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Pleural Mesothelioma Symptoms

Early symptoms of pleural mesothelioma include fatigue, coughing and chest pain. These symptoms mimic signs of less serious conditions. If you have a history of asbestos exposure, recognize the early warning signs to ensure you receive the most effective treatment.

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What Are the Early Symptoms of Pleural Mesothelioma?

The early symptoms of pleural mesothelioma include worsening shortness of breath, weight loss and chest-wall pain. They can mimic signs of many less serious conditions such as bronchitis.

This is why malignant pleural mesothelioma can be difficult to diagnose early in the disease process. According to a 2019 Expert Review of Respiratory Medicine article, the clinical presentation of pleural mesothelioma is often nonspecific.

Advanced Mesothelioma Symptoms

As the disease progresses to later stages, symptoms become more serious and persistent.

Advanced symptoms of pleural mesothelioma include:

  • Coughing or wheezing
  • Shortness of breath (dyspnea)
  • Chest pain
  • Fever or night sweats
  • Fatigue or muscle weakness
  • Unexplained weight loss
  • Loss of appetite
  • Swelling of the face and arms
  • Coughing up blood (hemoptysis)
  • Trouble swallowing (dysphagia)

What Are the Most Common Symptoms of Mesothelioma?

Symptoms vary from person to person. Mesothelioma experts have documented that more than 50 percent of mesothelioma patients experience the following symptoms before diagnosis:

About one-third of patients noted they had a chronic cough or unexplained weight loss months before being diagnosed with pleural mesothelioma.

If you experience any of these symptoms and you have a history of asbestos exposure, see a specialist as soon as possible. It may not be mesothelioma, but if it is, early diagnosis offers the best chance of treating the disease effectively.

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Pleural Mesothelioma Symptoms by Disease Stage

Pleural mesothelioma may take up to 70 years to develop after exposure to asbestos. Symptoms vary by stage. Stage 1 is the earliest, and stage 4 is the most advanced.

Stage 1

In the first stage, the tumor burden is small and may not cause any noticeable symptoms. When a patient is diagnosed in stage 1, it is usually because a doctor accidentally found the cancer through a routine X-ray or other tests.

Although X-rays can’t give a definitive pleural mesothelioma diagnosis, they can alert your doctor to lung changes and the need for further tests.

Stage 2

In the second stage, tumors spread beyond the pleural lung lining and into the lung and diaphragm. Chest pain may occur or increase. Pain also may be felt in the shoulder or upper abdomen.

Coughing and other breathing issues can appear or worsen at this stage, and people may begin losing weight without trying.

Stage 3

During the third stage, tumors spread further throughout the chest, placing pressure on the lungs and chest wall. These physical changes can lead to an increase in pain and difficulty breathing, a persistent dry cough, tightness in the chest, fatigue and weight loss.

The tumor also may spread into layers around the lung and nearby lymph nodes. This may contribute to unexplained weight loss and fatigue.

Stage 4

By the fourth stage, tumors have spread throughout the chest and to locations around the body. The degree of tumor burden in the chest can severely worsen pulmonary symptoms such as shortness of breath.

Others symptoms may include lumps of tissue under the skin on the chest, pain in the lower back, fever and night sweats. Some patients experience a hoarse voice and difficulty swallowing.

At this stage, patients often need help breathing and may require oxygen.

Can Mesothelioma Be Cured If Caught Early?

Mesothelioma is not curable. However, if caught early, it is considered treatable. People can live several years with mesothelioma.

According to the American Society of Clinical Oncology, the 2-year survival rate for early stage pleural mesothelioma is 41 to 46 percent.

Because early symptoms of mesothelioma can be vague and nonspecific, and it takes decades for asbestos exposure to cause the cancer, medical professionals may misdiagnose this rare disease.

How Are Pleural Mesothelioma Symptoms Managed?

There are many ways to manage the symptoms of malignant mesothelioma. Symptom-management options include:

Regardless of how you decide to manage your mesothelioma symptoms, don’t suffer in silence.

Let your health care team know if you’re struggling to manage symptoms. They can help you come up with a multifaceted approach to give you the best quality of life possible.

What Should I Do If I Think I Have Mesothelioma?

The most important thing is to find a specialist who understands the disease and all its intricacies and treatment options.

The process of recognizing the symptoms and turning them into a pleural mesothelioma diagnosis may require multiple procedures with different medical professionals. This can take several months.

Early diagnosis methods, greater awareness and improved treatments allow some patients to live well beyond the average life expectancy.

Snehal Smart, M.D.

Snehal Smart, M.D.

Snehal Smart is the Pleural Mesothelioma Center’s in-house medical doctor, serving as both an experienced Patient Advocate and an expert medical writer for the website. When she is not providing one-on-one assistance to patients, Dr. Snehal stays current on the latest medical research, reading peer-reviewed studies and interviewing oncologists to learn about advancements in diagnostic tools and cancer treatments.

Medically Reviewed By Dr. Joanne Getsy
Last Modified April 3, 2019

5 Cited Article Sources

  1. Harris, E.J.A. et al. (2019, January 16). Diagnosis of asbestos-related lung diseases. Retrieved from
  2. American Cancer Society. (2018, November 16). Malignant Mesothelioma Stages. Retrieved from
  3. Sage, A.P. et al. (2018, July 27). Genomics and Epigenetics of Malignant Mesothelioma. Retrieved from
  4. Cassandro, R., Montrasio, S., & Espsito, V. (2008). Natural history of human pleural mesothelioma. In A. Baldi (Ed.), Mesothelioma from bench side to clinic (pp. 337-345). New York, NY: Nova Science Publishers, Inc.
  5. Moore, A., Parker, J., & Wiggins, J. (2008). Malignant Mesothelioma. Orphanet Journal of Rare Diseases. Retrieved from

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