Patients with mesothelioma generally do not demonstrate symptoms of this disease until 20 to 50 years after their initial exposure to asbestos. Fibers that embed in the tissue surrounding the body’s internal organs, the mesothelium, usually must be present for many decades before cancer develops. These fibers gradually accumulate and cause scarring, which leads to inflammation and cancer. Although the fibers are most often introduced into the body through inhalation, they can be introduced through ingestion as well. Initially, symptoms may be mild and an individual might not find them cause for alarm. However, as the cancer spreads, these symptoms become more severe and debilitating.
Consulting a Physician Early
As a result of this slow development and the long delay between asbestos exposure and cancer growth, individuals frequently overlook initial symptoms of mesothelioma. Furthermore, these symptoms often mimic those of less serious illnesses, leading to the common delay in seeking treatment. Unfortunately, this delay can limit treatment options and effectiveness. Therefore, it remains vital for any individuals who suspect past asbestos exposure to seek medical screening for the disease, even if symptoms are not currently present. Often, a second opinion is also recommended, as mesothelioma is commonly misdiagnosed. Whether it is the stage the cancer is in or the type of cancer, misdiagnosis happens, and specialists advise patients to get second opinions. Diagnosis of mesothelioma as a Stage 3 when it really is a Stage 2 is a big difference, and treatment options as well as prognosis may differ greatly between stages.
Several important steps after diagnosis exist for patients struggling with mesothelioma. These steps can be the difference between succumbing to the disease quickly and maintaining a high quality of life while fighting it. Even if symptoms that seem trivial arise, it is important to contact a physician immediately. This is especially vital for those who have had exposure to asbestos in the past.
Early symptoms of mesothelioma are generally absent in patients, leading to the disease’s late diagnosis. However, it remains vital for those who were exposed to asbestos to seek regular imaging and diagnostic tests to help detect any latent signs of mesothelioma development. Individuals who experienced prolonged asbestos contact should be even more attentive to this risk, as length and intensity of exposure is strongly correlated with the development of mesothelioma.
Sometimes early symptoms of mesothelioma mirror those of other diseases or physical issues such as congestive heart failure, emphysema, weight gain, or constipation. These symptoms may include shortness of breath, constant chest pain or cough, night sweats, weight loss but fluid gain, bowel obstruction, swelling of the feet, and a buildup of fluid on a chest X-ray. This fluid buildup is known as pleural effusion.
What Is Pleural Effusion?
One main symptom of mesothelioma is a buildup of the fluid between the parietal pleura and the visceral pleura. This buildup is called pleural effusion. These membranes are coated with mesothelial cells that normally secrete a fluid that lubricates and protects the space between one’s chest wall and lung. In a healthy body, excess fluid would be absorbed into the bloodstream and lymph nodes to avoid fluid buildup. Conversely, for abnormal cases such as those seen in mesothelioma, when too much fluid is present in the area, a pleural effusion occurs.
There are two types of pleural effusions. The most common form is a transudative pleural effusion. This effusion is typically clear in color and occurs when there is an imbalance between the fluid produced and that which is removed. This form is more common in a congestive heart failure.
An exudative effusion is likely to be a sign of mesothelioma. This effusion is cloudy in color and made up of cells, proteins, and other fluids resembling those of a diseased pleura. To differentiate between the two types of effusions, a fluid sample must be tested.
Removal of excess fluid can be done using a simple procedure that requires local anesthesia. The procedure, called pleurodesis, injects talc into the fluid in the lungs. According to the American Cancer Society, this substance causes irritation in the membranes, making them swell and stick together. Once this bond is formed, space is eliminated, making the area impermeable to fluid.
Another procedure, called pleurocentesis is a simple outpatient procedure typically lasting only 30 minutes. During this procedure, a long needle is injected through the chest cavity into the lung to drain excess fluid from the lungs.
Pleural Mesothelioma Symptoms
The most common form of this disease, pleural mesothelioma, makes up approximately 75% of all mesothelioma cases. Developing in the pulmonary (lung) region, symptoms of this disease include the following:
- Persistent dry cough without phlegm
- Pleural effusions (typically containing blood)
- Blood in the sputum (fluid) or coughing up blood (hemoptysis)
- Difficulty swallowing (dysphagia)
- Inexplicable weight loss
- Sweating or fever
- Persistent chest or rib area pain, painful breathing
- Inexplicable shortness of breath (dyspnea)
- Development of lumps under the skin on the chest
Pleural mesothelioma symptoms generally result from the thickening of the membrane surrounding the lungs, brought on by rapidly developing cancer cells. This rapid cell production frequently leads to an accumulation of fluid in the pleural space (pleural effusion), which brings on the most common symptoms of pleural mesothelioma, including shortness of breath, inexplicable cough, and chest pain.
