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Symptoms of mesothelioma can often be confused with the warning signs of other diseases.

Key Points about Symptoms of Mesothelioma

  • It is very difficult to diagnose mesothelioma based on symptoms alone – usually a biopsy is required.
  • The symptoms experienced by mesothelioma patients depend on the cell type and location of the tumor(s) in the body.
  • If you experience symptoms of mesothelioma, contact your doctor right away.

In most cases, mesothelioma symptoms develop decades after the initial exposure to asbestos. Many of the early symptoms are often vague and mimic the symptoms of other, more common conditions. As a result, individuals may not pay serious attention to their symptoms, and physicians often wrongly diagnose mesothelioma for other disorders.  Once symptoms develop, an average of four months elapses before most people with mesothelioma are accurately diagnosed.

What Are the Symptoms of Mesothelioma?

Symptoms can vary significantly depending on the type of mesothelioma a person has. Most people in the early stage of mesothelioma will have no symptoms or will hardly notice them. As the disease advances, the types of symptoms that manifest depends on the specific organ involved (lung, heart, abdomen, or testes). Many symptoms are caused in part by increased pressure in those organs from thickening of the lining and fluid buildup resulting from tumor growth. When the cancer spreads (metastasizes) to other sites in the body, a wider range of symptoms can occur depending of the affected area.

Mesothelioma Symptoms Can Look Like Other Diseases

Very often, the symptoms of mesothelioma can be confused with symptoms of other diseases. Unfortunately, this often leads to wrong diagnosis, which in turn can delay the appropriate treatment of mesothelioma and make it harder to overcome the disease.
For example, mesothelioma that develops in the lining of the lungs (pleural mesothelioma) is often mistaken for the flu or pneumonia. Mesothelioma affecting the abdomen (peritoneal mesothelioma) may be misdiagnosed as an inguinal hernia or irritable bowel syndrome (IBS). If the heart is affected (pericardial mesothelioma), the symptoms may be similar to what is experienced with heart failure, coronary heart disease, or pericarditis (inflammation of the lining of the heart). A rare form of mesothelioma that affects the testicles may be mistaken for a hernia.

Most Common Mesothelioma Symptoms

The most common signs and symptoms of mesothelioma vary by location and type:

  • Pleural mesothelioma: chest pain, fluid buildup around the lungs (pleural effusions), and shortness of breath (dyspnea).
  • Peritoneal mesothelioma: abdominal pain, bloating from the buildup of fluid in the abdominal cavity (ascites), weight loss, and loss of appetite.
  • Pericardial mesothelioma: chest pain, fluid buildup in the sac surrounding the heart (pericardial effusion), and abnormal heart sounds or murmurs.
  • Testicular mesothelioma: fluid build-up in the scrotum, also known as a hydrocele.

In advanced stages of mesothelioma, symptoms often reflect the pattern of spread and its effect on the part(s) of the body that are affected. In addition, blood tests often detect other abnormalities such as an increased tendency of blood to clot (thrombosis) and a low red blood cell count (anemia).

Symptoms in Advanced Stages of Mesothelioma

Pleural MesotheliomaPeritoneal MesotheliomaPericardial Mesothelioma
  • Fatigue
  • Low oxygen levels
    (hypoxemia)
  • Increased difficulty
    breathing (dyspnea)
  • Difficulty swallowing
    (dysphagia)
  • Hoarseness
  • Spinal cord compression
  • Horner’s syndrome
  • Night sweats or fever
  • Coughing blood
    (hemoptysis)
  • Nausea
  • Loss of appetite
    (anorexia)
  • Dramatic, unexplained
    weight loss
  • Fever
  • Anemia
  • Low blood sugar
    (hypoglycemia)
  • Blood clots (thrombosis)
  • Painful breathing due to
    pleural effusion
  • Palpitations or an
    irregular heartbeat
    (arrhythmia)
  • Coughing
  • Shortness of breath
    (dyspnea)
  • Chest pain
  • Fever
  • Night sweats

* Horner’s Syndrome is a set of symptoms that affect the eye, including drooping, pupil constriction, and local anhidrosis (inability to sweat).

Several Factors Affect Mesothelioma Symptoms

Because of the lengthy period of time between exposure to asbestos and the development of symptoms, and because of the large overlap between symptoms caused by mesothelioma and other conditions, mesothelioma is one of the hardest diseases to diagnose.

Several factors influence when and how symptoms of mesothelioma develop. Some of the most important factors are a person’s occupation, the duration of asbestos exposure, and the type of asbestos they were exposed to.

