Considered to be one of the primary symptoms of mesothelioma, dysphagia or difficultly swallowing can rapidly progress in an individual. However, many with a malignant mesothelioma diagnosis experience most, if not all, of the symptoms associated with this devastating disease. Many symptoms of mesothelioma are linked, causing a painful physiological chain reaction in the body.
Dysphagia is connected to several other symptoms of mesothelioma including chest pain, malnutrition, abnormal weight loss or in severe cases, anorexia.
Dysphagia presents in those diagnosed with pleural mesothelioma, the most common form of mesothelioma cancer. Since the mesothelium of the lungs is affected during the progression of the disease, individuals have difficulty breathing and swallowing.
With a rare form of mesothelioma, pericardial mesothelioma, the sac surrounding the heart is affected and an individual may also present dysphagia. As the increased pressure around the heart causes very little oxygen to pass, patients may experience shortness of breath and possibly develop dysphagia. With peritoneal mesothelioma – affecting the abdomen and possibly other organs including the liver and spleen – dysphagia may not be present.
Dysphagia is classified into two types, oropharyngeal dysphagia and esophageal dysphagia. The classifications point to the origin of the dysphagia rather than any resulting symptoms. Typically, oropharyngeal dysphagia results from muscular, neurological or nerve dysfunctions. With an eventual mesothelioma diagnosis, individuals suffering from difficulty swallowing suffer from esophageal dysphagia. For pleural mesothelioma, esophageal dysphagia is a mechanical reaction to the growing mesothelium on the lungs.
Difficulty swallowing is the primary presentation of dysphagia, though many individuals also complain about coughing or choking during eating. As the carcinogenesis of the mesothelium progresses, pressure in the chest builds up which causes individuals to have difficulty breathing. Specifically, the expanding mesothelium places pressure on the esophagus, restricting breathing. From this, difficulty regulating breath leads to difficulty regulating swallowing. Breathing is imperative while eating and drinking, and if the lungs are beginning to compress, swallowing becomes challenging.
Primarily, dysphagia is characterized by difficulty swallowing, which often progresses to coughing while eating or drinking. Some individuals have difficulty swallowing solid food or liquids, but in some exceptional cases, dysphagia causes difficulty swallowing for both. Coughing during ingestion can lead to asphyxiation or food particles ingested directly into the lungs. If food is swallowed, it may be extremely painful as it travels to the stomach.
As the dysphagia worsens, individuals may experience sensations of choking, as if food is stuck in the throat or the chest. Usually this complaint occurs several seconds after swallowing and is a primary red flag for dysphagia. Further, individuals may drool, vomit or have food exit through their nose. Dysphagia may also develop into an aversion to food in some individuals, including temperatures of the food, flavors or textures.
As the dysphagia progresses, pleural mesothelioma sufferers may have occasional difficulty swallowing solid food, but can swallow liquids easily. Typically, as the mesothelioma cancer advances, individuals may begin to have trouble swallowing every time they eat, and may begin to have difficulty drinking. Soon, the pressure surrounding the esophagus is too great and liquids become difficult, if not, impossible to swallow.
If dysphagia progresses quickly, an individual will likely not be receiving the necessary proper nutrition to remain healthy and vibrant. This quick progression may lead to malnutrition, dehydration and abnormal weight loss. In some extreme cases, individuals with progressive dysphagia develop anorexia.
Malignant mesothelioma, regardless of type, is a devastating disease, which is made worse by its progressive, interconnected symptoms. If an individual is presenting early symptoms of dysphagia, seek immediate medical attention. Progressive dysphagia caused by a spreading mesothelioma cancer robs the sufferer from essential nutrients, hydration and calories, and may exacerbate any underlying causes.Sources
C.E. Johnson, A.G. Wardman, M.J. McMahon and N.J. Cooke. Department of Respiratory Medicine and the University Department of Surgery, General Infirmary, Leeds. Dysphagia complicating malignant mesothelioma. August 1983. Accessed on November 6, 2010.
American Cancer Society. Malignant Mesothelioma Overview. Accessed on November 5, 2010.
C.A. Lockwood, H.W. Jones, C.K. Foote and M.J. Turner. Department of Medicine for the Elderly, Amersham General Hospital, Bucks. Dysphagia due to mesothelioma infiltrating the oesophags: palliative treatment. Accessed on November 6, 2010.
NYU Medical Center, Rusk Institute of Rehabilitative Medicine. Symptoms of Dysphagia. Accessed November 8, 2010.