What Are the First Signs of Mesothelioma?

The first signs of pleural mesothelioma include worsening shortness of breath and chest-wall pain. For peritoneal mesothelioma, signs include abdominal pain and distension or swelling. They can mimic signs of many less serious conditions such as bronchitis, pneumonia, hernias or irritable bowel syndrome.

This is why malignant 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.

What Are the Most Common Mesothelioma Symptoms?

  • Shortness of breath
  • Chest pain long before receiving a diagnosis
  • Pleural effusions (excess fluid around the lungs)
  • Pain around the abdomen
  • Abdominal swelling or distention
  • Ascites (excess fluid around the abdomen)

Approximately 70% of mesothelioma patients develop fluid around their lungs or abdomen. 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.

Factors Influencing Symptoms of Mesothelioma

Several factors have an influence on symptom severity and when mesothelioma symptoms arise, including:
  • Stage: Both the severity and development of symptoms are influenced by the cancer’s stage. As the cancer progresses into later stages, symptoms begin to develop and they increase in severity.
  • Overall Health: A patient’s overall health may influence the severity of symptoms. For example, patients in poor health may experience increased pain, fatigue and difficulty sleeping. People who are under a lot of stress may experience more intense symptoms. Those who smoke may have more difficulty breathing.
  • Multiple Conditions: Patients who have other underlying health conditions, such as cardiovascular disease, heart disease or chronic obstructive pulmonary disorder, may experience more severe symptoms sooner.
  • Treatments Elected: One the most impactful things a person can do to control mesothelioma symptoms is to undergo treatment. For example, chemotherapy controls chest pain and improves difficulty breathing, and it is available to patients at any stage.
Doctor speaking with an older woman
Connect with a Mesothelioma Doctor
Mesothelioma specialists play critical roles in improving prognosis

Common Symptoms by Type of Mesothelioma

The symptoms of the two most common types of mesothelioma, pleural and peritoneal, are well-documented in medical literature. Much is known about the symptoms and how they correlate to disease progression.

Less is known about the symptoms of the two least common types of mesothelioma, pericardial and testicular. Doctors are aware of the most common symptoms for these cancers, but they resemble symptoms of other conditions, making diagnosis challenging.

The primary symptoms of pericardial mesothelioma include heart palpitations, murmurs and arrhythmias, chest pain, difficulty breathing, fever and fatigue.

The primary symptoms of testicular mesothelioma include testicular pain and swelling, and fluid or a lump in the scrotum.

Pleural Mesothelioma Symptoms

The most common symptoms that pleural mesothelioma patients develop first include:
Top 3 pleural mesothelioma symptoms
As the cancer grows and spreads, other symptoms develop or worsen including:
  • Coughing or wheezing
  • Shortness of breath (dyspnea)
  • Chest pain
  • Pleural effusion (fluid around the lungs)
  • Fever or night sweats
  • Fatigue
  • Muscle weakness
  • Unexplained weight loss
  • Loss of appetite
  • Trouble swallowing (dysphagia)

Many of these symptoms may initially lead doctors to misdiagnose pleural mesothelioma as pneumonia, chronic bronchitis or adenocarcinoma.

Doctors control these symptoms with treatments and medications such as surgery, chemotherapy, radiation therapy, pleural drainage, pain medicine and steroids.

Peritoneal Mesothelioma Symptoms

The most common symptoms of peritoneal mesothelioma include:
Top 3 peritoneal mesothelioma symptoms
Other symptoms develop or worsen as the cancer spreads including:
  • Abdominal pain
  • Abdominal distention (bloating)
  • Abdominal swelling
  • Hernias (small portion of organ protrudes through the abdominal wall)
  • Loss of appetite
  • Weight loss
  • Feeling of fullness
  • Fatigue
  • Abdominal fluid buildup (ascites)
  • Bowel obstruction (blockage)

Potential misdiagnoses of peritoneal mesothelioma include hernia, irritable bowel syndrome, ulcerative colitis, Crohn’s disease and ovarian cancer.

Doctors control these symptoms with surgery, chemotherapy, abdominal drainage, pain medicine and steroids.

