Many people have probably asked the question “Do I have mesothelioma?” at least once before. The disease gets mentioned on advertisements and in various forms of media frequently and may make people wonder. Mesothelioma produces a wide range of different symptoms, partially because everyone’s body reacts differently to the onset of the illness. One patient may report high levels of one symptom than another patient only experiences to a minor degree.
Another reason that mesothelioma symptoms differ widely is that the disease has multiple forms. There are four known types of mesothelioma based on its location in the body.
Occurs in the lining of the lungs (or pleura) and accounts for roughly 70 to 90% of all mesothelioma cases
Occurs in the lining of the abdominal cavity and accounts for roughly 10 to 20% of all mesothelioma cases
Occurs in the lining of the heart (or pericardium) and accounts for only around 1% of all mesothelioma cases
Occurs in the lining of the testes and has fewer than 100 known cases
On a cellular level, all of these different types are relatively similar. Even so, a disease that attacks the lining of the lungs is going to be much different than one that attacks the lining of the abdomen (at least as far as symptoms are concerned).
So, what exactly are the symptoms and signs of mesothelioma?
Pleural Mesothelioma Symptoms
The most common form of the disease is pleural mesothelioma. Because it occurs in the lining of the lungs, it often causes a wide range of respiratory issues.
Some early signs of the disease include:
- A cough that won’t go away
- Difficulty breathing (dyspnea)
- Chest pain
- Pain in the lower back
- Trouble with swallowing
As you can see, many of these symptoms are non-urgent and non-specific to a single disease. So, many people end up not seeking treatment, expecting that these symptoms are simply a minor issue that will go away on their own.
In fact, more often than not, doctors will diagnose patients with much less severe ailments like:
As the disease progresses, however, the symptoms start to become harsher and not as easy to ignore. Individuals may start to cough up blood or experience pain that they can’t simply push through. Fluid (called pleural effusion) starts to build up between the lung lining and the chest wall, making breathing even more troublesome and causing increased pain due to pressure.
The more severe pleural mesothelioma symptoms begin to occur when the disease has entered its later stages. There is a clinically-accepted 4-tier staging system associated with pleural mesothelioma with stage 1 being the least severe and stage 4 being the most.
During stage 1, patients may only experience minor and almost unnoticeable mesothelioma signs. By stage 4, however, coughing up blood and pleural effusion are not rare.
Peritoneal Mesothelioma Symptoms
Peritoneal mesothelioma is the second most common variety of the disease, and it occurs in the lining of the abdominal cavity. Like pleural mesothelioma, the peritoneal type produces a range of non-specific and seemingly non-urgent signs and symptoms.
Early signs include:
- Pain in the abdomen (ranges from mild to severe)
- Trouble breathing
- Lack of appetite
- Weight loss
Again, none of these on their own are particularly distressing. In fact, peritoneal mesothelioma is often mistaken for relatively minor issues like irritable bowel syndrome or a hernia.
When the disease is allowed to progress, however, abdominal pain becomes more extreme, and many other issues start to crop up, including:
- Fluid buildup (called ascites) that produces swelling in the abdomen
- Obstruction in the bowels
- Noticeable weight loss
Peritoneal mesothelioma doesn’t have a clinically-accepted staging system standard like pleural mesothelioma, but the same concept applies. The longer the disease is allowed to proliferate, the more widespread it will travel, and the more severe the symptoms will become.
Later stage peritoneal mesothelioma can end up affecting organs in the abdomen or elsewhere if its progression isn’t stopped.
Organs that may be affected include:
As the disease spreads, there is a likelihood that the pain and other symptoms will travel with it. By this time, however, most people will have sought medical care. Sometimes, however, doctors will still mistake peritoneal mesothelioma for another disease.
In this case, it’s usually something like ovarian cancer or another type of cancer found in the abdomen.
Pericardial Mesothelioma Symptoms
Pericardial mesothelioma is exceedingly rare, accounting for only 1% of all mesothelioma diagnoses. Of the 3,000 cases of mesothelioma diagnosed in the United States each year, only around 30 or fewer are of the pericardial variety. Of course, this makes it very difficult to diagnose accurately.
Some of the symptoms include:
- Heart murmurs
- Irregular heartbeat
- Faster heart rate
- Fluid buildup around the pericardium (effusion)
- Pain in the chest
This could be a symptom list for any number of ailments. Doctors most commonly mistake pericardial mesothelioma for coronary heart disease or heart failure. It can also be misdiagnosed as pericarditis (inflammation of the pericardium) or myocarditis (inflammation of the heart muscle).
Even when doctors do diagnose pericardial mesothelioma, it could actually be a separate type of the disease that metastasized (spread) into the lining of the heart. For instance, it’s not uncommon for pleural mesothelioma to spread to the heart and mimic the symptoms of pericardial mesothelioma. Of course, in those cases, symptoms more specific to the pleural variety have probably already present in the patient.
Unfortunately, there have been cases in which pericardial mesothelioma was only diagnosed after the patient had passed. Even minor heart murmurs that appeared non-urgent could have been signs of a major issue. Many patients have heart attacks before severe symptoms even start showing up.
