Mesothelioma Symptoms

What are the most common warning signs of mesothelioma?

Mesothelioma is difficult to diagnose because the early signs and symptoms of the disease can be subtle or mistaken. Symptoms are all too frequently ignored or dismissed by people who are inclined to attribute them to common every day ailments. Sometimes patients live with symptoms for up to 6 months before being diagnosed but usually the symptoms are present for two to three months prior to a mesothelioma diagnosis.
About 60% of patients diagnosed with pleural mesothelioma experience lower back pain or side chest pain, and there are frequent reports of shortness of breath. Lower numbers of people may experience difficulty swallowing, or have a persistent cough, fever, weight loss or fatigue. Additional symptoms that some patients experience are muscle weakness, loss of sensory capability, coughing up blood, facial and arm swelling, and hoarseness.
Peritoneal mesothelioma originates in the abdomen and as a result, symptoms often include abdominal pain, weight loss, nausea, and vomiting. Fluid buildup may occur in the abdomen as well as a result of the cancer.
Asbestos exposure is considered the primary risk factor for the development of the cancer. Anyone previously exposed to asbestos displaying any of these symptoms should seek medical attention from their doctor first, only to be referred to a doctor who specializes in the treatment of mesothelioma and thoracic oncology after receiving a positive diagnosis.

How long does it take for mesothelioma symptoms to appear?

One of the most unique facts about mesothelioma is that the disease is characterized by a long latency period that is very often associated with the disease. The latency period is the amount of time that elapses from the first point of asbestos exposure to the point where symptoms begin to appear so that a diagnosis can be made. In some mesothelioma cases the latency period is reported to be 10 years but the average latency for the majority of cases is between 35 and 40 years. As a result, the cancer often progresses to later stages before a diagnosis is made. When diagnosed in the later stages, mesothelioma treatment options become more limited and are less effective.

Symptoms of Mesothelioma

Provided below is a list of symptoms that mesothelioma patients may experience. Please click on a symptom to learn more about it.

Anemia

Mesothelioma patients diagnosed with anemia have a lower than normal red blood cell count or hemoglobin in the blood.

Blood Clotting Disorder

A symptom experienced by many mesothelioma patients that can lead to anemia and other serious complications if not given appropriate medical attention.

Bowel Obstruction

Bowel obstructions can be a direct effect of the cancer. It is a very painful symptom that can sometimes develop in peritoneal mesothelioma patients.

Chest Pain

Often experienced in pleural mesothelioma and pericardial mesothelioma patients, chest pain can develop as the tumor grows and places strain on the lungs and heart.

Dysphagia

Pleural mesothelioma patients often develop difficulty swallowing (esophageal dysphagia) as the mesothelium continues to grow on the lungs.

Fluid Effusion

An effusion can occur in mesothelioma patients when there is fluid buildup affecting either the pleura or pericardium. This may need to be drained in a relatively limited surgical procedure to control the effusion and associated symptoms.

Hemoptysis

Hemoptysis, or the symptom of coughing up blood, can have its origins in the lungs, bronchi or trachea of mesothelioma patients.

Nausea

Nausea is experienced in a number of cancer patients, as it is often a side effect of chemotherapy treatment and sometimes the underlying cancer. Those diagnosed with peritoneal mesothelioma may also experience nausea as a result of increasing abdominal pressure.

Peritoneal Effusion

Peritoneal mesothelioma patients may experience a buildup of fluid in the peritoneum as the tumor continues to grow. This can result in an effusion which can inhibit the function of abdominal organs.

Peritoneal Effusion

In pleural mesothelioma patients, pleural effusion may develop when there is a large amount of fluid present in the pleura, the lining between the lungs and chest cavity.

Weight Loss

Weight loss can occur in mesothelioma patients as a side effect from cancer treatment or as the result of other symptoms that may also be present, such as difficulty swallowing or nausea.

Stage IV Mesothelioma Treatment

In Stage IV, mesothelioma treatment focus changes to end-of-life care, emotional support and management of physical symptoms. Invasive surgery may offer temporary relief from pain but is not recommended for this late stage of malignant mesothelioma.

What is Stage IV Mesothelioma?

