Mesothelioma Cancer: Causes and Symptoms

Last Updated on 11 May 2023

Mesothelioma is a form of cancer where everybody believes to know everything, while none knows it at all. Mesothelioma is indeed a rare type of cancer which could be fatal if it does not get properly discovered. Many symptoms and causes of mesothelioma are still unclear, especially because the cases of today often relate to the causes of yesterday.

How to recognize the symptoms of this cancer during these challenging times? But, above all, is there a correlation between mesothelioma and other modern environmental factors? If you need to find the answers, read this guide.

Mesothelioma Cancer Definition

Malignant mesothelioma is a rare form of cancer that, more frequently, affects men. The name derives from the origin of this cancer. The disease, in fact, affects the subtle tissue that covers our internal organs: mesothelium. This lining has not only a protective function, but also has the one to carry fluids.

Mesothelioma cancer is originated from the mesothelial cells, which, at a certain stage of their life, suffer a DNA damage which drives them to grow uncontrollably. That is the overall mechanism of any types of cancer. What is different is the type of cells where cancer begins. It is as if cells received a wrong order to grow in the wrong way.

In mesothelioma cancer, this wrong order occurs in mesothelial cells, which, in turn, give rise to mesothelium, the protective tissue of our internal organs. Usually, mesothelioma affects the protective tissue of lungs, known as pleura, and for this reason, this cancer is called pleural mesothelioma. However, this malignant tumor can also affect the protective membranes of

  • abdominal cavity
  • heart
  • testicles

When mesothelioma affects the membrane of abdominal cavity, is called peritoneal mesothelioma. When it affects heart, it is called pericardial mesothelioma. When it affects testicles, it is called testicular mesothelioma.

The latter is also called vaginal mesothelioma, even if it affects men. This definition depends on the fact that the internal tissue of testicles is called vagina, too, or vaginal tunic. In women, instead, mesothelioma may affect uterus, but, usually, this is a consequence of peritoneal mesothelioma, because women’s abdominal peritoneum covers the back of bladder and reaches the front of uterus, marking a space called “uterine bladder cavity”.

The more frequent type is, anyway, pleural mesothelioma, because the ones of abdomen and testicles are still classified as more rare than pleural one. Indeed, as regards epidemiology, mesothelioma cancer represents only the 1% of all the other types of cancer.

However, even if rare, mesothelioma is quite insidious when it occurs. That is why is helpful to recognize causes and symptoms promptly. The zones in which mesothelioma develops can also host benign forms of cancer, but in this case, they are not called mesothelioma, but just benign, localized cancer or adenomatoid tumor. The latter is a rare benign tumor affecting mesothelial cells of the reproductive system. Adenomatoid tumor grows very slowly with solitary lumps, while malignant mesothelioma spreads more aggressively.

All types of cancer defined as mesothelioma are, indeed, malignant cancer. In turn, malignant cancer may also be called carcinoma when it affects epithelial cells. The latter also relates to non-small cell cancer in the lungs. The non-small cell lung cancer splits into: adenocarcinoma, squamous cell carcinoma, and large cell lung carcinoma. Their name depends on the type of cells and structure of the lungs affected.

Pleural cancer, for example, affects the subtle membrane covering lungs and rib cage. Mesothelioma is a sub-type of pleural cancer. There are, indeed, up to 20 sub-types of lung cancer.

In short, pleural mesothelioma cancer, lung carcinoma and lung adenocarcinoma are different things. “They are not the same thing, they are different. Indeed, they have different diagnoses and need different treatments” Italian oncologist Santo Fortunato said to me on the phone.

Furthermore, there are 3 types of pleural mesothelioma:

  • Epithelial mesothelioma: the most common type tending to have the best prognosis;
  • Sarcomatoid mesothelioma: the least common type characterized by the absence of epithelial cells and with the presence of spindle cells.
  • Biphasic mesothelioma: it represents less than the half of pleural mesothelioma cases. It is also called mixed mesothelioma because has traits of epithelial and sarcomatoid cells.

As you can see, there are several variants of lung cancer, and several variants of mesothelioma.

For this reason and to avoid you get confused, I’ll discuss only about causes and symptoms of mesothelioma, even though, several causes and symptoms are common in other types of cancer, also.

Mesothelioma Causes

The causes of mesothelioma are environmental and genetical. The main cause of this cancer is asbestos exposure. Asbestos is a mineral whose fibers are toxic when spread in the environment in the guise of powder and particles. When inhaled, asbestos fibers affect the cells of lung parenchyma (the tissue of lungs).

