One of the most frustrating aspects of mesothelioma is that the cancer can hide inside your body for decades without showing any kind of outward sign. For all intents and purposes you may appear to be healthy while actually harboring the condition, and as it invisibly grows and gains strength it becomes more and more difficult to treat.
The symptoms of this type of cancer are an important part of why mesothelioma is so difficult to treat. In order to have the best prognosis and for treatment to be successful, it is important that people at risk for mesothelioma know the signs and symptoms and carefully watch for them. Don’t let the symptoms be mistaken or anything else and if you feel your doctor isn’t taking your symptoms or concerns seriously enough, it may be time to seek a second opinion.
Early Symptoms and Misdiagnosis
The symptoms of mesothelioma play an important role in the overall outlook of this condition and how it is treated. They are at the heart of what makes mesothelioma difficult to treat and impossible to cure in nearly every case. Mesothelioma symptoms are often ignored because they simply don’t seem that serious, especially in the early stages.
Even more difficult is the fact that mesothelioma’s early symptoms often mimic those of other, less serious conditions, leading many to disregard them entirely or misdiagnose them and treat for the wrong illness. This is why it is so vital that if you have been exposed to asbestos, you are aware of mesothelioma’s symptoms and be aware of the potential for a misdiagnosis that could delay life-saving treatment.
Symptoms Vary by Type of Mesothelioma
Though mesothelioma is a single disease there are different types. Each appears in a different part of the body, and each has its own symptoms, though fatigue and weight loss are common in all types. It is important to remember that as the disease progresses, symptoms will change. New ones will appear and old ones will grow worse.
The most common categorization for mesothelioma is by the location in the body in which the tumor originated. So for pleural mesothelioma, for instance, the form of the cancer that attacks the lining of the lungs, the symptoms involve the respiratory system and breathing, while for peritoneal mesothelioma they are related to the abdomen and digestion.
Symptoms of Pleural Mesothelioma
This is the type of mesothelioma that attacks the pleura, the lining of tissue that surrounds the lungs. It is the most common form of mesothelioma and the type most closely associated with exposure to asbestos. Some of the most common, earlier symptoms of pleural mesothelioma are chest pains, shortness of breath, wheezing, coughing, and pleural effusion. Pleural effusion occurs when fluid collects between the two layers of the pleura. This is a symptom of mesothelioma, but also causes symptoms like pain while breathing.
Pleural effusion is the most common of all symptoms of this type of mesothelioma. Shortness of breath is the next most often cited symptoms, followed by chest pains and a chronic, often painful cough. Weight loss that is unexplained may also be a symptom of pleural mesothelioma. These symptoms will vary by individual and by the severity or the stage of the cancer. If the tumor has grown very large or if it has spread and invaded other tissues, these symptoms are likely to be more severe.
The most common symptoms of pleural mesothelioma are easy to mistake for the symptoms of other conditions that are not as serious or life-threatening. Before the symptoms become too severe a patient may be given a diagnosis or bronchitis or chronic pulmonary obstructive disorder, or even pneumonia or other infections. This confusion about symptoms delays diagnosis and treatment for many patients, which only makes the cancer more difficult to treat once finally diagnosed correctly.
Symptoms of Peritoneal Mesothelioma
The second most common type of mesothelioma affects the lining of the organs in the abdomen called the peritoneum. Peritoneal mesothelioma, like the pleural form of the cancer, is associated with asbestos exposure, the biggest risk factor for it. It primarily causes symptoms related to abdominal organs. As with pleural mesothelioma, the most common symptom of peritoneal mesothelioma is the buildup of fluids. In the abdomen this is called ascites and it can cause swelling, discomfort, and even pain.
The second most common symptoms are decreased appetite and the resulting weight loss that occurs. Someone with peritoneal mesothelioma may also experience a feeling of fullness because of the distension caused by ascites. This contributes to the loss of appetite and weight loss. Other symptoms include fatigue, bowel obstructions, indigestion, and hernias.
The symptoms of peritoneal mesothelioma may not seem that serious in the early stages, which can lead to a delay in diagnosis. They also mimic the signs of gastrointestinal conditions, which often leads a doctor to make a misdiagnosis of Crohn’s disease, ulcerative colitis, a food allergy or sensitivity, or irritable bowel syndrome. As with pleural mesothelioma, delay in diagnosis and treatment are common.
Not very common among mesotheliomas is pericardial mesothelioma. This is the form of the cancer that originates in the lining of the heart, called the pericardium. Like the mesothelium around the lungs and abdominal cavity, the pericardium can swell with fluid or simply thicken as a result of the presence of tumors. This is the leading cause of symptoms, which again can be mistaken for other health conditions.
Pericardial mesothelioma can cause many of the same symptoms as pleural mesothelioma, including trouble breathing, shortness of breath, and chest pains. These are the most common symptoms of this form of mesothelioma, but patients may also experience fatigue and fever, shortness of breath that gets worse when lying on the back, heart palpitations, and heart murmurs.
Misdiagnoses also happen with pericardial mesothelioma. It can be misdiagnosed as a pleural effusion, which can be caused by a number of conditions. It may be misdiagnosed as heart disease, heart failure, pericarditis, cardiac tamponade, cardiomyopathy, or other types of heart-related conditions.
