Early Symptoms Are Easy to Ignore
Mesothelioma symptoms are often ignored for too long because they are mild, especially in the early stages. They also mimic signs of less serious illnesses.
Because the early signs are easy to disregard, too many people receive a diagnosis of mesothelioma at a late stage. If you have been exposed to asbestos, or think you have, be vigilant about symptoms.
Also be aware that a misdiagnosis of mild symptoms is common and can delay a true diagnosis. Get a second opinion if necessary.
Symptoms Vary by Type of Mesothelioma
There are different types of mesothelioma depending on the location of the primary tumor. Each causes specific symptoms, though fatigue and weight loss are common in all types. It is important to remember that as the disease progresses, symptoms will change and worsen.
- Pleural mesothelioma symptoms begin in the respiratory system and impact breathing.
- Peritoneal mesothelioma symptoms start in the abdomen and affect digestion.
Signs and symptoms of this most common type of mesothelioma include:
- Chest pain
- Coughing up blood
- Difficulty swallowing
- Fatigue and muscle weakness
- Night sweats and fever
- Shortness of breath
- Weight loss
This is the type of mesothelioma that attacks the pleura, the lining of tissue that surrounds the lungs, so most symptoms are associated with breathing and the chest.
Some symptoms result from complications of the cancer, like pleural effusion. This occurs when fluid collects between the two layers of the pleura. It causes pain and shortness of breath that worsen over time and with activity.
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:
- Chronic pulmonary obstructive disorder
- Other respiratory infections
Peritoneal mesothelioma can cause the following:
This is the second most common type of mesothelioma. It affects the lining of the organs in the abdomen called the peritoneum. Peritoneal mesothelioma primarily causes symptoms related to abdominal organs.
As with pleural mesothelioma, the buildup of fluid is a common complication that causes symptoms. In the abdomen, this is called ascites and it causes swelling, discomfort, and even pain.
Other potential complications 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 more common gastrointestinal conditions:
- Crohn’s disease
- Ulcerative colitis
- A food allergy or sensitivity
- Irritable bowel syndrome
Affecting the lining of tissue around the heart, this type can cause:
- Trouble breathing
- Shortness of breath
- Chest pain
- Fatigue and fever
- Heart murmurs
Pericardial mesothelioma is rare. Swelling and fluid buildup in pericardium is the leading cause of symptoms, which can be mistaken for more common health conditions.
Pericardial effusion, the fluid buildup around the heart, is caused by a number of conditions other than pericardial mesothelioma. Possible misdiagnoses include:
- Heart disease
- Heart failure
The presence of a hydrocele, a buildup of fluid between the layers of the mesothelium within the scrotum, may be the first symptom.
It may also present as a lump under the skin on one or both of the testicles, which may be mistaken for a hernia. Without surgery it is difficult to determine if it is a hernia, mesothelioma, or another type of cancer.
Symptoms by Stage
Mesothelioma, like other cancers, is staged between one and four, from least to most advanced. The symptoms of all types of mesothelioma get more severe as the cancer grows and spreads.
The stage I and II symptoms may be mild enough that a patient is not 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 more common conditions.
Many people do not get a diagnosis of mesothelioma until the cancer is in a later stage. By this point symptoms have become severe and difficult to manage. Treatment options are limited at this point, which is why it is important to understand symptoms and seek a diagnosis early.
Symptoms of Benign Mesothelioma
Mesothelioma is almost always malignant. 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 can grow large, making surgical removal necessary.
The symptoms of benign mesothelioma are similar to the early symptoms of malignant pleural or peritoneal mesothelioma:
- Shortness of breath
- Chest pain
- Abdominal swelling
- Loss of appetite
The larger the tumor grows, the worse the symptoms become. Surgery should relieve all symptoms and usually cures the condition.
Symptoms and the Latency Period
Mesothelioma has a long latency period—between twenty and fifty years—compared to other illnesses and cancers. This is the period of time between the exposure to asbestos and a diagnosis.
The mild early symptoms is one reason for this long latency. Many people do not take symptoms seriously until they worsen as the cancer develops. Another issue is that the symptoms mimic those of more common illnesses. This further delays diagnosis and lengthens the latency period.
Symptoms of Metastasis
Metastasis is the spread of cancer cells to more distant tissues in the body. As the tumor metastasizes, symptoms typically become more severe. Chest pain, 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, pericardium, peritoneum, diaphragm, 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 Crucial
It is vitally important that if you know, or even suspect, that you have been exposed to asbestos, you educate yourself about these symptoms. Let your physician know about your occupational or environmental history.
Because few physicians have ever dealt with mesothelioma, the condition and its symptoms are easy to overlook. Being aware of early symptoms and pushing for a diagnosis gives 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.
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.
Page Medically Reviewed and Edited byLuis Argote-Greene, M.D.
Luis Argote-Greene is an internationally recognized thoracic surgeon. He has trained and worked with some of the most prominently known thoracic surgeons in the United States and Mexico, including pioneering mesothelioma surgeon Dr. David Sugarbaker. He is professionally affiliated with University Hospitals (UH). His areas of interest and expertise are mesothelioma, mediastinal tumors, thoracic malignancies, lung cancer, lung transplantation, esophageal cancer, experimental surgery, and lung volume reduction. Dr. Argote-Greene has also done pioneering work with video-assisted thoracoscopic surgery (VATS), as well as robotic assisted minimally invasive surgery. He has taught the procedures to other surgeons both nationally and internationally.