Common Early Mesothelioma Symptoms

Malignant mesothelioma (me-zoe-thee-lee-O-muh) is a type of cancer that occurs in the thin layer of tissue that covers the majority of your internal organs (mesothelium).

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Mesothelioma is an aggressive and deadly form of cancer. Mesothelioma treatments are available, but for many people with mesothelioma, a cure isn’t possible.

Doctors divide mesothelioma into different types based on what part of the mesothelium is affected. Mesothelioma most often affects the tissue that surrounds the lungs (pleura). This type is called pleural mesothelioma. Other, rarer types of mesothelioma affect tissue in the abdomen (peritoneal mesothelioma), around the heart and around the testicles.

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Symptoms

Signs and symptoms of mesothelioma vary depending on where the cancer occurs.

Pleural mesothelioma, which affects the tissue that surrounds the lungs, causes signs and symptoms that may include:

  • Chest pain
  • Painful coughing
  • Shortness of breath
  • Unusual lumps of tissue under the skin on your chest
  • Unexplained weight loss

Peritoneal mesothelioma, which occurs in tissue in the abdomen, causes signs and symptoms that may include:

  • Abdominal pain
  • Abdominal swelling
  • Nausea
  • Unexplained weight loss

Other forms of mesothelioma

Signs and symptoms of other types of mesothelioma are unclear, since these forms of the disease are very rare.

Pericardial mesothelioma, which affects tissue that surrounds the heart, can cause signs and symptoms such as breathing difficulty and chest pains.

Mesothelioma of tunica vaginalis, which affects tissue surrounding the testicles, may be first detected as swelling or a mass on a testicle.

When to see a doctor

See your doctor if you have signs and symptoms that worry you. Signs and symptoms of mesothelioma aren’t specific to this disease and, due to the rarity of mesothelioma, are more likely to be related to other conditions. If any persistent signs and symptoms seem unusual or bothersome, ask your doctor to evaluate them. Tell your doctor if you’ve been exposed to asbestos.

Causes

In general, cancer begins when a series of changes (mutations) happens in a cell’s DNA. The DNA contains the instructions that tell a cell what to do. The mutations tell the cell to grow and multiply out of control. The abnormal cells accumulate and form a tumor.

It isn’t clear what causes the initial genetic mutations that lead to mesothelioma, though researchers have identified factors that may increase the risk. It’s likely that cancers form because of an interaction between many factors, such as inherited conditions, your environment, your health conditions and your lifestyle choices.

Risk factors

Asbestos exposure: The primary risk factor for mesothelioma

Most mesotheliomas are thought to be related to asbestos exposure. Asbestos is a mineral that’s found naturally in the environment. Asbestos fibers are strong and resistant to heat, making them useful in a wide variety of applications, such as in insulation, brakes, shingles, flooring and many other products.

When asbestos is broken up, such as during the mining process or when removing asbestos insulation, dust may be created. If the dust is inhaled or swallowed, the asbestos fibers will settle in the lungs or in the stomach, where they can cause irritation that may lead to mesothelioma. Exactly how this happens isn’t understood. It can take 20 to 60 years or more for mesothelioma to develop after asbestos exposure.

Most people with asbestos exposure never develop mesothelioma. This indicates that other factors may be involved in determining whether someone gets mesothelioma. For instance, you could inherit a predisposition to cancer or some other condition could increase your risk.

Factors that may increase the risk of mesothelioma include:

  • Personal history of asbestos exposure. If you’ve been directly exposed to asbestos fibers at work or at home, your risk of mesothelioma is greatly increased.
  • Living with someone who works with asbestos. People who are exposed to asbestos may carry the fibers home on their skin and clothing. Exposure to these stray fibers over many years can put others in the home at risk of mesothelioma. People who work with high levels of asbestos can reduce the risk of bringing home asbestos fibers by showering and changing clothes before leaving work.
  • A family history of mesothelioma. If your parent, sibling or child has mesothelioma, you may have an increased risk of this disease.
  • Radiation therapy to the chest. If you had radiation therapy for cancer in your chest, you might have an increased risk of mesothelioma.

