10 Warning Signs and Symptoms of Mesothelioma You Should Know

Mesothelioma is a rare and aggressive form of cancer that develops in the thin layer of tissue covering most of your internal organs, known as the mesothelium. This disease is primarily caused by exposure to asbestos, and its symptoms often don’t appear until decades after the initial exposure. Understanding the warning signs of mesothelioma is crucial for early detection and better treatment outcomes.

The symptoms of mesothelioma can vary depending on where the cancer is located in the body. Pleural mesothelioma, which affects the tissue surrounding the lungs, is the most common type, accounting for about 75% of cases. Peritoneal mesothelioma affects the abdominal lining, while rarer forms can affect the heart and testicles. Because mesothelioma symptoms often mimic those of less serious conditions, many people don’t realize they have this serious illness until it has progressed to later stages.

In this comprehensive guide, we’ll explore the ten most common symptoms of mesothelioma, helping you recognize the warning signs that should prompt immediate medical attention.

1. Persistent Chest Pain

Chest pain is one of the most common and earliest symptoms of pleural mesothelioma. This pain typically develops in the lower back or along the sides of the chest and is caused by the accumulation of fluid between the lung and chest wall, or by tumors pressing against the chest wall and ribs.

The characteristics of mesothelioma-related chest pain include:

• Persistent and worsening nature: Unlike temporary pain from muscle strain, mesothelioma chest pain tends to be ongoing and gradually intensifies over time
• Sharp or dull sensations: Patients may experience either sharp, stabbing pains or a constant dull ache
• Pain during breathing: The discomfort often becomes more pronounced when taking deep breaths or coughing
• Limited relief from over-the-counter pain medications: Standard pain relievers typically provide little to no relief

Many patients initially mistake this chest pain for less serious conditions such as pneumonia, pulled muscles, or general aging-related discomfort. However, if chest pain persists for more than two weeks or progressively worsens, it’s essential to consult a healthcare provider, especially if you have a history of asbestos exposure.

2. Shortness of Breath (Dyspnea)

Difficulty breathing, medically known as dyspnea, is another hallmark symptom of pleural mesothelioma. This occurs when fluid accumulates in the pleural space (the area between the lungs and chest wall), a condition called pleural effusion, or when tumors grow and compress the lungs, reducing their capacity to expand fully.

Patients with mesothelioma-related breathing difficulties typically experience:

• Progressive breathlessness: The symptom often starts mildly, with shortness of breath during physical activities, but gradually worsens to affect even resting states
• Sensation of not getting enough air: Many patients describe feeling like they cannot take a full, satisfying breath
• Rapid, shallow breathing: As the condition progresses, breathing patterns may change to become faster and more shallow
• Increased difficulty when lying flat: Many patients find they can breathe more easily when sitting upright or propped up with pillows

This symptom can significantly impact quality of life, making it difficult to perform everyday activities such as climbing stairs, walking short distances, or even carrying on conversations. The gradual onset of this symptom often causes patients to adapt their lifestyle slowly without realizing the severity of their condition, which can delay diagnosis.

3. Persistent Dry Cough

A chronic, persistent cough is a common respiratory symptom of pleural mesothelioma. This cough is typically dry and non-productive, meaning it doesn’t produce mucus or phlegm. The irritation causing the cough stems from the tumors and fluid accumulation affecting the lungs and surrounding tissues.

Key features of mesothelioma-related cough include:

• Prolonged duration: The cough persists for weeks or months without improvement
• Worsening at night: Many patients report that their cough intensifies when lying down
• No response to typical cough remedies: Over-the-counter cough suppressants and home remedies provide little relief
• May be accompanied by chest pain: Coughing often triggers or intensifies chest discomfort
• Sometimes produces small amounts of blood: In some cases, patients may notice blood-tinged sputum, a concerning sign that requires immediate medical attention

Because a persistent cough is also a symptom of many other conditions, including bronchitis, allergies, and the common cold, it’s frequently overlooked as a potential sign of mesothelioma. However, any cough lasting more than three weeks, especially in individuals with asbestos exposure history, warrants thorough medical evaluation.

