Pleural Mesothelioma

Pleural mesothelioma develops in the lining of the lungs (pleura) 10-50 years after exposure to asbestos. Common symptoms include shortness of breath, chest pain, and a cough. Pleural mesothelioma patients live for 12-21 months on average, but with the right treatments, it may be possible to live much longer. Lung Cancer Group can help you find treatments and afford medical care.

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Written and Fact-Checked by: Lung Cancer Group

What Is Pleural Mesothelioma?

Pleural mesothelioma is a type of cancer that forms within the lining of the lungs, also known as the pleura. It can take 10-50 years to develop after exposure to asbestos, which is the only known cause of this cancer.

Pleural mesothelioma is the most common form of this cancer. According to the American Cancer Society (ACS), over 75% of patients have this type of mesothelioma.

Quick Facts About Pleural Mesothelioma
  • This cancer develops when asbestos fibers get trapped in the lung lining
  • There are four stages of this cancer — stage 1 is the easiest to treat while stage 4 is the hardest
  • The average lifespan for patients is 12-21 months, but some may live for many years with treatment
  • Treatment options include surgery, chemotherapy, radiation therapy, and immunotherapy

Life after a pleural mesothelioma diagnosis can be uncertain and scary, but Lung Cancer Group is here to help. Work with our on-staff mesothelioma nurses to find the top doctors, treatments, and financial aid.

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Amy Fair
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Mesothelioma Patients

Pleural Mesothelioma vs. Lung Cancer

Pleural mesothelioma is sometimes mistaken for a type of lung cancer, but they aren’t the same disease.

Here are some key differences between the two:

  • Where they form: Lung cancer forms within the lung, but pleural mesothelioma starts in the lining around the lungs.
  • Number of cases: Pleural mesothelioma is a very rare cancer, with only a few thousand cases per year. In contrast, the American Cancer Society (ACS) projected nearly 240,000 lung cancer cases in 2023 alone.
  • Causes: Mesothelioma is only caused by asbestos. Lung cancer is commonly associated with smoking, but it can also be caused by exposure to asbestos and other toxins.
  • Treatments: Doctors can’t treat mesothelioma in the same way that they treat lung cancer. Each cancer has its own unique treatments.

Pleural Mesothelioma Symptoms

Patients with pleural mesothelioma may suffer from chest and lung-related symptoms that can worsen as the cancer spreads.

Symptoms of pleural mesothelioma may include:

  • Chest pain
  • Difficulty swallowing
  • Fatigue
  • Fever
  • Hoarseness
  • New and unusual lumps under skin
  • Night sweats
  • Painful and persistent coughing
  • Pleural effusion (fluid buildup in lung lining)
  • Pleural plaques (chalky protein buildup in lung lining)
  • Pleural thickening (scarring of lung lining)
  • Shortness of breath
  • Unexplained weight loss

Many pleural mesothelioma patients may not notice symptoms until the cancer has spread, but these patients can still access treatments to hopefully live longer.

“If you feel like you’re not getting better and the symptoms are something new for you, it’s certainly best to encourage your doctor to proceed with more testing.”

- Amy Fair, Mesothelioma Nurse

Connect with our skilled nurses and patient advocates now if you have any symptoms listed above and are worried about pleural mesothelioma. We may be able to assist you.

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Amy Fair
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Causes of Pleural Mesothelioma

The only known cause of pleural mesothelioma is asbestos exposure. Asbestos is a highly durable, fiber-like carcinogen (cancer-causing substance) that was once used in thousands of different products.

You could still be at risk of pleural mesothelioma today if you were previously exposed to asbestos, as it takes decades for this cancer to develop.

Here’s how asbestos causes pleural mesothelioma:

  1. You are exposed to asbestos-containing products and breathe in stray fibers.
  2. The asbestos fibers get trapped in the lining of your lungs and never leave.
  3. The fibers cause damage, and after 10-50 years, mesothelioma tumors could form.

Anyone with a history of asbestos exposure could develop malignant pleural mesothelioma later in life. However, those who worked with asbestos-containing products every day in high-risk occupations are at the highest risk.

Did You Know?

About one-third of all mesothelioma cases affect U.S. veterans because asbestos was used so heavily in all branches of the U.S. military prior to the 1980s.

