Most Common Symptoms of Mesothelioma

It can take decades for someone who was exposed to asbestos to develop mesothelioma symptoms. Doctors call this the latency period, or the time between the patient’s initial exposure to asbestos and the occurrence of tumors. The standard latency period is 20 to 50 years but can range from 10 to 60 years or even longer.

The patient’s disease, stage of illness, overall health, and age, are all variables that affect this. Where the tumors are located will also affect a patient’s symptoms. Those with pleural mesothelioma usually notice effects to the respiratory symptom, with peritoneal affecting the stomach region, and pericardial causing symptoms around the heart. Besides physical reactions, patients with cancer may also develop related mental and emotional issues.

Often, mesothelioma is mistaken and misdiagnosed for other, less severe illnesses with similar symptoms, like the common cold. Additionally, it can be confused with other serious conditions, such as heart disease or ovarian cancer. Due to its long latency period, the slow onset of symptoms, and the fact that it is easily mistaken for other diseases, mesothelioma is often not diagnosed until it has progressed to stages 3 or 4. Unfortunately, a late-stage diagnosis can negatively affect prognosis and treatment options.

Mesothelioma Signs by Site

The earlier you are diagnosed, the more available treatment options are possible, significantly extending your life expectancy and improving your quality of life and that largely depends on where the cancer is. The three most common sites of mesothelioma are the pleura, the peritoneum, and the pericardium. Generally, the source of tumors influences the type of symptoms patients may experience. Each site has multiple warning signs that we’ve outlined below.

Pleural Mesothelioma Symptoms

Pleural mesothelioma is the most common form, accounting for approximately 80 percent of all cases. It affects the lining of the lungs and chest, called the pleura. The chest pain and respiratory symptoms of pleural mesothelioma are associated with the growth and spread of the primary tumor as it develops and hardens into a sheath-like formation across the pleura. Symptoms can also result from fluid buildup around the lungs, known as pleural effusion.

Pleural Symptoms

  • Anemia
  • Back pain
  • Shoulder pain
  • Blood clots
  • Body aches
  • Chest pain
  • Coughing up blood
  • Difficulty swallowing
  • Difficulty breathing
  • Fatigue
  • Anxiety
  • Fever/night sweats
  • Fluid buildup
    around the lungs
  • Hoarseness
  • Loss of appetite
  • Persistent dry cough
  • Shortness of breath
  • Weight loss
  • Wheezing

The symptoms of pleural mesothelioma often mirror those of other respiratory ailments, such as:

  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Emphysema
  • Influenza
  • Laryngitis
  • Lung cancer
  • Malignant neoplasm (primary or metastatic)
  • Mesothelial hyperplasia
  • Pneumonia
  • Pulmonary fibrosis
  • Synovial sarcomatoid
  • Tuberculosis

Peritoneal Mesothelioma Symptoms

Peritoneal mesothelioma accounts for approximately 20 percent of all cases and affects the lining of the abdomen. The abdominal symptoms of peritoneal mesothelioma are associated with the growth and spread of the primary tumor throughout the abdomen. In some later-stage patients, fluid buildups in the abdomen — also known as ascites.

Peritoneal Symptoms

  • Abdominal pain
  • Abdominal swelling/distension
  • Anemia
  • Bloating
  • Body aches
  • Bowel obstruction
  • Constipation
  • Diarrhea
  • Fatigue
  • Fever/night sweats
  • Fluid build up around the lungs
  • Hernia
  • Loss of appetite
  • Weight loss or gain
  • Nausea
  • Seizures
  • Vomiting
  • Wheezing
  • Shortness of breath
  • Shoulder pain

The symptoms of peritoneal mesothelioma can be mistaken for other conditions, such as:

  • Colorectal
  • Inguinal hernia
  • Irritable bowel syndrome (IBS)
  • Ovarian cancer
  • Primary peritoneal carcinoma
  • Stomach cancer
  • Gallbladder disease
  • Pancreatitis
  • Peptic ulcer disease

Pericardial Mesothelioma Symptoms

Pericardial mesothelioma accounts for less than 5 percent of cases and affects the heart’s lining. The initial symptoms of pericardial mesothelioma are associated with the growth and spread of primary tumors around the heart. Respiratory symptoms — such as shortness of breath and dry cough — occur in later-stage patients as cancer spreads throughout the chest cavity and into the pleura.

Pericardial Symptoms

  • Arrhythmia
  • Body aches
  • Chest pain
  • Fatigue
  • Fever/night sweats
  • Fluid build up around the heart
  • Heart murmur
  • Heart palpitations
  • Shortness of breath
  • Cough

The symptoms of pericardial mesothelioma can be confused for other cardiac issues, such as:

  • Coronary heart disease
  • Heart failure
  • Myocarditis (inflammation of the heart muscle)
  • Pericarditis (inflammation of the lining of the heart)

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Symptoms of Mesothelioma by Stage

This is an image representing stages 1 and 2 mesothelioma.

Stages 1 and 2

In addition to the type of mesothelioma, the stage can also significantly affect which symptoms are present. Patients with early-stage diagnoses — stages 1 and stage 2 may exhibit few symptoms, if any. At this point, the disease is still localized and there is minimal spreading to the lymph nodes or nearby organs. If symptoms are present, they are likely mild and can be easily mistaken for other diseases.

Specific symptoms depend on the type of mesothelioma. But in general, stage 1 and 2 symptoms may include a dry cough, chest or stomach pain, shortness of breath (dyspnea), fever, body aches, fatigue, and weight loss.

This is an image representing stages 3 and 4 of mesothelioma.