4. Unexplained Weight Loss

Unintentional weight loss is a significant symptom that occurs in many mesothelioma patients, particularly as the disease progresses. This weight loss happens without deliberate dieting or changes in eating habits and is often one of the symptoms that prompts people to seek medical attention.

Several factors contribute to weight loss in mesothelioma patients:

• Cancer cachexia: This is a complex metabolic syndrome associated with cancer that causes muscle wasting and weight loss. The cancer cells alter the body’s metabolism, making it difficult to maintain weight even with adequate nutrition
• Reduced appetite: The disease and its symptoms often cause a decrease in appetite and interest in food
• Difficulty swallowing: When tumors affect the esophagus or cause chest pain, eating may become uncomfortable
• Early satiety: Patients with peritoneal mesothelioma may feel full quickly due to abdominal fluid accumulation and tumor growth
• Increased energy expenditure: The body uses more energy fighting the cancer

Losing 10 pounds or more without trying over a period of six months or less is considered significant and should be evaluated by a healthcare provider. In mesothelioma patients, weight loss often accelerates as the disease advances and can lead to weakness, fatigue, and decreased ability to tolerate treatment.

5. Fatigue and Weakness

Extreme fatigue is one of the most debilitating symptoms experienced by mesothelioma patients. This isn’t ordinary tiredness that improves with rest; it’s a profound, persistent exhaustion that interferes with daily activities and doesn’t resolve with sleep or rest.

Mesothelioma-related fatigue is characterized by:

• Overwhelming tiredness: Patients often describe feeling completely drained of energy, making even simple tasks feel exhausting
• No relief from rest: Unlike normal fatigue, this exhaustion persists despite adequate sleep and rest periods
• Physical weakness: Muscle weakness may accompany the fatigue, making it difficult to perform physical activities
• Mental exhaustion: Many patients also experience difficulty concentrating, memory problems, and mental fog
• Disproportionate to activity level: The fatigue is excessive compared to the amount of physical or mental exertion

This fatigue results from multiple factors, including the body’s immune response to cancer, anemia caused by the disease, malnutrition due to poor appetite, sleep disturbances from pain and breathing difficulties, and the psychological stress of dealing with symptoms. The chronic nature of this fatigue can significantly impact a patient’s quality of life, affecting their ability to work, maintain social relationships, and perform self-care activities.

6. Abdominal Pain and Swelling

For patients with peritoneal mesothelioma, which affects the lining of the abdomen, abdominal pain and swelling are primary symptoms. The abdomen may become noticeably distended due to fluid accumulation (ascites) or tumor growth within the peritoneal cavity.

Abdominal symptoms of peritoneal mesothelioma include:

• Persistent abdominal pain: The pain may be localized to one area or generalized throughout the abdomen, ranging from mild discomfort to severe cramping
• Visible swelling: The abdomen may appear bloated or enlarged, with clothes feeling tighter around the waist
• Feeling of fullness: Patients often report feeling full or bloated even after eating small amounts
• Ascites: Fluid accumulation in the abdominal cavity can cause the belly to expand significantly and may cause a feeling of heaviness
• Tenderness to touch: The abdominal area may be sensitive or painful when pressed
• Changes in bowel habits: Some patients experience constipation, diarrhea, or alternating between the two

These abdominal symptoms are often initially attributed to less serious conditions such as irritable bowel syndrome, indigestion, or weight gain, which can delay proper diagnosis. Women may also mistake these symptoms for ovarian or gynecological issues. Any persistent abdominal pain, especially when accompanied by swelling, should be thoroughly evaluated, particularly in individuals with known asbestos exposure.

7. Fever and Night Sweats

Many mesothelioma patients experience recurrent low-grade fevers and episodes of night sweats. These symptoms occur as the body’s immune system responds to the presence of cancer cells and are considered constitutional symptoms of the disease.

Characteristics of fever and night sweats in mesothelioma include:

• Low-grade fever: Body temperature typically ranges from 99°F to 101°F (37.2°C to 38.3°C), often fluctuating throughout the day
• Intermittent nature: The fever may come and go rather than being constant
• Night sweats: Patients often wake up drenched in perspiration, sometimes requiring a change of clothes or bedding
• No apparent infection: Unlike fever caused by infections, mesothelioma-related fever doesn’t respond to antibiotics and has no identifiable infectious source
• Associated with disease progression: These symptoms may become more frequent as the cancer advances

Night sweats can be particularly disruptive, leading to poor sleep quality and contributing to the overall fatigue experienced by mesothelioma patients. While fever and night sweats can be caused by many conditions, including infections and hormonal changes, their persistence without an identifiable cause should prompt further investigation, especially when accompanied by other mesothelioma symptoms.