Stage IV Mesothelioma is terminal. The cancer has spread to vital organs through the lymphatic system and blood stream. Tumors occur beyond the point of origin in the pleura, pericardium or peritoneum. The removal of large or primary tumors may provide comfort, but at this stage, removing all tumors from affected tissues is impossible and does not prevent future metastasizing.
With Stage IV Pleural Mesothelioma, the entire lung (s) may be involved, along with the esophagus and lymph nodes in the neck and under the arms.
With Stage IV Pericardial Mesothelioma, the cancer may have metastasized beyond the heart into the chest cavity. Through the blood stream, mesothelioma may travel to remote parts of the body.
With Stage IV Peritoneal Mesothelioma, not only does the cancer spread throughout the entire abdominal cavity, it may have metastasized to nearby lymph nodes in the groin and to other organs.
At this stage, metastasized cells may have penetrated organs near the original site.

What are the Common Treatments for Stage III Mesothelioma?

Surgery / Radiation / Chemotherapy

Conventional multimodal treatment plans that combine surgery, radiation and chemotherapy are not typically used for Stage IV Mesothelioma patients. They are, however, sometimes used for pain management reasons.
Surgery may remove the primary tumor, but it does not guarantee relief from further metastasizing or reoccurrence.
With pleural mesothelioma, surgery may remove the primary tumor to ease pressure on the lungs and improve breathing. Similarly, surgery for pericardial and peritoneal mesothelioma may reduce pressure on the heart and abdomen and provide pain relief.
Chemotherapy may lessen pain for some patients, but at this advanced stage of mesothelioma, there are considerable risks. In some cases, after removing the primary tumor, chemotherapy may help slow metastasizing.
A Stage IV prognosis is terminal and the treatment plan is palliative rather than curative.

Thoracentesis / Paracentesis / Pericardiocentesis

Draining excess fluid from the affected areas may provide symptomatic relief but is not a curative option for Stage IV Mesothelioma.
Thoracentesis drains excess fluid in the lungs; paracentesis drains excess fluid in the abdomen; and pericardiocentesis drains fluid from the heart.
These procedures, however, may only provide temporary relief because there is a significant risk for fluid buildup to reoccur.

Palliative Care

With advanced stages of mesothelioma, treatment turns to palliative care, ensuring that the patient is pain free and comfortable.
Hospice care provides a dignified option for some Stage IV Mesothelioma patients. Quality of life is a primary goal of hospice care along with providing necessary emotional support not only for the patient but for loved ones as well.
Integrating alternative options with palliative care may provide additional physical, emotional and spiritual support. For those with Stage IV Mesothelioma, meditation or art therapy may provide a necessary emotional outlet and help cope with the terminal nature of the disease. Other alternative mesothelioma treatments may not be appropriate for Stage IV Mesothelioma patients because many of them require movement.

Stage III Mesothelioma Treatment

Stage III Mesothelioma has a much less favorable prognosis than Stages I and II and the Mesothelioma treatment options most often used focus on maximizing patient comfort and minimizing symptomatic pain.

What is Stage III Mesothelioma?

Depending on the staging system used, Stage III Mesothelioma likely includes the metastasizing of cells to other areas of the body, lymphatic system and blood.
Stage III Mesothelioma is typically incurable and inoperable because the malignancy has spread to other vital organs.
With Stage III Mesothelioma, the cancer has spread past the pleura or the protective linings of the lungs, heart or abdomen. In some cases, the cancerous cells traveled into the lymphatic system or blood stream. When the cancer spreads to the lymph nodes, containing the mesothelioma is nearly impossible.

What are the Common Treatments for Stage III Mesothelioma?

Surgery

With Stage III Mesothelioma, surgery is typically palliative. With operable tumors, surgery is an option to ease symptomatic suffering and aid in quality of life. However, surgery may only remove the main tumor, but since the cancer has spread through the lymphatic system, blood and other organs, surgery cannot remove the remaining cancerous cells.
Location of the tumor or tumors dictates whether surgery is an option or potentially detrimental to the overall health of patient.
At this stage of mesothelioma, surgery depends entirely on the individual and type of mesothelioma. In most cases, surgery is not an option.

Radiation Therapy

For Stage III Mesothelioma patients, radiation therapy also provides symptomatic relief. Though radiation therapy typically inhibits metastases of cells, radiation therapy may specifically target areas of the body where tumors associated with Stage III Mesothelioma are painful and severely affect quality of life.
Administering radiation at this stage only provides palliative care.

