Mesothelioma Symptoms
Mesothelioma is cancer that forms in the mesothelium, or membrane, of various organs, such as the lungs, heart, and digestive system. Symptoms of mesothelioma vary depending on where cancer develops. General symptoms may include unexplained weight loss, fever, night sweats, and fatigue.
Mesothelioma is a cancer of the membrane surrounding the lungs, abdominal organs, heart, or testicles. Besides the location where it develops, this cancer can be further categorized by the specific type of cancer cells that develop. The three main mesothelioma cell types are sarcomatoid, epithelioid, and biphasic.
In approximately 20 percent of mesothelioma cases, both sarcomatoid and epithelioid cells are present. This is generally called biphasic mesothelioma but can also be known as mixed mesothelioma. For mesothelioma to be classified as biphasic, there must be a minimum of 10 percent each of sarcomatoid and epithelioid cells within the tumor.
Pleural Mesothelioma Symptoms
Malignant pleural mesothelioma develops in the pleura, which is a membrane that surrounds the lungs. Common symptoms of pleural mesothelioma include:
Dyspnea (Shortness of Breath)
This may occur due to the space that the cancer takes up in the chest, which can put pressure on the airways or on the lungs themselves, leaving less room for air movement. It may also be due to a pleural effusion, which is a buildup of fluid around the lungs that restricts their ability to fill with air.
Difficulty Swallowing
This can occur when the cancer grows large enough to put pressure on the esophagus, which is the tube that carries food from the mouth to the stomach.
Swelling of the Face and/or Arms
This can happen when the cancer puts pressure on structures of the lymphatic system, which drains excess fluid from tissues. If the cancer has spread to lymph nodes, then it can block the flow of lymphatic fluid, leading to swelling in certain areas.
Dry Cough
This is often related to irritation or compression of the airways by the cancer. It can also happen when the cancer puts pressure on certain nerves, or because of the inflammatory response of the body to the cancer, which can trigger a cough response.
Chest Pain
This occurs as the cancer invades the tissues of the chest.
Hoarseness of the Voice
This often means that the cancer is pressing on a nerve in the chest known as the recurrent laryngeal nerve, which is involved in voice production.
Similar symptoms are common in a number of other diseases, such as pneumonia, COPD (emphysema), asthma and lung cancer.
Peritoneal Mesothelioma Symptoms
Malignant peritoneal mesothelioma forms in the peritoneum, which is a membrane around the digestive system. Symptoms of peritoneal mesothelioma may include:
- Nausea and/or vomiting. This can result from pressure on the stomach or other parts of the digestive system, either caused by the tumors themselves or by the presence of fluid in the abdomen.
- Constipation, which can occur due to a bowel obstruction when the cancer puts pressure on the intestine and blocks the normal flow of material through it.
- Diarrhea. When tumors partially block the small intestine, solid material may get stuck while liquid material flows around the blockage. This leads to diarrhea.
- Abdominal pain. This occurs when the cancer invades tissues in the abdominal cavity and the abdominal wall.
- Swelling of the abdomen. This is usually due to ascites, which is a fluid buildup in the abdomen.
Similar symptoms can also be caused by a variety of other conditions, including Crohn’s disease, irritable bowel syndrome, celiac disease and colon cancer.
Pericardial Mesothelioma Symptoms
Pericardial mesothelioma occurs in a membrane around the heart known as the pericardium. Common symptoms experienced by pericardial mesothelioma patients include:
Pain in the Chest or Shoulder
This is caused by the cancer invading the tissues of the heart and surrounding areas. Pain from the heart may be felt in the left shoulder; this is known as referred pain.
Trouble Swallowing
This is a result of the cancer pressing on the esophagus, which is the muscular tube that carries food from the mouth to the stomach.
Heart Murmurs
(Unusual sounds heard when listening to the heart with a stethoscope), which also result from the cancer interfering with the function of the heart.
Dyspnea (Shortness of Breath)
This can occur because the tumors take up space in the chest cavity, which leaves less room for the movement of air through the lungs and results in difficulty breathing. It may also be due to heart failure caused by the cancer, which causes fluid to build up in the lungs.
Irregular Heartbeat or Heart Palpitations
These occur when the cancer starts to put pressure on the heart or invade the heart muscle, which interferes with the heart’s function.
Swelling of the Legs
Which is caused by heart failure that occurs when the cancer interferes with the heart’s function.
