Reading Time: 12 mins
Last Edited On: 02/23/2024

Written by Karen Selby, RNEdited By Walter PachecoMedically Reviewed By Dr. Jacques Fontaine

What Are the Symptoms of Mesothelioma? 

Pleural effusion is the most common mesothelioma symptom, occurring in 90% of survivors. Because pleural mesothelioma makes up the majority of diagnoses, many common symptoms are respiratory. The four types of mesothelioma share common symptoms, however, such as fatigue, pain, fever, loss of appetite and swelling. 

“Most commonly, patients present with cough, shortness of breath, difficulty in walking and loss of stamina,” Dr. Marcelo DaSilva, chief of thoracic surgery and medical director at AdventHealth Cancer Institute, told the Mesothelioma Center.

Common mesothelioma symptoms and the percentage of patients experiencing these symptoms
Pleural mesothelioma patients may experience chest pain and symptoms affecting the respiratory system. Most mesothelioma patients experience fatigue, nausea and unexplained weight loss.

Early signs of pleural mesothelioma include a dry, persistent cough and shortness of breath. Some patients may have nausea, constipation or diarrhea with peritoneal cancer. Mesothelioma symptoms can vary based on cancer stage as well as tumor location. 

Many symptoms don’t appear until later stages, making mesothelioma diagnosis challenging. Discuss any history of asbestos exposure, the primary cause of mesothelioma, with your doctor who can arrange regular screenings. Statistics indicate early intervention improves life expectancy.

Pleural Mesothelioma Symptoms

The Mesothelioma Center, in its work with more than half of all mesothelioma diagnosed each year, conducted a survey of pleural mesothelioma survivors. When asked about their most common symptoms, most respondents reported experiencing symptoms that are often mistaken for other conditions, such as chest pain and shortness of breath.

“Many oncologists, primary care providers and even pulmonologists don’t realize that a pleural effusion or shortness of breath and pain could be mesothelioma because it is so rare,” Dr. Jeffrey Velotta, a cardiothoracic surgeon at Kaiser Permanente, told The Mesothelioma Center. “If they know what to look for, they can refer patients to mesothelioma specialists.”

Common Pleural Mesothelioma Symptoms

Pleural mesothelioma forms on the soft tissue lining the outside of the lungs. Irritation of the pleura from asbestos fibers can cause thickening, pleural plaques and fluid buildup in the pleural space.

The most common pleural mesothelioma symptoms according to respondents of the survey

Pleural thickening and plaques can make the lungs stiffer. Pleural effusion can be painful and prevent lung expansion, making breathing more difficult. Pleural effusion is often the first sign of pleural mesothelioma. Symptoms of pleural mesothelioma typically affect the lungs but also affect the body as a whole.

Peritoneal Mesothelioma Symptoms

Peritoneal mesothelioma commonly causes abdominal and digestive symptoms, but it can also affect breathing and cause systemic symptoms throughout the body. In The Mesothelioma Center’s exclusive survey, most peritoneal mesothelioma respondents reported symptoms that are often initially confused with many other conditions such as Crohn’s disease, ulcerative colitis and liver disease.

“I began to feel slight discomfort in the upper abdominal area,” peritoneal mesothelioma survivor Kasie Coleman told The Mesothelioma Center. “My family practitioner said I’d probably bruised a rib. Seven months later, I could hardly stand.”

Coleman spent nearly two years with persistent and worsening symptoms because of misdiagnosis, including abdominal fluid and extreme pain. When she underwent hernia surgery, doctors found a mass and confirmed her peritoneal mesothelioma diagnosis.

Common Peritoneal Mesothelioma Symptoms
  • Abdominal fluid buildup (ascites)
  • Abdominal pain
  • Abdominal swelling
  • Constipation
  • Loss of appetite
  • Nausea and vomiting
  • Unexplained weight loss

Peritoneal mesothelioma develops on the soft tissue that lines the abdominal cavity and organs. This can cause excess fluid accumulation in the abdominal cavity called ascites. Tumors in the abdomen can also cause bloating, pain, diarrhea, constipation and bowel obstruction.

The most common peritoneal mesothelioma symptoms according to respondents of the survey

Pericardial Mesothelioma Symptoms

Symptoms of pericardial mesothelioma primarily affect the heart but also affect breathing. Symptoms are often mistaken for other more common conditions, particularly because pericardial mesothelioma is one of the rarest forms of cancer with only about 150 cases reported in medical literature. 

Dr. Wickii Vigneswaran shared with The Mesothelioma Center, “Patients can present with heart failure initially. It’s not unusual to diagnose pericardial mesothelioma as an incidental finding. You’re not suspecting pericardial mesothelioma. You’re treating pericardial effusion or heart failure or constrictive pericarditis.”

