Mesothelioma

UT Southwestern Medical Center is one of the few institutions in the country with a treatment and research program dedicated to mesothelioma. Our specialized chest (thoracic) cancer experts offer an evidence-based, multidisciplinary approach to accurately diagnose, stage, and treat mesothelioma. 

As the only National Cancer Institute-designated comprehensive cancer center in North Texas, we deliver the best cancer care available today and push to discover new treatments. NCI designation means we offer patients the ability to participate in the broadest possible range of clinical trials, with access to potential therapies not available at other facilities.

Dedicated Program, Excellent Outcomes

Mesothelioma is a cancer that develops from the mesothelial cells that make up the membrane lining the lungs and other organs in the chest. The majority of patients have the thoracic or pleural form of the disease, known as malignant pleural mesothelioma. 

Often caused by the inhalation of asbestos, pleural mesothelioma arises in the chest and can spread to other areas in the body, such as the abdomen. Most of these cancers grow very slowly, often taking 20 to 40 years to become apparent to the patient. Symptoms are most commonly shortness of breath and chest wall pain.

Diagnosis and treatment can be challenging and often require specialty cancer surgeons, pulmonologists, and medical and radiation oncologists to manage the disease. Approximately 3,000 new cases of malignant mesothelioma are diagnosed in the U.S. each year, making it a relatively uncommon disease. 

At UT Southwestern, our dedicated mesothelioma program delivers excellent surgical outcomes for this disease, and we were the lead center for a national chemotherapy clinical trial. 

Our specialists engage in weekly cancer conferences, where every patient’s case is discussed among all the disciplines to ensure that we are taking the most effective approach to care. We work together to tailor treatment to each patient’s situation.

Symptoms of Mesothelioma

Many people diagnosed with mesothelioma have had symptoms of the disease for some time but thought it was something else, such as the flu or pneumonia. The most common symptoms include:

• Chest pain
• Fatigue
• Night sweats
• Pleural effusion, or accumulation of abnormal amounts of fluid around the lung
• Shortness of breath
• Weight loss

Risk Factors

The single most important risk factor is being exposed to asbestos (a fibrous mineral that was widely used as a building material from the 1950s to the 1990s). Occupations related to use of asbestos include:

• Construction
• Heating and air conditioning
• Insulation
• Mining
• Plumbing
• Shipyard work 

Diagnosis

The accurate diagnosis and staging of mesothelioma is key to delivering the most appropriate treatment. 

If we suspect mesothelioma, the doctor will conduct a physical examination and order tests to confirm the diagnosis. A number of tests might be needed to help determine the cancer’s stage and precise location. 

Imaging techniques used to diagnose mesothelioma might include:

• Chest X-ray: X-rays help visualize abnormalities in the pericardium.
• Contrast enhanced or multidetector computed tomography (CT) scan: CT technology helps physicians visualize the location and extent of mesothelioma.
• Magnetic resonance imaging (MRI): MRI helps physicians identify suspicious areas that could indicate mesothelioma and learn if, and how far, it has spread.
• Positron emission tomography (PET): Cancer cells absorb large amounts of radioactive sugar that are used in this technique, and a special camera creates images of that radioactivity, enabling physicians to identify cancerous mesothelioma cells.
• Endoscopic ultrasonography: This technology maps sound waves to show physicians if mesothelioma has invaded the heart muscle. 

Additional testing might also include a tissue sample (biopsy) of the suspicious area of the mesothelium to determine the presence of cancer. 

Treatment for Mesothelioma

Mesothelioma treatment options depend on the cancer’s precise location and stage, the patient’s overall health, goals, and preferences, and other factors.

Our specialists might consider these therapies for treating mesothelioma:

• Minimally invasive interventional surgery: Highly precise surgery to remove cancerous tissue might be used in some cases of mesothelioma. Procedures include pleural decortications – aimed at preserving the lung – and extrapleural pneumonectomy.
• Medical treatment (chemotherapy): Chemotherapy drugs, taken orally or intravenously, can be used to target and kill cancer cells in the pericardium. Chemotherapy might also be used in conjunction with radiation therapy (chemoradiation) to treat mesothelioma.
• Intensity-modulated radiation therapy (IMRT): This sophisticated treatment allows doctors to use multiple radiation beams of varying lengths and intensity. The radiation beams can be moved scores of times during treatment, resulting in a radiation field that is “sculpted” in three dimensions. Rather than creating a uniform field of radiation, the radiation is delivered to precisely conform to the actual shape of the tumor, thus sparing surrounding healthy tissue. 

Clinical Trials

Depending on the cause and extent of their mesothelioma, some patients might be eligible to participate in clinical trials of new treatments for the disease. 

UT Southwestern conducts clinical trials aimed at improving the care and outcomes of patients with mesothelioma. Patients should speak with their physician to determine if they are eligible to participate in a clinical trial. 

In addition to working on clinical trials, our researchers are exploring new approaches to improve current treatments to reach better outcomes. Promising areas currently under investigation include immunotherapy and genomics.

Support

To help patients and their families through the cancer journey, we provide a number of support services such as cancer psychology, oncology nutrition, social work, transitional care coordination, spiritual support, and integrative therapy.