Family members could also be at risk due to secondhand exposure, which could have occurred when those who worked with asbestos unknowingly brought stray fibers into the home on clothing, skin, or hair.

Risk Factors for Pleural Mesothelioma

There are a couple of factors that increase your chances of developing pleural mesothelioma if you were exposed to asbestos.

Risk factors for pleural mesothelioma include:

  • Age: 72 years of age is the average age for a diagnosis of mesothelioma
  • Gender: Mesothelioma is more common in men
  • Race: Most people who develop pleural mesothelioma are white

How to Diagnose Pleural Mesothelioma

To diagnose pleural mesothelioma, doctors typically start with a physical exam and a review of your health history.

Tell your doctor if you or a loved one was ever exposed to asbestos during this review. This can help them consider if any symptoms you have are related to mesothelioma.

Your doctors may then order a couple of different tests to see if you have mesothelioma or not.

Diagnostic tests for pleural mesothelioma include:

  • Blood tests can detect biomarkers — substances in the blood showing that you might have cancer.
  • Imaging tests such as chest X-rays, CT scans, and MRIs can detect signs of cancer in and around your chest and lungs, such as pleural effusions and possibly cancerous tumors.
  • Biopsies involve taking fluid or tissue samples and testing them for cancer tumors.

While imaging tests can show signs of cancer, a biopsy is the only way to confirm that a person has mesothelioma.

Pleural Mesothelioma Prognosis

A prognosis is the expected health outlook after a diagnosis. Pleural mesothelioma is an aggressive cancer and the average prognosis isn’t very favorable, but you may be able to live for many years after a diagnosis.

Factors that affect a pleural mesothelioma prognosis include:

  • How far the cancer has spread before starting treatment (cancer stage)
  • The type of cell(s) that make up your cancer tumors
  • Which treatments you receive and how your cancer responds
  • Your age and overall health

Doctors measure mesothelioma prognosis with two main statistics: life expectancy and survival rate. Learn more about each below.

Pleural Mesothelioma Life Expectancy

Life expectancy measures how long the average person lives after diagnosis.

The average pleural mesothelioma life expectancy is 12-21 months, but some patients have lived for 15 years or more after being diagnosed.

Doctors often recommend getting treatments if you want to live as long as possible with pleural mesothelioma. Treatments like chemotherapy, immunotherapy, and surgery allow doctors to destroy mesothelioma tumors.

Pleural Mesothelioma Survival Rate

Survival rate measures the number of patients still alive after a certain amount of time has passed.

According to the American Cancer Society, the 5-year median survival rate for pleural mesothelioma is 12%.

But, you may be able to outlive the average mesothelioma survival rate depending on your diagnosis and the treatments you receive.

Get in touch with our mesothelioma nurses now — they can help you find top treatments that could help improve your prognosis.

Pleural Mesothelioma Cell Types

Mesothelioma tumors can be made up of different types of cells. Which mesothelioma cell type you have can greatly impact your overall prognosis, as some are easier to treat than others.

The three mesothelioma cell types are:

  • Epithelioid (or epithelial) is the most common cell type. These rectangle-shaped cells don’t spread as quickly as the other types of mesothelioma cells do, so they’re easier to treat.
  • Sarcomatoid is the rarest mesothelioma cell type. These spindle-shaped cells can easily spread to other parts of the body, and so they don’t respond as well to treatments. Patients with this type have the worst overall prognosis.
  • Biphasic describes when a mesothelioma tumor has both epithelioid and sarcomatoid cells. It’s the second most common cell type. Patients typically live longer if there are more epithelial cells present.

Stages of Pleural Mesothelioma

There are four stages of pleural mesothelioma. Which stage you are diagnosed with will have a big impact on the treatments you receive and your life expectancy. Learn about each pleural mesothelioma stage below.

Stage 1 Pleural Mesothelioma

In stage 1 pleural mesothelioma, the cancer is in the lung lining but has not spread past it.

Surgery, chemotherapy, immunotherapy, and radiation therapy are all possible treatment options. The life expectancy for this stage is approximately 21 months when surgery is used, according to a Frontiers in Oncology report.

Stage 2 Pleural Mesothelioma

In cases of stage 2 pleural mesothelioma, the cancer has started to spread outside of the lung lining and into a lung or the diaphragm (muscle near the lungs that helps with breathing).