Pericardial Mesothelioma Symptoms
  • Chest pain
  • Cough
  • Difficulty breathing (dyspnea)
  • Fatigue
  • Heart murmurs
  • Heart palpitations or irregular heartbeat (arrhythmia)
  • Shortness of breath when lying down

The pericardium is a layer of mesothelial tissue that forms a sac around the heart. Mesothelioma causes the pericardium to thicken and become stiff and can cause a pericardial effusion or fluid buildup around the heart. This can prevent the heart from pumping properly, leading to many heart-related symptoms.

There are several common conditions that are more likely to cause these symptoms than mesothelioma. These include cardiac tamponade, cardiomyopathy, constrictive pericarditis, coronary heart disease, heart failure, tuberculosis pericarditis and localized fibrous tumors, a type of benign mesothelioma.

Testicular Mesothelioma Symptoms

A common symptom of testicular mesothelioma is inflammation of the testes. A lump in the testes is the most common sign of testicular mesothelioma.

Symptoms of Testicular Mesothelioma
  • Hydrocele (fluid in the scrotum)
  • Lump in the scrotum
  • Swollen testes
  • Testicular pain

This is the rarest of all types of mesothelioma. It accounts for less than 1% of all mesothelioma cases.

Early signs may feel like a groin injury or other illnesses. This condition can look like epididymitis, which is inflammation of the testes usually the result of infection.

Rare But Serious Signs and Symptoms of Mesothelioma

Pleural mesothelioma patients have a higher risk of developing blood clots. Signs of blood clots include redness, pain and swelling on one side. 

You may also notice strange lumps under the skin. Pleural patients may have pain or swelling along the sides of the chest. Peritoneal patients may see this around the abdomen.

Serious Mesothelioma Symptoms
  • Anemia
  • Blood clots
  • Fever
  • Night sweats
  • Painful swelling or lumps

Some symptoms of mesothelioma may be less noticeable, but are no less dangerous. You may have anemia with pale skin, cold extremities or dizziness. Fewer than 10% of patients experience fever or night sweats.

When Should I See a Doctor?

See a doctor immediately if you have chest pain, abdominal pain or other symptoms. This is especially important if you have a history of asbestos exposure. Early detection of mesothelioma can improve treatment outcomes. 

Raising awareness about mesothelioma signs and symptoms and the risk of asbestos-related diseases from exposure is critical in increasing early detection. Awareness is particularly important for those who worked with asbestos or products containing asbestos who have a higher risk of mesothelioma

When you recognize symptoms, make an appointment with a mesothelioma doctor or speak with your general practitioner. Early treatment is more effective in slowing your cancer and improving your survival.

Vanessa Blanco, Patient Advocate and Oncology Patient Navigator

Patient Advocates at The Mesothelioma Center at have connected thousands of patients and families with our network of 500+ mesothelioma specialists. Their stories highlight why seeing a specialist when symptoms appear is critical.

Vanessa Blanco, Patient Advocate and Oncology Patient Navigator

Early- and Late-Stage Symptoms of Mesothelioma

Symptoms may not appear in Stage 1, making it rare for mesothelioma to be diagnosed this early. It’s more common for patients to be diagnosed in later stages as symptoms become more pronounced.

Symptoms of mesothelioma will increase as cancer spreads or metastasizes from the early to late stages. Tumors that develop on distant organs can cause more damage, affecting the diaphragm, cardiac lining or liver.

Early-Stage Mesothelioma Symptoms

In conducting its exclusive study, The Mesothelioma Center gathered data from mesothelioma survivors. Respondents shared key insights into the most common symptoms seen with early- and late-stage mesothelioma.

The top ten most common symptoms of early-stage mesothelioma

Early-stage mesothelioma (stages 1 & 2) most commonly causes fatigue or weakness and pleural effusions. Pain and breathing problems typically follow.

Early-Stage Symptoms
  • Chest or abdominal pain
  • Coughing or wheezing
  • Fatigue or weakness
  • Shortness of breath

Localized tumors are typically the cause of early symptoms of mesothelioma. Small tumors that have not spread far can all cause pleural effusions, ascites, shortness of breath and pain.

Late-Stage Mesothelioma Symptoms

New or worsening symptoms can be a sign of disease progression. This can include metastasis to other parts of the body. 

“Chest pain can indicate that the tumor has invaded the chest wall,” Dr. DaSilva told The Mesothelioma Center. He urges patients not to ignore any of these symptoms.

Top ten most common symptoms of late-stage mesothelioma according to survey respondents

The most common late-stage symptoms (stages 3 & 4) involve pain and difficulty breathing. This includes fatigue or weakness, shortness of breath, abdominal or chest pain, weight loss and pleural effusions in most patients.

Late-Stage Symptoms
  • Anemia and associated fatigue
  • Bowel obstruction
  • Difficulty swallowing
  • Fever or night sweats
  • Loss of appetite
  • Respiratory complications
  • Severe or persistent pain
  • Weight loss

Local and distant spread of mesothelioma to other organs, including the diaphragm, often causes later stage symptoms. Many of these symptoms are systemic, affecting the whole body. This can indicate that cancer is affecting multiple organs throughout the body.