Occupation: People whose working conditions exposed them to very high levels of asbestos may develop symptoms sooner than those with low levels of exposure.

Amount and Duration: Individuals who are exposed to large amounts of asbestos over a long period of time may have symptoms develop more quickly than those who are exposed to a small amount for a short period of time.

Asbestos Type: Exposure to crocidolite, a particularly hazardous type of asbestos, may cause symptoms to manifest sooner than exposure to other types of asbestos.

The location of mesothelioma, cell type, and the extent to which the cancer has spread beyond the original site also influence how and when symptoms will start to manifest.

Details of Mesothelioma Symptoms by Type

The symptoms due to mesothelioma are a direct result of the location of the tumor and its pattern of spread.

Pleural Mesothelioma Symptoms

Pleural mesothelioma is cancer of the lining that surrounds the lungs and is the most common type of mesothelioma, accounting for 60 – 70% of all cases. Eighty percent of patients have a known history of asbestos exposure, and many patients will have no symptoms until late in the disease. Early symptoms such as chest pain and shortness of breath may be dull and slight when they first occur, and they are often ignored or thought to be due to aging or some other disorder.

Pleural mesothelioma is often misdiagnosed as influenza (flu), pneumonia, chronic obstructive pulmonary disease (COPD), and even lung cancer.

Symptoms of Pleural Mesothelioma

  • Chest pain
  • Persistent coughing
  • Fluid build-up in the lining of the lungs (pleural effusion)
  • Fever
  • Fatigue
  • Weight loss
  • Body aches

Peritoneal Mesothelioma Symptoms

Peritoneal mesothelioma is cancer of the lining surrounding the abdomen and represents between 22% and 30% of cases. Only about 50% of individuals with peritoneal mesothelioma have a known history of asbestos exposure. The initial appearance of symptoms varies considerably depending on the individual. The most common initial signs and symptoms are abdominal pain and swelling, loss of appetite (anorexia), significant weight loss and fluid build-up in the abdomen (ascites). In addition, individuals may experience nausea, fever and show signs of anemia.

Inguinal hernia and irritable bowel syndrome (IBS) are commonly mistaken diagnoses.

Symptoms of Peritoneal Mesothelioma

  • Abdominal pain
  • Abdominal swelling
  • Loss of appetite (anorexia)
  • Weight loss
  • Fluid build-up (ascites)
  • Nausea
  • Fever
  • Anemia

Pericardial Mesothelioma Symptoms

Cancer of the lining surrounding the heart is referred to as pericardial mesothelioma, a very rare cancer that represents less than 1% of mesothelioma cases and is often diagnosed after death. The most common signs and symptoms associated with pericardial mesothelioma are chest pain, fluid build-up in the sac surrounding the heart (pericardial effusion) and heart murmurs. Individuals may also experience shortness of breath, an irregular heartbeat (arrhythmia), fever and night sweats.

Depending of the dominant symptom, pericardial mesothelioma can be mistaken for heart failure, coronary heart disease, inflammation of the lining of the heart (pericarditis) and muscle (myocarditis).

Symptoms of Pericardial Mesothelioma

  • Chest pain
  • Pericardial effusion
  • Heart murmur
  • Shortness of breath (dyspnea)
  • Irregular heartbeat (arrhythmia)
  • Fever
  • Night sweats

Testicular Mesothelioma Symptoms

Cancer of the lining covering the testes or tunica vaginalis is known as testicular mesothelioma. Testicular mesothelioma is also very rare, representing less that 1% of mesotheliomas. Only about 30% of individuals have a history of asbestos exposure. Individuals will often complain of painless enlargement of the scrotum. There may also be accumulation of fluid around the testicle (hydrocele), and in about 30% of cases, a solid testicular mass may be detected.

A hernia or other tumors of the testes may be confused with testicular mesothelioma.

Symptoms of Testicular Mesothelioma

  • Painless enlargement of the scrotum
  • Fluid accumulation (hydrocele)
  • Solid mass

When Do Mesothelioma Symptoms Arise?

The onset of symptoms of mesothelioma can vary considerably between individuals and is influenced by several factors such as gender, the severity of asbestos exposure, and the length of time of exposure.

Furthermore, people with a history of heavy asbestos exposure over a prolonged period of time may experience symptoms sooner that those with lighter exposure over a shorter duration. With prolonged exposure to asbestos, symptoms may appear in less than 30 years. However, if the level of exposure is extremely high and the exposure time is short, such as occurred with first responders after the attack on the World Trade Center in 2001, symptoms may appear within a few years (less than 5 years) and the disease may be rapidly fatal.

