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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, Last modified: November 3, 2021
Common Symptoms 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 symptoms of heart palpitations and arrhythmias.
Early signs of mesothelioma can resemble other respiratory diseases such as pneumonia or the flu.
Pleural Mesothelioma (Mesothelioma of the Lungs) Symptoms
When symptoms are identified and treated quickly, patients may benefit from a higher quality of life and an improved life expectancy. Symptom control is a vital component of comprehensive treatment for pleural mesothelioma.
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.
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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.
First Signs of Mesothelioma
The earliest signs of mesothelioma can include a cough, shortness of breath and chest, shoulder or abdominal pain. Too often mesothelioma isn’t diagnosed until symptoms become severe and patients are already in the later stages of this rare and serious form of cancer.
Knowing the first warning signs and symptoms, and knowing your history of asbestos exposure, can help confirm an early mesothelioma diagnosis. An early diagnosis can help you qualify for life-extending therapies that may be unavailable to patients in later stages of mesothelioma.
Watch: Oncology writer and Registered Nurse Sean Marchese of The Mesothelioma Center discusses common symptoms of early-stage mesothelioma.
In a 2020 report published in Case Reports, a patient’s first and only sign of pleural mesothelioma was gastric and colonic polyps discovered on an imaging scan. Testing revealed the polyps were metastases of pleural mesothelioma.
How Do You Know if You Have Mesothelioma?
A biopsy will confirm if you have mesothelioma. But doctors may first notice the early signs of mesothelioma by accident. A routine test, such as an X-ray or blood tests, may detect something unusual. Because symptoms resemble less serious diseases, they are not good indicators of the cancer.
In addition to a biopsy, mesothelioma testing commonly includes X-rays, CT scans and blood tests. Researchers are working on other innovative tests to confirm a mesothelioma diagnosis, including a breath test.
If you’re experiencing symptoms, consult a doctor and share exposure history and symptoms.
Dr. Snehal Smart
Medical advisor at The Mesothelioma Center
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.
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
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.
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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.
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.
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.
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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.
If you’re experiencing symptoms, consult a doctor and share exposure history and symptoms.Dr. Snehal SmartMedical advisor at The Mesothelioma Center
When you learn about how integrative medicine works, it will blow you away.Beth MixonPeritoneal Mesothelioma Survivor
