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Mesothelioma vs. Lung Cancer

Mesothelioma and lung cancer have a lot of similarities: both are deadly forms of cancer that develop in the chest cavity, both lead to chest pains and difficulty breathing and both can develop as a result of exposure to asbestos. To an expert, however, mesothelioma and lung cancer are different diseases that require different treatments.

Pleural (lung) mesothelioma develops in the lining around the lungs, while lung cancer develops directly on and in the lungs themselves. Mesothelioma can also develop in the heart (pericardial), abdominal (peritoneal) and testicular (testes) areas.

Lung cancer appears as masses on the lungs, while mesothelioma tumors develop on the lining around the lungs and eventually form sheets that cover the organs.

Differences between Mesothelioma and Lung Cancer

Lung cancer and mesothelioma, also called asbestos cancer or asbestos lung cancer, are not the same disease. There are distinct differences, as follows:

Lung Cancer

  • Abnormal cells on the lungs multiply to form tumors that reduce the flow of oxygen into the bloodstream.
  • Occurs primary as a result of environmental factors, smoking and radon gas. Asbestos is also a cause of lung cancer.
  • Most common cancer in the United States with about 223,000 new cases a year.
  • Treated by a combination of chemotherapy, surgery and radiation. Tumors are well-defined masses that form on the lungs
  • Tumors are well-defined masses that form on the lungs.
  • Targeted treatment available for localized tumors.
  • Five-year survival rate for localized disease: 17.7 percent.
  • Takes 10 to 30 years from time of exposure to cancer-causing agent (cigarette smoke, radon gas, air pollution) to appearance of cancer.

Pleural Mesothelioma

  • Abnormal cells form malignant sheets on the lining around the lungs that can rigidly encase the lungs, causing pain, restricted breathing and reduced oxygen in the bloodstream.
  • Occurs primarily due to asbestos exposure. Smoking is not a risk factor.
  • Among the most rare forms of cancer in the United States, with about 3,000 new cases annually.
  • Treatment options include chemotherapy, surgery and radiation but are targeted differently than lung cancer.
  • Tumors appear as nodular masses that spread along the pleura, the two thin layers that encase the lungs.
  • Targeted treatment available for localized tumors but may not be available in many cases due to the spread of the disease.
  • Five-year survival rate for localized disease: About 10 percent.
  • Takes 20 to 50 years from time of exposure to cancer-causing agent (asbestos) to appearance of cancer.

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Diagnostic Tests for Mesothelioma and Lung Cancer

There are several tests doctors perform to diagnose either disease. The tests are useful in diagnosing both diseases, but some tests are more effective than others for either lung cancer or mesothelioma. The key to getting an accurate diagnosis is consulting with a mesothelioma expert who understands the disease process and can provide the best path to effective treatment. Overall, tests used include the following:

  • Imaging tests – Patients who are suspected of having a lung disease are given an X-ray as their first imaging test. If abnormal masses or nodules are detected, physicians will order CT scans, PET scans and MRIs.
  • Bronchoscopy – Using a thin tube with a camera attached, physicians are able to observe the inner area of the lungs and the airway to look for abnormalities.
  • Sputum Cytology – Doctors take a mucus sample to look for cellular abnormalities for a sputum cytology test. The test is commonly used to diagnose lung cancer.
  • Biopsy – When doctors suspect mesothelioma, they use a biopsy to confirm a diagnosis. A tissue biopsy is the only way to accurately diagnose mesothelioma. Biopsies are also used in a lung-cancer diagnosis.

Lung Cancer and Asbestos

Scientific studies show asbestos can also cause lung cancer, but there are no other external factors besides asbestos that cause mesothelioma. When people are exposed to asbestos of any kind they run the risk of developing lung cancer or mesothelioma. There is no safe level of exposure to asbestos.

Laboratory studies show asbestos fibers enter the body through the airway in both lung cancer and mesothelioma. From there, there are divergent paths that could include the following:

  • Asbestos pathway for lung cancer – When asbestos fibers are inhaled and not expelled through coughing or swallowing, they stick to the mucus in the windpipe and bronchi. Some of the microscopic fibers can get caught in the complex airway inside the lungs, causing irritations that lead to cancerous cells.
  • Asbestos pathway for Mesothelioma – Asbestos fibers enter the airway through the same pathway as lung cancer. However, instead of becoming lodge in the lungs, the fibers move to the outer layers through a process called mucociliary clearance. The process, described as the self-clearing mechanism of the lung area, expels the fibers to the pleural lining to later form sheet-like tumors.

Treating Mesothelioma and Lung Cancer

Treatment for both types of cancer largely depends on how much the disease has spread, or metastasized. In both cases, the types of treatments include surgery, chemotherapy and radiation. But the methods of treatments are different:

  • Surgery – In early stage lung cancer patients, surgery to remove the disease lung is an option. For later-stage patients, surgery may be used as palliative care. In early stage mesothelioma, specialized mesothelioma surgical procedures, including the extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D), are considered possible curative treatments. In later-stage patients, surgery may be used as palliative care.
  • Chemotherapy – Researchers have found specific types of chemotherapy are better for lung cancer or mesothelioma. For lung cancer, the chemotherapy medications docetaxel, vinorelbine and paclitaxel are commonly used. For mesothelioma, cisplatin and pemetrexed are frequently used.
  • Radiation – In both cases, radiation is used sparingly due to the close proximity to the heart and other vital organs. Radiation is typically used in the early disease stages or as a palliative treatment later in the disease.

Is it Lung Cancer or Mesothelioma?

General oncologists typically only see one or two cases of mesothelioma through the course of a career, so they are not likely to recognize the differences between mesothelioma and lung cancer symptoms and test results.

Anyone who has been exposed to asbestos and diagnosed with lung cancer, should seek a second opinion from an experienced mesothelioma specialist immediately. Mesothelioma is often misdiagnosed as lung cancer, reducing the chances for fast and effective treatment. Contact us now for more information about getting fast access to a mesothelioma physician who can administer testing.

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