Mesothelioma is a rare disease with symptoms that can mimic other more common conditions, leading to frequent misdiagnosis. Early detection is the only way to improve prognosis for mesothelioma patients, making it important to identify and address symptoms right away.
Though there are common symptoms of mesothelioma, they may vary based on mesothelioma type and staging. There is a long latency period for mesothelioma, meaning it can take 10 – 50 years for these symptoms to emerge.
Common Mesothelioma Symptoms
The best way to improve mesothelioma prognosis is early detection. If patients experience any common symptoms of malignant mesothelioma, they should seek medical care right away. Patients diagnosed at early stages are typically able to undergo more treatment options, extending their life expectancy.
- Abdominal pain and swelling
- Chest pain
- Difficulty breathing (dyspnea)
- Difficulty swallowing (dysphagia)
There are many factors that can challenge early detection of mesothelioma, including its long latency period. Symptoms may emerge any time from 10 to 50 years after asbestos exposure, the only known cause of the disease. Other factors that may impact the onset of symptoms include:
- Duration of exposure: Individuals exposed to asbestos for longer periods of time may experience symptoms sooner than those with one-off exposures.
- Amount of exposure: Individuals exposed to asbestos in large quantities may develop symptoms sooner than those exposed to low levels.
- Type of asbestos: Crocidolite is considered to cause a higher risk of health concerns than other types of the mineral, potentially leading to earlier development of symptoms than with other types of asbestos.
- Other factors: Stage of mesothelioma, cell type and metastasis (how the disease has spread) can also impact when and how symptoms manifest.
Symptoms by Mesothelioma Type
Symptoms may vary greatly for patients based on mesothelioma type, since each type affects a different area of the body. The symptoms a patient is experiencing may help guide physicians during the diagnostic process and provide information on where to conduct imaging scans and biopsies.
Pleural Mesothelioma Symptoms
Malignant pleural mesothelioma is the most common type, accounting for around 80 – 90% of all mesothelioma cases. Pleural mesothelioma affects the linings of the lungs, and symptoms often affect breathing and the thoracic cavity (chest). They are often associated with other, more common diseases, such as pneumonia, flu or lung cancer.
- Blood clotting disorders
- Body aches
- Chest pain
- Chronic cough
- Excessive sweating
- Night sweats
- Pleural effusion
- Unexplained weight loss
Peritoneal mesothelioma occurs in the peritoneum, which is the lining of the abdomen, and makes up 10 – 20% of all cases. Symptoms can vary significantly for this type, as peritoneal tumors can affect many organs throughout the abdominal cavity. Symptoms such as loss of appetite, swelling and abdominal pain are often confused with more common conditions like irritable bowel syndrome (IBS) and Crohn’s disease.
- Abdominal pain and swelling (distention)
- Anemia (most common in women)
- Bowel obstruction
- Loss of appetite (anorexia)
- Nausea and vomiting
- Peritoneal effusion
- Unexpected weight loss
Pericardial mesothelioma makes up less than 1% of all mesothelioma patients and affects the pericardium, or lining of the heart. Due to its rarity and aggressive nature, pericardial mesothelioma is often not diagnosed until the late stages or posthumously during an autopsy.
- Chest pain
- Fever and night sweats
- Heart murmur
- Irregular heartbeat or heart palpitations (arrhythmia)
- Pericardial effusion (fluid buildup around the heart)
Also accounting for less than 1% of all mesothelioma cases, testicular mesothelioma affects the tunica vaginalis testis, which is the membrane lining the testes. Because this type is so rare, there are limited case studies available to understand disease progression and typical stage at diagnosis.
- A lump or mass on the testicle
- Fluid buildup and swelling around the scrotum (hydrocele)
- Inflammation of the epididymis (epididymitis)
- Pain in the testes
Symptoms by Mesothelioma Stage
Symptoms for mesothelioma patients also vary greatly based on staging. Misdiagnosis of mesothelioma is common during early stages when symptoms go unnoticed or are very mild. However, improving diagnostic tools are helping mesothelioma specialists recognize symptoms sooner for early detection.