Stages 3 and 4

As cancer advances to stages 3 and 4, symptoms will become more apparent and more acute as the tumors spread to other organs, lymph nodes, and blood vessels. Stage 3 and stage 4 symptoms may include persistent dry cough or coughing up blood (hemoptysis), more severe chest or stomach pain, shortness of breath, fever, night sweats, body aches, fatigue, weight loss, anemia, blood clots, and fluid buildup around the affected organ(s).

Patients with advanced pleural mesothelioma may have difficulty speaking or swallowing (dysphagia), while those with peritoneal mesothelioma may experience nausea, vomiting, hernia, bowel issues, or seizures. Late-stage pericardial mesothelioma can cause heart complications, such as arrhythmia or heart palpitations. Unfortunately, due to the rarity of pericardial mesothelioma, it is usually diagnosed only after the patient has died.

Other Risk Factors That Can Affect Symptoms?

Metastasis: If cancer metastasizes, spreading beyond the original tumor site to other parts of the body, the patient may experience additional symptoms in those areas of the body. For instance, peritoneal mesothelioma often spreads to other abdominal organs, such as the liver, kidneys, spleen, appendix, and pancreas. This can prompt new symptoms not necessarily associated with peritoneal mesothelioma that hasn’t metastasized.

The Type of Asbestos: Although mesothelioma symptoms usually appear gradually over months or years, the type of asbestos the patient was exposed to can speed up the onset of symptoms. More hazardous forms of asbestos, such as crocidolite, can cause asbestos exposure symptoms to present earlier and more acutely.

Duration of Exposure: Patients who were continuously exposed to asbestos — even small amounts — in the workplace over a span of years may display symptoms sooner than usual. Similarly, patients who were exposed to a larger-than-average amount of asbestos all at once may experience an earlier onset of mesothelioma even if the exposure was short-lived.

For example, the original World Trade Center in New York was built in the early 1970s. Asbestos was used in the steel support beams, walls, insulation, and other fireproofing materials. After the towers collapsed during the terrorist attack on Sept. 11, 2001, hundreds of tons of asbestos fibers were released into the air. First responders, such as paramedics, firefighters, and police officers; search and rescue crews; and those tasked with cleaning up the site, were exposed to enormous amounts of asbestos both on the day of the attack and in the days, weeks, and months after.

In 2004 — just three years after asbestos exposure at Ground Zero — a 9/11 first responder died of mesothelioma. Another died in 2006, demonstrating a significantly shortened latency period compared to the average mesothelioma patient.

How to Relieve Painful Symptoms

The symptoms of mesothelioma can range from uncomfortable, to painful, to life-threatening. However, there are things you and your doctors can do to relieve pain and mitigate these symptoms. After you have been diagnosed with the type and stage of your cancer, you and your doctor will determine a customized course of treatment, often involving a combination of surgery, chemotherapy, radiation, and other treatments, such as immunotherapy. Your treatment will likely address many of your symptoms by attacking the root cause: cancer itself. But there are also steps and procedures that can help alleviate many of the symptoms apart from or in addition to potentially curative treatment.

Medical treatments

This is an image of fluid drained from the lung.

One of mesothelioma’s most painful symptoms is the fluid buildup around the affected organs. This is called pleural effusion around the lungs, ascites in the abdomen, and pericardial effusion around the heart. Several surgical procedures like thoracentesis (drainage of fluid from around the lungs), pleurodesis (injecting medicine into the lung space that causes the lung to stick to the chest wall), Paracentesis (drainage of fluid from the abdomen), pericardiocentesis (drainage of fluid from around the heart) and tunneled pleural or peritoneal catheter insertion can be performed to alleviate some of the symptoms caused by mesothelioma. These surgical procedures relieve fluid buildup to make patients more comfortable

This is an image of a needle


Your doctor may recommend steroids for you during the course of the disease to treat symptoms or prevent complications. Many patients experience weakness, fatigue, loss of appetite, and weight loss, both as symptoms of the disease itself and as side effects of treatment. Steroids can help increase energy and appetite, helping patients maintain active lives before, during, and after treatment. Steroids can also effectively reduce inflammation, especially after surgery, or reduce the risk of side effects of chemotherapy treatment.

Pain Medicine

Your doctor may recommend over-the-counter pain medicine, such as acetaminophen or ibuprofen, for mild symptom relief. They may prescribe stronger pain relievers, such as morphine, hydrocodone, oxycodone, or fentanyl to address worsening symptoms if necessary. Nerve blocks may also be used to target pain in specific areas of the body. Certain antidepressant medications can also be used for certain types of pain. Some patients may get referred to pain specialists to manage their pain.

Lifestyle Changes

Although lifestyle factors like diet, exercise, weight management, and adequate sleep cannot cure mesothelioma, they can help you stay healthy during treatment and positively influence your prognosis. On the other hand, smoking can worsen symptoms (especially respiratory problems) and has been shown to decrease life expectancy. The American Cancer Society also recommends that cancer patients get an annual flu shot – mesothelioma and the methods used to treat it can weaken the immune system. This can put patients at a higher risk of contracting and developing complications from the flu virus. However, it’s important to talk with your mesothelioma specialist before getting a flu shot to ensure that it will not interfere with your current course of treatment.

Mental Health

Patients also have to deal with the mental and emotional ramifications of their diagnosis, in addition to the physical symptoms. Talk to your doctor about methods for reducing stress (meditation, yoga, counseling, etc.), or consider speaking with a mental health care provider or spiritual counselor. In some cases, your doctor may prescribe antidepressants for stress or depression. Certain antidepressant medications may also be used for certain types of pain related to mesothelioma. Our patient advocate team can also help connect you to resources.

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