Mesothelioma

Mesothelioma is a rare and aggressive cancer originating from mesothelial cells, the specialized cells lining the pleura (lungs), peritoneum (abdomen), pericardium (heart), and tunica vaginalis (testes). Approximately 80% of cases are pleural mesothelioma, and the vast majority are linked to asbestos exposure. Asbestos fibers, when inhaled or ingested, become lodged in tissue and cause chronic inflammation that over decades can trigger malignant transformation. The long latency period means cases continue to be diagnosed despite asbestos regulations. Treatment typically involves multimodal approaches: surgery (pleurectomy/decortication or extrapleural pneumonectomy for eligible patients), chemotherapy (pemetrexed/cisplatin), and radiation. In 2020, the combination of nivolumab plus ipilimumab (checkpoint immunotherapy) was approved as first-line treatment, showing improved survival compared to chemotherapy alone. For peritoneal mesothelioma, heated intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery has shown promise.