What Are the Symptoms of Mesothelioma? 

The most common mesothelioma symptom is pleural effusion. It’s fluid buildup in the space between the lungs and chest wall. It usually occurs in patients with pleural mesothelioma, the most common type. 

This type of mesothelioma also causes shortness of breath, coughing and hoarseness. Tumors developing in the lung lining cause these issues.

Common mesothelioma symptoms and the percentage of patients experiencing these symptoms
Respiratory difficulties are the most reported mesothelioma symptoms.

Respiratory difficulties are the most reported mesothelioma symptoms.

Patients with peritoneal mesothelioma often experience a fluid buildup in the abdomen. Doctors know the medical condition as ascites. All mesothelioma patients report fatigue, pain and weight loss. 

Many symptoms don’t appear until mesothelioma progresses to later stages. This can make getting a diagnosis challenging.

Symptoms of Pleural Mesothelioma

A dry cough and shortness of breath are early symptoms of pleural mesothelioma. Pleural effusion is often the first sign of pleural mesothelioma. Chest pain and breathing struggles are common consequences. Symptoms such as trouble swallowing may develop as the disease progresses.

Pleural mesothelioma symptoms usually affect the lungs. They can also impact the whole body. They’re sometimes mistaken for signs of other, more common conditions. 

Pleural Mesothelioma Symptoms

“Many oncologists, primary care providers and even pulmonologists don’t realize that a pleural effusion or shortness of breath and pain could be mesothelioma because it is so rare,” Dr. Jeffrey Velotta, a cardiothoracic surgeon at Kaiser Permanente, told The Mesothelioma Center. “If they know what to look for, they can refer patients to mesothelioma specialists.”

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Symptoms of Peritoneal Mesothelioma

Peritoneal mesothelioma cancer often causes abdominal and digestive symptoms. These include bloating, pain, diarrhea, and constipation. Abdominal pain is a very common peritoneal mesothelioma symptom. A 2023 study in Oncology in Clinical Practice found abdominal distension in 30% to 80% of peritoneal mesothelioma patients. Poor appetite and weight loss may go with it. Tumors can also cause small bowel obstruction.

Peritoneal Mesothelioma Symptoms
  • Abdominal fluid buildup (ascites)
  • Abdominal pain
  • Abdominal swelling
  • Constipation
  • Loss of appetite
  • Nausea and vomiting
  • Unexplained weight loss

Peritoneal mesothelioma triggers widespread symptoms. Some patients report fatigue, fever and difficulty breathing. 

Pericardial Mesothelioma Symptoms

Symptoms of pericardial mesothelioma typically include chest pain, heart palpitations, shortness of breath or an irregular heartbeat. Cough, fever, night sweats and weakness are also common. Patients in later stages of the disease may have heart pressure from fluid buildup. This is a common symptom of benign mesothelioma.

Pericardial Mesothelioma Symptoms
  • Chest pain
  • Cough
  • Difficulty breathing (dyspnea)
  • Fatigue
  • Heart murmurs
  • Heart palpitations or irregular heartbeat (arrhythmia)
  • Shortness of breath when lying down

The symptoms are often mistaken for other, more common conditions. Only 150 cases exist in medical literature. Doctors may not suspect it at first.

“Patients can present with heart failure initially. It’s not unusual to diagnose pericardial mesothelioma as an incidental finding. You’re not suspecting pericardial mesothelioma,” Dr. Wickii Vigneswaran, a thoracic surgeon, told The Mesothelioma Center.

Testicular Mesothelioma Symptoms

The main symptoms of testicular mesothelioma are a lump or swollen testes. Other early symptoms include pain similar to a groin injury. These symptoms are sometimes mistaken for epididymitis. It is an infection of the testes.

Symptoms of Testicular Mesothelioma
  • Fluid in the scrotum
  • Lump in the scrotum
  • Swollen testes
  • Testicular pain

Testicular mesothelioma is the rarest of the disease, comprising about 1% of mesothelioma cases. Despite its rarity, if you have a history of asbestos exposure, you should be aware of these symptoms and seek medical attention if they occur.

Rare But Serious Signs and Symptoms of Mesothelioma

Night sweats, fever, and small lumps under the skin are serious but rare symptoms. Patients with pleural mesothelioma may have pain or swelling in the chest. Patients with peritoneal mesothelioma may develop swelling around the abdomen. 

A 2024 study found that pleural and peritoneal mesothelioma can cause thromboses. These are blood clots that block blood flow in the body. Symptoms will vary by the clot’s location. Symptoms can include an altered mental state, chest pain, and numbness or weakness on one side or in a lower leg. Thrombotic events can be fatal. Some immunotherapy drugs for the disease may raise the risk of blood clots.

Rare Mesothelioma Symptoms
  • Anemia
  • Blood clots
  • Fever
  • Night sweats
  • Painful swelling or lumps

Late-stage pleural mesothelioma may cause difficulty swallowing. Late-stage peritoneal mesothelioma may develop small bowel obstruction. Some symptoms of mesothelioma may be less noticeable but are no less dangerous. You may have anemia with pale skin, cold extremities or dizziness. Fewer than 10% of patients experience fever or night sweats.

Early-Stage and Late-Stage Symptoms of Mesothelioma

It is rare to diagnose mesothelioma this early because symptoms may not appear in stage 1. Patients are often diagnosed with advanced mesothelioma stages. This is when symptoms start showing.

