Written By: Devin Golden
Mesothelioma Symptoms
Mesothelioma symptoms usually take decades to develop, and many mirror those of common health issues. Early detection and diagnosis is difficult.
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Important Facts About Mesothelioma Symptoms
- The main symptoms are fluid buildup and pain wherever the original tumor exists. This occurs either in the stomach or chest.
- Other symptoms include trouble breathing and swallowing, fever, persistent coughing, nausea, fatigue and weight loss.
- As mesothelioma advances, new symptoms appear and older ones worsen. Your symptoms may indicate your stage.
What Are the Main Symptoms of Mesothelioma?
Symptoms vary by the type and stage of mesothelioma. Symptoms can also affect a patient’s prognosis. If you are displaying many of the common mesothelioma symptoms, you should see a doctor immediately.
Symptoms by Mesothelioma Type
Pleural Mesothelioma
Common symptoms of pleural mesothelioma are chest pain, pleural effusions (fluid buildup in the pleura), painful breathing and a persistent cough.
Peritoneal Mesothelioma
Symptoms of peritoneal mesothelioma are stomach pains, ascites (fluid buildup in the peritoneum), unexplained weight loss and decreased appetite.
Pericardial Mesothelioma
The frequent symptoms of pericardial mesothelioma are chest pain, pericardial effusion (fluid buildup in the pericardium) and heart murmurs.
Pleural Mesothelioma Symptoms
Pleural mesothelioma makes up 80% of cases and is caused by inhaling asbestos fibers. These sharp fibers lodge into the lining of your lungs (known as the pleura). These microscopic fibers cause irritation and inflammation in your pleura, which is comprised of two walls of mesothelial cells.
Irritation causes cellular mutation and tumors to form. This results in tissue thickening and the buildup of fluid around your lungs (pleural effusion). The thickening of this lining prevents your nearby lung from fully expanding. This causes chest discomfort and painful breathing.
Symptoms of Early-Stage Pleural Mesothelioma
Patients with an early-stage pleural mesothelioma experience symptoms similar to common illnesses. 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 it needs to expand during breathing.
Pleural thickening is caused by tuberculosis, pleurisy and empyema (infection in the lung that causes a buildup of pus in the pleura). However, in 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 include ones from the earlier stages. In stage 3 and stage 4, symptoms still include difficulty breathing, chest pains, pleural effusions and persistent coughing, but they may be more severe.
Many patients are diagnosed with pleural mesothelioma in later stages because they notice more unique 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
Treatment may be used to relieve pain and discomfort. For example, doctors may drain pleural fluid to reduce chest pain and make breathing easier.
What to Expect When You Have Mesothelioma Pleural Effusion
Most pleural mesothelioma patients experience pleural effusion, the buildup of fluid in the pleural space around the lungs. This fluid can cause pain for patients by restricting the lungs from expanding normally. Luckily, doctors have several minimally invasive options for removing this fluid to help mesothelioma patients breathe easier.
In a recent study, 108 of 126 or 85.7% of patients experienced symptomatic benefit from fluid drainage.
Doctors usually use an X-ray to get an image of the effusion, but sometimes they will use a computed tomography (CT) scan. Doctors use imaging to check for pleural effusion if their patient is showing certain 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
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 tumor has 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 short and simple procedure to drain the fluid from the pleural space using a needle. This procedure usually only takes about 15 minutes and is done while the patient is awake.
The steps of thoracentesis are:
The patient is positioned on the edge of a chair or bed with their head and arms resting on a table
Doctors often perform an ultrasound to find the best place to drain from
The area is cleaned and then numbed so the patient isn’t uncomfortable
A needle or tube is inserted into the pleural space
The fluid is drained into a bag or other containere
Some patients experience pleural effusions multiple times. These patients need a more permanent solution than a thoracentesis if their fluid has already been drained once and returned. Preventing the reaccumulation of fluid is an important step to improving long-term quality of life for pleural mesothelioma patients.
Below are two common options:
- Pleurodesis – Pleurodesis is a procedure that seals the pleural space to prevent fluid buildup. Doctors usually do this by injecting talc between the layers of pleural around the lungs. The talc irritates the pleura and causes them 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.
Peritoneal Mesothelioma Symptoms
Peritoneal mesothelioma makes up around 20% of cases and is most often caused by ingesting (swallowing) asbestos dust. The sharp fibers reach the peritoneum and irritate the cells within this lining.
Peritoneal mesothelioma shares some symptoms with pleural mesothelioma, such as fatigue, excessive sweating, blood clots and weight loss. Peritoneal mesothelioma does not have the same staging system as pleural mesothelioma, so symptoms may occur at various times for each patient.
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
- Irritation and thickening of the pericardium
- Irregular heartbeats
- Pericardial bleeding
- Difficulty breathing
- Pericardial effusions (fluid buildup in the pericardium)
- Chest pain
- Irritation and thickening of the pericardium
- Irregular heartbeats
- Pericardial bleeding
- Difficulty breathing
- Pericardial effusions (fluid buildup in the pericardium)
In extremely rare cases, mesothelioma can form in mesothelial cells lining the testicles. These cells make up tissue that is part of the peritoneum extending into the scrotum.
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 dull and insignificant. So they did not associate these warnings to a malignant disease.
Overall, symptoms vary by stage and for each patient. Some patients show few symptoms — and no unique signs — until the late stages, whereas some experience telling symptoms during stage 1.
Peritoneal Mesothelioma Misdiagnosis
Misdiagnosis of peritoneal mesothelioma is also common — and for similar reasons. Many symptoms are not specific to this cancer.
Additionally, the disease 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 or Irritable Bowel Syndrome (IBS).
Pericardial Mesothelioma Misdiagnosis
Misdiagnosis of pericardial mesothelioma occurs because the symptoms associated with the cancer are so general. It’s commonly mistaken for pericarditis (inflammation of the pericardium) and myocarditis (inflammation of the heart).
Early Detection
Talk with your doctor if you experience lasting signs that you may have 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 not linked to mesothelioma, such as the spine or throat. Experiencing any metastatic symptoms is 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 and hoarseness
- Nerve issues – Nerve malfunction in arms or spinal cord
- 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. Get connected with our patient advocates to find a mesothelioma specialist right away.
Common Questions About Mesothelioma Symptoms
How do you know if you have mesothelioma?
Some of the common symptoms can indicate the presence of mesothelioma. For pleural mesothelioma, chest pain, coughing, difficulty breathing and fluid buildup in the chest are all evidence of the cancer. For peritoneal mesothelioma, stomach pain, nausea and indigestion, and fluid buildup in the abdominal region are the main symptoms.
What are the late-stage symptoms of mesothelioma?
Some symptoms occur in the early stages, while more severe ones occur in later stages. These are stage 3 and stage 4, also called the “end stages” of mesothelioma. For pleural mesothelioma, the late-stage symptoms include night sweats, anemia, coughing up blood, difficulty swallowing, hoarseness and swelling of the face or arms.
What are the early-stage symptoms of mesothelioma?
The common symptoms in stage 1 and stage 2 are shortness of breath, fatigue, low-grade fever, weight loss, body aches and fluid buildup in the region of the disease.
What should you do if you experience mesothelioma symptoms?
If you are experiencing any common 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 results, they’ll likely do additional scans and may request a biopsy for definitive proof.
Last Edited: March 15, 2023.
