Written By: Devin Golden

Pleural Mesothelioma Symptoms

The main symptoms of pleural mesothelioma are usually chest pain, chest fluid buildup, coughing, and trouble breathing. If you have any of the symptoms mentioned on this page, you should contact your doctor for their medical expertise and undergo imaging tests.

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse

Karen Ritter, RN BSN

Medically Reviewed By

Karen Ritter, RN BSN

Registered Nurse


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Important Facts About Pleural Mesothelioma Symptoms

  • The first sign of pleural mesothelioma for most people is experiencing symptoms such as trouble breathing, chest pain, and an ongoing cough. After experiencing symptoms, people should see their doctor to begin tests.
  • Your symptoms can hint at the stage of your pleural mesothelioma. Some symptoms usually occur in later stages, and some of the symptoms from earlier stages worsen as the cancer spreads.
  • Remember that many of the malignant pleural mesothelioma symptoms are also symptoms of noncancerous conditions, such as pneumonia or even COVID-19. You should never assume that you have any condition. We recommend seeing your doctor and getting their expertise before making any other decisions.

What Are the Symptoms of Pleural Mesothelioma?

Many of the pleural mesothelioma symptoms relate to the respiratory system, which involve the lungs.

Most Common Symptoms

Difficulty Breathing Icon

Painful breathing

Coughing Icon

Persistent coughing

Fluid Buildup Icon

Fluid build up in the pleura (mesothelioma pleural effusion)

Chest Pain Icon

Chest pain

Other symptoms include:

  • Difficulty breathing
  • Shortness of breath
  • Chest pains
  • Fatigue
  • Fluid buildup around the lungs
  • Difficulty swallowing
  • Unexplained weight loss
  • Back pain
  • Pleural thickening (development of scar tissue in the pleura, also called pleural plaques)

Not every person with pleural mesothelioma will experience all or even most of these symptoms. The signs of this cancer can occur in different stages, and some don’t occur at all.

Caution From Making Assumptions About Pleural Mesothelioma Symptoms

Experiencing these symptoms does not necessarily mean you have pleural mesothelioma cancer. You could have the common cold, pneumonia, or another noncancerous respiratory condition. Even COVID-19 shares symptoms with pleural mesothelioma.

You should not assume that you have pleural mesothelioma just because you’re experiencing a few symptoms. Additionally, if you have malignant pleural mesothelioma symptoms, you should act quickly by contacting a doctor and going through testing.

The only definitive way to learn if you have pleural mesothelioma is with imaging tests and a tissue biopsy. A tissue biopsy is the only medical way to diagnose pleural mesothelioma.

What to Do if You Have Symptoms of Pleural Mesothelioma

If you notice any of the symptoms of pleural mesothelioma, then you should see your doctor for a full evaluation and testing.

Your doctor will look for evidence of these symptoms and may have you do imaging tests, such as a chest X-ray or CT scan. If there is evidence of tumors, then you may have a biopsy, which involves removing samples of tissue to see if cancer cells are present. This will usually be done by an oncologist, which your primary doctor will refer you to.

After you’re diagnosed with pleural mesothelioma, you should see a mesothelioma specialist. A local oncologist can usually diagnose you with pleural mesothelioma, but they may not have much experience with staging this rare cancer. They also won’t have experience with pleural mesothelioma surgery, so your options for treatment will probably be limited.

Your primary doctor or local oncologist should refer you to a mesothelioma specialist, or you can search through the Mesothelioma Guide doctor database to find one. You can also ask for help by contacting our lead patient advocate and registered nurse, Karen Ritter. Email her at karen@mesotheliomaguide.com.

Importance of Symptoms for Staging Pleural Mesothelioma

Not all of the malignant pleural mesothelioma symptoms happen right when the first tumor forms in your pleura. Usually, there are just a few mild symptoms at first. In fact, the early stages of this cancer have many of the same symptoms as pneumonia, and pleural mesothelioma is often misdiagnosed as pneumonia or other noncancerous respiratory conditions.

