Symptoms and Signs of Mesothelioma
Pleural mesothelioma patients typically experience respiratory-related symptoms, including shortness of breath, chest pain and a cough. Mesothelioma patients may also experience fatigue, swelling and unexplained weight loss.
- Written by Karen Selby, RN
- Edited By Walter Pacheco
- Medically Reviewed By Dr. Jacques Fontaine
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APA
Selby, K. (2023, January 9). Symptoms and Signs of Mesothelioma. Asbestos.com. Retrieved January 30, 2023, from https://www.asbestos.com/mesothelioma/symptoms/
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Selby, Karen. "Symptoms and Signs of Mesothelioma." Asbestos.com, 9 Jan 2023, https://www.asbestos.com/mesothelioma/symptoms/.
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Selby, Karen. "Symptoms and Signs of Mesothelioma." Asbestos.com. Last modified January 9, 2023. https://www.asbestos.com/mesothelioma/symptoms/.
Common Symptoms of Mesothelioma
Mesothelioma symptoms can include shortness of breath, chest pain or abdominal distress. Some symptoms appear among all mesothelioma types. Others vary by tumor location.

For example, fatigue can occur in pleural, peritoneal and pericardial mesothelioma cancers. Pericardial mesothelioma often leads to abnormal heart rates.
Pleural Mesothelioma Symptoms
Pleural mesothelioma can mimic respiratory diseases such as pneumonia or the flu. This cancer forms on the soft tissue lining the lungs. Most symptoms affect breathing.
Common symptoms of pleural mesothelioma include:
- Chest pain
- Shortness of breath
- Dry cough
- Unexplained weight loss
- Fatigue
- Hoarseness
- Difficulty swallowing
- Reduced chest expansion (difficulty breathing)
- Fever
- Muscle weakness
- Swelling of the face and arms
Early symptom management leads to improved life expectancy. Symptom control is a vital part of therapy for mesothelioma in the lungs.
Peritoneal Mesothelioma Symptoms
Early signs of peritoneal mesothelioma are often digestive conditions. They can mimic irritable bowel syndrome or pelvic disorders like fibroids. This cancer forms on the soft tissue lining the abdomen.
Common symptoms include:
- Abdominal pain
- Abdominal swelling
- Abdominal fluid buildup (ascites)
- Unexplained weight loss
- Nausea and vomiting
- Constipation
- Loss of appetite
Chemotherapy shrinks and slows peritoneal mesothelioma tumors. It can also help control symptoms, which may vary based on tumor location.
Other successful therapies include surgery and heated chemo. They can allow many people to live longer than predicted. Symptom control and early treatment are essential.
Pericardial Mesothelioma Symptoms
Pericardial mesothelioma symptoms affect the heart. Many of these mimic heart disease. Examples include irregular heart rate or chest pain. Common symptoms are:
- Difficulty breathing (dyspnea)
- Chest pain
- Shortness of breath
- Heart palpitations or irregular heartbeat (arrhythmia)
- Heart murmurs
Pericardial mesothelioma develops in the pericardium, known as the lining around the heart. It is one of the rarest forms of this cancer. Symptoms stem from pericardial thickening. The condition makes it harder for the heart to pump blood.
Testicular Mesothelioma Symptoms
Early signs of testicular mesothelioma can be mistaken for an injury or other illnesses. A common symptom is inflammation of the testicles. This condition can mimic epididymitis. Common symptoms 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. This is the rarest of all types of mesothelioma. It accounts for less than 1% of all mesothelioma cases.