Testicular mesothelioma is the rarest type of this cancer, with only about 100 cases ever reported. There is no comprehensive list of symptoms because this is so rare even for a type of cancer that is rare in itself. Most often, what leads a patient to ultimately get a diagnosis of testicular mesothelioma is something called a hydrocele. This is the buildup of fluid between the layers of the mesothelium within the scrotum.
The next most common complaint with this type of mesothelioma is a lump under the skin on one or both of the testicles. This is often mistaken for a hernia, a condition in which part of an abdominal organ or tissue protrudes through the wall of the abdominal muscle. Surgery to remove a lump discovered on the testicles is most often what leads to a diagnosis of mesothelioma. Without surgery it is difficult to determine if it is a hernia, mesothelioma, or another type of cancer.
Symptoms and Stage
Mesothelioma, like other cancers is staged between one and four. Stage I cancer is the earliest stage when the original tumor has not yet metastasized or invaded other tissues. As the original tumor grows and metastasis occurs, the cancer develops into stage II, III, and finally IV. The symptoms of all types of mesothelioma get more severe as the cancer develops.
The stage I and II symptoms may be mild enough that a patient does not get alarmed and does not seek out a diagnosis. By stage III the patient may seek a diagnosis, but there may still be a delay as symptoms worsen, but seem similar to other, more common conditions. Many people are not diagnosed with mesothelioma until the cancer is already at stage IV. By this point symptoms have become severe, painful, and very uncomfortable. Treatment at this stage can help relieve symptoms.
Other Types of Cancer
A common misdiagnosis for every type of mesothelioma is cancer of another type. This is because mesothelioma is rare, but also because the symptoms mimic those of other types of cancer. For instance, pleural mesothelioma is often misdiagnosed as lung cancer. Both can be caused by exposure to asbestos and both cause similar symptoms. Peritoneal mesothelioma may be likewise misdiagnosed as stomach cancer, while testicular mesothelioma can be misdiagnosed as testicular cancer.
Because the symptoms are often similar to other types of cancer and because mesothelioma is rare, a misdiagnosis of cancer is not uncommon. The only way to really know if a tumor is caused by mesothelioma as opposed to lung cancer or another type of cancer is to biopsy it, followed by examination of the cells under a microscope or with immunohistochemical stains. Even these diagnostic steps are not foolproof, though, and mesothelioma can still be misdiagnosed.
Mesothelioma is almost always malignant, which means that it has the potential to spread and invade tissues and organ outside of where it originated in the body. Benign mesothelioma is very rare, but possible. It is unrelated to asbestos exposure and may begin with a tumor in any area of the mesothelium. The tumor may grow very large and can be surgically removed, but it may also recur after surgery.
The symptoms of benign mesothelioma are similar to the early symptoms of malignant mesothelioma. In the pleura it may cause shortness of breath, pleural effusion, and chest pains, just as with malignant pleural mesothelioma. In the peritoneum it can cause indigestion, swelling, and loss of appetite. The larger the tumor grows, the worse the symptoms may be, although surgery typically relieves all symptoms and cures the condition.
Symptoms and the Latency Period
The latency period for mesothelioma is defined as the time period between the first exposure to asbestos and the diagnosis of the cancer. It is characteristically long for mesothelioma, in part because of the symptoms. Because the symptoms are minor initially and because they mimic other conditions, diagnosis often gets delayed. The latency period for mesothelioma averages around two to three decades, but may be as long as 50 years.
Symptoms of Metastasis
Metastasis, the invasion of new tissues and organs by the cancer cells, may first begin in stage III of mesothelioma. As the tumor metastasizes, symptoms typically become more severe. Chest pains, pleural effusion, shortness of breath, and other signs worsen. The symptoms may also shift depending on where the cancer spreads.
As pleural mesothelioma metastasizes, it may begin to spread to the lymph nodes, the pericardium and peritoneum, the diaphragm, the chest wall, and the lungs. Symptoms may progress to include abdominal symptoms, fatigue, and fever. Peritoneal mesothelioma may spread to the intestines, liver, spleen, stomach, and other abdominal organs causing more related symptoms with greater severity.
Early Detection of Symptoms is Important
It is vitally important that if you know that you have been exposed to asbestos, you educate yourself about these symptoms and let your physician know about your occupational or environmental history. Because few physicians have been exposed to mesothelioma, the condition is easy for them to miss, and this is a big part of the problem of treating this difficult disease. Time is of the utmost importance. Knowledge of the condition’s symptoms can gain you valuable treatment time.
If you suspect you have been given a misdiagnosis, don’t be afraid to seek a second opinion. A good doctor not only won’t mind that you do, he or she will encourage you to take the steps you need to feel more comfortable. A second opinion for a condition as serious and as easy to misdiagnose as mesothelioma just makes sense.
It’s also a good idea to take your concerns to a specialist. Mesothelioma is a highly specialized type of cancer. Most doctors, even oncologists, have little to no experience diagnosing or treating it. Especially if you have the risk factors for mesothelioma, if you experience symptoms that concern you, seek out a specialist in this kind of cancer or a cancer center that staffs experts in mesothelioma. It could be the best decision you make for your health and your future.
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