Thoracentesis / Paracentesis / Pericardiocentesis

Thoracentesis is a palliative treatment option for pleural mesothelioma in which excess fluid is drained from the lungs. Paracentesis also drains excess fluid built up in the abdomen for peritoneal mesothelioma while pericardiocentesis drains fluids from the pericardium. These treatments alleviate pain and pressure, but do not cure the disease.

Palliative Care

Palliative care plans are individualized and target the specific issues that each patient faces. They almost always include a pain management component, however, to ensure that the patient is not suffering.
Medical professionals may also prescribe dietary and lifestyle changes aimed at improving patient comfort. Proper nutrition and maintaining hydration is critical. Many conventional treatment options – radiation therapy or chemotherapy – rob the body of vital vitamins and minerals.
The emotional impact of Stage III Mesothelioma may be more painful than the disease itself, not only for the patient but also for loved ones and care givers. Counseling may be a necessary part of any palliative care plan.
Integrating alternative therapies into a conventional palliative care plan is also a viable option. Massage therapy, for example, may provide temporary relief to sore muscles and joint tissue. However, most alternative therapies provide short-term comfort and are not a replacement for conventional treatments.
Ultimately, a palliative care plan is individual. Determining what quality of life means is unique as the individual with Stage III Mesothelioma.

Stage II Mesothelioma Treatment

Mesothelioma may affect the lungs (pleural), heart (pericardial) or the abdomen (peritoneal). The extent of mesothelioma determines what sorts of treatment options are available. For Stage II cancer, the mesothelioma treatment strategies are somewhat similar to that of Stage I.

What is Stage II Mesothelioma?

Much like Stage I, Stage II Mesothelioma is a rare diagnosis. Most mesothelioma cancer diagnoses stem from late detection and it is fairly rare to have an early stage (Stage I or Stage II) mesothelioma diagnosis. If you have been diagnosed with Stage I or Stage II mesothelioma, however, this is far more promising news.
Fundamentally, Stage II Mesothelioma has encased the pleura of the lungs, heart or abdomen. In some cases the lymphatic system is involved, typically only with pleural mesothelioma, which is the most common form of the cancer.
Further, whether the mesothelioma is resectable, or in an operable place, is also a quantifying factor of staging. Most cases of Stage II Mesothelioma are resectable; however, as each individual is different, so are the treatment options.
It is important to understand that while earlier stages of mesothelioma are far easier to diagnose and treat, a cure for the disease has not yet been discovered.

What are the Common Treatments for Stage II Mesothelioma?

Surgery

As with Stage I Mesothelioma, if the cancer is resectable or operable, mesothelioma surgery is the best treatment option for Stage II.
Treatments options will vary from patient to patient, however, and it is always best to consult with your oncologist or primary care physician to see what your available options are.

Radiation Therapy

As a collaborative and supportive treatment along with surgery and chemotherapy, radiation is a typical therapy method for Stage II Mesothelioma. Specifically, radiation therapy targets the cancerous cells, damaging the inherent DNA. By destroying the cancerous cells, radiation therapy inhibits any metastases.

Chemotherapy

Similarly to radiation therapy, chemotherapy stops the metastases of cancer by killing off the cancerous cells with chemotherapy drugs. Chemotherapy is a common treatment for many types of cancers and is commonly used to treat Stage II Mesothelioma.

Gene Therapy

Gene therapy is showing promise as a treatment option for Stage II Mesothelioma patients. During treatment, an individual's healthy genes are implanted into the patient with the aim of having the new, healthy genes replace cancerous cells. In some cases, genes can be manipulated to target specific cancerous cells. On-going research for this treatment modality continues and remains encouraging.

Immunotherapy

Immunotherapy, much like gene therapy, is still in its infancy but some studies are suggesting positive results in mesothelioma patients. With any type of cancer, especially mesothelioma, the disease compromises the immune system. Immunotherapy causes the white blood cells to target and invigorate unhealthy or cancerous cells. The long-term benefits and applications of immunotherapy are continuing to be researched.

Alternative Therapies

Alternative therapies may provide relief from symptoms and the side effects of cancer treatment. Acupuncture and massage therapy are both alternative treatments that integrate well with conventional treatment methods and provide much needed pain and stress relief to patients undergoing mesothelioma treatment.

