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Written By: Devin Golden

Mesothelioma Symptoms

Mesothelioma symptoms usually take decades to develop after asbestos exposure. Many of the symptoms can mirror those of common health issues. Early detection and diagnosis is difficult.

Dr. Hassan Khalil

Medically Reviewed By

Dr. Hassan Khalil

Mesothelioma Thoracic Surgeon

Dr. Hassan Khalil

Medically Reviewed By

Dr. Hassan Khalil

Mesothelioma Thoracic Surgeon

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Important Facts About Malignant Mesothelioma Symptoms

  • The main symptoms are fluid buildup and pain wherever the original tumor exists. This occurs either in the stomach or chest.
  • Other mesothelioma symptoms include trouble breathing and swallowing, fever, persistent coughing, nausea, fatigue and weight loss.
  • As mesothelioma advances, new symptoms develop and early signs worsen. Your signs and symptoms of mesothelioma may indicate your stage.

What Are the Main Symptoms of Mesothelioma?

Symptoms can vary based on the type and stage of mesothelioma. Symptoms can also affect a patient’s prognosis. If you are experiencing new or worsening symptoms and signs of mesothelioma, you should see a doctor immediately.

Symptoms by Mesothelioma Type

Pleural Mesothelioma Icon

Pleural Mesothelioma

Common symptoms of malignant pleural mesothelioma may include chest pain, pleural effusions (fluid buildup in the pleura), painful breathing and a persistent cough.

Peritoneal Mesothelioma Icon

Peritoneal Mesothelioma

Malignant peritoneal mesothelioma patients may experience abdominal pain, ascites (fluid buildup in the peritoneum), unexplained weight loss and decreased appetite.

Pericardial Mesothelioma Icon

Pericardial Mesothelioma

Pericardial mesothelioma is a rare type of cancer of the lining around the heart. Patients with pericardial mesothelioma may experience chest pain, pericardial effusion (fluid buildup in the pericardium) and heart murmurs.

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Symptoms of Pleural Mesothelioma

Pleural mesothelioma makes up 80% of cases and is caused by inhaling asbestos fibers. These sharp fibers can become lodged in the lining of the lungs (known as the pleura). These microscopic fibers cause irritation and inflammation in your pleura, which is made up of mesothelial cells.

Irritation and chronic inflammation cause cellular mutation and tumors to form. This results in tissue thickening and the buildup of fluid around the lungs (pleural effusion). The thickening of this lining prevents the lungs to fully expanding. This causes chest discomfort and painful breathing.

Symptoms of Early-Stage Pleural Mesothelioma

Patients with early-stage pleural mesothelioma experience symptoms similar to common illnesses. The early stages are known as stage 1 and stage 2.

If you have an early stage of pleural mesothelioma, you’ll likely experience:

  • Shortness of breath
  • Chest pain
  • Blood clots
  • Persistent coughing
  • Pleural effusions (fluid buildup)
  • Low-grade fever
  • Lower back pain
  • Fatigue
  • Weight loss
  • Body aches
  • Shortness of breath
  • Chest pain
  • Blood clots
  • Persistent coughing
  • Pleural effusions (fluid buildup)
  • Low-grade fever
  • Lower back pain
  • Fatigue
  • Weight loss
  • Body aches

These symptoms are similar to those of other disorders, such as pneumonia, asthma, influenza and Chronic Obstructive Pulmonary Disease (COPD). Pleural effusions and inflammation of the pleura are main symptoms of pleural mesothelioma, but they are also linked to pneumonia and COPD.

According to a published book on malignant pleural mesothelioma, around 46% of patients experience shortness of breath. Around 10% have a dry cough.

Pleural thickening is also common in other diseases. This effect is caused by scarring of the pleura tissue. It causes a loss of elasticity in your lungs, which they need to expand during breathing.

Pleural thickening is caused by tuberculosis, pleurisy and empyema (an infection in the lung that causes a buildup of pus in the pleura). However, in cases of mesothelioma, this is specifically caused by scarring of your pleura due to asbestos fibers.

Symptoms of Late-Stage Pleural Mesothelioma

The late stages of pleural mesothelioma have more specific symptoms but also may include early warning signs. In stage 3 and stage 4, symptoms still include difficulty breathing, chest pains, pleural effusions and persistent coughing, but these symptoms may be more severe.

