Symptoms of Mesothelioma
Cancers like mesothelioma can cause a range of adverse reactions in the patient. These reactions are called symptoms. Not every patient experiences the same effects, still, others may have similar symptoms, but with varying severity.
Medically Reviewed by: Kenyatta M. Cosby, MD | April 2nd, 2024
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Most Common Symptoms of Mesothelioma
It can take decades for someone who has been 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 it can range from 10 to 60 years or even longer.
The patient’s disease, stage of illness, age and overall health, and age, are all variables that can clinical outcomes. Where the tumors are located will also affect a patient’s symptoms. Those with pleural mesothelioma usually notice effects associated with respiratory symptom. Peritoneal disease affects the stomach region as pericardial disease usually causes symptoms around the heart. Besides physical reactions, patients with cancer may also develop disease-related mental and emotional symptoms.
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 clinical tumor stages 3 or 4. Unfortunately, a late-stage diagnosis can negatively affect the patient’s prognosis and limit the treatment options.
Mesothelioma Signs by Site
The earlier you are diagnosed; the more available and effective treatment options can have on overall clinical outcome. This can significantly extend your life expectancy and improve your quality of life, which largely depends on where the cancer is located. 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 have been 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 also associated with the growth and spread of the primary tumor as it develops into a hardened, sheath-like formation around the pleura. Symptoms can also be the result of fluid buildup around the lungs, known as pleural effusion. Some of the more common symptoms of this process are:
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 can build up within the abdomen — also known as ascites. The most common signs and symptoms are:
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 lining of the heart. 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 late-stage patients as cancer spreads throughout the chest cavity and into the pleural space. Some common symptoms include:
Pericardial Symptoms
- Arrhythmia
- Body aches
- Chest pain
- Fatigue
- Fever/night sweats
- Fluid buildup 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 surrounding the heart)
If you believe that you’ve worked somewhere with high asbestos risk, then you should request a case evaluation to assess your chances of past exposure.
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Symptoms of Mesothelioma by Stage
Stages 1 and 2
In addition to the types of mesothelioma, the stage of the disease can also significantly affect which symptoms are present. Patients with early-stage diagnoses — stages 1 and stage 2 may exhibit fewer 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.
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 rare clinical nature 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 directly 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 many 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 afterward.
In 2004 — just three years after the 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 event treatments, such as immunotherapy. Your treatment will likely address many of your symptoms by attacking the root cause of 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 treatments.
Medical Procedures
Thoracentesis/Pleurodesis/Paracentesis
One of mesothelioma’s most painful symptoms is the fluid buildup around the affected organs. This is called a pleural effusion, if around the lungs, ascites if in the abdomen, and/or pericardial effusion if 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) aand for a tunneled pleural or peritoneal catheter insertion which is performed to alleviate some of the long-term symptoms caused by mesothelioma. These surgical procedures are used to relieve fluid buildup and make patients more comfortable while performing everyday activities.
Pain Medicine
Your doctor may recommend over-the-counter pain medicine, such as acetaminophen or ibuprofen, for mild symptomatic relief. They may also prescribe stronger pain relievers, such as morphine, hydrocodone, oxycodone, or fentanyl to address worsening symptoms if necessary. Nerve blocks may be used to target pain in specific areas of the body. Certain antidepressant medications can also be used for certain types of pain. In addition, some patients may even get referred to a pain specialist to manage their pain.
Steroids
Your doctor may recommend steroids for you during the course of the disease to treat new onset symptoms or prevent long-term complications. Many patients experience weakness, fatigue, loss of appetite, and weight loss, which are as symptoms of the disease itself and can be side effects of treatment. Steroids can help increase energy and appetite levels while 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 after the use of chemotherapy treatment.
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 concerns) and has been shown to decrease overall 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 unfortunately, 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
Mesothelioma 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 to treat stress and/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 with useful resources.