Mesothelioma
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What is mesothelioma?
Mesothelioma is a cancer of the mesothelium. The mesothelium is a thin lining (membrane) that covers the outer surface of many organs in the body. It also lines the spaces (cavities) within the body, such as the chest and abdominal cavity.
The mesothelium has different names depending on where it is in the body. For example:
- the mesothelium in the chest is called the pleura
- the mesothelium in the tummy (abdomen) is called the peritoneum.
The mesothelium is made up of mesothelial cells. If these cells develop abnormally, they can develop into cancer called malignant mesothelioma. Malignant mesothelioma is usually just called mesothelioma.
In the UK, more than 2,700 people are diagnosed with mesothelioma (pronounced mee-so-thee-lee-oma) each year.
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Booklets and resources
Types of mesothelioma
When mesothelioma affects the chest, it is called pleural mesothelioma. When it affects the abdomen, it is called peritoneal mesothelioma. Pleural mesothelioma is much more common.
Very rarely, mesothelioma may develop in the outer lining of other organs.
We have more information on types of mesothelioma.
Symptoms of mesothelioma
The symptoms of mesothelioma vary depending on whether it is in the pleura or peritoneum.
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Symptoms of pleural mesothelioma
The symptoms of pleural mesothelioma may include:
- shortness of breath
- chest pain that feels heavy, dull or aching
- a high temperature (fever)
- heavy sweating at night
- extreme tiredness (fatigue)
- weight loss
- loss of appetite
- a cough that does not go away.
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Symptoms of peritoneal mesothelioma
The symptoms of peritoneal mesothelioma may include:
- swelling in the tummy (abdomen)
- tummy pain
- loss of appetite
- weight loss
- feeling sick (nausea)
- changes in your normal bowel function, for example constipation or diarrhoea – especially if you are aged over 50 and this happens for the first time.
If you have any of these symptoms, it is important to get them checked by your GP. These symptoms can be caused by conditions other than mesothelioma.
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Causes of mesothelioma
Over 9 out of 10 cases of mesothelioma (90%) are caused by exposure to asbestos fibres. Asbestos is a natural mineral found in many countries.
We have more information about asbestos and other causes of mesothelioma.
Diagnosis of mesothelioma
If you have symptoms of mesothelioma, you usually begin by visiting your GP. They will ask you about your symptoms and examine you. They may also ask if you have been exposed to asbestos in the past. You may have blood tests and a chest x-ray.
Depending on the results of any tests, your GP may refer you to hospital for further tests. At the hospital, you will see a specialist doctor. They will ask you about your general health and any previous medical problems.
Tests for pleural mesothelioma
You may have the following tests:
Tests for peritoneal mesothelioma
You may have the following tests:
We have more information about diagnosing mesothelioma.
Waiting for test results can be a difficult time. We have more information that can help.
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Staging of mesothelioma
The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.
Knowing the stage helps your doctors plan the best treatment for you.
We have more information about mesothelioma staging.
Treatment for mesothelioma
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).
The treatments you may be offered depend on many different things. These include:
- the type of mesothelioma
- the stage of the mesothelioma
- your general fitness
- any other illnesses you may have.
For most people with pleural and peritoneal mesothelioma, the aim of treatment is to slow the growth of the cancer. This can help improve symptoms and may help improve quality of life.
Your cancer doctor or specialist nurse will explain the different treatments and their side effects. You may have some treatments as part of a clinical trial.
They will also talk to you about things to consider when making treatment decisions before you agree (consent) to have treatment.
Your cancer team may also give you advice about preparing for your treatment. This is sometimes called prehabilitation. It helps to improve your fitness and diet and to get you ready mentally before treatment.
Treatments for mesothelioma include:
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Immunotherapy
The immune system protects the body against illness and infection. Immunotherapies are treatments that use the immune system to find and attack cancer cells.
The immunotherapy drugs used to treat mesothelioma are nivolumab and ipilimumab. They are usually given in combination. These drugs are also called checkpoint inhibitors or CPIs. You have them as a drip into the vein (intravenous).
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Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells. These drugs disrupt the way cancer cells grow and divide but they also affect normal cells.
Your doctor may offer chemotherapy to help slow the growth of mesothelioma. It may also help with symptoms. Your doctor will tell you if chemotherapy is suitable for you.
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Radiotherapy
Radiotherapy uses high-energy rays to treat cancer. It is normally given as a series of short, daily outpatient treatments in the radiotherapy department.
Radiotherapy for pleural mesothelioma may be given to help relieve symptoms, such as pain or swelling.
