Mesothelioma
Topics Covered
Topics Covered
Topics Covered
Topics CoveredUnderstanding Mesothelioma
Mesothelioma develops in the thin protective lining that surrounds the lungs (pleura).
It can cause the pleura to thicken and produce fluid, leading to symptoms such as shortness of breath and chest discomfort.
While asbestos exposure remains the main cause, other factors — including genetic susceptibility and previous radiotherapy — can also contribute.
Main types:
- Pleural mesothelioma: affects the lining around the lungs (most common).
- Peritoneal mesothelioma: affects the lining of the abdomen (less common).
- Pericardial or testicular mesothelioma: extremely rare forms.
Understanding which type and stage a patient has is essential for choosing the best treatment approach.
Symptoms and Early Signs
Mesothelioma symptoms can develop slowly, often many years after exposure to asbestos.
Early detection remains challenging, but recognising the signs can lead to earlier diagnosis and better symptom control.
Common symptoms include:
- Shortness of breath or chest pain
- Persistent cough
- Unexplained fatigue or weight loss
- Fluid buildup around the lungs (pleural effusion)
- Shoulder or upper back pain
Because these symptoms are nonspecific, early referral to a specialist is crucial when there is a history of asbestos exposure.
Diagnosis and Assessment
Diagnosing mesothelioma involves a combination of imaging, tissue sampling, and laboratory testing.
Each patient undergoes a thorough assessment to confirm the diagnosis and determine disease stage.
Typical diagnostic steps:
- Imaging tests: chest X-ray, CT, PET, or MRI to detect pleural thickening and fluid.
- Pleural fluid analysis: a sample may be taken to look for cancer cells.
- Biopsy: tissue removal via thoracoscopy or needle biopsy confirms mesothelioma and subtype.
- Molecular and biomarker testing: helps identify specific features that can guide personalised treatment.
All results are reviewed by a multidisciplinary team (MDT), ensuring a precise diagnosis and coordinated care plan.
Treatment Options
Treatment depends on several factors — including the cancer’s stage, the patient’s health, and whether surgery is possible.
Dr Papadatos-Pastos works closely with thoracic surgeons, respiratory physicians and palliative care specialists to create an individualised plan for each patient.
Surgery
In selected cases of early-stage pleural mesothelioma, surgery may be considered to remove affected tissue.
Procedures such as pleurectomy/decortication or extrapleural pneumonectomy may be used to reduce tumour burden and control symptoms.
Chemotherapy
The combination of pemetrexed and cisplatin or carboplatin remains the standard first-line treatment for many patients.
This can shrink tumours, relieve symptoms, and improve quality of life.
Immunotherapy
Recent advances include the use of nivolumab and ipilimumab, which help the immune system recognise and attack cancer cells.
These treatments have shown encouraging results for patients who are not suitable for surgery.
Radiotherapy
May be used to control local symptoms such as pain or to target small areas of residual disease after surgery.
In some cases, a multimodal approach — combining surgery, chemotherapy, and immunotherapy — offers the best possible outcome.
Living with Mesothelioma
Beyond medical treatment, mesothelioma care focuses on maintaining comfort, independence, and dignity.
Supportive care can include pain management, breathing exercises, and psychological support.
Dr Papadatos-Pastos and his team provide ongoing guidance for both patients and families, helping to manage symptoms and improve quality of life throughout treatment and follow-up.
Your Mesothelioma Care Journey
Step 1
Rapid Initial Consultation
Immediate access to a thoracic oncology specialist. In this first meeting, your history (including asbestos exposure), symptoms and any prior imaging are reviewed.
Step 2
Diagnostic Testing & Review
Advanced imaging (CT, PET) and a biopsy are arranged swiftly. All findings are discussed by Dr Papadatos-Pastos and a multidisciplinary team for clarity and direction.
Step 3
Personalised Treatment Planning
Based on your diagnostic results, a tailored plan is developed — factoring stage, your health, and goals.
Step 4
Targeted Therapy Implementation
Treatment may involve surgery (when possible), chemotherapy (e.g. pemetrexed + platinum), immunotherapy (e.g. nivolumab + ipilimumab), or radiotherapy as needed.
Step 5
Follow-Up Care & Support
After active treatment, regular monitoring, supportive care, symptom management (e.g. fluid drainage, pain control) and holistic support continue.
Support and Follow-Up Care
Dr Papadatos-Pastos and his team provide ongoing support beyond medical treatment.
Patients receive clear communication, psychological care and access to nutrition, physiotherapy and symptom-management services.
Regular follow-up ensures early detection of recurrence and long-term wellbeing.
Book a Consultation
If you or someone close to you has been diagnosed with lung cancer, early consultation with a specialist can make a real difference. Appointments are available at several London clinics.
Faq
Answers to Common Questions
We understand that a diagnosis of mesothelioma can feel overwhelming. Here are some answers to common questions that may help you understand your condition and care options.
The majority of cases are linked to previous asbestos exposure — often many years earlier. However, not everyone exposed to asbestos develops the disease, suggesting that individual factors also play a role.
Mesothelioma is challenging to cure, but treatment can often control the disease, relieve symptoms, and extend survival while maintaining quality of life.
Regular check-ups and imaging may be recommended for individuals with a known history of exposure. Early evaluation allows prompt action if any changes occur.
CONDITIONS TREATED
Dr Dionysis Papadatos-Pastos specialises in diagnosing and treating complex thoracic cancers with evidence-based therapies and compassionate care.