Some of the contaminated cells can go across the pleural tissue and reach its surface, forming clusters of mesotheliomas. The mechanism of peritoneal mesothelioma is still unclear, instead. It has been supposed that microfibers of asbestos are carried to abdominal organs through the lymphatic system. Asbestos was widely used all over the world in Construction in the past century.

Several workers, men, and women, who were in touch with the toxic inhalations of these fibers, developed asbestosis, a chronical pulmonary disease that may increase the risk to develop mesothelioma. Asbestosis is not the same thing od mesothelioma cancer. The former is an inflammation of lungs representing the early damage from asbestos exposure.

Asbestosis causes respiratory complications and, sometimes, is lethal. Mesothelioma can occur also after 20-40 years after the exposure. In Italy, my Country, the law forbidding asbestos was issued in 1992 and the increase of mesothelioma incidence has been estimated until 2020. Epidemiological data match with this prevision, because the incidence of mesothelioma has had a remarkable growth in the latest 30 years.

The risk to develop mesothelioma (not only pleural, but also other types) depends on the exposure level to asbestos and on the time spent in touch with this substance. An early exposure increases the risk to have mesothelioma cancer. The carcinogenic effect of asbestos, instead, depends on the sizes of particles. The smaller they are, the more they can severely damage the DNA of pleural cells. Furthermore, the risk to develop mesothelioma increases with aging. If potential patients have over 55 years, they may develop this type of cancer.

Mesothelioma Causes Without Asbestos Exposure

Other Causes of Mesothelioma Are:

  • Exposure to minerals which are alike asbestos, such as erionite
  • Thoracic and abdominal radiation
  • Infection from SV40 virus (but this cause is not fully confirmed)
  • Thorium dioxide injections, a medication used until 1950
  • Genetical mutations
  • Smoking

Some clinical trials confirm the close correlation between smoking and mesothelioma. Asbestos exposure and smoking increase the risk to develop a lethal type of malignant mesothelioma. Smokers are 55 times more likely to die from mesothelioma than the not smokers and without asbestos exposure.

It seems that asbestos fibers and tobacco work synergically to damage the lung tissue. In particular, the research published in 2020 by the US National Library of Medicine affirms that: “… asbestos contributes to improved uptake of chemical carcinogens in cigarette smoke and their metabolism to carcinogenic metabolites in lung epithelial cells…

For example, carcinogens in cigarette smoke such as benzo[a]pyrene (B[a]P) may be adsorbed onto asbestos fibers (e.g., crocidolite or chrysotile), with subsequent delivery of the carcinogens into cells at high concentrations. Tobacco smoke may interfere with the clearance of asbestos from the lungs…”.

There aren’t factual evidences proving that only cigarette smoke causes mesothelioma cancer, even though it is widely confirmed that smoking is the main cause of the most fatal types of lung cancer.

However, some clinical trials reported cases of mesothelioma in young adults and women without any previous asbestos exposure.

Uncommon cases regard:

  • a 40-year-old woman diagnosed with deciduous mesothelioma never exposed to asbestos, but with a smoking history
  • a 36-year-old woman, who, in 2014, received the devasting diagnosis of peritoneal mesothelioma
  • a 13-year-old little girl with clinical and radiological features of malignant mesothelioma
  • a 17-year-old boy diagnosed with pleural mesothelioma.

These cases are labeled as rare entity cancer never described before. Maybe smoking could be the primary cause of mesothelioma in young women, or maybe they have been unaware about asbestos exposure in their living environment. It will be hard to recognize the true causes of malignant mesothelioma in young people and women with no history of asbestos exposure.

A clinical trial concludes that “MPM is rare in young adults and its clinical presentation makes it different from mesothelioma in elderly patients, so it will be necessary to identify the new risk factors that can identify these patients”.

Of course, medical research talks about risk factors, namely uncommon causes for aggressive and invasive types of mesothelioma in young patients. But what are these uncommon causes? These ones could be asbestos hidden in other minerals or genetical mutations.

As regards asbestos contaminated minerals, recent studies confirmed a connection with talcum baby powder and mesothelioma. Talc is a mineral which is naturally mined. Unfortunately, mining may contaminate it with asbestos. Talc powder is linked to ovarian cancer, but mesothelioma cancer cases pushed researchers to further investigations that proved the contamination of talc powder with asbestos. This evidence permitted women and men to act and win their lawsuits.