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Treatment Options for Mesothelioma Symptoms

Therapies that treat symptoms of mesothelioma include surgery, chemotherapy, immunotherapy and radiation therapy. Targeted or gene therapy may also be effective. 

Many patients have concerns about treatment side effects, worrying that they may be as bad or worse than their current symptoms. During treatment, side effects can limit your daily activities.

When mesothelioma survivors speak with patient advocates, they ask about treatments to manage their symptoms and what their quality of life will be like after treatment. They ask, ‘Will it make me sicker than I’m already feeling at this moment?’ and ‘Is it worth going through it?

A good treatment plan, including pain management, will take into account your health and specific symptoms. Palliative care, pain management, nutrition, alternative and complementary therapies and mental health support are all important parts of treating mesothelioma symptoms and complications.

Mesothelioma Palliative Care

Palliative care can help ease severe pain, shortness of breath and fatigue. It also addresses patients’ and families’ physical, emotional and spiritual needs. It can improve your quality of life and allow you to perform more activities you enjoy.

Common Palliative Treatments
  • Medication
  • Physical and occupational therapy
  • Pleurodesis
  • Respiratory therapy
  • Thoracentesis

“Patients want to know how long they will have to go through treatment,” noted VA-accredited claims agent and Patient Advocate Danielle DiPietro. “Surgical patients are concerned about whether it is ‘worth it,’ and their quality of life after surgery.”

Pain Management for Mesothelioma Symptoms

Mesothelioma can cause significant pain and discomfort. Pain medications can address neuropathic, bone and visceral pain.

Common Pain Medications
  • Adjuvant medications
  • Nonsteroidal anti-inflammatory drugs, called NSAIDs
  • Opioids

“Patients are sometimes challenged with taking pain medication as they worry about becoming addicted,” said registered nurse and Patient Advocate Karen Selby. Consulting with a pain management specialist is the best way to ease concerns about pain medication.

Survivor Story
Michael Cole Mesothelioma Survivor

Don’t Be Afraid of Aggressive Mesothelioma Treatment

Survivor Story

When I was diagnosed with malignant pleural mesothelioma in 2015, thoracic surgeon and mesothelioma expert Dr. David Sugarbaker told me there were choices about how aggressively we could go about treating it.

Read Michael’s Story

Alternative Therapies for Mesothelioma Symptoms

Complementary techniques can help manage pain and improve stress alongside standard treatment. These options should not replace traditional cancer care.

Common Alternative Therapies
  • Massage
  • Physical therapy
  • Relaxation

Gentle exercise and activities such as mild yoga or meditation are often helpful. Try to avoid activities or positions that worsen the pain.

Nutrition and General Health for Every Stage of Mesothelioma Symptoms

Good nutrition is a vital concern for mesothelioma patients. A healthy diet helps the immune system. It can also increase energy levels. You may have a low appetite, nausea, vomiting or trouble swallowing during treatment.

Tips to Improve Nutrition
  • Avoid foods labeled as low-fat, nonfat and low-calorie.
  • Eat protein-rich foods regularly.
  • Work with a registered dietitian to create a tailored nutrition plan.

“Losing the desire to eat is extremely common,” registered and licensed dietitian Tejal Parekh explained. “Several changes can cause this, including the stress of a diagnosis, the treatment and the side effects or pain that the tumor causes. Excess weight loss can lead to delayed healing after surgery and longer recovery between chemo cycles.”

Supportive Therapies for Emotional and Psychological Effects

Supportive therapies help patients and families cope with mesothelioma’s emotional and psychological effects. Patients may experience a range of emotions. They may feel fear, anxiety and depression.

Common Support Therapies
  • Mental health counseling
  • Support groups

Support groups and organizations can provide a sense of community, emotional support and a safe space for patients.

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Common Questions About Mesothelioma Symptoms

When do mesothelioma symptoms start?

Mesothelioma symptoms tend to present between 20 and 60 years after asbestos exposure. This delay is known as the latency period. The signs also mimic many common diseases. These factors make a mesothelioma diagnosis challenging for unspecialized doctors.

Can you have mesothelioma and not know it?

Yes, you may have mesothelioma without any symptoms. Many mesothelioma symptoms are mild and mimic the flu or a stomach virus. Most only appear decades after asbestos exposure. Doctors may also misdiagnose this rare cancer as other illnesses, delaying your mesothelioma diagnosis.

Can mesothelioma symptoms come on suddenly?

Yes, some mesothelioma symptoms may occur suddenly. Some patients do not experience symptoms until the cancer has spread to another organ, such as the kidneys or liver. The cancer location determines the type and severity of symptoms you may have.

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