Stage 2 patients can still typically receive any treatment available to stage 1 patients. The life expectancy is around 19 months with surgery.

Stage 3 Pleural Mesothelioma

In this stage of pleural mesothelioma, the cancer has spread further through the chest and possibly into lymph nodes — filters that help your body flush out toxins.

If cancer gets into your lymph nodes, it may spread to other parts of the body that are far away from the lungs, which limits the treatments you can get.

Surgery may or may not be an option for patients in this stage, but other treatments may help patients live longer. Stage 3 pleural mesothelioma has a life expectancy of 16 months with surgery.

Stage 4 Pleural Mesothelioma

In stage 4 pleural mesothelioma, metastasis (spread to distant parts of the body) has occurred. The cancer has reached the liver, both lungs, bones, or brain.

Treatments for stage 4 mesothelioma typically focus on improving quality of life. The average life expectancy for patients in this stage is around 12 months with surgery, but some patients may live for many years.

For example, John Stahl is still alive today after being diagnosed with stage 4 pleural mesothelioma in 2019 and getting chemotherapy.

Our nurses can help you find top treatments for any stage of pleural mesothelioma. Get in touch with a mesothelioma nurse now.

Top Treatments for Pleural Mesothelioma

Doctors can use several different pleural mesothelioma treatments in order to help you live longer and improve your quality of life. Many specialists will use a multimodality approach to treatment as well, which incorporates multiple types of cancer treatment.

Learn about the treatment of malignant pleural mesothelioma below to get a better idea of how they can help you or a loved one.

Pleural Mesothelioma Surgery

Doctors typically recommend one of two main surgeries if you or a loved one has early-stage pleural mesothelioma.

These pleural mesothelioma surgeries are:

  • Extrapleural pneumonectomy (EPP): Doctors remove all cancer tumors they can see, along with the lung nearest to the cancer tumors and the lung lining. It’s an intense surgery, but patients who get an EPP along with other treatments live for 35.6 months on average.
  • Pleurectomy with decortication (P/D): Doctors take out the cancer tumors and the lung lining but both lungs are spared. This allows the patient to recover with fewer complications compared to an EPP. Patients typically live for 34 months after a P/D.


Chemotherapy (cancer-killing medication) is one of the main treatments used for pleural mesothelioma. It can be used by itself or with other treatments to help patients live longer.

When used alone, pleural mesothelioma patients lived for nearly 16 months on average, according to a 2022 Translational Lung Cancer Research report.

The most commonly used chemotherapy drugs for pleural mesothelioma are pemetrexed and cisplatin or carboplatin.

Radiation Therapy

Through mesothelioma radiation therapy, doctors use beams of high-powered X-rays to damage cancer cells so they can’t spread.

Pleural mesothelioma patients treated with radiotherapy lived for 12.2 months on average, according to a 2022 review of the National Cancer Database.


Immunotherapy involves boosting the immune system in order to fight cancer. Pleural mesothelioma patients treated with immunotherapy typically lived for over 18 months — a year and a half — according to a 2020 OncLive report.

Types of immunotherapy techniques include checkpoint inhibitors, cytokines, CAR T-Cell therapy, cancer vaccines, and monoclonal antibodies.


Tumor treating fields (TTFields) use electric pads that stick to the chest to stop cancer cells from spreading. The electricity doesn’t hurt the patient.

Pleural mesothelioma patients treated with TTFields and chemotherapy lived for more than 18 months on average in a study published by the Annals of Oncology. All patients who are getting treated with TTFields must also receive chemotherapy.

Clinical Trials

You may be able to receive new and possibly more effective malignant pleural mesothelioma treatments by joining a clinical trial. These trials safely study upcoming therapies that could help you live longer.

New mesothelioma treatments being tested in trials include:

  • Cryotherapy: Using extreme cold to freeze cancer tumors and destroy cells
  • Photodynamic therapy: Using light-activated medication to kill cancer
  • Targeted therapy: Using medications that target specific molecules in cancer cells to kill them

Connect with one of our mesothelioma nurses for help finding top cancer treatments and joining a clinical trial.

