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Symptoms of Pleural Mesothelioma

Early symptoms of pleural mesothelioma can be as nondescript as a dry cough, slight fatigue, or a shortness of breath during physical activity. Symptoms often mirror signs of less serious respiratory issues and are hardly unusual for a senior. Don’t be fooled.

Pleural mesothelioma cancer may take decades to develop after exposure to asbestos, but it attacks quickly once taking hold. Those microscopic asbestos fibers that are inhaled can lodge themselves in the thin lining around the lungs and trigger physiological cellular changes that lead to this rare but aggressive cancer.

Many people with pleural mesothelioma are unaware of their own condition for months or even years because early symptoms are so often mistaken for less threatening illnesses. Any history of asbestos exposure, or even suspected asbestos exposure, should be discussed with a physician, who can refer a patient to a specialist right away. An early diagnosis is critical to survival because it can lead to more effective therapy options.

Symptoms Can Be Confusing

Most symptoms of pleural mesothelioma involve the respiratory system and often are misdiagnosed because most medical professionals rarely see this disease. It's estimated that more than 2,000 people in the United States are diagnosed annually with this cancer. By comparison, an estimated 150,000 Americans are diagnosed with lung cancer each year.

Early symptoms of pleural mesothelioma often are confused with pneumonia or asthma or another respiratory ailment. Even a specialist will need considerable time – in addition to results of various, complex tests – to provide a definitive diagnosis.

According to a 2011 study of 221 pleural mesothelioma patients, many reported similar symptoms in the early stages, often before it was diagnosed.

They included:

79 percent experienced shortness of breath
64 percent suffered chest pain
36 percent had a chronic cough
90 percent presented with pleural effusions (excess fluid around lungs)
30 percent experienced significant weight loss

If any of these symptoms appear, and there is a history of asbestos exposure, it is important to see a specialist.

Others symptoms may include lumps of tissue under the skin on the chest, pain in the lower back, and an inability to breathe without discomfort. Some patients experience a hoarse voice, difficulty swallowing and unusual coughing discharge.

Near the end of life, patients often need help breathing and require continuous oxygen. Even with expert palliative care, there is considerable discomfort.

Recognizing Symptoms

Because a pleural mesothelioma diagnosis often comes too late, after the cancer has spread, the prognosis can be grim. The best hope is to recognize symptoms early.

The process of recognizing the symptoms and turning them into a definitive diagnosis so treatment can begin often involves multiple procedures with different medical professionals.

During the diagnostic process, a patient may see a pulmonologist, a radiologist, a pathologist and a surgeon, as well as an oncologist and a primary care physician. Patients might also then opt for a second opinion.

Early symptoms could lead to imaging tests that include X-rays, an MRI, CT scans and PET scans. If one of the scans reveals an irregularity, a biopsy may be needed to confirm the presence of mesothelioma.

Although it can take 10 to 50 years after exposure to asbestos before symptoms appear, the survival time after symptoms are diagnosed can be short. The majority of patients are given a prognosis of six to 18 months to live.

Earlier diagnostic methods, more awareness and improved treatments have allowed some patients to live two years and beyond. The most important thing is to find a specialist who understands the disease and understands all the intricacies and options.

“It’s important to have someone who is comfortable with the disease,” said Hedy Kindler, M.D., director of the mesothelioma program at the University of Chicago Medical Center. “You need a quarterback who understands all the options.”

Source

Kindler, H (2012, February). University of Chicago Medical Center, Phone interview with Hedy Kindler, M.D.
Moore, A., Parker, J., Wiggins, J. (2008). Malignant Mesothelioma. Orphanet Journal of Rare Diseases. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652430/?tool=pubmed
Alexander, R. (2011, October). University of Maryland. Phone interview with Richard Alexander, M.D.