Complications

As pleural mesothelioma spreads in the chest, it puts pressure on the structures in that area. This can cause complications, such as:

  • Difficulty breathing
  • Chest pain
  • Difficulty swallowing
  • Pain caused by pressure on the nerves and spinal cord
  • Accumulation of fluid in the chest (pleural effusion), which can compress the lung nearby and make breathing difficult

Prevention

Reducing your exposure to asbestos may lower your risk of mesothelioma.

Find out whether you work with asbestos

Most people with mesothelioma were exposed to the asbestos fibers at work. Workers who may encounter asbestos fibers include:

  • Asbestos miners
  • Electricians
  • Plumbers
  • Pipefitters
  • Insulators
  • Shipyard workers
  • Demolition workers
  • Brake mechanics
  • Selected military personnel
  • Home remodelers

Ask your employer whether you have a risk of asbestos exposure on the job.

Follow your employer’s safety regulations

Follow all safety precautions in your workplace, such as wearing protective equipment. You may also be required to shower and change out of your work clothes before taking a lunch break or going home. Talk to your doctor about other precautions you can take to protect yourself from asbestos exposure.

Be safe around asbestos in your home

Older homes and buildings may contain asbestos. In many cases, it’s more dangerous to remove the asbestos than it is to leave it intact. Breaking up asbestos may cause fibers to become airborne, where they can be inhaled. Consult experts trained to detect asbestos in your home. These experts may test the air in your home to determine whether the asbestos is a risk to your health. Don’t attempt to remove asbestos from your home — hire a qualified expert.

How Do Mesothelioma Symptoms Contribute to Diagnosis?

Mesothelioma symptoms are the driving force that brings patients to the doctor to begin the diagnostic process. Because mesothelioma symptoms most commonly develop in stage 3 or stage 4, most patients don’t go to the doctor until the cancer has progressed to a late stage.

Inform your primary care doctor about any history of asbestos exposure. Ask if they recommend any cancer screenings based upon your exposure history and personal health history. Catching cancer early provides a better chance of qualifying for aggressive cancer treatments that may improve survival.

Because it does not usually produce such signs until much later in the disease process, it is difficult to diagnose mesothelioma in stage 1 or 2 based on symptoms alone. However, in some instances, early-stage mesothelioma can produce enough pleural fluid around the lung to cause shortness of breath or cough without having spread.

A 2019 study found that stage 1 and stage 2 pleural mesothelioma patients who received less aggressive surgery combined with chemotherapy, radiation therapy or both lived the longest after diagnosis. The median survival of this group was 35 months, or nearly three years.

Mesothelioma cell type, epithelial versus sarcomatoid, does not alter the typical symptoms experienced by most patients with this cancer.

Common Symptoms by Type of Mesothelioma

Some types of mesothelioma share similar symptoms, while other signs of the cancer are unique to the tumor location.

For example, fatigue can be common to pleural, peritoneal and pericardial mesothelioma cancers. However, pericardial mesothelioma is the only type that routinely leads to heart palpitations and arrhythmias.

Pleural Mesothelioma Symptoms

Early signs of mesothelioma can resemble other respiratory diseases such as pneumonia or the flu. Common symptoms of pleural mesothelioma, which forms on the soft tissue lining the lungs, include:

  • Shortness of breath (dyspnea)
  • Chest pain
  • Dry cough or wheezing
  • Hoarseness
  • Reduced chest expansion (difficulty breathing)
  • Unexplained weight loss
  • Fatigue
  • Fever
  • Muscle weakness

Addressing symptoms as soon as they develop may improve medical outcomes and life expectancy.

When symptoms are identified and treated quickly, patients may benefit from higher quality of life and longer life. Symptom control is a vital component of comprehensive treatment for pleural mesothelioma.

The most frequently reported pleural mesothelioma symptoms
Pleural effusions, chest pain and shortness of breath are the most reported symptoms of pleural mesothelioma. Source: A 2011 study of 221 pleural patients.

Peritoneal Mesothelioma Symptoms

Early signs of peritoneal mesothelioma can be mistaken for digestive conditions like irritable bowel syndrome or menstrual disorders like fibroids. Common symptoms of peritoneal mesothelioma, which forms on the soft tissue lining the abdomen, include:

  • Abdominal pain
  • Abdominal swelling
  • Abdominal fluid buildup (ascites)
  • Unexplained weight loss
  • Nausea and vomiting
  • Constipation
  • Loss of appetite

Doctors can prescribe chemotherapy drugs, such as pemetrexed, cisplatin, carboplatin and gemcitabine, to shrink peritoneal mesothelioma tumors and slow cancer growth.

