Overview

Malignant mesothelioma (me-zoe-thee-lee-O-muh) is a type of cancer that occurs in the thin layer of tissue that covers the majority of your internal organs (mesothelium).

Mesothelioma is an aggressive and deadly form of cancer. Mesothelioma treatments are available, but for many people with mesothelioma, a cure isn't possible.

Doctors divide mesothelioma into different types based on what part of the mesothelium is affected. Mesothelioma most often affects the tissue that surrounds the lungs (pleura). This type is called pleural mesothelioma. Other, rarer types of mesothelioma affect tissue in the abdomen (peritoneal mesothelioma), around the heart and around the testicles.

Mesothelioma care at Mayo Clinic

Symptoms

Signs and symptoms of mesothelioma vary depending on where the cancer occurs.

Pleural mesothelioma, which affects the tissue that surrounds the lungs, causes signs and symptoms that may include:

  • Chest pain
  • Painful coughing
  • Shortness of breath
  • Unusual lumps of tissue under the skin on your chest
  • Unexplained weight loss

Peritoneal mesothelioma, which occurs in tissue in the abdomen, causes signs and symptoms that may include:

  • Abdominal pain
  • Abdominal swelling
  • Nausea
  • Unexplained weight loss

Other forms of mesothelioma

Signs and symptoms of other types of mesothelioma are unclear, since these forms of the disease are very rare.

Pericardial mesothelioma, which affects tissue that surrounds the heart, can cause signs and symptoms such as breathing difficulty and chest pains.

Mesothelioma of tunica vaginalis, which affects tissue surrounding the testicles, may be first detected as swelling or a mass on a testicle.

When to see a doctor

See your doctor if you have signs and symptoms that worry you. Signs and symptoms of mesothelioma aren't specific to this disease and, due to the rarity of mesothelioma, are more likely to be related to other conditions. If any persistent signs and symptoms seem unusual or bothersome, ask your doctor to evaluate them. Tell your doctor if you've been exposed to asbestos.

Get Mayo Clinic cancer expertise delivered to your inbox.

Subscribe for free and receive an in-depth guide to coping with cancer, plus helpful information on how to get a second opinion. You can unsubscribe at any time. Click here for an email preview.

I would like to learn more about

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Causes

In general, cancer begins when a series of changes (mutations) happens in a cell's DNA. The DNA contains the instructions that tell a cell what to do. The mutations tell the cell to grow and multiply out of control. The abnormal cells accumulate and form a tumor.

It isn't clear what causes the initial genetic mutations that lead to mesothelioma, though researchers have identified factors that may increase the risk. It's likely that cancers form because of an interaction between many factors, such as inherited conditions, your environment, your health conditions and your lifestyle choices.

Risk factors

Asbestos exposure: The primary risk factor for mesothelioma

Most mesotheliomas are thought to be related to asbestos exposure. Asbestos is a mineral that's found naturally in the environment. Asbestos fibers are strong and resistant to heat, making them useful in a wide variety of applications, such as in insulation, brakes, shingles, flooring and many other products.

When asbestos is broken up, such as during the mining process or when removing asbestos insulation, dust may be created. If the dust is inhaled or swallowed, the asbestos fibers will settle in the lungs or in the stomach, where they can cause irritation that may lead to mesothelioma. Exactly how this happens isn't understood. It can take 20 to 60 years or more for mesothelioma to develop after asbestos exposure.

Most people with asbestos exposure never develop mesothelioma. This indicates that other factors may be involved in determining whether someone gets mesothelioma. For instance, you could inherit a predisposition to cancer or some other condition could increase your risk.

Factors that may increase the risk of mesothelioma include:

  • Personal history of asbestos exposure. If you've been directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.
  • Living with someone who works with asbestos. People who are exposed to asbestos may carry the fibers home on their skin and clothing. Exposure to these stray fibers over many years can put others in the home at risk of mesothelioma. People who work with high levels of asbestos can reduce the risk of bringing home asbestos fibers by showering and changing clothes before leaving work.
  • A family history of mesothelioma. If your parent, sibling or child has mesothelioma, you may have an increased risk of this disease.
  • Radiation therapy to the chest. If you had radiation therapy for cancer in your chest, you might have an increased risk of mesothelioma.

