What Are the Most Common Mesothelioma Symptoms?

The first symptoms of mesothelioma include chest or abdominal pain, bloating and shortness of breath, depending on the location of the cancer. Because early-stage signs can be slight, doctors often mistake them as normal aches and pains or symptoms of less serious illnesses.

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Thoracic surgeon Dr. Jacques Fontaine talks about the most common mesothelioma symptoms.

Mesothelioma tumors begin as tiny nodules on the lining of the lungs or abdomen. The cancer doesn’t cause symptoms until the tumors have grown and spread, usually around cancer stage III and IV, and they begin to press against the chest wall or abdominal cavity.

Recognizing mesothelioma symptoms early in the cancer’s development is nearly impossible because the disease doesn’t produce early symptoms to identify.

But when signs of the cancer start to arise, the most common mesothelioma symptoms include:

  • Dry cough or wheezing
  • Shortness of breath (dyspnea)
  • Respiratory complications
  • Pain in the chest or abdomen
  • Fever or night sweats
  • Pleural effusion (fluid around the lungs)
  • Fatigue
  • Muscle weakness

Most early mesothelioma diagnoses happen by accident through routine X-rays or blood tests. By the time someone identifies warning signs, the cancer often has spread, making it difficult for doctors to treat.

Informing your primary care doctor about any history of asbestos exposure and seeking cancer screenings can help lead to an earlier-than-normal mesothelioma diagnosis and a much better chance of a potentially curative therapy.

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Symptoms of Mesothelioma by Stage

  • Early-Stage Symptoms

    In the early stages of mesothelioma, you may notice:

    • 1
      Dry cough or wheezing
    • 2
      Shortness of breath (dyspnea)
    • 3
      Difficulty breathing
    • 4
      Pain in chest or abdomen
    • 5
      Pleural effusion (fluid)
    Early-Stage Mesothelioma Symptoms Diagram
  • Late-Stage Symptoms

    Late-Stage Mesothelioma Symptoms Diagram

    In the late stages of mesothelioma, you may notice:

    • 1
      Increased pain
    • 2
      Anemia
    • 3
      Weight loss
    • 4
      Loss of appetite
    • 5
      Respiratory complications
    • 6
      Difficulty swallowing
    • 7
      Bowel obstruction

Early-Stage Symptoms:

  • 1
    Dry cough or wheezing
  • 2
    Shortness or breath (dyspnea)
  • 3
    Difficulty breathing
  • 4
    Pain in chest or abdomen
  • 5
    Fever or night sweats
  • 6
    Pleural effusion (fluid)
  • 7
    Fatigue
  • 8
    Muscle weakness

Late-Stage Symptoms:

  • 1
    Increased pain
  • 2
    Anemia
  • 3
    Weight loss
  • 4
    Loss of appetite
  • 5
    Respiratory complications
  • 6
    Difficulty swallowing
  • 7
    Bowel obstruction

Use our guide to learn more about your mesothelioma symptoms.

Chest Pain

Chest pain is most often caused by tumors pressing against the chest wall. Pain medication is the most effective and least invasive option to control chest pain. In addition to improving mesothelioma prognosis, chemotherapy and radiation therapy can reduce chest pain by shrinking tumors. Certain herbs may help control pain including turmeric, boswellia and medical marijuana. Complementary therapies, such as relaxation techniques, mind-body exercise and dietary changes, also help people cope with pain.

Nerve Pain

Nerve pain may develop as a result of tumors pressing against nerves or as a result of chemotherapy. Medicines used to control nerve pain include anticonvulsants, antidepressants and opioid painkillers. NSAIDs, such as ibuprofen, might help some people with nerve pain. Lidocaine – in ointment, gel or patches – helps localized areas of pain. Lidocaine is available over the counter and by prescription. Certain compound pharmacies throughout the U.S. make topical creams for nerve pain. People often turn to complementary therapies to help control nerve pain. Relaxation techniques, meditation, guided imagery, acupressure, warm baths and avoiding alcohol may reduce nerve pain. Cancer patients living in states where medical marijuana is available claim the herb is effective at reducing nerve pain.

Shortness of Breath

Shortness of breath may develop when the lung lining fills with fluid or becomes inflexible as a result of growing tumors. Respiratory therapists can help patients learn how to breathe easier using simple breathing techniques. Medicines, such as bronchodilators and corticosteroids, can open lung airways and reduce inflammation. Some patients benefit from supplemental oxygen to improve oxygen intake. Changing position, sitting down and pacing yourself may help. Reducing stress and practicing relaxation techniques improves anxiety-related breathlessness.

Wheezing

Wheezing can develop when the lung’s airways narrow or become obstructed. Treatment options may involve bronchodilators, corticosteroids, nebulizer breathing treatments and supplemental oxygen. Relaxation therapies often help with anxiety related to wheezing and breathlessness.

Dry Cough

Dry cough is usually caused by tumors that irritate lung tissue and airways. Cough suppressants are commonly prescribed to control coughing, especially if a patient is losing sleep. Dry cough may be soothed by honey in hot water or tea, but not all patients can easily swallow liquids to use this natural remedy. Lying down may increase cough. Prop yourself on pillows at night to sleep.