As the stages progress, though, more symptoms begin to show and they become more severe. Here are examples of some pleural mesothelioma symptoms in each stage:

Early Pleural Icon

Early stages

(stage 1 and stage 2)

Coughing, fluid buildup in the chest, body aches, lower back pain, loss of appetite, and trouble breathing

Late Pleural Icon

Late stages

(stage 3 and stage 4)

Severe chest pain, lumps in the chest, trouble swallowing, consistent fatigue, night sweats, anemia, face or arm swelling, and fever

The symptoms you’re experiencing can help give you and your doctor a hint of the stage you’re in. However, the only definitive way to learn your stage of pleural mesothelioma is through a biopsy and thorough testing.

Symptoms of Pleural Mesothelioma Metastasis Icon

Symptoms of Pleural Mesothelioma Metastasis

Pleural mesothelioma metastasis is when the cancer has spread well beyond the pleura. Metastasis is a sign of late-stage pleural mesothelioma, usually stage 4.

There are symptoms to consider with pleural mesothelioma metastasis. Some of them occur in the spine or throat:

  • Difficulty swallowing
  • Upper back pain
  • Chest and side pain
  • Worsening Fatigue
  • Weight loss — decreased appetite

Here are other symptoms of pleural mesothelioma metastasis:

  • Hemoptysis — Coughing or spitting up blood
  • Laryngeal nerve palsy — Damage to the throat, which causes paralysis of the voice box
  • Nerve damage — Numbness, tingling or weakness in arms, legs or chest
  • Jaundice — Yellowing of the skin or eyes
  • Headaches
  • Loss of balance

Frequently Asked Questions About Pleural Mesothelioma Symptoms

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What Are Some of the Pleural Mesothelioma Symptoms?

The main tests used for a pleural mesothelioma diagnosis are imaging scans and a tissue biopsy. People who suspect they may have pleural mesothelioma cancer need to see their physician for a detailed evaluation, chest X-ray, followed by a CT scan and an MRI scan, if indicated. If there’s enough evidence of the cancer, then doctors will recommend a tissue biopsy. These are the most likely steps to pleural mesothelioma diagnosis testing

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How Do Malignant Pleural Mesothelioma Symptoms Help With Staging?

The symptoms of pleural mesothelioma don’t all happen at first. Usually, the symptoms start out mild – such as a cough or chest pain – and worsen as the pleural tumors grow in your chest cavity. You’ll also probably experience more symptoms as the tumors grow and begin affecting the lungs or spreading to other organs, like the liver. As the symptoms get worse, it can indicate that the pleural mesothelioma is in stage 3 or stage 4.

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Is Pleural Mesothelioma Often Misdiagnosed?

Yes, pleural mesothelioma can be misdiagnosed as a few other respiratory conditions, such as pneumonia or COPD (chronic obstructive pulmonary disease). Pleural mesothelioma shares many symptoms with these conditions due to their effect on the lungs. They can cause trouble breathing and persistent coughing.

Sources & Author

  1. Signs and Symptoms of Mesothelioma. American Cancer Society. Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/signs-symptoms.html. Accessed: 04/10/19.
  2. Mesothelioma: Symptoms and Signs. American Society of Clinical Oncology. Retrieved from: https://www.cancer.net/cancer-types/mesothelioma/symptoms-and-signs. Accessed: 04/10/19.
  3. Mesothelioma Symptoms, Causes and Risk Factors. American Lung Association. Retrieved from: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/mesothelioma/mesothelioma-symptoms-causes-risks.html. Accessed: 11/21/19.
  4. Malignant Pleural Mesothelioma. Edited by Kenneth O’Byrne and Valerie Rusch. Oxford University Press. 2006.
  5. Mesothelioma. National Organization for Rare Diseases. Retrieved from: https://rarediseases.org/rare-diseases/mesothelioma/. Accessed: 11/22/19.
  6. Mesothelioma. Mayo Clinic. Retrieved from: https://www.mayoclinic.org/diseases-conditions/mesothelioma/symptoms-causes/syc-20375022. Accessed: 11/22/19.
  7. Malignant Pleural Mesothelioma. Pulmonology Advisor. Retrieved from: https://www.pulmonologyadvisor.com/home/decision-support-in-medicine/pulmonary-medicine/malignant-pleural-mesothelioma/. Accessed: 11/22/19.
Devin Golden

About the Writer, Devin Golden

Devin Golden is a content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.