NCCN Guidelines for Patients
Malignant Pleural Mesothelioma, Version 1.2014
How does mesothelioma start?
There is space between the visceral and parietal
pleura called the pleural cavity. It is filled with a small
amount of pleural fluid made by the mesothelium.
Pleural fluid acts as a lubricant. It helps the two pleura
layers slide against each other during breathing.
Pleural fluid also helps the lungs glide against other
organs, such as the heart.
The same type of tissue as the pleura is found in
other areas of the body. However, it is called other
names. The tissue lining around the heart is called
the pericardium. The tissue lining around the belly
area between the chest and pelvis (abdomen) is
called the peritoneum. This book is about
cancer of the pleural mesothelium.
Cancer is a disease of cells. Abnormal
changes (mutations) in genes can turn
normal cells into cancer cells. Genes
are instructions in cells for making new
cells and controlling how cells behave.
Gene mutations cause cancer cells to act
differently than normal cells.
Normal cells grow and then divide to form
new cells as the body needs them. When
normal cells grow old or get damaged, they
die. Cancer cells don’t do this. Cancer cells
make new cells that aren’t needed and
don’t die quickly when old or damaged.
Over time, the cancer cells grow and divide
enough to form a mass called the primary
tumor. If the primary tumor isn’t treated, it
can grow and invade nearby tissues and
organs, such as the lungs.
Unlike normal cells, cancer cells can spread and
form tumors in other parts of the body. Cancer that
has spread is called a metastasis. Cancer cells often
spread through lymph or blood. Lymph is a clear fluid
that gives cells water and food. It also has white blood
cells that fight germs. Lymph nodes are groups of
disease-fighting cells that filter lymph and remove the
germs. Lymph travels throughout the body in vessels
like blood does. As shown in
and nodes are found everywhere in the body.
Figure 2. Lymph vessels and lymph nodes
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