Specialists are now seeing extraordinary results with hyperthermic intraperitoneal chemotherapy (HIPEC). With excellent symptom control and the best treatments, many people live longer than mesothelioma statistics predict.

Pericardial Mesothelioma Symptoms

Early signs of pericardial mesothelioma can be mistaken for heart disease. Common symptoms of pericardial mesothelioma include:

  • Difficulty breathing (dyspnea)
  • Chest pain
  • Shortness of breath
  • Heart palpitations or irregular heartbeat (arrhythmia)
  • Heart murmurs

Pericardial mesothelioma develops in the lining around the heart called the pericardium. It is one of the rarest forms of the disease. Symptoms stem from thickening of the pericardium, which can make it harder for the heart to pump efficiently.

Testicular Mesothelioma Symptoms

Early signs of testicular mesothelioma can be mistaken for injury or illnesses such as epididymitis, which involves inflammation of the testicles. Common symptoms of testicular mesothelioma include:

  • Hydrocele (fluid in the scrotum)
  • Testicular pain
  • Swollen testes
  • Lump in scrotum

A lump in the testes is the most common sign of testicular mesothelioma — the rarest of all types of mesothelioma. It accounts for less than 1% of all mesothelioma cases.

Symptoms of Mesothelioma by Stage

A mesothelioma patient will experience symptoms that differ from stage 1 to stage 4 mesothelioma. The size of tumors and how far they have spread determines the stage classification and the location and size of tumors directly impacts the patient’s symptoms.EARLY-STAGE MESOTHELIOMA SYMPTOMS: STAGE 1 AND STAGE 2

  • Dry cough or wheezing
  • Shortness of breath
  • Difficulty breathing
  • Pain in chest or abdomen
  • Pleural effusion (fluid buildup), leading to worsening pain and breathing difficulties

LATE-STAGE MESOTHELIOMA SYMPTOMS: STAGE 3 AND STAGE 4

  • Increased and more persistent pain
  • Anemia and associated fatigue
  • Weight loss
  • Loss of appetite
  • Respiratory complications
  • Difficulty swallowing
  • Bowel Obstruction

Factors That Impact Mesothelioma Symptoms

Small tumor size is the main reason mesothelioma patients don’t experience symptoms in the early stages of the cancer’s growth. 

Mesothelioma tumors typically don’t become big enough to impact the body until late stages of cancer development including stage 3 and stage 4.

  • Chest Pain: Primarily due to tumors spreading into the chest wall and its nerves.
  • Difficulty Breathing: Caused by tumors restricting full expansion of the lungs.
  • Pleural Effusion: Results from tumors spreading extensively into the pleural lining or lymph nodes in the chest. This prevents fluid from properly draining out of the pleural cavity, which restricts the lung from expanding.

As tumors grow, they begin to place pressure against and grow into nearby organs and tissues. As infiltrating cancer tissue compress and compromise tissues and organs, they begin to malfunction, and, eventually, this leads to organ failure.

How Can I Cope with Mesothelioma Symptoms?

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Mesothelioma symptoms result from the cancer itself and may be similar to some of the side effects of cancer treatment.

Side effects of cancer treatment usually diminish days to weeks after treatment ends. Mesothelioma symptoms tend to progress as the cancer advances. Symptom management is critical to quality of life.When you learn about how integrative medicine works, it will blow you away.Beth MixonPeritoneal Mesothelioma Survivor

Talk to your oncologist about a referral to a palliative care specialist. These doctors specialize in symptom management and maintaining or improving quality of life. Many cancer centers now offer palliative cancer care that may include prescription medication, physical therapy, occupational therapy and other approaches that improve your daily life and keep your symptoms in control.