First Signs of Mesothelioma
A cough or shortness of breath may be the earliest sign of mesothelioma malignancy. Other symptoms include chest, shoulder or abdominal pain. Many symptoms do not appear until the later stages of cancer.
Some signs are essential for an early mesothelioma diagnosis. You should also know your asbestos history. An early diagnosis can help you qualify for life-extending therapies. These may be unavailable to patients in the later stages of mesothelioma.
A 2020 report described one patient’s only sign as gastric and colonic polyps. The patient’s doctor discovered them on an imaging scan. Further testing revealed the polyps were metastases of pleural mesothelioma.
How Do You Know if You Have Mesothelioma?
A biopsy can confirm mesothelioma. Doctors may first notice the early signs accidentally. A routine test, such as an X-ray or blood test, may detect something unusual.
“If you’re experiencing symptoms, consult a doctor and share exposure history and symptoms.”Dr. Snehal SmartMedical advisor at The Mesothelioma Center
Symptoms often resemble less severe diseases. They are not always good indicators of this cancer.
Mesothelioma testing includes X-rays, CT scans and blood tests. Researchers are studying innovative tests to confirm a mesothelioma diagnosis. One example consists of a breath test.
How Do Mesothelioma Symptoms Contribute to Diagnosis?
The emergence of mesothelioma symptoms begins the diagnostic process. Because symptoms often develop in later stages, a diagnosis is uncommon until cancer has progressed.
Inform your primary care doctor about any history of asbestos exposure. Ask if they recommend any cancer screenings. Aggressive cancer treatments in early stages improve survival.
Early-stage mesothelioma may cause shortness of breath or cough. This occurs when chest fluid builds up.
A 2019 study examined stage 1 and stage 2 pleural mesothelioma patients. The median survival of this group was 35 months or about three years. Those who received less aggressive surgery lived the longest after diagnosis.
Mesothelioma cell type does not alter symptoms for most patients.
Symptoms of Mesothelioma by Stage
Symptoms differ from stage 1 to stage 4 mesothelioma. They depend on tumor size and spread. This also determines the cancer stage.
- 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
- Increased and more persistent pain
- Anemia and associated fatigue
- Weight loss
- Loss of appetite
- Respiratory complications
- Difficulty swallowing
- Bowel obstruction
Fever and night sweats, for example, are uncommon in the early stages of the cancer. Less than 10% of mesothelioma patients experience fever or night sweats when they are diagnosed. These symptoms are more common in the final stage of mesothelioma, when the cancer begins to spread throughout the body.
Fever can be a sign the body is fighting cancer cells, and it is also a common side effect of cancer treatments such as surgery, chemotherapy and immunotherapy. Fever can also be a sign of infection. Chemotherapy often weakens a patient’s immune system, leaving the patient vulnerable to viruses, bacteria and other types of germs.
Factors That Impact Mesothelioma Symptoms
Patients with early-stage cancer rarely have symptoms. Mesothelioma tumors aren’t big enough to impact the body at this point. Tumors are larger and more involved in stage 3 and stage 4.
- Chest Pain: Primarily because of tumors spreading into the chest wall and its nerves.
- Difficulty Breathing: Tumors cause the restriction of full lung expansion.
- 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.
Large tumors press against and grow into nearby organs and tissues. When this happens, organs begin to malfunction and fail.

How Can I Cope with Mesothelioma Symptoms?
Palliative care helps patients cope with symptoms and improve daily life. Many cancer centers now offer palliative cancer care. These symptom management treatments may include prescription medication, therapy or procedures.
Some symptoms are side effects of cancer treatment. These side effects usually diminish days to weeks after treatment.
Managing Mesothelioma Symptoms
Talk to your oncologist about a referral to a palliative care specialist. These doctors specialize in symptom management.
- 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. 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 asbestos exposure, inform your doctor. Tell your doctor about past work around asbestos. Alert them to any new symptoms and the possibility of an asbestos-related disease. Ask for a second opinion from a mesothelioma specialist if needed.
Common Questions About Mesothelioma Symptoms
- What are the most common symptoms of pleural mesothelioma?
-
Symptoms of pleural mesothelioma include cough, chest pain, shortness of breath, fatigue and unexpected weight loss. Signs of mesothelioma resemble many common diseases. If you think you have been exposed to asbestos, talk to your doctor.
- What are the most common symptoms of peritoneal mesothelioma?
-
Symptoms of peritoneal mesothelioma include stomach pain, abdominal swelling, nausea, constipation and fluid buildup in the abdomen. Speak to your doctor if you suspect you were ever exposed to asbestos.
- 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?
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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?
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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.