In 2015, a woman from California sued a popular brand of Talc powder because she was diagnosed with mesothelioma after using the powder for 15 years. The brand compensated her with 13 million dollars. In 2016, a similar victory was achieved for a man from California, diagnosed with mesothelioma cancer after the usage of talc powder. The man received a reimbursement of 18 million dollars.

Hence, talc contaminated with asbestos is another cause of mesothelioma. The details about this cause have been reported on Mesothelioma.net.

Even drinking water may be contaminated by asbestos. This contamination caused pericardial cases of mesothelioma.

In the past century, indeed, water containers were made with asbestos. Many of them are still on the roofs of buildings in my Country and wait to be disposed.

The risk factor of genetical mutations is, instead, described in another study affirming that low and high risk factors with genetical DNA mutations and variants on BRCA1 and BRCA2 genes in “patients with ovarian cancer may produce a lethal interaction when both of them are present”.

However, due to its rarity, it is not easy to detect genetical risk factors for malignant mesothelioma. Often, genetical mutations are the main cause of several types of cancer. These mutations are in turn caused by ionizing radiation exposure.

The above-mentioned study reported that “A very limited proportion of malignant Pleural Mesothelioma (estimated range 1.7–4.7% in Italy) is caused by exposure to ionizing radiation for diagnostic or therapeutic purpose [3,4]. The incidence of MM varies greatly across countries, with the highest incidence rates (age-standardized rates over 30/1,000,000) observed in Great Britain, Australia, Germany, Italy and other industrialized countries…”.

In short, when we make frequent examinations with medical devices emitting ionizing radiation for diagnostic usage, we could have genetical mutations that lead to develop any form of cancer.

In Italy, for instance, when I am undergone to X rays or MR examinations, I must sign an agreement where I confirm I am aware on any risks related to the usage of ionizing radiation.

Uranium emits ionizing radiation, also, but this mineral has been linked to other types of malignant cancer, not to mesothelioma. The latter remains always linked to asbestos, the mineral used in many industries, such as manufacturing, automotive, construction, mining, aerospace, military devices. The latter caused a real massacre of soldiers and veterans in the past decades.

Many military depots had a high presence of radon, uranium, and asbestos. This data is contained in a report of the Commission of Italian Defense Ministry and several convictions have been issued by Italian Courts over the years.

I hope you’ll obtain a fair verdict in your Country, also. I don’t know about the law in force in every Country in the world, but professional and military exposure to cancerogenic substances is not only unjust, but even criminal.

Many people gave their lives out to do their duty, but job is for living, not for dying! Deadly asbestos fibers have been found in Italian military ships, also, and due to that, 570 soldiers got sick for malignant mesothelioma, while 2000 of them have died for asbestos exposure.

Furthermore, other soldiers got affected by pulmonary cancer due to radon exposure. How to get justice for this horrible injustice? I am not a lawyer, but I suggest that you read Gray Mountain, the novel by John Grisham on the mining workers seeking for legal assistance for their professional diseases caused by asbestos exposure.

The novel is based on true experiences and can give you valuable clues to help you deal with this painful matter. For more information about the symptoms of mesothelioma, instead, go to the following paragraphs.

Mesothelioma Symptoms

The symptoms of malignant mesothelioma are non-specific and may be confused with the ones of other diseases or other types of cancer. Moreover, some symptoms may be common in the several types of mesothelioma.

Symptoms specifically related to mesothelioma usually occur in the advanced stage of cancer. However, it is important to detect them early in order to obtain the remission and the consequent recovery from the disease. That is why it is better to know the symptoms of the different types of mesothelioma. Let’s see them one by one.

  • Pleural Mesothelioma Symptoms

The common symptoms of pleural mesothelioma are:

  • Breathlessness (due to pleural effusion)
  • Chest Pain
  • Cough
  • Swallowing Difficulty
  • Swollen Neck and Face
  • Weight Loss
  • Overall Feeling of Malaise
  • Peritoneal Mesothelioma Symptoms

The symptoms of peritoneal mesothelioma are non-specific and sometimes hard to detect. However, they include:

  • Weight Loss
  • Abdominal Pain and Swelling (due to ascites – effusion in the peritoneal cavity-)
  • Intestinal obstruction
  • Fever
  • Anemia
  • Blood Clotting Abnormalities
  • Cachexia (severe body wasting)
  • Testicular Mesothelioma Symptoms

Testicular mesothelioma is the rarest of the different types of cancer we discussed here. In the past 30 years, only 73 cases have been recorded. Testicular mesothelioma is also the most aggressive cancer caused from asbestos exposure. The symptoms are variable and initially start with a lymph node (with the guise of a lump) in the testicles. Other symptoms are:

  • Testicular lumps
  • Scrotum Swelling
  • Painless Swelling
  • Painful Swelling
  • Testicular Pain
  • Gynecomastia (enlarged breasts in men)

Other symptoms may occur in the advanced stage of the disease.