Pericardial mesothelioma occurs in a very vulnerable location which means that it’s rare for patients to survive a year after diagnosis.
Testicular Mesothelioma Symptoms
Testicular mesothelioma is even more rare than pericardial mesothelioma with only around 100 known cases ever reported.
Symptoms are usually localized to the testicles and include:
- A lump or growth
- Pain in the testes
- Fluid buildup (hydrocele) that causes scrotal swelling
- Inflammation in the epididymis
Again, what we know about testicular mesothelioma is minimal. Because of this, it often goes undiagnosed. Doctors will likely think that it is another form of testicular cancer like rete testis adenocarcinoma before they will diagnose testicular mesothelioma. Like pericardial mesothelioma, the testicular form may just be another more common type of the disease that metastasized to the testicles.
Later Stage Symptoms
Although most symptoms that patients will incur are specific to the type of mesothelioma they have, there are a few later stage symptoms that all mesothelioma types have in common. As problems become systemic, the whole body starts to exhibit symptoms. This is most notable in the nervous system.
Symptoms that start occurring in later stages of mesothelioma include:
- Coughing up blood (hemoptysis)
- Horner’s syndrome – nerve damage that affects the eye area
- Laryngeal nerve palsy – nerve damage that affects the voice box and causes more difficulty speaking
- Excessive pain to due tumors putting pressure on nerves
- Other face and limb nerve issues
No one wants to experience these types of symptoms. As the disease progresses, doctors will likely prescribe more palliative treatments to ensure the patient is comfortable.
There are numerous different treatment methods that doctors may use to relieve some of the mesothelioma’s most pressing symptoms. When patients start to exhibit signs of mesothelioma, they are usually not in dire straits. Therefore, pain may be managed with something small like ibuprofen. If the doctor is unaware of the incidence of the disease in the patient, they may prescribe items like an inhaler to improve breathing.
Over time, however, the pain tends to build, and patients will require more care. This could include standard medical treatments like stronger painkillers, but eventually, patients will likely require other methods to relieve symptoms.
The most common treatment options for mesothelioma are:
- Radiation therapy
Obviously, the best way to eliminate symptoms is to remove the growths causing those symptoms. Many surgical options are available to help remove tumors or even entire organs that have become diseased. Smaller procedures can be performed in order to reduce pain.
All of these procedures essentially use a fine needle to remove fluid buildup from affected areas. If the fluid is allowed to remain in the body, it produces swelling and pressure that can cause the patient pain and discomfort. The fluid also causes difficulty breathing and increases in coughing. These procedures can be performed as a diagnostic tool, as the fluid usually contains cancerous cells that a pathologist can study.
Chemotherapy and radiation therapy treatments can also reduce symptoms. In many cases, tumors grow to such a large size that they impede other organs and cause a great amount of pain. The goal of chemotherapy and radiation therapy is to reduce the size of those tumors to alleviate some of that pressure.
All treatments can be either curative or palliative. Curative treatments are performed in order to extend the life of the patient while palliative treatments are performed in order to reduce pain and improve quality of life. Curative treatments are usually only used for patients who already have a good prognosis.
Of course, engaging in any of these treatments can also cause other side effects to develop. Major surgery often requires extended recovery times. There are also inherent risks in any surgery. Chemotherapy is well-known to have a wide variety of side effects associated with it.
- Hair loss
- “Chemo brain” (impairment of memory and concentration)
These side effects occur because chemotherapy drugs attack healthy cells as well as cancerous ones. Radiation therapy does the same thing although to a much lesser degree. It’s clear that, in order to reduce mesothelioma symptoms, you are going to have to incur other short-term symptoms.
Latency Period and Diagnosis
One of the issues with accurately diagnosing mesothelioma signs is the latency period. The term is used to describe the period of time between an individual’s first exposure to the substance that caused the disease and the first time they begin experiencing symptoms. The substance that causes mesothelioma is asbestos, and any long-term exposure to it can ultimately result in the disease.
Unfortunately, it can take anywhere from 20 to 50 years for symptoms to begin presenting themselves. So, the link between the symptoms many people experience, and the onset of mesothelioma isn’t readily apparent.
The other issue is that the early symptoms people experience are usually very mild and not any cause for concern. Very few people seek treatment for a minor cough and occasional chest pain, and, when they do, their doctor may also consider the ailment a non-issue. If you suspect that you or a loved one may have mesothelioma, it’s important to let your doctor know if you had prolonged exposure to asbestos at any point in your life.
You may also be unsure if you’ve had any interaction with asbestos in your life. Asbestos is a fiber that was used abundantly in building materials like insulation and electrical wiring. It started to go out of use in the 1960 and 70s, but it remains in many products today.
While exposure today is much less common, it frequently happened between the 1940s and 1980s, usually in the workplace.
The most common occupations for asbestos exposure include:
- Construction workers
- Shipyard workers
- Industrial workers
- Oil refinery employees
- Power plant employees
If you worked in any of these fields in the past, then you may be at risk for asbestos exposure. Even if a family member or someone you associated with work in these jobs, you may be at risk.
Again, it’s important to let your doctor know if you have a history of asbestos exposure because catching mesothelioma early offers patients the best prognosis. Early detection can extend life spans much further than later diagnoses.