosis of mesothelioma. However, some stage 2 patients still experience mild symptoms, and they may ignore these or consider them not to be serious.

Stage 2 mesothelioma is still considered an early stage, and surgery often remains an option. Unfortunately, many patients do not receive a diagnosis until after the cancer has progressed beyond this stage. Stage 2 pleural mesothelioma patients who receive treatment have a life expectancy of 19 to 22 months.


Stage 3

Pleural mesothelioma reaches stage 3 when the tumor has spread to lymph nodes on both sides of the chest and/or has spread more extensively in the local area around the tumor. It is common to be diagnosed at this stage. Unfortunately, surgery is less likely to be an option during stage 3 pleural mesothelioma, although some stage 3 patients may be eligible for surgery. 

In stage 3, the symptoms may be uncomfortable enough to require palliative care. You may begin to experience weight loss, fatigue, and loss of appetite during this stage, as well as a worsening of shortness of breath, coughing, and chest pain as the tumor grows.  The life expectancy for pleural mesothelioma patients diagnosed during stage 3 is 16 months.

Stage 4

Stage 4 pleural mesothelioma is diagnosed when the cancer has spread to distant parts of the body. In many cases, the primary tumor has also spread extensively to nearby organs and tissues, such as the spine, ribs, and heart. However, if the cancer has metastasized to organs in distant parts of the body, then the cancer is automatically considered to be in stage 4, even if the primary tumor is still small.

Pain and shortness of breath may become severe during this phase, requiring medical intervention. Pain, which may be felt both in the chest and in other parts of the body where tumors have formed, may be unbearable without medical management, such as medication. 

You may need supplemental oxygen, and some patients become bedridden. Severe weight loss, weakness, loss of appetite, fever, and night sweats are common at this stage.

You may benefit from hospice care during this stage because of the increased focus on comfort. Stage 4 pleural mesothelioma patients often need 24-hour care. It is not uncommon to receive your initial diagnosis at this stage. Stage 4 cancer is inoperable, because it has already spread throughout the body.

However, systemic therapy, such as immunotherapy and chemotherapy, may still be options to prolong life. The life expectancy for pleural mesothelioma patients diagnosed during stage 4 is 12 months.

Peritoneal Mesothelioma Progression

Peritoneal mesothelioma does not have a formal staging system, but some doctors use a scoring system known as the pericardial cancer index to measure the spread of mesothelioma within the abdominal cavity. This index is considered in conjunction with the spread of the cancer to other parts of the body. 

Like pleural mesothelioma, peritoneal mesothelioma may spread to the lymph nodes throughout the body and reach distant organs. As other organs are affected, you may experience pain and organ failure in these parts of the body. 

Can Mesothelioma Go into Remission?

There have been rare cases of mesothelioma patients experiencing remission. However, there is no known cure for mesothelioma, and remission is extremely rare. Researchers have not given up, and many clinical trials are currently being conducted in search of a cure.

If you have been diagnosed with mesothelioma, the Lanier Law Firm may be able to help you recover financial compensation. Contact us today for a free case review.

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