They are:

  • Abdominal pain
  • Lower back pain
  • Supraclavicular or inguinal adenopathy
  • Cough
  • Dyspnea (shortness of breath)
  • Body wasting
  • Pericardial Mesothelioma

Mesothelioma from asbestos exposure can also affect heart, or rather, the membrane which protects it. This further type of malignant mesothelioma is called Pericardial mesothelioma. It can be localized or with multiple metastases. The symptoms can be easily confused with other diseases, because they depend on the stage of cancer.

Initial Symptoms:

  • Asthenia
  • Cough
  • Tachycardia
  • Weight loss
  • Ascites (effusion in peritoneal cavity due to weakening heart)

Further Symptoms

  • Sweating
  • Thrombophilia or Hypercoagulability (blood clots)
  • Fever of unknown origin
  • Intestinal obstruction
  • Acute inflammatory lesions

As you can see, the symptoms of pericardial mesothelioma are common in peritoneal mesothelioma, also, especially in the advanced stages of cancer.

However, if you have been exposed to asbestos for reasons of work, any change in your normal bodily functions must be carefully investigated with your doctor.

As said, malignant mesothelioma may also affect women. Peritoneal Mesothelioma in women is rare and for the structure of women’s genital apparatus, this cancer may extend to the uterus and ovaries.

The symptoms may be vague and not easy to identify. Some of them are common to the ones described for peritoneal mesothelioma. Abdominal and pelvic pain, weight loss, vomit and nausea could be some of the symptoms, but they are also common in other diseases. Hence, never turn to self-diagnosis or jump to wrong conclusions. The correct diagnosis will be done only by your doctor.

Conclusion

According to the US Centers for Disease Control and Prevention, mesothelioma deaths among women have increased of 2% since 2011. In Italy instead, 2 new mesothelioma cases are recorded every year. The rise of the incidence, is due to the massive asbestos exposure in the past decades.

Toxic material has been poured everywhere, even in water. But the awful tragedy is the massacre of millions of people who got sicked for not secure workplaces. Some of them have been compensated, but no compensation will give back us those who lost their lives for mesothelioma.

Medical science made big steps forward today and new mesothelioma cases are more and more curable. Other lung cancer cases are taking hold nowadays. The causes are clear and evident. They are always environmental.

Lung adenocarcinoma, for instance, a big cell cancer such as mesothelioma, which attacks the epithelial tissue and extends to bronchi is caused by passive and active smoking, but also by exposure to several toxic substances such as: chrome, nickel, radon, arsenic, asbestos, vinyl chloride, polycyclic aromatic hydrocarbons.

Only a thing is sure: our lungs have been severely damaged by environmental pollution. The common symptoms of this damage are short breath, chest pain, cough. They can mark any respiratory disease and even mesothelioma.

The risk is global and regards everybody: even children. If you know other mesothelioma causes and symptoms, feel free to share your experience. Your contribution will be very helpful to continue the fight against the main cause of cancer: pollution.