8. Difficulty Swallowing (Dysphagia)

Difficulty swallowing, known medically as dysphagia, can occur in mesothelioma patients when tumors grow large enough to press against the esophagus or when they develop in areas close to this vital structure. This symptom is more common in advanced stages of pleural mesothelioma.

Patients experiencing dysphagia may notice:

• Sensation of food sticking: A feeling that food is lodged in the throat or chest rather than moving smoothly to the stomach
• Pain while swallowing: Discomfort or pain may occur when attempting to swallow food or liquids
• Choking or coughing: Increased episodes of choking on food or coughing while eating or drinking
• Need to eat slowly: Taking longer than usual to complete meals due to swallowing difficulties
• Preference for soft foods: Avoiding solid foods in favor of liquids or soft foods that are easier to swallow
• Regurgitation: Food or liquid coming back up after being swallowed

Dysphagia can contribute to weight loss and malnutrition in mesothelioma patients, as eating becomes increasingly difficult and uncomfortable. It can also lead to anxiety around mealtimes and social situations involving food. This symptom should never be ignored, as it can lead to aspiration (food or liquid entering the lungs), which can cause serious complications such as pneumonia.

9. Fluid Accumulation (Pleural or Peritoneal Effusion)

Abnormal fluid accumulation is one of the most distinctive signs of mesothelioma. In pleural mesothelioma, fluid builds up between the lung and chest wall (pleural effusion), while in peritoneal mesothelioma, fluid accumulates in the abdominal cavity (peritoneal effusion or ascites).

The impact of fluid accumulation includes:

• Respiratory compromise: Pleural effusion compresses the lungs, causing shortness of breath and reduced lung capacity
• Chest discomfort: The pressure from fluid buildup causes pain and tightness in the chest
• Abdominal distension: Peritoneal effusion causes visible swelling of the abdomen, which may be dramatic
• Pressure sensations: Patients often describe feeling pressure or heaviness in the affected area
• Progressive worsening: The amount of fluid tends to increase over time if left untreated
• Recurrence after drainage: Even when fluid is removed through medical procedures, it often reaccumulates

Fluid accumulation is often one of the first signs detected on imaging studies when mesothelioma is suspected. The fluid itself can be analyzed to help diagnose the condition, as it may contain cancer cells or other markers indicating mesothelioma. While the fluid can be drained to provide temporary symptom relief, it typically returns as long as the underlying cancer remains active.

10. Clubbing of Fingers

Finger clubbing, though less common than other symptoms, can occur in mesothelioma patients, particularly those with pleural mesothelioma. This condition involves changes in the shape of the fingertips and nails due to chronic low oxygen levels in the blood.

Characteristics of finger clubbing include:

• Enlarged fingertips: The soft tissue at the tips of the fingers becomes swollen and bulbous
• Curved nails: The nails curve downward more than normal, resembling the back of a spoon turned upside down
• Loss of nail bed angle: The normal angle between the nail bed and the cuticle disappears
• Spongy nail base: The nail bed may feel soft or springy when pressed
• Shiny appearance: The skin around the nails may appear glossy or shiny
• Usually painless: The changes typically occur without discomfort

Finger clubbing develops gradually over time and is associated with various lung and heart conditions that cause chronic oxygen deprivation. In the context of mesothelioma, it occurs because the cancer affects lung function, reducing the amount of oxygen that reaches the blood and body tissues. While clubbing can be subtle and often goes unnoticed by patients, healthcare providers look for this sign during physical examinations, as it can provide an important clue to underlying respiratory disease. Not all mesothelioma patients develop finger clubbing, but its presence, especially in combination with other respiratory symptoms, warrants thorough investigation.

