Mesothelioma symptoms

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on June 6, 2022.

Mesothelioma is a rare cancer of the thin tissue (mesothelium) that lines the lungs, chest wall, abdomen and other organs. The leading risk factor for mesothelioma is exposure to asbestos fibers. Symptoms typically develop years after the initial asbestos exposure and may be generally felt across the body (somatic) or in specific areas that are affected by mesothelioma (somatic).

The majority of mesotheliomas occur in the pleural (lung) cavity. Mesothelioma tumors may also be found in the peritoneal (abdominal) cavity, the pericardium (heart) sac and, rarely, the outer layer of the testicles (the tunica vaginalis).

Pleural mesothelioma is the most common type of mesothelioma, followed by peritoneal mesothelioma. The frequency of pericardial mesothelioma and testicular mesothelioma is quite low, and the symptoms are not well understood.

To help answer questions on mesothelioma symptoms, this guide will cover:

Pleural mesothelioma symptoms

The symptoms associated with pleural mesothelioma tumors may be similar to other conditions affecting the lungs or chest. Pleural effusion, a complication of the disease, is the buildup of fluid in the chest. It may cause difficulty breathing.

Other common signs of pleural mesothelioma include:

Chest pain. Tumor growth in the pleura of the lungs may lead to pain in the chest under the rib cage and in the lower back.

A dry (sometimes painful) cough. A dry cough caused by restriction of the affected lung(s) due to tumor growth is often the earliest sign of cancer.

Shortness of breath. Pleural effusion, a buildup of fluid in the pleura that lines the lungs and chest, may cause breathing difficulties in patients with mesothelioma and other conditions.

Difficulty swallowing. Difficulty swallowing, or dysphagia, is often a sign of advanced disease and is typically caused by enlargement of the lymph nodes in the chest, which then constrict the esophagus.

Weakness and/or fatigue. Fatigue among cancer patients may be caused by a number of factors, including as a side effect of treatments and medications or a sign of poor nutrition, sleep problems or mood disorders.

Back pain. Mesothelioma-related back pain may be a result of various treatments, medications or, in rarer cases, tumor progression that involves the structures of the spine.

Unexplained weight loss. Challenges with swallowing and/or breathing may diminish appetite in cancer patients. Cancer may also lead to cachexia, a syndrome in which patients with chronic disease lose body weight and muscle mass.

Peritoneal mesothelioma symptoms

Tumors that develop in the membrane lining the abdominal cavity may cause pain in that area of the body. Common peritoneal mesothelioma symptoms include:

Abdominal pain. Peritoneal mesothelioma abdominal pain is largely unspecific for most patients. In rare cases, it may be caused by bowel obstruction or perforation.

Accumulation of fluid in the abdomen (swelling). Excess abdominal fluid, or ascites, occurs in most patients with malignant peritoneal mesothelioma. Signs of ascites may include abdominal swelling, nausea and pressure.

Diarrhea, constipation or other changes in bowel habits. Tumor progression, treatments and medications may cause gastrointestinal symptoms and complications.

Unexplained weight loss. Loss of appetite may be a side effect of some cancer drugs and treatments. In patients with peritoneal mesothelioma, pain, nausea and/or fullness in the abdomen may make eating difficult, resulting in rapid weight loss.

A visual guide to early mesothelioma symptoms

Early mesothelioma symptoms

Because mesothelioma symptoms often resemble those caused by other common health conditions, mesothelioma is often challenging to diagnose. It’s important for patients to recognize when something doesn’t feel right and to share these concerns with their health care providers—particularly if they were exposed to asbestos.

Early signs of pleural mesothelioma include:

  • A dry cough and hoarse throat
  • Pain in the shoulder and/or chest
  • Difficulty breathing and/or swallowing

Early signs of peritoneal mesothelioma include:

  • Constipation
  • Nausea and vomiting
  • Abdominal pain and/or swelling

Next topic: What are the types of mesothelioma?

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