Complications

As pleural mesothelioma spreads in the chest, it puts pressure on the structures in that area. This can cause complications, such as:

  • Difficulty breathing
  • Chest pain
  • Difficulty swallowing
  • Pain caused by pressure on the nerves and spinal cord
  • Accumulation of fluid in the chest (pleural effusion), which can compress the lung nearby and make breathing difficult

Prevention

Reducing your exposure to asbestos may lower your risk of mesothelioma.

Find out whether you work with asbestos

Most people with mesothelioma were exposed to the asbestos fibers at work. Workers who may encounter asbestos fibers include:

  • Asbestos miners
  • Electricians
  • Plumbers
  • Pipefitters
  • Insulators
  • Shipyard workers
  • Demolition workers
  • Brake mechanics
  • Selected military personnel
  • Home remodelers

Ask your employer whether you have a risk of asbestos exposure on the job.

Follow your employer's safety regulations

Follow all safety precautions in your workplace, such as wearing protective equipment. You may also be required to shower and change out of your work clothes before taking a lunch break or going home. Talk to your doctor about other precautions you can take to protect yourself from asbestos exposure.

Be safe around asbestos in your home

Older homes and buildings may contain asbestos. In many cases, it's more dangerous to remove the asbestos than it is to leave it intact. Breaking up asbestos may cause fibers to become airborne, where they can be inhaled. Consult experts trained to detect asbestos in your home. These experts may test the air in your home to determine whether the asbestos is a risk to your health. Don't attempt to remove asbestos from your home — hire a qualified expert.

Mesothelioma care at Mayo Clinic

Oct. 11, 2022

Living with mesothelioma?

Connect with others like you for support and answers to your questions in the Cancer support group on Mayo Clinic Connect, a patient community.

Cancer Discussions

Colleen Young, Connect Director
Diagnosed with sarcoma? Let's share

755 Replies Sun, Mar 17, 2024

johnsoncs1
Anyone diagnosed with Phyllodes tumor?

46 Replies Wed, Mar 13, 2024

Colleen Young, Connect Director
Have you ever had hiccups with or after chemotherapy?

101 Replies Wed, Mar 13, 2024

See more discussions
  1. Malignant pleural mesothelioma. Plymouth Meeting, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Nov. 7, 2018.
  2. Niederhuber JE, et al., eds. Diseases of the pleura and mediastinum. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. https://www.clinicalkey.com. Accessed Nov. 7, 2018.
  3. Mason RJ, et al. Pleural tumors. In: Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Nov. 7, 2018.
  4. An JY, et al. Clinical features and outcomes of tunica vaginalis mesothelioma: A case series from the National Institutes of Health. Clinical Genitourinary Cancer. 2017;15:e871.
  5. Kim J, et al. Malignant peritoneal mesothelioma: A review. Annals of Translational Medicine. 2017;5:236.
  6. Dudgeon D, et al. Assessment and management of dyspnea in palliative care. https://www.uptodate.com/contents/search. Accessed Nov. 21, 2018.
  7. AskMayoExpert. Mesothelioma (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
  8. Maleszewski JJ, et al. Neoplastic pericardial disease. Cardiology Clinics. 2017;35:589.
  9. Mutti L, et al. Scientific advances and new frontiers in mesothelioma therapeutics. Journal of Thoracic Oncology. 2018;13:1269.
  10. Protect your family. U.S. Environmental Protection Agency. https://www.epa.gov/asbestos/protect-your-family-exposures-asbestos. Accessed Nov. 21, 2018.
  11. Amin MB, et al., eds. Malignant pleural mesothelioma. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017.
  12. Warner KJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. July 17, 2018.
  13. Mansfield AS (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 12, 2018.
  14. Tsao AS, et al. Current and future management of malignant mesothelioma: A consensus report from the National Cancer Institute Thoracic Malignancy Steering Committee, International Association for the Study of Lung Cancer and Mesothelioma Applied Research Foundation. Journal of Thoracic Oncology. 2018;13:1655.
  15. McCambridge AJ, et al. Progress in the management of malignant pleural mesothelioma in 2017. Journal of Thoracic Oncology. 2018;13:606.