Managing Mesothelioma Symptoms

  • Alternative Therapies: Supportive complementary and alternative treatments, such as acupuncture and mind-body therapies, are shown to help patients manage pain, anxiety and nausea.
  • PleurX Catheter: This allows the patient to drain the fluid at home every 2-3 days with the help of a small silicone catheter.
  • Radiation Therapy: Radiation therapy alone will not cure mesothelioma, but it can shrink tumors and relieve pain and pressure.
  • Communication: Let your doctor know about changes in type or intensity of your symptoms. This will allow your doctor to recommend other procedures or therapies that will significantly lessen discomfort and pain.
  • Mesothelioma Specialists: Mesothelioma is a rare disease and seeking care from a mesothelioma specialty doctor can improve your access to cutting-edge therapies proven to improve symptoms and prolong survival after diagnosis. Treatment plans may include participation in clinical trials or prescriptions for immunotherapy medications. While success rates for immunotherapy treatment vary for each patient, these medications have shown promise and the U.S. Food and Drug Administration has approved Keytruda, Opdivo and Yervoy for malignant mesothelioma treatment.

Finding a Specialist

If you have a history of exposure to asbestos and believe your symptoms indicate mesothelioma, seek immediate medical attention. Tell your doctor about past work around asbestos and alert them to the possibility of an asbestos-related disease. Ask for a second opinion from a mesothelioma specialist if needed.Mesothelioma specialist speaking with a patient and his wife

Connect with a Top Mesothelioma SpecialistGet specialized treatment from experienced mesothelioma doctors.Find a Doctor Now

Common Questions About Mesothelioma Symptoms

What are the signs that you have mesothelioma?

The best mesothelioma doctors report that the most common pleural mesothelioma symptoms are shortness of breath, cough and chest pain. Common peritoneal mesothelioma symptoms include abdominal pain and swelling, bowel changes and lack of appetite.How do you test for mesothelioma if you have symptoms?

Mesothelioma testing includes radiological imaging and confirmation through a biopsy. After a patient displays symptoms of mesothelioma, a doctor will order radiology exams such as chest X-rays and CT scans of the chest or abdomen. The surgeon or oncologist will then perform a thoracoscopy or other type of biopsy to confirm the mesothelioma diagnosis. Mesothelioma blood tests are still mostly experimental but can help narrow the diagnosis.Can mesothelioma be misdiagnosed?

Mesothelioma misdiagnosis is unfortunately common because of the rarity and complexity of the illness. It takes specialists with years of experience to accurately diagnose the disease, driving many patients to seek a mesothelioma second opinion. Many physicians and oncologists often misdiagnose the disease as other cancers or less severe conditions due to the similarity of symptoms.What should you do if you think you have mesothelioma?

If you suspect you may have mesothelioma, the best course of action is to seek qualified mesothelioma experts. These specialists have years of experience diagnosing, treating and managing this disease. There are experts in the fields of surgery, radiation oncology and pathology, all with specialized training and years of experience handling mesothelioma.

Mesothelioma is cancer of the mesothelium, a membrane that lines the inside of the body’s cavities, such as the abdomen or chest. Three out of every four cases of mesothelioma disease begin in the chest cavity. Mesothelioma can also begin in the abdominal cavity and around the heart.

Regardless of where they originate, malignant cells from the mesothelium can invade and damage nearby tissues. Cancer cells can also metastasize, or spread, to other parts of the body.

Often by the time mesothelioma is diagnosed, the disease is advanced. The 5-year survival rate is around 5% to 10%. Most patients with mesothelioma of the lung die as a result of respiratory failure or pneumonia. Some patients get a small-bowel obstruction when the tumor extends through the diaphragm, a muscle that separates the chest and abdominal cavity. A smaller number people die of complications of the heart when the tumor invades the pericardium — a thin sac that surrounds the heart — and the heart itself.

Causes of Mesothelioma

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The main risk factor for mesothelioma is working with asbestos. Asbestos is a group of minerals with thin microscopic fibers. Because these fibers are resistant to heat, fire, and chemicals and do not conduct electricity, asbestos has been mined and used widely in the construction, automotive, and other industries.

If tiny asbestos fibers are released into the air, as they are in the manufacturing process, they can be inhaled or swallowed, leading to serious health problems. As many as 75% of mesothelioma cases can be linked to exposure to asbestos at work. There is also some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. Cases of mesothelioma have also been seen in people living close to asbestos mines.

However, mesothelioma has been reported in some individuals without any known exposure to asbestos. Other, uncommon, but possible causes include:

Zeolites. These minerals are chemically related to asbestos. One of these related minerals, erionite, is common in the soil in some areas of Turkey, according to the American Cancer Society. Exposure to erionite is believed to be responsible for high rates of mesothelioma rates in those areas.

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