Pleural Cancer

Thoracic cancer specialists at UT Southwestern Medical Center have the expertise patients need for the diagnosis and treatment of pleural cancer. 

As the only National Cancer Institute-designated comprehensive cancer center in North Texas, we deliver the best cancer care available today and push to discover new treatments. NCI designation means we offer patients the ability to participate in the broadest possible range of clinical trials, with access to potential therapies not available at other facilities.

Experts in All Types of Pleural Cancer

Pleural cancer occurs outside the lungs in the chest or pleural cavity and along the pleural lining, the membrane that surrounds the lungs and covers the inside of the chest cavity. Cancer that occurs in the pleural cavity has most often spread (metastasized) to the pleura from somewhere else in the body. For this reason, the disease is sometimes referred to as unknown primary pleural cancer. It has most commonly spread to the pleural space from the lung but can come from the breast, ovary, pancreas, colon, and other locations. 

Primary pleural cancer is cancer that develops in the pleural cavity itself, such as malignant pleural mesothelioma, but this type is less common. 

Determining the cancer’s origin and degree of involvement often requires special diagnostic testing and procedures. UT Southwestern’s experienced chest (thoracic) cancer physicians expertly diagnose and treat both primary and unknown primary pleural cancer. 

Our thoracic cancer physicians work closely with UT Southwestern pathologists to identify cancers that have spread to the pleura, enabling the most appropriate treatment. 

Symptoms of Pleural Cancer

Pleural cancer might not have symptoms at first, or it might produce symptoms similar to lung cancer. These include:

• Shortness of breath when active
• Chest pain
• General discomfort
• Cough
• Unexplained weight loss 

Diagnosis

We will conduct a physical examination and order tests to diagnose pleural cancer. Further tests might be needed to help determine the cancer’s stage and precise location. In some cases, pathologists can determine the primary cancer that has spread to the pleura. 

Imaging techniques used to diagnose pleural cancer might include:

• Chest X-ray: This type of imaging is used to visualize abnormalities in the pericardium.
• Contrast-enhanced or multidetector computed tomography (CT) scan: CT technology helps physicians visualize the location and extent of unknown primary pleural cancer.
• Magnetic resonance imaging (MRI): MRI helps physicians identify suspicious areas that could indicate unknown primary pleural cancer and learn if and how far it has spread.
• Positron emission tomography (PET): Cancer cells absorb large amounts of radioactive sugar used in this technique, and a special camera creates images of that radioactivity, enabling physicians to identify cancerous cells in the pleura.
• Endoscopic ultrasonography: This technology maps sound waves to help physicians visualize pleural cancer. 

Additional testing might also include a tissue sample (biopsy) of the pleural tissue to determine the presence of cancer.

Treatment for Pleural Cancer

Treatment options for unknown primary pleural cancer depend on the cancer’s precise location and stage; the patient’s overall health, goals, and preferences; and other factors.

UT Southwestern’s thoracic cancer specialists might consider these therapies for treating unknown primary pleural cancer:

• Treatment with medication: Chemotherapy drugs, taken orally or intravenously, can target and kill cancer cells in the pleura. Chemotherapy can also be used in conjunction with radiation therapy (chemoradiation) to treat unknown primary pleural cancer.
• Radiation therapy: High-energy radiation, such as X-rays, can destroy cancer cells in the pleura, and UT Southwestern is a recognized leader in the development and use of this approach.
• Surgery: Highly precise surgery to remove cancerous tissue can be used in some early-stage cases of unknown primary pleural cancer. 

Clinical Trials

Depending on the cause and extent of unknown primary pleural cancer, some patients might be eligible to participate in clinical trials of new treatments for the disease. 

UT Southwestern conducts clinical trials aimed at improving the care and outcomes of patients with pleural cancer. Patients should speak with their doctor about clinical trial options. 

Support Services

We also offer a range of support services to help patients and families before, during, and after treatment for pleural cancer. These services include nutrition counseling, physical rehabilitation, social work, support groups, and more.