Many patients are diagnosed with pleural mesothelioma in later stages because they begin to experience more severe symptoms:

Symptoms include:

  • Fever
  • Night sweats
  • Anemia
  • Coughing up blood (hemoptysis)
  • Difficulty swallowing (dysphagia)
  • Face or arm swelling
  • Hoarseness
  • Fever
  • Night sweats
  • Anemia
  • Coughing up blood (hemoptysis)
  • Difficulty swallowing (dysphagia)
  • Face or arm swelling
  • Hoarseness

Treatments for mesothelioma may be used to relieve pain and other symptoms. For example, doctors may drain pleural fluid to reduce chest pain and make breathing easier.

What to Expect From a Mesothelioma Pleural Effusion

Patients with pleural mesothelioma often experience pleural effusion, the buildup of fluid in the pleural space around the lungs. This fluid can cause pain from pressure in the thoracic cavity and restrict the lungs from expanding normally. Doctors have minimally invasive treatment options to remove this fluid and help mesothelioma patients breathe easier.

In a recent study, 108 of 126 or 85.7% of patients experienced symptomatic benefit from fluid drainage.

Doctors often use an X-ray, computed tomography (CT) scan or ultrasound to diagnose pleural effusions and during procedures to remove the fluid. Doctors will also use these imaging techniques to re-evaluate for recurrent pleural effusions as they continue to evaluate for symptoms.

The symptoms of pleural effusion include:

  • Chest pain
  • Pleurisy (inflammation of the pleura)
  • Dyspnea (shortness of breath)
  • Dry cough
  • Chest pain
  • Pleurisy (inflammation of the pleura)
  • Dyspnea (shortness of breath)
  • Dry cough

A pleural effusion is one of the early signs of pleural mesothelioma. As the disease progresses, pleural effusions are less common in patients. This can be because doctors have treated the effusion effectively or because the tumors have grown and taken over the pleural space.

How to Treat Mesothelioma Pleural Effusion

Controlling pleural effusion is an important part of palliative care and symptom management for mesothelioma. Draining the fluid around the lungs can help patients breathe easier and reduce pain. Doctors usually drain the fluid in the pleural space through a process called thoracentesis.

Thoracentesis is a procedure to drain the fluid from the pleural space using a needle or thin catheter. This procedure usually only takes about 15 minutes and is done while the patient is awake.

The steps of a thoracentesis include:

  1. The patient is positioned on the edge of a chair or bed with their head and arms resting on a table.
  2. Doctors often perform an ultrasound to find the best place to drain from.
  3. The area is cleaned and then numbed, so the patient isn’t uncomfortable.
  4. A needle or tube is inserted into the pleural space
  5. The fluid is drained into a bag or other container

Many pleural mesothelioma patients experience multiple pleural effusions. These patients need a more permanent solution to their fluid accumulation. Preventing recurrent fluid buildup is an important step in improving long-term quality of life.

Below are two common options:

  • Pleurodesis – Pleurodesis is a procedure that seals the pleural space to prevent future fluid buildup. Doctors typically inject a talc solution between the layers of the pleural around the lungs. The talc irritates the pleura and causes the layers to fuse together.
  • Indwelling catheter – An alternative to pleurodesis is inserting an indwelling pleural catheter. The catheter is a small tube that can drain fluid from the lungs. Once the catheter is in place, the fluid can be drained regularly at home with instructions from the doctor.

Symptoms of Peritoneal Mesothelioma

Peritoneal mesothelioma makes up nearly 20% of cases and is most often caused when people are exposed to asbestos and then ingesting (swallowing) asbestos particles. The sharp asbestos fibers reach the peritoneum and start to irritate the tissue in the abdomen.

Peritoneal mesothelioma shares some common symptoms with pleural mesothelioma, such as fatigue, unexplained weight loss, and development of blood clots. Peritoneal mesothelioma does not have the same staging system as pleural mesothelioma and is has many other symptoms that are contained to the abdominal region and the abdominal organs.

Additional peritoneal mesothelioma symptoms include:

  • Fluid buildup in the peritoneum
  • Abdominal swelling
  • Stomach pain
  • Loss of appetite
  • Constipation or other bowel issues
  • Intestinal obstruction
  • Fluid buildup in the peritoneum
  • Abdominal swelling
  • Stomach pain
  • Loss of appetite
  • Constipation or other bowel issues
  • Intestinal obstruction

Symptoms for Other Types of Mesothelioma

Pericardial mesothelioma makes up less than 1% of mesothelioma cases, and the way asbestos fibers reach the pericardium (lining of the heart) is unknown.