The latency period for mesothelioma is between 30 and 45 years. However, this latency period can be considerably shortened by factors such as extremely high levels of asbestos exposure. When symptoms such as cough, mild chest pain, or breathlessness first develop, they are usually vague and nonspecific, leading many people to believe they are caused by common illnesses or aging. Physicians may also delay in making an accurate diagnosis because of the tremendous overlap of symptoms with other disorders.

All of these factors combined lead to very few patients being diagnosed with early Stage 1 mesothelioma, which has the most promising prognosis.

Mesothelioma Symptoms by Stage

Staging of mesothelioma is used to determine how far the cancer has spread and is an important determinant of the prognosis (outlook). Generally, symptoms are worse in later stages of the cancer than in earlier stages.

Stage 1: Cancer is found in the lining of the lung, stomach or heart, is located only on one side of the body, and there are no lymph nodes involved. Most people have no major symptoms during this stage.

Stage 2: Cancer has spread to the lining of the lungs, diaphragm, close lymph nodes, and possibly the lining of the heart on one side of the body. Alternatively, the tumors have grown beyond the point of origin, and there is some lymph node involvement. Symptoms such as coughing and shortness of breath (pleural mesothelioma) or weight loss and bloating (peritoneal mesothelioma) may become more obvious, but may still be vague.

Stage 3: The mesothelioma has now spread to the organs surrounding the original place of origin, is located on the same side of the body and has not spread to the other side. However, cancer cells may also be found in the lymph nodes. This is considered an advanced stage, and most diagnoses are made in Stage 3. Symptoms typically include increased difficulty breathing and chest pain (pleural) or bowel obstruction, abdominal pain, and discomfort (peritoneal)

Stage 4: The cancer has spread to the lymphatic system and the tumor is found in many different parts of the body. The severity of symptoms increases and new symptoms develop depending on the parts of the body affected. Symptoms include difficulty breathing, severe pain, digestive problems, and difficulty swallowing.

Metastatic Mesothelioma Symptoms

Metastasis is the spread of cancer to parts of the body away from where the first tumor(s) originated. Symptoms caused by metastases may not appear in the location where the mesothelioma initially developed. When symptoms do appear, they are evidence of advanced mesothelioma. The most common symptoms associated with metastatic mesothelioma are;

  • Coughing or spitting up blood (hemoptysis)
  • Laryngeal nerve palsy (due to damage to the laryngeal nerve leading to paralysis of the voice box)
  • Nerve issues, such as problems with the arms
  • Horner’s syndrome

What Should I Do if I Exhibit Mesothelioma Symptoms?

If you have been exposed to asbestos, there is at least some risk that you could develop mesothelioma. If you are experiencing symptoms consistent with mesothelioma, the first thing to do is to talk to your family doctor to discuss potential causes of the symptoms and determine whether mesothelioma or some other disease may the culprit. It is extremely important to not wait, since mesothelioma is a very aggressive form of cancer and the prognosis is best for those who catch it early.

Your doctor may refer you to a thoracic oncologist or another specialist for consultation and further tests. We have information about mesothelioma specialists across the country who can help you. We also have information on cancer centers that contain mesothelioma treatment programs. Some of these centers also are conducting clinical trials, which may offer experimental treatments that are otherwise not available to the general public.

Finally, if you are diagnosed with having mesothelioma, you will need to explore treatment options. You should also learn about what financial assistance may be available, and understand your legal rights as a mesothelioma patient.

Sources & About the Writer [+]
  • 1 Chekol S. S., Sun C.C. “Malignant mesothelioma of the tunica vaginalis testis: diagnostic studies and differential diagnosis.” Archives of Pathology and Laboratory Medicine. 2012;136(1):113-117. PMID: 22208496.
  • 2 Sterman, D.H., et al. “Clinical presentation, diagnosis, and staging of malignant pleural mesothelioma.” UpToDate.
  • 3 Ribak J., Lilis R., Suzuki Y., Penner L., Selikoff I. J. “Malignant mesothelioma in a cohort of asbestos insulation workers: clinical presentation, diagnosis, and causes of death.” British Journal of Industrial Medicine. 1988;45(3):182-187. PMID: 3348994. PMCID: PMC1007965.
  • About The Writer Photo of Dan Heil Dan Heil

    Dan is a contributing writer for The Mesothelioma + Asbestos Awareness Center. He hopes to help educate on everything related to a mesothelioma diagnosis and answer any questions patients or family members may have.