Palliative Care

Palliative care is always provided to those with Stage II Mesothelioma. As there is no mesothelioma cure, most treatment plans include a palliative approach. This approach is aimed at alleviating the symptomatic pain and discomfort associated with conventional treatment such as chemotherapy. Palliative care designed is to provide the best quality of life for anyone suffering from a terminal disease.
Additional mesothelioma treatments may also be available. Consult with an oncologist to understand the full range of options that may be available to you

Stage I Mesothelioma Treatmen

After a mesothelioma diagnosis, further testing is required to determine the stage of the cancer. Depending on the type of mesothelioma, different methods of testing may be used. Diagnostic tools assess whether the cancer is in Stage I, Stage II, Stage III or Stage IV.
The most common staging tools are x-rays, computed tomography scan (CT) or a magnetic resonance imaging scan (MRI).
In cases of pleural mesothelioma, bronchoscopy allows oncologists to have a visual image of the airways and bronchi, to help determine the stage that the cancer has advanced to.
There are three mesothelioma staging systems typically used by physicians: TNM Classification of Malignant Tumors, Butchart Staging System and the Brigham Staging System.
TNM is the most common grading system for all types of mesothelioma in which “T” refers to the size of the tumor; “N” if the lymph nodes are involved; and “M” whether the has cancer metastasized to other organs.
The Butchart Staging System, used mainly for pleural mesothelioma, determines the size and metastases of the mesothelioma.
Staging designation within the Brigham Staging System is based on whether or not the mesothelioma is operable and whether the lymphatic system is involved.

What is Stage I Mesothelioma?

Within the range of progressive staging metrics, Stage I Mesothelioma is the most treatable form of the disease. Stage I mesothelioma is an extremely rare diagnosis, however, as symptoms do not usually present until after the disease has progressed to advanced stages.
Stage I mesothelioma is classified in cases where the cancer is localized to a specific region – lungs, heart or abdomen – and has not yet metastasized to other organs or reached the lymphatic system.
With pericardial or peritoneal mesothelioma, the cancer has yet to breach the lining of the heart or abdomen.
Stage I Mesothelioma is typically operable and treatable with chemotherapy or radiation but as mentioned earlier, is rare.

What are the Common Treatments for Stage I Mesothelioma?

The range of Mesothelioma treatment options available for Stage I patients is the broadest available because, at this stage, the cancer is still localized. Conventional treatments and / or participation in clinical trials are most often recommended for patients presenting with early stages of mesothelioma.

Surgery

For Stage I Mesothelioma, surgery is the first treatment option explored, and in most cases, it is usually the best option. Surgery removes the affected lining around the lungs, heart or abdomen.

Radiation Therapy

Typically used in conjunction with surgery and chemotherapy, radiation is a common treatment method for Stage I Mesothelioma. Radiation therapy targets and controls the metastases of cancerous cells. By destroying cancerous cells, radiation therapy inhibits the spread of mesothelioma. Though there are some side effects associated with the treatment, like fatigue and joint pain, radiation therapy usually yields positive results for Stage I Mesothelioma.

Chemotherapy

Another common treatment option for Stage I Mesothelioma is chemotherapy. By administering high doses of specific medications, chemotherapy targets the cancerous cells and destroys them. With chemotherapy, however, the side effects of the treatment can be worse than the symptoms of the cancer itself.

Hyperthermia and Chemotherapy

Recent studies have shown that cancerous cells are more responsive to chemotherapy in cases of hyperthermia due to the increase of body temperature. Currently this treatment modality shows only a minimal impact on overall life expectancy and is still in its infancy.

Gene Therapy

A breakthrough in carcinoma treatment, gene therapy involves implantation of healthy genes that target cancerous cells. Though not commonly used for Stage I Mesothelioma, gene therapy is a growing treatment for several types of cancer, and is under going further research.

Immunotherapy

By “enhancing” the immune system’s ability to fight off disease, immunotherapy is showing some promise for treating Stage I Mesothelioma. Through intravenous immune-enhancing drugs, the immune system is “jump-started” to attack invading cancerous cells. Research for this type of treatment is still ongoing and results, thus far, are inconclusive as to whether immunotherapy is a viable option for Stage I Mesothelioma.

Clinical Trials

For some mesothelioma patients, taking part in a clinical trial may be the best option. Clinical trials often test treatment and drug options on mesothelioma patients that have already undergone vigorous scientific testing. Many clinical trials use a placebo as a control, and mesothelioma patients should consult with their doctor to understand the risk involved before entering any trial.

