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.
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. This is usually around cancer stage 3 and 4, when tumors 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.
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 qualifying for life-extending therapy.
Mesothelioma expert Dr. Sugarbaker explains the most common mesothelioma symptoms.
Symptoms of Mesothelioma by Stage
In the early stages of mesothelioma, you may notice:
Dry cough or wheezing
Shortness of breath (dyspnea)
Difficulty breathing
Pain in chest or abdomen
Pleural effusion (fluid buildup) making these symptoms worse
In the late stages of mesothelioma, you may notice:
Increased pain
Anemia
Weight loss
Loss of appetite
Respiratory complications
Difficulty swallowing
Bowel obstruction
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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 3 or 4 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 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.
In a 2011 study of 221 pleural patients, symptoms were reported with the following frequency:
In a 2011 study of 221 pleural patients, symptoms were reported with the following frequency:
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. This helps 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.
This form of asbestos-related cancer develops in the lining around the heart. It is one of the rarest types of the disease. Symptoms include difficulty breathing and chest pains. They stem from thickening of the pericardium, the lining around the heart.
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.
Symptoms of mesothelioma and other asbestos cancers first emerge in small, subtle ways. This happens after the cancer has spread, which is around stage 3 or stage 4. Some are so minor that people and their doctors mistake them as symptoms of some other disorder or shrug them off entirely.
Mesothelioma starts to develop around 20 to 50 years after exposure to asbestos. This latency period is not related to the delayed onset of mesothelioma symptoms, but these concepts get easily confused because both involve an unexpected delay.
Symptoms usually don’t make a noticeable 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 3 or stage 4. These are considered late or end stages.
“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.”
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.
Initial Mesothelioma Symptoms May Contribute to Misdiagnosis
Nonspecialists often mistake pleural mesothelioma for less serious conditions. These include 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.
“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.”
A mesothelioma misdiagnosis can delay proper treatment. Anyone with a history of asbestos exposure should inform their primary care physician of their exposure. Also ask about 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.
What Affects Mesothelioma Symptom Onset?
The primary factor that affects the onset of mesothelioma symptoms is tumor growth and spreading.
Mesothelioma symptoms are caused by tumors that press against nerves, organs, bones and other parts of the body.
Chest pain is primarily caused by tumors that have begun to spread into the chest wall.
Difficulty breathing is caused by tumors that are restricting full expansion of the lungs.
Pleural effusion is caused by tumors that have spread to the lymphatic system, including lymph nodes, preventing fluid from properly draining out of the pleural lining.
Small tumor size is the main reason why mesothelioma patients don’t experience symptoms in the early stages of the cancer’s growth. Mesothelioma tumors typically don’t become big enough to press against body parts until stage 3 or stage 4.
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Symptoms such as nerve pain that shoots down an arm may indicate cancer invasion has occurred locally in the chest. Mesothelioma tends to spread locally throughout the chest or abdominal cavity more often than spreading to distant locations throughout the body.
Common Stage 4 Symptoms
Dysphagia (difficulty swallowing)
Hemoptysis (coughing up blood)
Laryngeal nerve palsy (hoarseness)
Horner’s syndrome (nerve damage to face)
Hypoglycemia (low blood sugar)
Nerve involvement (of the arm)
Superior vena cava syndrome (obstruction of the vein that returns blood from the upper body to the heart)
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.
How Can I Cope with Mesothelioma Symptoms?
“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.”
Mesothelioma symptoms result from the cancer itself and may overlap with side effects caused by cancer treatment. Side effects of cancer treatment usually fade away after the treatment ends. Mesothelioma symptoms tend to progress along with the cancer. Symptom management is critical to quality of life.
Talk to your oncologist about working with a palliative care specialist. These doctors specialize 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.
Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections. She is also a member of the Academy of Oncology Nurse & Patient Navigators. Read More
Llanos, M.D., & Sugarbaker, P.H. (2017). Symptoms, signs and radiologic findings in patients having reoperative surgery for malignant peritoneal mesothelioma. European Journal of Surgical Oncology, 43(1), 138-143. https://doi.org/10.1016/j.ejso.2016.08.010
Garcia-Fadrique, A. et al. (2017). Clinical presentation, diagnosis, classification and management of peritoneal mesothelioma: a review. Journal of Gastrointestinal Oncology, 8(5). Retrieved from:
http://jgo.amegroups.com/article/view/15305
Mercadante, S., Degiovanni, D., & Casuccio, A. (2016). Symptom burden in mesothelioma patients admitted to home palliative care. Current Medical Research and Opinion, 32(12), 1985-1988. http://dx.doi.org/10.1080/03007995.2016.1226165
