Written By: Karen Selby, RN,
Last modified: June 17, 2021

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 pleural mesothelioma can resemble other respiratory diseases. Pleural mesothelioma, which forms on the soft tissue lining the lungs, may cause symptoms that include:

Pleural mesothelioma symptoms by frequency
Frequency of symptoms reported in a 2011 study of 221 pleural patients.

Addressing symptoms as soon as they develop can 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 treatment for pleural mesothelioma.

Mesothelioma Nutrition Guide from Asbestos.com
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Eating right and balancing your diet while undergoing mesothelioma treatment can help ease your symptoms.

Peritoneal Mesothelioma Symptoms

  • 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

  • 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

  • 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 and Symptoms of Mesothelioma

Mesothelioma begins as tiny nodules on the lining of the lungs or abdomen. The cancer doesn’t usually cause symptoms until 20 to 50 years after exposure to asbestos and when the disease has grown or spread.

Symptoms of chest pain, weight loss and fatigue commonly do not appear until the tumors start to press against nerves, organs, bones and other parts of the body, which happens during stage 3 or stage 4 mesothelioma.

Some pleural mesothelioma patients may even experience shoulder pain. As tumors grow in the chest cavity, pressure may cause discomfort in the shoulder and other areas surrounding the chest.

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.

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.

Watch: Learn the symptoms of mesothelioma when the cancer is in its early stages.

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.

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.

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Symptoms of Mesothelioma by Stage

A mesothelioma patient will experience symptoms that differ from stage 1 to stage 4 mesothelioma. Tumor location and the organs those tumors affect will determine symptoms.

In the early stages of mesothelioma, you may notice:

  1. Dry cough or wheezing
  2. Shortness of breath
  3. Difficulty breathing
  4. Pain in chest or abdomen
  5. Pleural effusion (fluid buildup), leading to worsening pain and breathing difficulties

In the late stages of mesothelioma, you may notice:

  1. Increased and more persistent pain
  2. Anemia and associated fatigue
  3. Weight loss
  4. Loss of appetite
  5. Respiratory complications
  6. Difficulty swallowing
  7. Bowel Obstruction

Causes of Late-Stage 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 press against body parts until stage 3 or 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.

How Can I Cope with Mesothelioma Symptoms?

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 quality of life. Many cancer centers now offer palliative cancer management to patients undergoing treatment or participating in clinical trials.

Steps to Manage 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.
  • 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.
  • 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.
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 Coleman
Peritoneal mesothelioma survivor diagnosed in 2010

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.

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How Do Mesothelioma Symptoms Contribute to Diagnosis?

Informing your primary care doctor about any history of asbestos exposure and seeking cancer screenings can help lead to an earlier mesothelioma diagnosis. Catching cancer early provides a better chance of qualifying for life-extending cancer treatments and improved survival.

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.

Did You Know?
Most symptoms of malignant pleural mesothelioma mimic many other respiratory diseases such as COVID-19. Patients experiencing any respiratory abnormalities should speak with their doctors as soon as possible to prevent delays in treatment.
Learn How COVID-19 Can Delay Mesothelioma Treatment

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.

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