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Surgery
Surgery is sometimes used to treat peritoneal mesothelioma. A small number of people with peritoneal mesothelioma may be offered surgery. If you are having surgery for peritoneal mesothelioma, your doctor may suggest having chemotherapy into the tummy (abdomen) during the surgery. This is called HIPEC (hyperthermic intraperitoneal chemotherapy).
Surgery is rarely used to treat pleural mesothelioma but may be used to help control symptoms. The most common procedure is placing a drain. This is to drain fluid that has built up around the lung. This can help with symptoms such as breathlessness.
Coping with advanced cancer
For people with mesothelioma, the main aim of treatment is to control symptoms. The symptoms of pleural and peritoneal mesothelioma can be controlled in many ways.
Your cancer doctor, specialist nurse or GP can help you manage your symptoms. They may refer you to a palliative care team. These teams specialise in managing symptoms and giving emotional support to you and your family. Palliative care teams have specialist nurses who can sometimes visit you at home.
We have more information about coping with advanced cancer.
Who can help?
Many people are available to help you and your family. If you think you need extra help at home, tell the doctors or nurses looking after you. They can look at your needs and organise extra support. We have more information about care and support for people with advanced cancer.
Caring for someone with mesothelioma
If you are a family member or friend of someone who has mesothelioma, you may be a carer. You may be very happy to do this, but there may be times when you need some extra support.
There are also many health and social care professionals who can support you and the person you are caring for. You can speak to your GP, or the specialist nurse involved in your friend or relative’s care. They can help make sure you are both getting the support you need.
We have more information for caring for someone with mesothelioma.
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After treatment for mesothelioma
Follow-up after treatment for mesothelioma
You will have regular check-ups during and after your treatment. Follow-up appointments are a good time to talk to your cancer doctor or specialist nurse about any concerns you have. Tell them as soon as possible if you have any problems or notice new symptoms between appointments.
Mesothelioma compensation
Most people who have been diagnosed with mesothelioma can get financial help.
This may be through compensation from an employer, or government benefits, such as Industrial Injuries Disablement Benefit (IIDB).
It is important to get advice from a specialist solicitor.
We have more information about compensation and benefits for people with mesothelioma, including how to find a solicitor.
More information and advice
We know cancer can affect you physically, emotionally and financially. We have information and advice about different ways cancer might impact you, such as help with:
Mesothelioma support
People often have many different feelings during and after mesothelioma treatment.
It is important to know where to get support or information if you need it. People often need support even some time after mesothelioma treatment. But sometimes it is difficult to know who to ask for help.
To find support:
- ask your GP or someone from your cancer team for advice about support in your area
- find cancer support services near you
- call the Macmillan Support Line free on 0808 808 00 00
- chat to our cancer information specialists online
- visit our Online Community mesothelioma forum to talk to people who have been affected by mesothelioma, share your experience, and ask questions.
The HOPE programme is a free 6 week self-management course designed to help you develop techniques and strategies when living with or after cancer. Topics include goal setting, fatigue management, and wellbeing. You can sign up for the online HOPE programme. Or to find out more about face to face programmes in your area, email ServiceOpsSupport@macmillan.org.uk
Other organisations who offer information and support
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Mesothelioma UK
Helpline 0800 169 2409 (Mon to Thurs 9am to 4pm, Fri 9am to 3pm).
A national organisation providing up-to-date information for patients with mesothelioma and their carers through its helpline, support groups and a team of clinical nurse specialists throughout the UK.
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Asbestos Victims Support Group Forum UK
Tel 0808 278 2515
Organisation representing asbestos victims support groups. You can find your local support group by selecting ‘Forum members’ on the website.
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Association of Personal Injury Lawyers (APIL)
Tel 0115 943 5400
Helps find lawyers for people who are seeking compensation for injury or work-related illnesses.
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Asthma + Lung UK
Helpline 0300 222 5800
Supports people affected by any type of lung disease.
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June Hancock Mesothelioma Research Fund
Tel 0114 274 4420
Raises funds for research into mesothelioma. Supports people with mesothelioma and their carers
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our mesothelioma cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Kusamura S, Kepenekian V, Villeneuve L, Lurvink RJ, Govaerts K, De Hingh IHJT, Moran BJ, Van der Speeten K, Deraco M, Glehen O; PSOGI. Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up. Eur J Surg Oncol. 2021 Vol, 47(1) pp6-59. [accessed April 2024].
Popat, S., Baas P., Faivre-Finn, C., Girard, N., Nicholson, A., Nowak, A., Opitz, I., Scherpereel, A, and Reck, M. 2021. ESMO Pleural mesothelioma guidelines. Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Available from: https://www.annalsofoncology.org/action/showPdf?pii=S0923-7534%2821%2904820-1 [accessed April 2024].
Date reviewed
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We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
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We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.