Mesothelioma Metastasis: Where & How the Cancer Spreads (2024)

Metastasis occurs when cancer from an initial site, such as the pleura, travels to a distant location within the body and forms new tumors. Mesothelioma patients should be aware of how their cancer spreads and the risk factors that affect the rate of metastasis.

Mesothelioma commonly spreads throughout the cavity where it initially forms. Cancer develops locally or regionally up to stage 3. Distant metastasis occurs in end-stage mesothelioma for about 10% to 50% of patients.

Metastasis can affect a patient’s eligibility for surgery and other treatment options. Mesothelioma has a long latency period of 20 to 40 years, and many patients do not have symptoms until the disease is in its later stages, when metastasis is more likely to occur.

Doctors can make a metastatic mesothelioma diagnosis through radiology imaging scans such as MRI, CT or PET. Symptoms or abnormalities not consistent with the initial site of cancer may indicate metastatic progression, prompting the treating physician to order a biopsy or additional tests.

How Does Mesothelioma Cancer Spread?

Cancer cells spread through the body using lymph nodes in the lymphatic system or through blood vessels in the circulatory system. Metastatic mesothelioma can travel through these structures and establish new cancer sites on distant organs and tissues such as the liver or kidneys.

Malignant mesothelioma is also prone to spreading locally, within the immediate area of its origin. Pleural mesothelioma, for example, will typically progress within the pleura on the same side of the affected lung. Regional metastasis signifies tumor involvement of deeper tissues within the region such as lymph nodes or fatty tissue.

Mesothelioma Metastasis by Type

The initial site of mesothelioma can affect where metastatic cancer sites might develop. If tumors are close to large blood vessels or lymph nodes, distant metastasis may be more likely to occur. Pleural mesothelioma that forms close to the middle of the chest could progress into the protective structures that surround the heart.

Where Does Mesothelioma Commonly Spread?

Secondary sites of cancer often depend on the initial type and location of the disease. The most common pleural mesothelioma metastasis sites include the:

  • Liver
  • Kidneys
  • Adrenal glands
  • Pericardium (heart sac)

Peritoneal mesothelioma metastasizes most often to the following sites:

  • Liver
  • Spleen
  • Stomach
  • Intestines

Pleural Mesothelioma Metastasis

Researchers have only recently discovered the potential of malignant pleural mesothelioma to spread to other parts of the body. Importantly, doctors also consider mesothelioma that travels to the opposite lung as distant metastasis.

The most common site of metastasis for pleural mesothelioma is the liver, occurring in 55.9% of late-stage metastatic patients. The next most common areas are the kidneys and adrenal glands, which sit on the top of the kidneys, both occurring in about 30% of cases.

Peritoneal Mesothelioma Metastasis

The peritoneal cavity houses the abdominal organs such as the liver, spleen, kidneys, intestines and others. As mesothelioma progresses within the peritoneal tissue that surrounds the abdomen, many of these organs are at risk of metastatic disease.

Approximately 50% of malignant peritoneal mesothelioma patients develop distant metastasis, most commonly in the liver. Cancer can also spread into the brain and central nervous system, though this only occurs in roughly 3% of patients. Other less common sites include the thyroid, heart, pancreas, appendix, skin and bone.

Pericardial Mesothelioma Metastasis

Pericardial mesothelioma is a rarer subtype of the disease and metastatic trends are not yet well known. As cancer spreads, the most likely sites of regional metastasis include the lungs, pleura, lymph nodes and mediastinum, the area between the lungs. Less commonly, pericardial mesothelioma can also metastasize to the kidneys.

Mesothelioma Metastasis: Where & How the Cancer Spreads (1)

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Cell Type

The mesothelioma cell types that make up tumors include epithelial, sarcomatoid and biphasic, which is a mixture of both. Patients have different cellular makeups that define the structure of their tumors.

Epithelial tumors grow slower than other types and are more responsive to treatment. Patients with epithelial type tend to have a longer mesothelioma life expectancy. Conversely, sarcomatoid and biphasic cancer cells spread more rapidly to distant sites in the body, limiting treatment options and worsening prognosis.

Cancer Stage

The most recognized pleural mesothelioma staging system is the TNM method. TNM measurements include tumor size and location, lymph node involvement and the presence of metastasis. Doctors use the Peritoneal Cancer Index to stage peritoneal mesothelioma, which tracks the presence of tumors in sectors throughout the abdomen.

Early-stage mesothelioma includes stage 1 and stage 2, which have a lower risk of metastasis and the most treatment options. Late-stage, or end-stage, mesothelioma includes stages 3 and 4, where distant metastasis is more likely to occur. Treatment options are limited to palliative therapies that control symptoms.