- Stage 1: Tumors are localized at this stage, with no spreading to the lymph nodes. Most patients experience no or very minor symptoms.
- Stage 2: The cancer has spread to nearby organs, tissues and possibly lymph nodes by stage 2. Symptoms like shortness of breath, weight loss and chronic cough are common during this stage, though are often still mild and misdiagnosed.
- Stage 3: The cancer has spread to nearby organs and tissues and potentially to distant lymph nodes at stage 3. Difficulty breathing and chest or abdominal pain are common during this stage for malignant pleural and peritoneal mesothelioma patients as symptoms begin to worsen.
- Stage 4: Patients experience distant spreading of cancer cells during stage 4 with varied, severe symptoms as more organs and lymph nodes are affected. Common symptoms include pain, difficulting swallowing and breathing and systemic problems. Palliative care is commonly recommended for stage 4 patients to lessen symptoms.
As the cancer metastasizes, or spreads throughout the body, symptoms will worsen as patient health declines and other organs are affected outside of the point of origin. Symptoms of metastasis may include:
- Hemoptysis: Coughing up blood
- Laryngeal nerve palsy: Hoarseness caused by damage to the laryngeal nerve and paralysis of the voicebox
- Horner’s syndrome: Damage to the sympathetic trunk, resulting in certain eye-related conditions
- Other nerve issues in the face or limbs, most commonly in the arms
What to Do If Mesothelioma Symptoms Arise
Patients should seek medical care immediately when symptoms are recognized to pursue treatment as soon as possible. If the cancer is caught early, aggressive treatments may be an option to improve prognosis. After symptoms emerge, physicians will conduct a physical exam and look at medical history. A history of asbestos exposure may also help guide doctors to a mesothelioma diagnosis and should be brought to their attention immediately.
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Imaging scans are often the first step in the diagnostic process that will look for tumors or abnormalities in the body. Blood tests will also be performed to look for biomarkers that can suggest a mesothelioma diagnosis, reveal mesothelioma symptoms or reveal a history of asbestos exposure. Neither of these diagnostic tools can definitively diagnose mesothelioma, which is why a biopsy is required. A biopsy will take a fluid or tissue sample from the patient for analysis to confirm cancer, determine cancer type and cell type, while aiding in staging of the disease.
Treatment of Mesothelioma Symptoms
Once the cancer has been confirmed, patients will work with their mesothelioma specialists to determine a treatment plan that will destroy or remove as much of the cancer as possible, while also treating symptoms to improve quality of life. For example, pleurodesis and paracentesis are common surgeries that can be used palliatively to drain fluid buildup, taking pressure off of the lungs and abdominal organs to improve breathing and reduce pain. Surgery, chemotherapy and radiation therapy may also be used to reduce or remove tumors, alleviating pressure and associated symptoms.
Author: Linda Molinari
Editor in Chief, Mesothelioma Cancer AllianceRead about Linda
Reviewer: Annette Charlevois
Patient Support CoordinatorRead about Annette
American Cancer Society. Signs and Symptoms of Mesothelioma. Updated February 2016.
Frontario SCN, Loveitt A, Goldenberg-Sandae A, et al. Primary Peritoneal Mesothelioma Resulting in Small Bowel Obstruction: A Case Report and Review of Literature. The American Journal of Case Reports. July 2015;16:496-500. doi: 10.12659/AJCR.894180
Mezei G, Chang ET, Mowat FS, et al. Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis. Annals of Epidemiology. May 2017;27(5):348-359.e11. doi: 10.1016/j.annepidem.2017.04.001
Odisio EG, Marom EM, Shroff GS, et al. Malignant Pleural Mesothelioma: Diagnosis, Staging, Pitfalls and Follow-up. Chest Imaging. December 2017;38(6):559-570. doi: 10.1053/j.sult.2017.07.006