Main Causes of Mesothelioma

Understanding the causes of mesothelioma is crucial for identifying individuals at risk and facilitating early detection. The primary cause of mesothelioma is well-established, though other contributing factors may also play a role.

Asbestos Exposure

Asbestos exposure is the leading cause of mesothelioma, responsible for approximately 80% of all cases. Asbestos is a group of naturally occurring minerals composed of microscopic fibers that were widely used in construction, shipbuilding, automotive, and manufacturing industries due to their heat resistance and durability.

When asbestos materials are disturbed, tiny fibers become airborne and can be inhaled or swallowed. These fibers then become lodged in the lining of the lungs, abdomen, or heart, where they cause inflammation and genetic damage over many years, eventually leading to mesothelioma. The latency period between asbestos exposure and mesothelioma diagnosis is typically 20 to 50 years, which is why the disease often affects older adults.

High-risk occupations for asbestos exposure include:

• Construction workers and demolition crews
• Shipyard workers and Navy veterans
• Asbestos miners and millers
• Insulation installers and removers
• Auto mechanics (brake and clutch repair)
• Power plant workers
• Industrial workers in steel mills and refineries
• Firefighters
• Plumbers and pipefitters

Secondary Asbestos Exposure

Family members of workers exposed to asbestos can also develop mesothelioma through secondary exposure. This occurs when workers unknowingly bring asbestos fibers home on their clothing, hair, or skin, exposing their loved ones to the harmful material.

Environmental Asbestos Exposure

Some people develop mesothelioma from environmental exposure to naturally occurring asbestos in soil or rock formations. Communities near asbestos mines or processing facilities have higher rates of the disease. Additionally, older buildings containing asbestos materials can pose risks if the materials deteriorate or are disturbed during renovation.

Radiation Exposure

Though rare, high doses of radiation to the chest or abdomen, such as radiation therapy for treating other cancers, have been linked to mesothelioma development in some cases. This typically occurs many years after the radiation exposure.

Genetic Predisposition

While asbestos exposure is necessary for most cases of mesothelioma, genetic factors may make some individuals more susceptible to developing the disease. Mutations in the BAP1 gene have been associated with increased mesothelioma risk in some families. However, genetic predisposition alone, without asbestos exposure, rarely causes mesothelioma.

Zeolite Exposure

Zeolites are minerals with similar properties to asbestos. Exposure to certain types of zeolites, particularly erionite found in volcanic rock, has been linked to high rates of mesothelioma in specific regions, particularly in Turkey.

Prevention Strategies

While mesothelioma cannot always be prevented, especially in cases involving historical asbestos exposure, there are important steps that can significantly reduce the risk of developing this disease.

Workplace Safety Measures

For those working in industries where asbestos exposure is possible, following proper safety protocols is essential:

• Use appropriate protective equipment: Wear approved respirators, protective clothing, and safety gear when working with or near asbestos materials
• Follow safety regulations: Adhere to OSHA (Occupational Safety and Health Administration) guidelines and workplace safety protocols regarding asbestos handling
• Proper decontamination: Shower and change clothes before leaving work to avoid carrying asbestos fibers home
• Regular monitoring: Participate in workplace asbestos monitoring programs and air quality testing
• Training and education: Ensure proper training on asbestos hazards and safe work practices

Home and Environmental Precautions

Protecting yourself and your family from asbestos exposure at home is equally important:

• Professional asbestos inspection: Before renovating or demolishing older homes (built before 1980), have them inspected by certified asbestos professionals
• Do not disturb asbestos materials: If asbestos-containing materials are in good condition, it’s often safer to leave them undisturbed rather than attempting removal
• Hire licensed professionals: Only use licensed asbestos abatement contractors for removal or repair of asbestos-containing materials
• Avoid DIY removal: Never attempt to remove asbestos materials yourself, as this can release dangerous fibers into the air
• Address deteriorating materials: If asbestos materials in your home are damaged or deteriorating, contact professionals for assessment and remediation

Lifestyle Considerations

• Quit smoking: While smoking doesn’t cause mesothelioma, it significantly increases the risk of lung cancer in people exposed to asbestos and can worsen outcomes
• Inform your doctor: If you have a history of asbestos exposure, inform your healthcare provider so they can monitor for early signs of asbestos-related diseases
• Regular health screenings: Those with known asbestos exposure should discuss appropriate screening schedules with their doctor

Community Awareness

Be aware of natural asbestos deposits in your area and avoid activities that might disturb soil or rock containing asbestos. Support proper regulations and enforcement regarding asbestos use and removal in your community.