Speak With a Mesothelioma Nurse
  • Find Top Doctors and Treatments
  • Connect You With Clinical Trials
  • Answer Medical Questions
Talk with Amy

Amy Fair
20+ Years Helping
Mesothelioma Patients

Palliative Care

For people whose pleural mesothelioma is in an advanced stage and no longer responding to treatment, palliative care or hospice care may be the most helpful treatments.

Palliative care treatments for pleural mesothelioma include pain-relieving medications, minor surgeries, and more.

These services make patients comfortable as they near the end of their life so they can make the most out of time with loved ones.

Top Hospitals Treating Pleural Mesothelioma

As you seek out medical care, make sure to find a hospital that has doctors on staff who specifically treat pleural mesothelioma. Fortunately, there are hospitals across the country that can help you and other patients.

Top pleural mesothelioma treatment centers include:

  • Baylor College of Medicine, Houston, TX: This hospital has been nationally recognized by the National Cancer Institute. Its Mesothelioma Treatment Center is led by some of the top mesothelioma experts in the nation.
  • Brigham and Women’s Hospital, Boston, MA: This hospital runs the International Mesothelioma Program, which has been treating this cancer since 2002 and helps hundreds of patients every year.
  • University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA: This hospital is home to the Mesothelioma Specialty Care Program, which offers standard treatment options and clinical trials.

Pleural Mesothelioma Doctors

Pleural mesothelioma doctors include physicians with a wide range of specialties, including medical oncologists, radiation oncologists, and surgical oncologists.

Top pleural mesothelioma doctors include:

  • Dr. Raphael Bueno is a thoracic surgeon with more than 20 years of experience, and he leads the mesothelioma treatment team at Brigham and Women’s Hospital.
  • Dr. Raja Flores is a highly sought-after mesothelioma and thoracic oncology expert with over 25 years of experience. He is the Chairman for the Department of Thoracic Surgery at The Mount Sinai Medical Center based in New York.
  • Dr. Taylor Ripley is a mesothelioma specialist who leads the Mesothelioma Treatment Center at Baylor College of Medicine. He has treated pleural mesothelioma for over 15 years.
  • Dr. Anne Tsao is a surgeon leading the Mesothelioma Program at MD Anderson Cancer Center, located in Texas. She has decades of experience treating pleural mesothelioma.

Our nurses can help you find a top pleural mesothelioma doctor near you. Speak with a nurse now to get started.

Pleural Mesothelioma Survivor Stories

Though pleural mesothelioma is aggressive, long-term survival may be possible with the right medical care. Several pleural mesothelioma patients have gone on to live for many years or even decades after being diagnosed.

Learn about long-term survivor stories below.

John Panza, Diagnosed 2012

John Panza received a stage 3 pleural mesothelioma diagnosis when he was just 38 years old. John was exposed to asbestos through his father, who came home covered in asbestos-laced dust while working at a company that made car brakes.

After he received an EPP, chemotherapy, and radiation, John successfully achieved remission (where cancer signs and symptoms disappear). The cancer came back in 2019, but John was successfully treated with chemotherapy and he’s still living today.

“I was sad. Then I was pissed. Then I was resolved to beat it. Then I realized that nobody ever really beats it, per se, but that I’d fight it.”

- John Panza

John Stahl, Diagnosed 2019

John Stahl was diagnosed with stage 4 pleural mesothelioma in 2019 after complaining of difficulty breathing. He worked with asbestos-containing products for decades as a construction worker.

Though shocked about his diagnosis, John was determined to take action and live as long as he could. John underwent chemotherapy to help him live longer, and today, John is still alive and has resumed an active lifestyle.

“It’s going to end my life eventually, but I’m going to live it as well as I can.”

- John Stahl

Walter Twidwell, Diagnosed 2017

Walter, a U.S. Navy veteran, was diagnosed with pleural mesothelioma following recurring bouts of pneumonia. Decades prior, Walter had been exposed to asbestos while working on gaskets in the U.S. Navy.

Even though Walter decided against getting chemotherapy, he was still able to live for 2 and a half years after his initial diagnosis.

“Asbestos didn’t kill anybody on the spot that’s for sure, but it did years later when it started catching up with us.”

- Walter Twidwell

Compensation Options for Pleural Mesothelioma Patients

A pleural mesothelioma diagnosis can be very expensive, even if you have insurance. Treatments, living expenses, and costs of traveling for medical care can all add up.