Pleural Effusion

Pleural effusion is a buildup of fluid inside the lung lining that develops when tumors block the normal lymphatic flow of fluid throughout the chest. Treatment involves draining fluid from the lungs using a procedure known as thoracentesis. When the fluid quickly returns, a surgical procedure called talc pleurodesis is performed to close the lining of the lungs to prevent future fluid buildup.

Fever

Fever may be caused directly by the cancer or from a related infection. Anti-inflammatory drugs, such as ibuprofen or acetaminophen, are the first line of treatment for reducing fever. Resting, taking a tepid bath and placing a cool cloth on your forehead may offer a sense of relief.

Night Sweats

Night sweats may be caused directly by cancer or as a side effect of treatment. Night sweats may occur in tandem with fever or hot flashes. Anti-inflammatory drugs relieve fever-related night sweats. Chemotherapy reduces night sweats for mesothelioma patients by shrinking tumors or controlling their growth. Sleeping under or near a fan will help you keep cool at night. Wear loose-fitting clothing to bed and keep a set of clean sheets handy in case you need to change wet sheets in the night. Relaxation techniques can help you get back to sleep.

Fatigue

Fatigue sets in as the cancer progresses and may increase with cancer treatments such as chemotherapy. If fatigue is caused by anemia a blood transfusion can increase red blood cell counts to improve fatigue. You can manage fatigue by conserving energy, resting regularly, maintaining good sleep habits, exercising gently and eating well.

Muscle Weakness

Muscle weakness can develop as tumors grow and increasingly press against bones, muscles and soft tissues. Working with a physical therapist can help cancer patients maintain muscle mass, strength and mobility. Physical therapy exercises are gentle and keep mesothelioma patients active in ways that won’t cause any undue stress to the body.

Common Symptoms by Type of Mesothelioma

Pleural Mesothelioma Symptoms

  • Faint or harsh breathing
  • Dry cough or wheezing
  • Pleural effusions
  • Coughing up blood
  • Body aches
  • Blood clotting disorders
  • Chest pains
  • Shortness of breath
  • Reduced chest expansion

In a 2011 study of 221 pleural patients, symptoms were reported with the following frequency:

The exact stage of the cancer at the time of diagnosis — how far it has progressed — is impossible to predict through symptoms alone. Most patients are not diagnosed until stage III or IV because symptoms don’t develop until later stages. The earlier the cancer is caught, the better the prognosis.

Addressing symptoms as soon as they develop is can improve medical outcomes. When symptoms are identified and treated quickly, patients often benefit from higher quality of life and may live longer if the symptoms and cancer are controlled sooner.

Learn more about pleural mesothelioma

Peritoneal Mesothelioma Symptoms

  • Weight loss
  • Abdominal distention
  • Hernias
  • Loss of appetite
  • Feeling of fullness
  • Abdominal swelling
  • Fatigue
  • Abdominal fluid buildup
  • Bowel obstruction

Doctors can provide chemotherapy drugs that shrink peritoneal mesothelioma tumors and slow the growth and spread of cancer. It can be given before, during or after surgery. In some cases, doctors offer chemotherapy as the only treatment option. Chemotherapy drugs considered effective in treatment include pemetrexed, cisplatin, carboplatin and gemcitabine.

Doctors are now seeing extraordinary results with HIPEC. Once an experimental treatment, HIPEC starts with surgery to remove all visible tumors from the patient’s peritoneum. Next, doctors introduce a heated salt-water solution that contains chemotherapy drugs.

A machine pumps the medicine throughout the patient’s abdomen, helping destroy any cancer cells left behind after surgery. Nearly half of peritoneal mesothelioma cancer patients who receive HIPEC can live at least five years after diagnosis.

Learn more about peritoneal mesothelioma

Pericardial Mesothelioma Symptoms

  • Difficulty breathing
  • Chest pains
  • Heart palpitations
  • Heart murmurs
  • Fever or night sweats
  • Fatigue

This form of asbestos-related cancer, which develops in the lining around the heart, is one of the rarest types of the disease. Symptoms are similar to those of pleural mesothelioma and include difficulty breathing and chest pains. They stem from thickening of the pericardium, the lining around the heart.

Learn more about pericardial mesothelioma

Testicular Mesothelioma Symptoms

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

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

Learn more about testicular mesothelioma
Karen Selby, RN
Karen Selby, RN Patient Advocate

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When Do Mesothelioma Symptoms Emerge?

Symptoms of mesothelioma and other asbestos cancers first emerge in small, subtle ways after the cancer has spread. Some are so minor that people and their doctors mistake them as symptoms of some other disorder or shrug them off entirely. These small signals don't develop until 20 to 50 years after exposure to asbestos, known as the latency period.

Mesothelioma takes decades to develop, and symptoms usually don't make an impact on someone's life until the cancer has reached a late stage. Most people who get mesothelioma of any type are diagnosed in stage III or stage IV, which are considered late or end stages.