Frequently Asked Questions

What is mesothelioma cancer?

Mesothelioma is a rare and aggressive cancer that develops in the mesothelium, the thin layer of tissue that covers most internal organs. It’s primarily caused by asbestos exposure and most commonly affects the lining of the lungs (pleural mesothelioma) or abdomen (peritoneal mesothelioma). The disease has a long latency period, often appearing 20-50 years after initial asbestos exposure.

How long does it take for mesothelioma symptoms to appear?

Mesothelioma has an extremely long latency period. Symptoms typically don’t appear until 20 to 50 years after the initial asbestos exposure. This delayed onset is one reason why the disease is often diagnosed at advanced stages, as people may not connect their current symptoms to asbestos exposure that occurred decades earlier.

Are mesothelioma symptoms different in men and women?

The core symptoms of mesothelioma are generally the same in both men and women. However, men are more likely to develop pleural mesothelioma due to higher rates of occupational asbestos exposure in male-dominated industries. Women may be more likely to experience peritoneal mesothelioma and might initially mistake abdominal symptoms for gynecological issues, potentially delaying diagnosis.

Can mesothelioma symptoms come and go?

Mesothelioma symptoms typically worsen progressively over time rather than coming and going. However, some symptoms like fever or the severity of pain may fluctuate. The general trend is toward increasing symptom intensity as the disease advances. Any persistent or worsening symptoms should be evaluated by a healthcare provider.

Is mesothelioma always caused by asbestos?

Asbestos exposure is the cause of approximately 80% of mesothelioma cases and is considered the primary risk factor. However, a small percentage of cases occur in people without known asbestos exposure. These may be related to radiation exposure, exposure to other minerals like erionite, genetic predisposition, or unknown environmental factors. That said, the overwhelming majority of cases are directly linked to asbestos.

When should I see a doctor about potential mesothelioma symptoms?

You should consult a doctor if you experience persistent symptoms such as chest pain, shortness of breath, persistent cough, unexplained weight loss, or abdominal swelling, especially if you have a history of asbestos exposure. Any symptoms lasting more than two to three weeks warrant medical evaluation. Early detection can improve treatment options and outcomes.

Can mesothelioma be detected early?

Unfortunately, mesothelioma is difficult to detect early because symptoms often don’t appear until the disease is advanced, and there is no standard screening test for the general population. However, people with known asbestos exposure should inform their doctors and may benefit from regular monitoring. Research is ongoing to develop effective early detection methods for high-risk individuals.

What’s the difference between pleural and peritoneal mesothelioma symptoms?

Pleural mesothelioma affects the lung lining and causes primarily respiratory symptoms including chest pain, shortness of breath, persistent cough, and difficulty breathing. Peritoneal mesothelioma affects the abdominal lining and causes abdominal pain, swelling, digestive issues, and fluid accumulation in the belly. Both types may cause systemic symptoms like fatigue, fever, and weight loss.

Are mesothelioma symptoms similar to other diseases?

Yes, mesothelioma symptoms often mimic more common, less serious conditions, which is one reason diagnosis is frequently delayed. Symptoms can be mistaken for pneumonia, bronchitis, irritable bowel syndrome, acid reflux, or normal aging. This similarity to other conditions makes it crucial to inform your doctor about any history of asbestos exposure and to seek evaluation for persistent symptoms.

Can you have mesothelioma without symptoms?

In the very early stages, mesothelioma may not cause noticeable symptoms. Some cases are discovered incidentally during imaging tests performed for other reasons. However, as the disease progresses, symptoms will eventually develop. The asymptomatic period is one reason why mesothelioma is often diagnosed at advanced stages when treatment is more challenging.

References:

• American Cancer Society – Mesothelioma
• Mayo Clinic – Mesothelioma
• National Cancer Institute – Mesothelioma
• NHS – Mesothelioma
• Asbestos.com – Mesothelioma Information
• American Lung Association – Mesothelioma