Mesothelioma symptoms worsen as cancer spreads or metastasizes. Tumors that grow on distant organs can harm the diaphragm, heart or liver.

Early-Stage Mesothelioma Symptoms

Early-stage mesothelioma, stages 1 and 2, often causes fatigue, weakness, and pleural effusions. Breathing struggles and pain often follow.

Early-Stage Symptoms
  • Chest or abdominal pain
  • Coughing or wheezing
  • Fatigue or weakness
  • Shortness of breath

Tumors confined to a specific area trigger initial mesothelioma symptoms. Small, localized tumors can cause pleural effusions, ascites, and pain. They can also cause shortness of breath.

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Stage 1 Mesothelioma

Late-Stage Mesothelioma Symptoms

The most common late-stage symptoms of mesothelioma, in stages 3 & 4, are pain and trouble breathing. This includes fatigue or weakness, shortness of breath, abdominal or chest pain, weight loss and pleural effusions in most patients.

Late-Stage Symptoms
  • Anemia and associated fatigue
  • Bowel obstruction
  • Difficulty swallowing
  • Fever or night sweats
  • Loss of appetite
  • Respiratory complications
  • Severe or persistent pain
  • Weight loss

Local and distant spread of mesothelioma to other organs, including the diaphragm, often causes late-stage symptoms. Many of these symptoms are systemic, affecting the whole body. This can indicate that cancer is affecting multiple organs throughout the body.

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Stage 4 Mesothelioma

When Should I See a Doctor?

You should see a doctor immediately if you have chest pain, abdominal pain or other symptoms. This is especially important if you have a history of asbestos exposure. Your doctor may schedule regular mesothelioma screenings as a precaution.

Talk to your doctor about any possible exposure to asbestos. It is the main risk factor for mesothelioma.  Statistics show early diagnosis and intervention improve life expectancy for mesothelioma patients

Additionally, understanding that asbestos is the primary cause of mesothelioma is particularly important for those who worked with the toxic mineral or asbestos products. These workers have a higher risk of mesothelioma

If you have symptoms, see a mesothelioma doctor or your personal doctor. Early treatment is more effective in slowing your cancer and improving your survival.

Dr. Jacques Fontaine and Dr. Andrea Wolf
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Managing Mesothelioma Symptoms

Mesothelioma symptom management can include palliative therapies. These can reduce pain and increase comfort. It can also include traditional cancer treatment. Supportive therapy can help patients and families with the emotional toll of mesothelioma.

Surgery, chemotherapy and radiation can remove or reduce tumors that cause mesothelioma symptoms. Immunotherapy and targeted or gene therapy also provide patients relief. But these treatments may cause side effects. Some have tough recoveries. Many patients fear treatment effects may be worse than their symptoms. They worry these effects may limit their daily activities.

A good symptom management plan, including for pain, considers your health and symptoms. Nutrition, exercise and mental health are vital in treating mesothelioma symptoms.

Traditional approaches use respiratory therapy, physical and occupational therapy and pain medication. Sometimes, practitioners combine traditional and complementary therapies. These therapies include massage, gentle yoga or meditation. Support groups can help patients with mesothelioma symptoms. They can share tips on coping with its emotional symptoms.

Mesothelioma survivors ask me about treatments to manage their symptoms. They also want to know their quality of life after treatment. They ask me, ‘Will it make me sicker than I’m already feeling at this moment?’ and ‘Is it worth going through it?’

Snehal Smart, M.D. and Patient Advocate at The Mesothelioma Center

Most Commonly Reported Mesothelioma Symptoms in Our Exclusive Patient Survey

The Mesothelioma Center helps over 50% of all new mesothelioma patients each year. It conducted a survey among survivors for their feedback. Early diagnosis is critical. It gives patients more treatment options. So, we asked about the early signs or symptoms of mesothelioma. 

Some of the top 10 signs of mesothelioma were specific to where the tumors first developed. These included fluid around the lungs and coughing. Yet, some signs were common across mesothelioma types. These include fatigue, weight loss, and pain.

The top ten most common symptoms of early-stage mesothelioma

Most respondents reported that their symptoms are often mistaken for other conditions. These included chest pain and shortness of breath. The nonspecific nature of mesothelioma symptoms can make diagnosis challenging.

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Expert Takeaways on Mesothelioma Symptoms

  • Palliative care helps manage mesothelioma symptoms. It can be given alongside treatment. A 2024 Ottawa Hospital study found only 49% of mesothelioma patients received palliative care.
  • Our 2023 survey found similar results with only 48% of respondents receiving palliative care. Discuss potential palliative options for symptom management with your doctor.

“A number of treatments can help ease symptoms and improve quality of life. Discuss all your symptoms with your medical team. “Together, you can find the best treatment for you.”

Common Questions About Mesothelioma Symptoms

When do mesothelioma symptoms start?

Mesothelioma symptoms tend to present between 20 and 60 years after asbestos exposure. This delay is known as the latency period. Asbestos exposure, age, and health can affect the latency period.

 

Can you have mesothelioma and not know it?

Yes, you may have mesothelioma without any symptoms. Many mesothelioma symptoms are mild and mimic the flu or a stomach virus. Most only appear decades after asbestos exposure. Doctors may misdiagnose this rare cancer as other illnesses. This can delay your mesothelioma diagnosis.

Can mesothelioma symptoms come on suddenly?

Yes, some mesothelioma symptoms may occur suddenly. Some patients have no symptoms until the cancer spreads to other organs. The cancer’s location determines the type and severity of symptoms you may have.

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