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Understanding Epithelial Mesothelioma | Symptoms, Diagnosis, and Treatment Options



Mesothelioma is a rare and aggressive cancer that primarily affects the lining of the lungs, called the pleura, but can also involve the lining of the abdomen (peritoneum), heart (pericardium), or testes (tunica vaginalis). It is a devastating disease with a low survival rate, mainly due to its late diagnosis and limited treatment options. One particular form of mesothelioma, known as epithelial mesothelioma, accounts for roughly 70% of all cases. In this article, we will delve into the complexities of epithelial mesothelioma, exploring its causes, risk factors, symptoms, diagnosis, treatment options, and the critical need for prevention.

What is Epithelial Mesothelioma?

Understanding Epithelial Mesothelioma | Symptoms, Diagnosis, and Treatment Options

Epithelial mesothelioma, also known as malignant epithelioid mesothelioma, is a type of cancer that originates in the mesothelial cells that line various organs. These cells play a crucial role in lubricating the surfaces they cover, facilitating smooth movement and preventing friction. However, when exposed to asbestos fibers, these cells undergo significant changes that can lead to the development of cancer.

Epithelial mesothelioma is more prevalent in men than women, with men being four times more likely to develop the disease. The average age at diagnosis is between 50-70 years old, and it has a long latency period, meaning it can take anywhere from 20 to 50 years for symptoms to appear after exposure to asbestos.

Types of Epithelial Mesothelioma

There are three main types of mesothelioma: pleural, peritoneal, and pericardial. Epithelial mesothelioma can occur in any of these three areas, but it most commonly affects the pleura, which is the thin membrane that lines the chest cavity and covers the lungs. This type of mesothelioma is also known as pleural mesothelioma.

Peritoneal mesothelioma affects the lining of the abdomen, while pericardial mesothelioma affects the lining of the heart. However, both of these forms of mesothelioma are less common than pleural mesothelioma.

Symptoms of Epithelial Mesothelioma

Understanding Epithelial Mesothelioma | Symptoms, Diagnosis, and Treatment Options

One of the most unfortunate aspects of epithelial mesothelioma is that it does not usually cause symptoms until it has reached an advanced stage. Even then, the symptoms can be vague and easily mistaken for other, less severe conditions. The common symptoms of epithelial mesothelioma include:

  • Shortness of breath
  • Chest pain
  • Chronic cough
  • Fatigue
  • Loss of appetite
  • Unexplained weight loss
  • Abdominal pain
  • Swelling
  • Nausea and vomiting
  • Anemia
  • Fever
  • Night sweats

As you can see, many of these symptoms are shared with other respiratory conditions, making it incredibly challenging to diagnose epithelial mesothelioma in its early stages. This delayed diagnosis is one of the main reasons why this disease is so deadly.

The Importance of Early Detection

Early detection of epithelial mesothelioma is crucial for improving treatment outcomes and increasing survival rates. Unfortunately, there is no effective screening method for this type of cancer, so symptoms are often the first indication of the disease. However, if you have a history of asbestos exposure and experience any of the above symptoms, it is essential to seek medical attention immediately.

Diagnosis of Epithelial Mesothelioma

Diagnosing epithelial mesothelioma can be challenging due to the similarity of its symptoms with other respiratory conditions and the rarity of the disease. A thorough medical evaluation and various diagnostic tests are necessary to confirm a mesothelioma diagnosis.

Medical History and Physical Examination

The first step in diagnosing epithelial mesothelioma is a detailed medical history and physical examination. Your doctor will ask about your exposure to asbestos, any previous respiratory conditions, and any family history of cancer. They will also examine you for any physical signs of the disease, such as fluid buildup in the chest or abdomen.

Imaging Tests

Imaging tests, such as x-rays, CT scans, and MRI scans, can help detect any abnormalities in the body that may indicate mesothelioma. These tests can also show the location, size, and spread of a tumor.


A biopsy is a definitive test for diagnosing epithelial mesothelioma. During this procedure, a small sample of tissue is taken from the affected area and examined under a microscope for the presence of cancer cells. There are several types of biopsies, including:

  • Fine-needle aspiration: A thin needle is inserted into the affected area to remove a small sample of cells.
  • Thoracoscopy: A small incision is made in the chest wall, and a tiny camera is used to take a tissue sample.
  • Laparoscopy: A similar procedure to thoracoscopy, but it is used to obtain samples from the abdomen.
  • Surgical biopsy: In some cases, open surgery may be necessary to obtain a tissue sample.

Treatment Options for Epithelial Mesothelioma

Treatment for epithelial mesothelioma typically depends on the stage and location of the disease, as well as the overall health of the patient. As with most cancers, early detection and treatment are essential for improving outcomes. Unfortunately, due to the aggressive nature of epithelial mesothelioma, complete cure is rarely possible, and treatment is primarily focused on prolonging survival and improving quality of life.


Surgery is a common treatment option for epithelial mesothelioma, but it is typically only an option for patients in the early stages of the disease. The type of surgery performed will depend on the location and extent of the tumor. Some of the surgical procedures used to treat epithelial mesothelioma include:

  • Pleurectomy/Decortication (P/D): This surgery involves removing the pleura, along with the visible tumor.
  • Extrapleural Pneumonectomy (EPP): This is a more extensive procedure that involves removing the entire lung, the pleura, and other affected tissues or organs, such as the diaphragm or pericardium.
  • Cytoreduction with heated chemotherapy: This is a newer treatment approach that combines surgery with heated chemotherapy drugs to kill any remaining cancer cells after tumor removal.


Chemotherapy uses powerful drugs to target and destroy cancer cells. It is often used in conjunction with surgery or radiation therapy to improve outcomes. For epithelial mesothelioma, the most commonly used chemotherapy regimen is a combination of the drugs cisplatin and pemetrexed.

Radiation Therapy

Radiation therapy uses high-energy rays to target and kill cancer cells. It is primarily used to shrink tumors, relieve symptoms, and slow down the spread of the disease. Radiation therapy may also be used after surgery to destroy any remaining cancer cells.


Epithelial mesothelioma is a rare, but aggressive form of cancer that is primarily caused by exposure to asbestos fibers. Despite its rarity, it is a devastating disease with a low survival rate due to its late diagnosis and limited treatment options.

If you have a history of asbestos exposure or experience any symptoms related to mesothelioma, it is essential to seek medical attention immediately. Early detection and treatment can significantly improve outcomes and increase survival rates.

Prevention is also critical in the fight against epithelial mesothelioma. Avoiding exposure to asbestos, especially in the workplace, is crucial in preventing this deadly disease. Additionally, proper safety measures and regulations must be implemented to protect workers from coming into contact with asbestos fibers.

In conclusion, understanding the complexities of epithelial mesothelioma and its potential causes, symptoms, and treatment options is essential in promoting early detection and improving outcomes for those affected by this silent killer.

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