People with pericardial mesothelioma often experience:

  • Chest pain
  • Difficulty breathing
  • Irregular heartbeats
  • Pericardial bleeding
  • Irritation and thickening of the pericardium
  • Pericardial effusions (fluid buildup in the pericardium)
  • Chest pain
  • Difficulty breathing
  • Irregular heartbeats
  • Pericardial bleeding
  • Irritation and thickening of the pericardium
  • Pericardial effusions (fluid buildup in the pericardium)

Testicular mesothelioma is the rarest form of cancer that develops from mesothelial cells. This type of mesothelioma develops in the mesothelial lining of the testicles. Mesothelial cells make up the tissue lining that lines the peritoneum and extends down into the scrotum.

Risks of Mesothelioma Misdiagnosis

Pleural Mesothelioma Misdiagnosis

Misdiagnosis is common for pleural mesothelioma because many symptoms are not unique to this cancer. Cases are often misdiagnosed as influenza or pneumonia in the early stages.

For instance, chest pain and shortness of breath are very common in early stages. However, some patients reported that the chest pain they experienced was mild, dull and nonspecific. So they did not associate these warnings as early stages of mesothelioma. 

Overall, symptoms vary based on mesothelioma type and stage and for each patient. Some patients show very few symptoms — and no unique signs — until the later stages, whereas some experience telling symptoms during stage 1 or stage 2 mesothelioma.

Peritoneal Mesothelioma Misdiagnosis

Misdiagnosis of peritoneal mesothelioma is also common — and for similar reasons. Many symptoms are not specific to this cancer. 

Additionally, this type of mesothelioma is rare, accounting for just 10% to 15% of all mesothelioma cases. Therefore, only a few hundred Americans each year develop peritoneal mesothelioma. It is often misdiagnosed as a hernia, irritable bowel syndrome (IBS) or other digestive condition.

Pericardial Mesothelioma Misdiagnosis

Misdiagnosis of pericardial mesothelioma occurs because the symptoms are often not specific to this cancer. It’s commonly mistaken for pericarditis (inflammation of the pericardium) and myocarditis (inflammation of the heart).

Early Detection

Talk with your doctor as soon as symptoms start or if you experience lasting signs that you may be associated with mesothelioma. Fortunately, the diagnostic process is improving. Learn more about what methods are used for detecting and diagnosing mesothelioma.

Metastatic Mesothelioma Symptoms

Metastatic mesothelioma describes a cancer actively spreading in your body. Symptoms occur in areas outside the are where mesothelioma develops, cancer cells may spread to the liver, spleen or spine. Experiencing any metastatic symptoms may be a sign of mesothelioma metastasis.

Some symptoms of metastatic mesothelioma to remember are:

  • Hemoptysis – Coughing or spitting up blood
  • Laryngeal Nerve Palsy – Damage to the throat, resulting in paralysis of the voice box
  • Nerve issues – Nerve malfunction in the spinal cord, arms or legs
  • Horner’s Syndrome – A conjunction of eye-related issues such as a drooping eyelid, constriction of pupils, decreased tear production and conjunctival redness

These symptoms can be present with other common illnesses or conditions but can also be signs of advanced mesothelioma. You should immediately find a doctor if you experience any of these symptoms. Get connected with our patient advocates to find a mesothelioma specialist right away.

Frequently Asked Questions About Mesothelioma Symptoms

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How do you know if you have mesothelioma?

Mesothelioma cancer symptoms can vary depending on the type and stage of the cancer. For pleural mesothelioma - chest pain, coughing, difficulty breathing and fluid buildup in the chest are all evidence of the cancer. For peritoneal mesothelioma - abdominal pain, nausea, indigestion, and fluid buildup in the abdomen are the main symptoms of this type of cancer.

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What are the late-stage symptoms of mesothelioma?

Some symptoms occur in the early stages, while more severe ones can be found in later stages. Stage 3 and stage 4 mesothelioma are considered the “end stages”. For pleural mesothelioma, late-stage symptoms can include night sweats, anemia, coughing up blood, difficulty breathing, difficulty swallowing, hoarseness and swelling of the face or arms.

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What are the early-stage symptoms of mesothelioma?

Stage 1 and Stage 2 common mesothelioma symptoms include shortness of breath, fatigue, low-grade fever, weight loss, body aches and fluid buildup in the region of the disease.

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What should you do if you experience mesothelioma symptoms?

If you are experiencing any new or worsening general mesothelioma symptoms, talk to your primary physician immediately. They’ll use scans to detect any abnormalities in your body. If they see any unusual masses on the scans, they will likely do additional testing and request a biopsy. The only definitive way to be diagnosed with mesothelioma is with a tissue biopsy.

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 the senior 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.