Similar symptoms can also be caused by other conditions, including congestive heart failure and pericarditis (inflammation of the pericardium, which can be caused by viruses or autoimmunity).
Testicular Mesothelioma Symptoms
Testicular mesothelioma occurs in the tunica vaginalis, which is a membrane around the testes (the medical term for the testicles). Men with testicular mesothelioma may experience:
- Swelling of one testicle. This may be a hydrocele, which is a buildup of fluid in the scrotum. It may also represent thickening of the tunica vaginalis.
- A mass in the scrotum, which is usually painless.
These symptoms can also be caused by other more common conditions, like an inguinal hernia or testicular cancer.
General Symptoms of Mesothelioma
There are certain symptoms that commonly develop in the later stages of mesothelioma. These are also common in other types of cancer and are not specific to mesothelioma. These symptoms include:
Unexplained Weight Loss
Which occurs because the cancer cells are using up the body’s energy resources.
Night Sweats
Which are also related to the inflammatory response.
Fatigue
which cancer may cause in a variety of ways, including through the inflammatory response leading to anemia (low red blood cell count) and/or the cancer cells using up the body’s energy.
Fever
This occurs because cancer cells are seen as foreign and provoke an inflammatory response by the immune system.
Loss of Appetite
Which is another symptom of the inflammatory response and may contribute to more rapid weight loss.
These symptoms are strongly suggestive of cancer, but don’t indicate what type of cancer the patient may have. Similar symptoms can also be caused by conditions such as hormonal imbalances or can be side effects of certain medications or other treatments.
Challenges in Evaluating Mesothelioma Symptoms
Because many of the symptoms and signs of mesothelioma are nonspecific, the process of mesothelioma diagnosis may be delayed, or may even result in a misdiagnosis.
For example, for peritoneal mesothelioma patients, it takes an average of four to six months between the onset of symptoms and the diagnosis. For rare types of mesothelioma, such as pericardial mesothelioma, it’s not uncommon for the diagnosis to be made after the patient’s death. Imaging studies, a biopsy and sometimes blood tests are needed to determine that mesothelioma is the cause of the patient’s symptoms.
Early detection of mesothelioma leads to better outcomes, because when mesothelioma is diagnosed at an early stage, there are more treatment options. Patients who have risk factors for this cancer (such as a history of asbestos exposure) should be vigilant in watching for possible mesothelioma signs and should mention these to their doctor as soon as possible. This increases the likelihood that diagnosis will be made at an early stage.
Side Effects of Mesothelioma Treatment
Besides the symptoms created by the cancer itself, mesothelioma patients may also have side effects related to their treatments. For some patients, the treatment plan is intended to eliminate as much of the cancer as possible in order to extend their lives. Many of the treatments that are used to do this have significant side effects, some of which are similar to symptoms caused by the cancer itself.
For example, the chemotherapy agents commonly used for mesothelioma cause diarrhea, nausea and vomiting, loss of appetite, anemia and pain. They can also cause other side effects such as hair loss, muscle weakness, hearing loss and immune system damage (leading to frequent infections).
Managing Mesothelioma Symptoms
Some mesothelioma patients are treated only with palliative care, which is focused on managing symptoms to improve quality of life, rather than focusing on the length of life. Even for those who are receiving aggressive treatments intended to prolong life, symptom control is an important part of a mesothelioma treatment plan.
A variety of treatments may be used to manage the symptoms of mesothelioma, such as:
Surgical Procedures
Surgical procedures for mesothelioma that aim to drain excess fluid from the chest or abdomen can be helpful in relieving symptoms. In some cases, palliative surgery may be performed to remove a tumor that’s creating significant symptoms, without the intent to remove all of the cancer.
Chemotherapy or Radiation Therapy
Although these are commonly part of a treatment plan that’s focused on cure, they can also be used for palliative care to help shrink tumors that are causing symptoms.
Medications
Your oncologist can prescribe medications that help control symptoms like nausea and pain.
Complementary Therapies
such as acupuncture, mindfulness (meditation and/or yoga), herbs and supplements and transcutaneous electrical nerve stimulation (TENS), may be helpful in addressing symptoms and improving mood and outlook.
It’s important to discuss everything that you’re doing with your mesothelioma treatment team to ensure that it won’t interfere with your conventional medical treatment.
However, oncology experts generally encourage the use of complementary therapies like these to help patients with symptom control.