In a 2009 study of 221 cases of pleural mesothelioma, the Texas Occupational Medicine Institute found these symptoms to be the most presenting:
Peritoneal Mesothelioma Symptoms
The second-most common form of mesothelioma, peritoneal mesothelioma, develops in the tissue surrounding the abdominal cavity, known as the peritoneum. Symptoms of peritoneal mesothelioma include the following:
- Nausea or vomiting
- Inexplicable weight loss
- Sweating or fever
- Swelling or pain in the abdomen
- Ascites (fluid buildup between the peritoneum and the abdominal organs)
- Diarrhea, constipation, or any other inexplicable changes in the bowels
- Development of lumps under the skin on the abdomen
Peritoneal mesothelioma symptoms generally result from the thickening of the membrane surrounding the abdomen, brought on by rapidly developing cancer cells. This rapid cell production frequently leads to an accumulation of fluid between the membrane layers in this area, placing pressure on the abdomen and bringing on these symptoms.
In the 2009 study by the Texas Occupational Medicine Institute, symptom results from 13 cases of peritoneal mesothelioma disclosed the following as the most prevalent symptoms:
Pericardial Mesothelioma Symptoms
Less than 5% of mesothelioma patients develop this form of the disease, which is present in the membrane surrounding the heart. Symptoms of pericardial mesothelioma are brought on by a thickening of the pericardial membrane and subsequent fluid buildup. Pericardial mesothelioma symptoms include the following:
- Heart palpitations, irregular heartbeat
- Pain in the chest
- Inexplicable difficulty breathing (dyspnea)
- Sweating or fever
Because this form of mesothelioma so rarely affects patients, its symptoms are not as widely recognized, making this condition more difficult to diagnose. The difficulty in diagnosis makes treating this disease especially challenging , leading to a generally poorer prognosis for this form of mesothelioma than for others.
In a 1994 study by the Texas Heart Institute of 28 individuals diagnosed with pericardial mesothelioma, the following were the most commonly cited presenting symptoms:
Testicular Mesothelioma Symptoms
Since 1950, fewer than 100 cases of this form of mesothelioma have been recorded, making it extremely rare. Thus, the symptoms of this disease remain largely unknown. Today, the only recognized symptoms of testicular mesothelioma are testicular lumps and swelling of the scrotum.
Often the tumor in the testicle is discovered only when a patient undergoes surgery for other reasons, such as hernia repair.
Symptoms Indicative of Metastatic Spread
Unfortunately, not all mesothelioma cases stay confined to the originating site. When cancer cells travel to other parts of the body and form new tumors, this process is called metastasis. This can happen when cancer cells get into the bloodstream or lymph vessels and travel to other parts of the body.
Research indicates that about 44% of cases end up metastasizing. Moreover, since most cases of mesothelioma are not diagnosed until the later stages of the cancer, the cancer has usually spread, either making it inoperable or giving any possible operation a grim prognosis.
Symptoms that are most clearly noted for local invasion include the following:
- Dysphagia (coughing/spitting up blood)
- Horner’s syndrome
- Other neurological syndromes
- Laryngeal nerve palsy
- Nerve involvement of the arm
Furthermore, in rare instances, if the cancer spreads to the spinal canal, paraplegia can occur. Other rare occurrences include clubbing of the fingers and hypertrophic pulmonary osteoarthropathy (HPOA). These incidences tend to appear in patients who also have asbestosis.
When Mesothelioma Symptoms Arise
As stated above, because the latency period of mesothelioma is 20 to 50 years, most patients do not notice symptoms for years, even decades after their exposure to asbestos. In a 2009 study, the Texas Occupational Medicine Institute reviewed 217 men and 21 women diagnosed with malignant mesothelioma.
Latency, the time period between the initial exposure and diagnosis of the cancer, was detected in 191 of the 238 cases. The average latency time interval was 48.5 years, with a range of 18 to 70 years. The study also stated that there was no statistical difference in the latency for peritoneal versus pleural cases of mesothelioma (45.9 years versus 48.6 years, respectively). Also, there was no statistical difference between those with and without asbestosis. Conversely, the study found evidence to prove that women had a longer latency period then men (53.3 years versus 47.9 years).
The average age of diagnosis was 70.3 years, with a range of 34 to 92 years of age. The age of diagnosis for peritoneal mesothelioma was slightly younger than that of the pleural mesothelioma cases (65.4 versus 70.6). Another study with a larger pool of mesothelioma patients was conducted in 1992 . This study, encompassing 1,690 cases, found the median latency to be 32 years.
With such a great latency period, the best method is early detection. If the cancer is caught in Stages I or II, there is a better chance that the patient can undergo curative surgery. Only a medical specialist can diagnose something as complex as malignant mesothelioma, so it is best to consult a physician if symptoms present.
You can also have a Mesothelioma Information Packet delivered free of charge to your residence. For any questions, please call 855-379-4560.
- Merk Source
- Texas Occupational Medicine Institute
- Mayo Clinic
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- Thomason, R. “Primary Malignant Mesothelioma of the Pericardium.” Pub Med 21.2 (1994): 170-174. Web. 24 May 2011.
- Mak, CW. “Malignant Mesothelioma of the Tunica Vaginalis Testis .” British Journal of Radiology 77. (2004): 780-781. Web. 24 May 2011.