Treatment Response

The risk of metastasis decreases significantly for early-stage patients who undergo an aggressive treatment such as mesothelioma surgery. Adjuvant chemotherapy or radiation can slow or prevent new tumor growth. Patients who respond well to early therapies have the best prognosis and a mesothelioma life expectancy of about two to three years.

Newer mesothelioma treatments are also showing potential for controlling metastasis and prolonging survival. Immunotherapy is a targeted treatment that can potentially circulate anti-cancer antibodies for many years. Tumor Treating Fields are adhesive arrays applied by the patient that use painless electrical fields to limit cancer growth.

Symptoms of Metastatic Mesothelioma

When mesothelioma metastasizes to another site in the body, symptoms may not always be noticeable. When signs and symptoms of metastasis do appear, they typically relate to the area of new tumor growth. Doctors use imaging scans and physical examinations to detect metastatic sites as early as possible.

In some cases, symptoms of metastasis may mimic the expected effects of the primary mesothelioma site. Cancer does not spread distantly until the later stages of the disease, when mesothelioma symptoms may already be severe.

Common Metastatic Mesothelioma Symptoms

  • Weight loss
  • Pleural effusion (fluid buildup in the chest)
  • Abdominal swelling
  • Bone fractures
  • Blood pressure changes
  • Headaches

The most common site of mesothelioma metastasis is the liver. Symptoms of new tumor sites on the liver can include jaundice, abdominal pain and edema, or swelling of the legs. If cancer spreads to the kidneys or adrenal glands, patients may experience low back pain, blood in the urine and anemia.

While rare, metastatic spread to the brain is possible and can cause many different neurological symptoms. Metastatic brain cancer can cause changes in memory, vision and personality. Tumors in the brain are also responsible for poor coordination, seizures and severe headaches.

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Treatment for Metastatic Mesothelioma

Once the cancer has spread to other sites in the body, mesothelioma treatment options are limited and focus on palliative care. Palliative care options aim to reduce symptom severity, prolong survival and improve quality of life.

Doctors will prescribe traditional treatments, such as chemotherapy and radiation, in an attempt to manage the spread of cancer and decrease the risk of further metastasis. Radiation is useful for preventing recurrence within an area after surgical resection. Mesothelioma specialists determine the best course of treatment based on many factors.

Emerging Mesothelioma Treatments

Researchers are exploring many different types of therapies to combat mesothelioma metastasis. Anti-angiogenesis drugs, for example, combat tumor growth by limiting vascular growth and blood supply on new tumors.

Newer treatments involve the expanded use of targeted therapies, treatments that only affect cancer sites, as opposed to chemotherapy or radiation, which can damage healthy cells. Immunotherapy is significantly growing in popularity as an additional option in a multimodal treatment plan.

Many types of immunotherapy use antibodies that target cancer and direct the immune system to attack tumor cells in the same way as an infection, such as a virus. For immunotherapy to be most effective, the cancer cells must express specific biomarkers on their surface.

Gene therapy is another type of targeted therapy that manipulates the DNA within cells to prevent defects in cellular replication, which could lead to metastasis.

Proton therapy is a safer alternative to traditional radiation therapy for mesothelioma, allowing radiation oncologists greater control in treating metastatic sites without damaging healthy tissue.

Another option for metastatic patients is Tumor Treating Fields, a personal device that delivers painless, alternating electrical fields to slow tumor growth.

Clinical Trials for Metastatic Mesothelioma

Mesothelioma clinical trials are frequently enrolling metastatic patients as researchers attempt to learn more about preventing the spread of cancer. These trials offer experimental therapies that may provide improved patient survival and increased effectiveness against mesothelioma metastasis.

Phase 1 Study of INBRX-109 in Subjects with Metastatic Solid Tumors

This study is a first-in-human trial investigating the use of an artificial antibody that targets a death receptor on tumor cells, inciting cancer cells to kill themselves.

Study of BAY2287411 Injection, an Antibody-Chelator Conjugate, in Patients with Tumors Known to Express Mesothelin

Another first-in-human trial, this study is testing the use of an experimental anti-tumor injection for safety, efficacy and tolerability in mesothelioma patients.

Study of SO-C101 and SO-C101 in Combination with Pembrolizumab in Patients with Advanced or Metastatic Solid Tumors

Researchers are studying the preliminary effectiveness of investigational drug SO-C101 in combination with anti-PD1 immunotherapy, pembrolizumab.

Mesothelioma Metastasis: Where & How the Cancer Spreads (2024)


Mesothelioma Metastasis: Where & How the Cancer Spreads? ›

Metastatic mesothelioma can spread to several organs, such as the liver, lungs, kidneys, adrenal glands or spleen. Metastasis happens when cancer cells travel to distant sites. They may move through the bloodstream or lymph system.

