Mesothelioma Symptoms

Mesothelioma is a unique disease in that symptoms do not usually manifest themselves until anywhere from 20 to 50 years after exposure to asbestos. For patients and doctors, this is the most frustrating aspect of the disease. The latency period of mesothelioma is lengthy, making the disease undiagnosable until its later stages when symptoms finally begin to appear and little can be done to slow the progress of the disease.
Recognizing Symptoms
Just like any other disease, the symptoms of mesothelioma vary from case to case and with the severity of the illness. The type of mesothelioma - whether pleural, peritoneal, or pericardial - also determines what the symptoms might be. Often times, the general overall health of the individual, as well as his/her age, may also play a role in how the patient is affected by the disease and which symptoms are most bothersome.
One of the most difficult problems with diagnosing mesothelioma and connecting the symptoms with the disease is the fact that so many of the symptoms - both individually and in tandem - can easily be mistaken for other more common diseases like flu, pneumonia, bronchitis, heart disease, and others.
A doctor well versed in mesothelioma treatment will take time to investigate a patient's history and hopefully connect past exposure to asbestos with the symptoms. Patients, however, can do their part as well. Anyone that was ever exposed to asbestos, even if it was decades ago, should inform their doctor of the exposure. That information will not only aid the doctor in diagnosis but will also help eliminate the need for many costly and uncomfortable tests that may be ordered while fishing for a diagnosis.
Tests are being developed that will help diagnose mesothelioma at an earlier stage, even before the most common symptoms appear. It is hoped that these tests will aid in treating the disease before it reaches its most advanced stages.
The Symptoms
As was stated previously, symptoms of mesothelioma can vary, but the most common general symptoms are:
Shortness of breath or difficulty breathing
Coughing
Pain in chest or abdomen
Fluid in the chest, lungs, or abdomen
Weight loss
Loss of appetite
Inability to sleep
Husky voice
Difficulty swallowing
It is the first two symptoms that generally bring a patient to the doctor's office. Both difficulty breathing and persistent coughing are caused by the lung's inability to expand properly due to tumors in the pleural region. The growing tumors cause the pleura, pericardium, or peritoneum to expand, thus allow fluid to enter. That generally causes pain - acute to severe - in the affected regions, such as the chest or abdomen. Breathing difficulties also make it hard to sleep and often result in loss of appetite and, eventually, weight loss.
Depending on the type of mesothelioma diagnosed - pleural, pericardial, or peritoneal - symptoms might vary from the above, which pertain mostly to pleural mesothelioma, the most common form of the disease.
Common symptoms of peritoneal mesothelioma might include:
Abdominal pain, acute to severe
Swelling of the abdominal region due to fluid accumulation
Breathing difficulties
Loss of appetite resulting in weight loss
Bowel obstruction
Nausea
Vomiting
Weakness
Fever
Anemia
Common symptoms of pericardial mesothelioma might include:
Chest pain, ranging from uncomfortable to severe
Shortness of breath
Heart palpitations
Persistent coughing
Extreme fatigue after minimal activity or exertion
Because the three types of the disease are similar but centered in different parts of the body, the patient is likely to have symptoms that overlap. For example, nearly all meso patients suffer from shortness of breath and fatigue, but the pain may be more apparent in the abdominal/stomach area for peritoneal patients and in the chest for those with pleural or pericardial mesothelioma.
Ascertaining a Diagnosis
If a doctor recognizes symptoms as indicative of mesothelioma or another asbestos-related disease, such as asbestosis, the patient will be asked to undergo several tests. Most doctors begin by ordering a conventional x-ray in order to get a closer look at the chest or abdomen. What appears on this x-ray will be the first indication of whether or not the doctor should continue pursuing his suspected diagnosis and order additional tests.
If mesothelioma is still suspected after the x-ray, an MRI or CT scan will most likely be in order. These sophisticated imaging processes allow an even closer look at organs such as the lungs or abdomen. A blood test may be ordered as well because such tests can measure the levels of specific proteins, which might aid in the diagnosis.
However, because other more common diseases, such as benign asbestos-related pleural disease, can have very similar appearances on imaging studies, a tissue biopsy is usually recommended and is often the final test that leads to an accurate diagnosis.
References:
Dodson, R. and Hammar, S. Asbestos: Risk Assessment, Epidemiology, and Health Effects. Taylor & Francis: Boca Raton. 2006.
Stahel RA,Weder W, Felip E; ESMO Guidelines Working Group. Malignant pleural mesothelioma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Clinic and Policlinic of Oncology, University Hospital of Zurich, Switzerland. 2008.
Pass, I., Vogelzang, N., Carbone, M. Malignant Mesothelioma: Advances in Pathogenesis, Diagnosis, and Transitional Therapies. Springer: New York. 2005.
http://www.cancer.gov/cancertopics/types/malignantmesothelioma
http://www.nlm.nih.gov/medlineplus/mesothelioma.html