Early-Stage Symptoms

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

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

In the second stage of mesothelioma, tumors spread beyond the lining of the lungs or abdomen and into nearby tissues. Pain in the chest or abdomen may occur or increase. Pain also may be felt in the shoulder or upper abdomen.

Although rare, coughing, breathing issues, abdominal pain or digestive issues can appear or worsen at this stage, and some people may begin losing weight without trying.

Late-Stage Symptoms

During stage 3 mesothelioma, tumors spread further throughout the chest or abdomen, placing pressure on the lungs, chest wall and abdomen. These physical changes can lead to an increase in pain and difficulty breathing, dry cough, abdominal swelling or distension, bowel changes, fatigue and weight loss.

The tumors also may spread into close organs and nearby lymph nodes. This may contribute to unexplained weight loss and fatigue.

In stage 4 mesothelioma, tumors have spread throughout the chest or abdomen. It is rare for mesothelioma to spread to distant locations around the body. Tumors increasing in size can severely worsen pain, shortness of breath and digestive issues.

Other symptoms may include lumps of tissue under the skin on the chest or abdomen, 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.

Inside of our mesothelioma guide
Free 2020 Mesothelioma Guide
Critical Mesothelioma Information for Patients & Families

How Do Mesothelioma Symptoms Impact Diagnosis?

Patients usually receive a mesothelioma diagnosis in a later stage because symptoms don’t develop until the cancer has reached stage 3 or 4. By this time, the cancer has grown and spread to the point that aggressive treatment is no longer effective.

The fact that mesothelioma symptoms develop late in disease progression has a negative impact on a patient’s prognosis. This limits treatment options and ultimately shortens survival.

How Mesothelioma Specialists Address Mesothelioma Symptoms

A mesothelioma specialist has a lot of experience and background helping patients cope with mesothelioma symptoms. The treatments and medications they use to control symptoms are tailored to each patient based upon their type of cancer, the stage of mesothelioma and their overall health.

Mesothelioma specialists sometimes work closely with a palliative care specialist, which is a doctor with expertise in managing disease symptoms and improving patient quality of life.

Treating Mesothelioma Symptoms

The most important thing is to find a specialist who understands all the intricacies of treating mesothelioma. They have the expertise to know which treatments are appropriate to use, and they won’t recommend a treatment that could hurt you more than help you.

For example, surgery is the most effective treatment option for mesothelioma. But not all patients qualify for surgery. While surgery can improve many mesothelioma symptoms, it is typically only recommended to patients diagnosed in the first two stages.

Chemotherapy is available to mesothelioma patients at any stage, and it is effective at controlling chest pain and difficulty breathing. Radiation therapy is also available to all patients, and it effectively controls chest pain caused by tumors invading the chest wall.

Palliative procedures such as thoracentesis, pleurodesis and paracentesis drain fluid from the pleural lining around the lungs or the abdominal lining. These procedures reduce swelling, bloating and pain.

Certain complementary therapies, such as a healthy diet and gentle exercise, may help reduce mesothelioma symptoms. Be sure to discuss any complementary therapy with your doctor first so they can let you know if it will interfere with your treatment plan.

Steps to Manage Mesothelioma Symptoms

  • Surgery to remove tumors or fluid pressing on the lungs or abdomen
  • Radiation therapy or chemotherapy to shrink tumors
  • Medication to manage pain
  • Pulmonary rehabilitation to improve lung flexibility and diaphragm strength
  • Self-care options such as taking a warm bath or applying cold packs to painful areas
  • Good nutrition to boost your strength and energy

Advocate for Yourself

If you have a history of asbestos exposure and develop any symptoms of mesothelioma, you must advocate for yourself to receive proper testing. Imaging scans, blood tests and biopsies will lead to an accurate diagnosis, but you might have to fight for them.

Mesothelioma is rare, which means it isn’t the first diagnosis most doctors will think of. Make sure to explain how you were exposed to asbestos and for how long.

Regardless of how you decide to manage your mesothelioma symptoms, don’t suffer in silence. A mesothelioma specialist can help you feel better with the right treatment plan. And don’t underestimate the power of a strong support system to help you through tough days. Many mesothelioma survivors say the help they received from family, friends, neighbors and their community got them through challenging times.

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.