References and Bibliography

  1. Dr. Anna Maria Ascolese – Mesotelioma Pleurico – Humanitas- www.humanitas.it/malattie/mesotelioma-pleurico
  2. Dr. Silvia Novello – Tumore del polmone – Fondazione Umberto Veronesi –www.fondazioneveronesi.it/magazine/tools-della-salute/glossario-delle-malattie/tumore-del-polmone
  3. Tumori pleurici del polmone – Istituti Clinici Scientifici Maugeri- https://www.icsmaugeri.it/patologie/tumori-pleurici-e-del-polmone
  4. Associazione Italiana Oncologia Medica – Linee Guida Mesotelioma Pleurico – PDF file – http://media.aiom.it/userfiles/files/doc/LG/2016_LG_AIOM_Mesotelioma.pdf
  5. Dr. Santo Fortunato – Oncologist in Catania – Italy
  6. Agenzia Zoe – Mesotelioma – AIRC – November 17, 2017 – www.airc.it/cancro/informazioni-tumori/guida-ai-tumori/mesotelioma
  7. Gallizzi, G. & Crivellari, S. & Roveta, A. & Muzio, A. & Zai, Sutrisno & Taverna, G. & Aurelio, A. & Libener, Roberta & Mariani, Narciso & D’Angelo, M. & Degiovanni, D. & Grosso, Federica. (2015). Mesotelioma pleurico sarcomatoide: analisi clinico-patologica e di sopravvivenza di una serie di 80 casi, studio retrospettivo multicentrico. Working Paper of Public Health. 4. 10.4081/wpph.2015.6707
  8. Mesotelioma – AIMAC – PDF file – www.aimac.it/scarica-libretto.php?id=32&file=32_Mesotelioma
  9. Mesotelioma – Smaservice – PDF file – www.smaservice.it/wp-content/uploads/2018/08/mesotelioma.pdf
  10. Sonja Klebe, James Leigh, Douglas W. Henderson and Markku Nurminen – Asbestos, Smoking and Lung Cancer: An Update – December 30, 2019 – www.ncbi.nlm.nih.gov/pmc/articles/PMC6982078
  11. Gloeckner-Hofmann K, Zhu X, -Z, Bartels H, Feller A, C, Merz H: Deciduoid Pleural Mesothelioma Affecting a Young Female without Prior Asbestos Exposure. Respiration 2000;67:456-458. doi: 10.1159/000029549
  12. Women: The New Faces of Mesothelioma – www.asbestos.com/featured-stories/women-new-faces-mesothelioma
  13. Goyal, Manish & Swanson, K & Konez, O & Patel, D & Vyas, Pranav. (2000). Malignant pleural mesothelioma in a 13-year-old girl. Pediatric radiology. 30. 776-8. 10.1007/s002470000321.
  14. C. Pérez-Guzmán,a R. Barrera-Rodríguez,b,∗ and J. Portilla-Segura – Malignant pleural mesothelioma in a 17-year old boy: A case report and literature review – January 20, 2016 – www.ncbi.nlm.nih.gov/pmc/articles/PMC4821324
  15. Marta Betti, Anna Aspesi, Marika Sculco, Giuseppe Matullo, Corrado Magnani, Irma Dianzani, Genetic predisposition for malignant mesothelioma: A concise review, Mutation Research/Reviews in Mutation Research, Volume 781,2019, Pages 1-10, ISSN 1383-5742 https://doi.org/10.1016/j.mrrev.2019.03.001 -(http://www.sciencedirect.com/science/article/pii/S1383574218300656)
  16. Redazione – L’uranio impoverito e la strage dei militari italiani – July 6, 2018 -www.risarcimentomalattieprofessionali.it/uranio-impoverito-la-strage-dei-militari-italiani
  17. Quotidiano di Puglia – Amianto killer a bordo delle navi della Marina: 45 si trovano a Taranto – January 8, 2020 – www.quotidianodipuglia.it/taranto/amianto_marina_militare_navi_allarme_cancro-4967876.html
  18. Aimac – Sintomi del mesotelioma – www.aimac.it/libretti-tumore/il-mesotelioma/sintomi-mesotelioma
  19. Assistenza Risarcimento Amianto – Mesotelioma Testicolare – https://assistenzarisarcimentoamianto.it/mesotelioma-testicolare/
  20. Osservatorio Amianto – Mesotelioma pericardico: il tumore maligno cardiaco – www.osservatorioamianto.com/dipartimenti/ricerca-e-cura-del-mesotelioma/mesotelioma-pericardico/
  21. Adenocarcinoma: sintomi, terapia e sopravvivenza – Il Giornale sull’Amianto – https://onanotiziarioamianto.it/tumore-dolore-ai-polmoni/adenocarcinoma-polmonare-assistenza

Author: Rosalba Mancuso
Rosalba Mancuso is a medical journalist, an international content writer credited at the University of Washington and a blogger born in Sicily. She is popular for founding four websites in English. On Modernhealthinfo.com, Rosalba writes well researched and detailed health articles backed by her experience as a medical writer for pharma companies and as a PR assistant for a clinical analysis laboratory. She is also a member of the AHCJ, American Association of Health Care Journalists and Center for Excellence in Health Journalism.

Leave a Reply

Your email address will not be published. Required fields are marked *