Mesothelioma Treatment by Stage

The treatment protocol for mesothelioma differs based on the stage that the cancer has progressed to at the time of diagnosis. Although there is currently no cure for this disease, recent medical advances have made a wider range of treatment options available to help improve patient comfort and quality of life. While there are a number of staging systems available to assess how far mesothelioma cancer has advanced in the body, the Butchart staging system remains the most widely used, especially for pleural mesothelioma.

Stage 1 Mesothelioma Treatment

Mesothelioma surgery is the most commonly recommended course of treatment for pleural mesothelioma patients having a Stage 1 diagnosis. The procedures that are likely to be performed are pleurectomy/decortication or extrapleural pneumonectomy. Post surgery, doctors may further evaluate the patient to determine if chemotherapy or radiation treatment is necessary. It is often determined with stage 1 mesothelioma that those adjunct therapies are not required.

Stage 2 Mesothelioma Treatment

Patients diagnosed with Stage II Mesothelioma still have a fairly wide range of treatment options available to them. Chemotherapy and radiation therapy are the most common treatments that will be recommended. Surgery may or may not continue to be a viable treatment option at this stage. There are also a variety of experimental and alternative treatments that may be used to slow the progression of the disease and help manage the pain and stress associated with conventional treatment therapies.

Stage 3 Mesothelioma Treatment

The treatment options for Stage III Mesothelioma patients are fewer than those available for Stage I and II patients as the cancer, in this stage, has typically spread beyond the point of origin to other vital organs in the body or the lymphatic system. Treatments recommended for Stage III patients are primarily focused on providing patient comfort and improving quality of life.

Stage 4 Mesothelioma Treatment

A diagnosis of stage 4 mesothelioma usually indicates a very unfavorable mesothelioma prognosis. At this stage, the cancer has usually metastasized throughout the body to other organs and as with stages 2 and 3, cannot be cured. In this stage, symptoms generally increase in severity and pain management becomes the primary focus of the medical team. Therapies such as chemotherapy and radiation are typically not offered at this stage unless they are needed to support pain management objectives. Oftentimes families find that it is most helpful to seek out additional support through a local Hospice program. Hospice programs focus on providing patient care, developing a pain management protocol and providing support for both the patient and family members at this difficult time. Patients with stage 4 mesothelioma may also be interested in participating in specialized clinical trials offered at leading cancer hospitals and centers and are encouraged to seek out those programs if desired.

Thermography

Most individuals have probably heard of thermography. It’s been around for a while and is quite often associated with things other than clinical medicine. For example, firefighters might use thermography to see through smoke to find people trapped in a fire or engineers may use this technology to spot things like faulty power lines or leaky insulation.
However, thermography - which can record the heat produced by different parts of the body - is often used to study blood flow and to detect tumors. Lately, the technique has also made its way into the realm of alternative medicine. More and more, practitioners are using thermography to detect problems within the body and to keep an eye on the healing process.
The image map produced by the thermograph shows abnormal hot or cold areas, which can be indicative of a number of different diseases.  While, the U.S. Food and Drug Administration has not approved the use of thermography for screening for diseases, there is evidence to suggest it may be helpful in the future for diagnostic procedures involving breast cancer, vessel diseases of the head and neck (extra-cranial), neuro-musculo-skeletal disorders, and vascular disease of the lower extremities.
Most importantly, note proponents of alternative medicine, thermography is non-invasive and non-radiative, making it far safer than the standard x-ray and while it is not currently an approved diagnosis technique there is hope that one day it may become an  alternative diagnostic procedure for those with a variety of diseases wishing to limit their radiation exposure.

Cancer’s Connection to Thermography

While thermography is now used extensively to detect breast cancer and measure metastases, those who tout the use of this diagnostic procedure also note that this type of thermal imaging can spot certain types of cancerous masses long before more conventional imaging techniques, including mesothelioma disease.
Hopes are that, in the future, this form of digital imaging may be able to help detect   cancer at early stages, including difficult-to-diagnosis types of cancer like mesothelioma, which remains latent in the body for decades and is usually not able to be diagnosed until it reaches Stage 3 or 4 and is, at that point, difficult to manage.
This kind of medical imaging can also display pain by detecting any changes in skin surface temperature that can accompany pain states, note those who practice regular use of thermography. Hence, alternative medicine practitioners are better able to access the amount of pain a cancer patient is experiencing and may also be better able to address specific pain via complementary therapies including massage, touch therapy, energy field therapy, or other common complementary techniques.