Although the decades-long latency period is similar with each type of the cancer, some studies suggest it is shorter for people with peritoneal mesothelioma. A 2011 study found women have a slightly longer latency period than men.

Mary Lyons, pleural mesothelioma survivor

"I had gotten to the point where I couldn’t walk without being out of breath. It scared the heck out of me. But having my lung drained was immediate relief. I felt so much better.” Mary Lyons, pleural mesothelioma survivor diagnosed in 2015

Pleural mesothelioma survivor John Owens and his wife

“I feel lucky, but I don’t feel like a miracle. I’ll reserve miracles for bigger and better things than me. I’m just a grateful guy today who thinks every day I wake up is a gift.” John Owens, pleural mesothelioma survivor diagnosed in 2008

Initial Mesothelioma Symptoms May Contribute to Misdiagnosis

Nonspecialists often mistake pleural mesothelioma for less serious conditions such as pneumonia, bronchial infection and COPD. People with peritoneal mesothelioma may initially be diagnosed with ovarian cancer or irritable bowel syndrome. Pericardial mesothelioma is so rare that doctors can easily confuse it with heart failure, coronary heart disease and other common heart illnesses.

A mesothelioma misdiagnosis can delay proper treatment. Anyone with a history of asbestos exposure should inform their primary care physician of their exposure and ask for annual cancer screenings. If you develop any abdominal or pulmonary issues in your lifetime, make sure to mention your asbestos exposure history to the medical professionals who provide your care.

David Sugarbaker M.D.
Dr. David Sugarbaker Director of Lung Institute at Baylor College of Medicine, Chief of General Thoracic Surgery

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What Symptoms Indicate the Cancer Has Spread?

Symptoms that indicate the cancer has spread in the affected area, such as nerve pain that shoots down an arm, may not show up. Mesothelioma tends to spread locally throughout the chest or abdominal cavity more often than spreading to distant locations throughout the body.

Common Symptoms Relating to Local Asbestos Cancer Invasion:

  • Dysphagia(difficulty swallowing)
  • Superior vena cava syndrome(obstruction of the vein that returns blood from the upper body to the heart)
  • Laryngeal nerve palsy(hoarseness)
  • Horner's syndrome(nerve damage to face)
  • Hypoglycemia(low blood sugar)
  • Nerve involvement(of the arm)

Finding a Specialist

If you have a history of asbestos exposure and believe you have symptoms of mesothelioma, seek immediate medical attention. Tell your doctor about your exposure and alert them to the possibility of an asbestos-related disease. You will likely need to get a second opinion from a mesothelioma specialist.

Rebuilding and getting back to 'normal' isn’t a race for the swift. It’s for those who can endure the highs and lows. There are small victories and setbacks. But eventually, the battle is won.— Kasie ColemanPeritoneal mesothelioma survivor diagnosed in 2010

Woman consults doctor

How Can I Cope with Mesothelioma Symptoms?

Mesothelioma symptoms result from the cancer itself and may overlap with side effects caused by cancer treatment such as nausea related to chemotherapy. Side effects of cancer treatment usually fade away after the treatment ends. Mesothelioma symptoms tend to progress along with the cancer, making symptom management critical to quality of life.

Talk to your oncologist about working with a palliative care specialist, a doctor whose expertise lies in managing symptoms and improving quality of life. Many cancer centers now offer palliative care to patients undergoing treatment, even those participating in clinical trials.

Additional Resources

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Michelle Whitmer

Joining the team in February 2008 as a writer and editor, Michelle Whitmer has translated medical jargon into patient-friendly information at Asbestos.com for more than eight years. Michelle is a registered yoga teacher, a member of the Academy of Integrative Health & Medicine, and was quoted by The New York Times on the risks of asbestos exposure.

Sources
  1. Legha, S. and Muggia, F. (1977, November 1). Pleural Mesothelioma: Clinical Features and Therapeutic Implications. Retrieved from http://www.annals.org/content/87/5/613.short
  2. Moore, A., Parker, R. and Wiggins, J. (2008, December 19). Malignant Mesothelioma. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652430/?tool=pubmed
  3. Acherman, Y.I., Welch, L.S., Bromley, C.M. and Sugarbaker, P.H. (2003, May). Clinical Presentation of Peritoneal Mesothelioma. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12908781
  4. Munkholm-Larsen, S., Cao, C. and Yan, T. (2009, November). Malignant Peritoneal Mesothelioma. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999110/?tool=pubmed
  5. Taioli, E., Wolf, A., Moline, J., Camacho-Rivera, M. and Flores, R. (2015, April 30). Frequency of Surgery in Black Patients with Malignant Pleural Mesothelioma. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430630/
  6. Marinaccio, A. et al. (2006). Il Rapporto del Registro Nazionale dei Mesoteliomi. Roma Edizioni: Gruppo di Lavoro ReNaM.
  7. Chest Foundation. (2017). Treatment and Drugs. Retrieved from http://www.chestnet.org/Foundation/Patient-Education-Resources/Shortness-of-Breath/Treatment-and-Drugs

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