Fortunately, you and your loved ones can access financial aid resources after a diagnosis to cover costs.

Compensation options for pleural mesothelioma include:

  • Mesothelioma lawsuits allow victims to sue manufacturers of asbestos-containing products to receive financial compensation. The average payout from these lawsuits is $1 million with some getting much more.
  • Asbestos trust fund claims allow victims to seek compensation through trusts that have been set up by bankrupt asbestos companies. The trusts contain more than $30 billion collectively, and it may be possible to file multiple claims to receive compensation.
  • VA benefits award U.S. veterans with mesothelioma monthly disability payments worth nearly $4,000 a month in many cases. Veterans can also get free or discounted medical care through VA health care benefits.

Find Help for Pleural Mesothelioma

The entire team at Lung Cancer Group understands how a pleural mesothelioma diagnosis can change your life and the lives of your loved ones.

To that end, we will walk with you as you fight pleural mesothelioma and provide top resources to ease the stress.

Our mesothelioma nurses can help you:

  • Connect with top cancer doctors and hospitals
  • Find the most effective treatments for your case
  • Join clinical trials if eligible
  • Understand your financial aid options

Contact our mesothelioma nurses today to get help exploring all of the medical and financial options that are available after a diagnosis. There are no upfront costs to talk with us.

We’re committed to helping those with pleural mesothelioma, lung cancer, and other asbestos-related diseases in any way we can.

Pleural Mesothelioma FAQs

How long can you live with pleural mesothelioma?

The average life expectancy for pleural mesothelioma is 12-21 months, but you might be able to live for many years by getting aggressive treatments.

For example, John Panza has survived for over a decade with pleural mesothelioma since he received a combination of surgery, chemotherapy, and radiation.

The overall 5-year survival rate of pleural mesothelioma is 12%. This means that 12% of patients are still living 5 years after a diagnosis.

You may be among those who live 5 years or more if you get treatment. Connect with top mesothelioma nurses who can help you find treatments by calling (877) 446-5767.

There is no cure for pleural mesothelioma yet, but there are treatments available that may help you live longer.

Pleural mesothelioma can be treated with surgery, chemotherapy, radiation therapy, immunotherapy, and other methods.

Stage 4 is considered to be the “end stage” of pleural mesothelioma because the cancer has spread out of the lung lining and into the bones, brain, or other body parts.

But you could live for many years with stage 4 pleural mesothelioma. For example, John Stahl is still living an active life after being diagnosed with stage 4 mesothelioma in 2019.

No. Pleural mesothelioma and lung cancer are two different cancers. Symptoms may be similar, like shortness of breath and a persistent cough.

However, the cancer forms and spreads in different ways, and as a result both are treated differently.

Lung Cancer Group may be able to help if you have lung cancer or mesothelioma — call (877) 446-5767 to learn more.

Lung Cancer Group was established by a team of caring advocates so those with lung cancer and other asbestos-related diseases can get the help they deserve. Our site provides the most accurate and up-to-date information about lung cancer, its link to asbestos, and financial compensation available to patients. Contact us to learn more and get assistance.

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  4. American Cancer Society. (2018, November 16). What Is Malignant Mesothelioma? Retrieved November 13, 2023, from
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  6. Breda, C., et al. (2021, November 30). Long-term outcomes after lung-sparing surgery for epithelial mesothelioma. Journal of Thoracic Disease. Retrieved November 13, 2023, from
  7. Ceresoli, G. L., et al. (2019, April). STELLAR: Final updated results of a phase II trial of TTFields with chemotherapy for unresectable malignant pleural mesothelioma. Annals of Oncology. Retrieved November 13, 2023, from
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  12. Novocure. (n.d.). NovoTTF-100L System. Retrieved November 13, 2023, from
  13. Rossini, M., et al. (2018, April 03). New Perspectives on Diagnosis and Therapy of Malignant Pleural Mesothelioma. Frontiers in Oncology. Retrieved November 13, 2023, from
  14. Virgil, H. (2020, August 09). Nivolumab/Ipilimumab Demonstrates Durable OS Benefit in Malignant Pleural Mesothelioma. Retrieved November 13, 2023, from
  15. Webb, P. (2018, September 25). The curmudgeon in the woods. Retrieved November 13, 2023 from
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