Mesothelioma: what it is, symptoms, asbestos causes, diagnosis and treatment

NHS inform describes mesothelioma as a cancer of the mesothelium, a thin lining that covers the outer surface of many organs and lines spaces in the body such as the chest and tummy. In the chest it is called the pleura and in the tummy the peritoneum.

The NHS says it usually affects the lining of the lungs and can sometimes affect the lining of the tummy. How serious it is depends on the area affected, how big the cancer is, whether it has spread and your general health.

Cancer Research UK says very rarely a non-cancerous (benign) type can develop in the lining of the lungs or reproductive organs, but this page focuses on the cancerous types.

The two main types behave differently and are treated in different ways, according to NHS inform. Cancer Research UK says that in the UK 95 out of 100 mesotheliomas are in the chest, and that peritoneal mesothelioma does not usually spread to other parts of the body but is often diagnosed when quite advanced.

The NHS says symptoms vary depending on the type and area affected. Symptoms of pleural mesothelioma include:

• Chest pain.

• Shortness of breath.

• A cough that does not go away.

• Difficulty swallowing and a hoarse voice.

• A high temperature and heavy sweating at night.

• Feeling very tired.

• Loss of appetite or losing weight without trying.

• Curved nails over rounded fingertips (clubbing).

The NHS lists tummy pain, a swollen tummy, feeling or being sick, loss of appetite or losing weight without trying, and diarrhoea or constipation. NHS inform adds that bowel changes that develop for the first time over the age of 50 deserve attention.

Cancer Research UK says there are not many symptoms in the early stages, which is one reason it is often found late.

The NHS says to see a GP if you have symptoms of mesothelioma and think you have come into contact with and breathed in asbestos over a long period. These symptoms are very common and can have other causes, but it is important to get checked, because finding cancer early may make it easier to treat. The GP will ask about symptoms and your work history.

For sudden severe breathlessness or severe chest pain, call 999 or go to A&E.

The NHS says the main cause is breathing in asbestos fibres over a long period of time. Asbestos is a building material that was used in the UK from the 1950s until it was banned in 1999. NHS inform says imports of blue and brown asbestos were banned in the 1980s and all types in 1999.

Cancer Research UK says that in the UK asbestos exposure causes more than 95% of mesothelioma in men and almost 85% in women, but some people with mesothelioma say they have no history of exposure. NHS inform notes some people do not know or cannot remember being exposed.

The NHS says it can take 15 to 60 years to develop after exposure.

Cancer Research UK says mesothelioma is most common in people exposed to asbestos at work, for example in manufacturing using asbestos or in construction or engineering. Examples include metal plate workers (mainly in shipbuilding), carpenters, plumbers and mechanics. The NHS lists electricians, heating and ventilation engineers, and construction or demolition workers.

Cancer Research UK says painters may have a higher risk because until the 1990s some paints contained asbestos, and that there is some evidence families of people exposed to asbestos have a higher risk. White asbestos is now also thought to be harmful.

The Health and Safety Executive publishes guidance on asbestos safety and the duty to manage asbestos in buildings.

The NHS says the GP may arrange an X-ray of your chest or tummy. After referral to a specialist you may have scans such as CT, ultrasound or PET-CT, fluid drained from the lungs or tummy and checked for cancer cells, or a keyhole operation to look inside the chest or abdomen.

It says it can take several weeks to get results. If mesothelioma is confirmed, further tests such as a biopsy and specialised ultrasound help show whether and how far the cancer has spread (the stage).

NHS inform says a team of specialists, a multidisciplinary team, meets to decide the best treatment.

The NHS says mesothelioma can be difficult to treat, and that treatment depends on the type, where it is, whether it has spread and your general health. Your specialist team will explain treatments, benefits and side effects and create a plan with you.

Cancer Research UK says survival depends on many factors including stage and type, and that statistics are only a general guide, so discuss your outlook with your specialist team.

NHS inform says anxiety between appointments is natural and suggests support from family, friends and support organisations. It says most people diagnosed are able to receive financial help, through compensation from an employer or government benefits such as industrial injuries disablement benefit, and stresses the importance of advice from a specialist solicitor. Cancer Research UK suggests speaking to a solicitor as early as possible if you think the cancer is linked to asbestos exposure.

Mesothelioma care in the NHS is delivered through specialist cancer teams and is free at the point of use. If you seek a private opinion, ask that results and plans are shared with your NHS team and that your case is still discussed by a multidisciplinary team.