How fast does mesothelioma cancer spread? ›

Mesothelioma progresses quickly once symptoms begin. Metastasis may occur as quickly as in several weeks. Compared to other types of cancer, it is generally aggressive and quick-moving.

What is the progression of mesothelioma cancer? ›

The most common staging system for pleural mesothelioma is the TNM system. For this type of cancer, there are 4 stages. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread.

How is mesothelioma transmitted? ›

Even exposure to a mesothelioma patient's blood or bodily fluids cannot transmit the cancer. However, asbestos fibers can be passed from one person to another. Asbestos is the only known cause of mesothelioma and several other asbestos-related cancers.

Where does mesothelioma cancer come from? ›

Primary asbestos exposure: Primary exposure is direct physical exposure to asbestos fibers. Up to 80 percent of all mesothelioma cases result from primary exposure. Secondary asbestos exposure: People who work with asbestos can transfer asbestos fibers from their skin or clothing to other people.

Where does mesothelioma cancer metastasize to? ›

Metastatic mesothelioma can spread to several organs, such as the liver, lungs, kidneys, adrenal glands or spleen.

What are the final stages of mesothelioma? ›

Stage 4 mesothelioma cancer is the most advanced stage and is terminal. Cancer has spread to distant organs and parts of the body in this stage. You may have difficulty breathing, chest pain and fatigue. Treatment options are palliative to manage and ease mesothelioma symptoms until the end of life.

What is the average life expectancy after being diagnosed with mesothelioma? ›

Mesothelioma Survival Rate: The mesothelioma survival rates is typically 4 to 18 months after diagnosis, but there have been patients diagnosed with mesothelioma who have lived longer than 10 years. The current five-year survival rate for the disease is just 10 percent.

What is death from mesothelioma like? ›

Is Mesothelioma Death Painful? In the final days and hours of life, many patients stop eating or drinking. They often become withdrawn and unresponsive. They may be sleeping most of the time, finding it difficult to stay awake.

What are the odds of beating mesothelioma? ›

The 5-year survival rate for pleural mesothelioma is approximately 12%. The 5-year survival rate for peritoneal mesothelioma is 65%. Is mesothelioma always fatal? Malignant mesothelioma is an aggressive and fatal disease, however, some patients have survived more than 10 years after their diagnosis.

What are the signs that mesothelioma is getting worse? ›

The most common late-stage symptoms of mesothelioma (stages 3 & 4) involve pain and difficulty breathing. This includes fatigue or weakness, shortness of breath, abdominal or chest pain, weight loss and pleural effusions in most patients.

What organ does mesothelioma mainly affect? ›

Mesothelioma most often affects the tissue that surrounds the lungs (pleura). This type is called pleural mesothelioma. Other, rarer types of mesothelioma affect tissue in the abdomen (peritoneal mesothelioma), around the heart and around the testicl*s.

Who is the longest living person with mesothelioma? ›

Paul Kraus is well known for being the longest-living mesothelioma survivor.

Does mesothelioma spread fast? ›

Mesothelioma tends to spread (metastasize) fairly quickly. Because of this, many experts consider mesothelioma to be an aggressive form of cancer. Numerous factors can affect how quickly mesothelioma progresses and the areas of the body to which it spreads.

How did Steve McQueen get mesothelioma? ›

Oftentimes, asbestos exposure can be directly linked to specific job occupations, which many people would not associate with celebrities. But, before the world knew such famous actors as Steve McQueen or Ed Lauter, they each were exposed to asbestos, and ultimately succumbed to complications from mesothelioma.

Is mesothelioma an aggressive cancer? ›

Mesothelioma is an aggressive cancer that can involve the lining of the lungs or the abdomen,” explains Raffit Hassan, M.D., a Senior Investigator in the Thoracic and GI Malignancies Branch.

Is mesothelioma a fast growing cancer? ›

Mesothelioma tends to spread (metastasize) fairly quickly. Because of this, many experts consider mesothelioma to be an aggressive form of cancer. Numerous factors can affect how quickly mesothelioma progresses and the areas of the body to which it spreads.

How long does it take for mesothelioma to progress? ›

Mesothelioma may progress quickly once diagnosed, but symptoms can take years to develop. Mesothelioma has a long latency period, and patients may not experience symptoms for 10 to 50 years. Many factors can impact the latency period, such as age at first exposure to asbestos.

How long will I live if I have mesothelioma? ›

Mesothelioma Survival Rate: The mesothelioma survival rates is typically 4 to 18 months after diagnosis, but there have been patients diagnosed with mesothelioma who have lived longer than 10 years. The current five-year survival rate for the disease is just 10 percent.


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