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Mesothelioma Symptoms to Know

A cartoon of lungs with mesothelioma.

The mesothelium is a thin layer of tissue that covers internal organs. Malignant mesothelioma is an aggressive form of cancer that develops in the mesothelium. While it is a rare cancer affecting around 3,300 people in the US each year, it is aggressive and often fatal. Please continue reading to learn about malignant mesothelioma symptoms.

What are the types of mesothelioma?

Doctors classify mesothelioma into different types based on the part of the mesothelium that is affected. 

Malignant pleural mesothelioma

This is a common type of mesothelioma that affects the pleura or tissue surrounding the lungs

Peritoneal mesothelioma

This is a less common type of mesothelioma that affects the abdominal cavity. 

Pericardial mesothelioma

This rare type of mesothelioma affects the peritoneum or lining of the heart. 

Paratesticular mesothelioma

Also called mesothelioma of the tunica vaginalis, this type affects the testicles and is very rare.

How does mesothelioma begin?

The main risk factor for mesothelioma is asbestos exposure. Asbestos is a naturally occurring mineral that is resistant to heat. It is therefore used in many products, including insulation materials, flooring, shingles, brakes, and others.

During the mining process or when removing insulation, a cloud of dust containing asbestos fibers can form. This can lead to asbestos exposure through inhalation or swallowing. The asbestos fibers can settle on the lungs or abdominal organs, causing irritation and ultimately leading to cancer. The exact process of how this occurs is unclear. 

Who is at risk of mesothelioma?

It is worth noting that most people get exposed to asbestos during their lifetime and never go on to develop mesothelioma. That’s why scientists believe other factors besides asbestos exposure play a role in developing mesothelioma. It is believed to be an interplay of genetic and environmental factors. For instance, someone might inherit a gene that predisposes them to cancer and be exposed to asbestos, increasing their risk of mesothelioma.

Risk factors for mesothelioma include:

  • Personal history of exposure to asbestos.
  • Second-hand asbestos exposure, for example, living with someone who has an occupational exposure to asbestos and carries the asbestos fibers home on their skin and clothes. 
  • Family history of mesothelioma. People with a first-degree relative with mesothelioma are at an increased risk.
  • Radiation exposure to the chest.

Occupations that put a person at risk of mesothelioma include asbestos miners, plumbers and pipefitters, electricians, insulators, home remodelers, demolition workers, shipyard workers, brake mechanics, and certain military personnel.

You can lower your risk of mesothelioma by following all safety precautions at your workplace, such as using protective equipment and showering and changing out of work clothes before going home. 

If you suspect there is asbestos in your home, consult an expert to find out if it is present and dangerous. Sometimes, it can be more dangerous to try and remove the asbestos yourself than to leave it alone, as the former can cause the fibers to become airborne and be inhaled.

How long does it take for mesothelioma to show up? 

It can take several decades (20 to 60 years or more) for mesothelioma to develop after a person is exposed to asbestos.

What are the early warning signs and symptoms of mesothelioma?

The early signs and symptoms of mesothelioma depend on where the cancer cells are located:

  • Common pleural mesothelioma symptoms: Early symptoms can include chest pain, shortness of breath, and pain with coughing. As the disease progresses, a person may notice lumps under the skin of the chest and unexplained weight loss. As pleural mesothelioma progresses, it can also cause other symptoms and complications such as difficulty swallowing, pain due to pressure on the nerves in the chest, pleural thickening, pleural effusion (fluid buildup in the chest cavity), which can compress the lungs and cause difficulties with breathing.
  • Malignant peritoneal mesothelioma symptoms: Severe pain in the abdomen, swelling, nausea, and unexplained weight loss.
  • Pericardial mesothelioma symptoms: Chest pain and difficulty breathing.
  • Testicular mesothelioma symptoms: A swelling or mass in the testicle.

It is worth noting that many symptoms of mesothelioma, especially in the early stages, are non-specific and can be from common illnesses. For example, common mesothelioma symptoms such as difficulty breathing and swallowing can be due to many different causes. Symptoms of pleural mesothelioma, such as cough, shortness of breath, and chest pain, can be due to treatable lung conditions. Similarly, common symptoms in peritoneal mesothelioma patients, such as loss of appetite, nausea, pain, and swelling, can be from a wide range of health conditions, including less serious ones such as irritable bowel syndrome. 

These vague symptoms can be overlooked, and this can lead to a delay in mesothelioma diagnosis and treatment. That’s why it's important that you don’t ignore symptoms. If you notice symptoms that are unusual, bothersome, or persistent, or you have worsening symptoms, make an appointment to see your healthcare provider. Early detection and mesothelioma treatments can improve your outcome. 

How do doctors diagnose mesothelioma?

As mentioned, most of the symptoms of mesothelioma are non-specific. Your doctor will try to find the cause of your symptoms with a physical examination and imaging studies such as a chest X-ray or CT scan of the chest or abdomen. If they see any abnormalities, they may order a biopsy to remove a small tissue sample from a suspicious area and examine it in the laboratory. The biopsy can be done by inserting a needle to extract fluid from the chest or abdomen, or it may require a surgical procedure. 

What is the first stage of mesothelioma?

The first stage of mesothelioma is when the cancer cells are located in the area where the mesothelioma started. In other words, the cancer cells have not yet spread to the nearby lymph nodes or beyond the site of origin. Pleural mesothelioma patients with early-stage disease have a better prognosis than advanced mesothelioma, that is diagnosed in the later stages. 

What are the cancer treatments for mesothelioma?

According to the American Cancer Society, National Cancer Institute, and experts in clinical oncology, mesothelioma is, unfortunately, an aggressive form of cancer. It is frequently detected in the advanced stages, and a cure is usually not possible. However, symptom management can help to control pain, swelling, and other symptoms. In addition, surgery, radiation therapy, and chemotherapy can be used to kill cancer cells and control the cancer, especially if it is early mesothelioma or stage 1 disease. Other treatments like immunotherapy and targeted therapy are also used sometimes.

Surgery for a pleural mesothelioma may include the removal of cancerous tumors from around the lungs, removal of the lung tissue itself, and removal of excess fluid (pleural fluid from pleural effusions) to relieve symptoms of mesothelioma, such as shortness of breath and chest pain. Surgery for peritoneal mesothelioma may include the removal of as much of the cancer as possible. 

Your mesothelioma doctor will discuss all the treatment options with you and develop a plan of care depending on the stage of the disease. As the disease progresses, palliative care can help keep you comfortable.

What is the life expectancy for early-stage mesothelioma and advanced mesothelioma?

The average survival after receiving a diagnosis of mesothelioma is 18-31 months. Some mesothelioma patients have survived for 10 years or more after a mesothelioma diagnosis. Factors that affect life expectancy include the type and stage of mesothelioma and the underlying health status. In general, early diagnosis is associated with better survival rates. As the cancer progresses, the prognosis worsens. 
 

References:

  1. https://www.uptodate.com/contents/epidemiology-of-malignant-pleural-mesothelioma#
  2. https://www.mayoclinic.org/diseases-conditions/mesothelioma/symptoms-causes/syc-20375022
  3. https://www.mesothelioma.com/mesothelioma/prognosis/life-expectancy/