Pleural Mesothelioma Symptoms

Quick Summary

Pleural mesothelioma symptoms often go unnoticed for decades, which leads to late-stage diagnoses. If you have a history of asbestos exposure, then it’s critical to be aware of the early warnings signs of pleural mesothelioma. Detecting mesothelioma symptoms early can lead to an accurate, timely diagnosis and potentially life-saving treatments.

Pleural Mesothelioma Symptoms Overview

  • Pleural mesothelioma symptoms take 10-50 years to develop after initial asbestos exposure
  • Symptoms are often confused with other respiratory conditions such as pneumonia, bronchitis or chronic obstructive pulmonary disease (COPD)
  • One of the primary signs of pleural mesothelioma is a pleural effusion (buildup of fluid in the lung lining)
  • Symptoms progressively get worse as the mesothelioma metastasizes (spreads)
  • Pleural mesothelioma symptoms can be treated with multimodal therapies and palliative procedures

Pleural Mesothelioma Symptom Latency

Mesothelioma is characterized by a long latency period after initial asbestos exposure. When someone inhales asbestos fibers into their lungs, it can take anywhere from 10-50 years before symptoms of pleural mesothelioma develop.

Often, the early signs of mesothelioma are easily mistaken for nonlife-threatening conditions. It’s easy for the medical community to misdiagnose mesothelioma because it is so rare and not fully understood. That’s why knowing about your history of working or living around asbestos is key to diagnosing mesothelioma before it has advanced to end-stages. By the time mesothelioma has reached stage 3 or stage 4, treatment options are limited.

Understanding the nature of mesothelioma’s delayed onset and the full set of symptoms and signs can help lead to early diagnosis and potentially life-extending treatments.

Primary Pleural Mesothelioma Symptoms

Though it remains a rare cancer type, pleural mesothelioma symptoms are becoming more understood, and doctors have now identified specific sets of symptoms to be aware of. While we know more about mesothelioma today than ever before, it’s still possible to confuse early pleural mesothelioma symptoms with other conditions, especially if you have forgotten about or are unaware of your asbestos exposure history.

In general, specialists have identified early-stage pleural mesothelioma symptoms that are common in stages 1 and 2. These symptoms then progressively get worse as cancer advances into stages 3 and 4.

Early-Stage Pleural Mesothelioma Symptoms

In stage 1 and stage 2 of pleural mesothelioma, the tumor remains relatively localized within the pleura of one lung or the chest wall. Without any significant metastasis, early-stage pleural mesothelioma symptoms are typically mild, yet persistent.

Pleural Mesothelioma Symptoms Update

In the initial stages of pleural mesothelioma, the pleura (lung lining) begins to thicken and fill with fluid (pleural effusions). Over 90% of pleural mesothelioma patients experience pleural effusions, and it is considered a key sign of this disease. Pleural effusions and thickening are caused by the inflammation that results from asbestos fibers irritating the lung lining tissue. The inflammation causes a decrease in the flexibility of the lung lining, which compromises respiration.

Here are some common early warning signs of pleural mesothelioma:

  • Increased difficulty in breathing
  • Constriction in the chest
  • Shallow breathing, even when at rest
  • Chest pain
  • Persistent, dry cough
  • Unexplained weight loss
  • Body aches
  • Fever
  • Fatigue

These vague symptoms can easily be confused with a cold and flu in an otherwise healthy person. However, if they continue to persist well past a normal course of sickness, then it can indicate a much more serious underlying condition.

Many patients suffer from slight shortness of breath and chest pain for several months before they report their symptoms to a doctor. That’s because these symptoms are often not debilitating enough to cause concern. Instead, patients either ignore their symptoms or wait to see if they improve.

Usually, symptoms like chest pain and pressure do not improve and only worsen over time due to continual scarring of the pleural tissues by the asbestos fibers.

Late-Stage Pleural Mesothelioma Symptoms

By the time the mesothelioma advances into stages 3 and 4, there is significant metastasis throughout the chest cavity. With growing and spreading tumors, patients start to notice specific symptoms that clearly indicate some form of cancer, though this may still be misdiagnosed in these stages.

Stage 3 and 4 pleural mesothelioma patients will notice a decrease in quality of life, with increasingly more debilitating and worsening symptoms. What started out as slight chest pain and a dry cough has now progressed to painful, unrelenting symptoms.

Pleural effusions have diminished by late stages because the tumor is now occupying the majority of the pleura space. The tumor causes a significant restriction in the lung lining, which further compromises the ability for the patient to breathe.

Here are some common symptoms experienced in late-stage pleural mesothelioma patients:

  • Chronic dry cough
  • Coughing up blood
  • Lumps of tissue forming under the skin around the chest
  • Severe pain under the rib cage
  • Dull and heavy chest pain
  • Painful breathing
  • Difficulty swallowing
  • Anemia (due to lack of nutrition)
  • Chronic fatigue
  • Fever and night sweating

In rare cases, patients will also experience vocal cord paralysis and nerve damage in the limbs, This is because the mesothelioma has spread to distant sites and is now impairing bronchial tubes and neurological function.

By end-stage pleural mesothelioma, patients are generally very weak, tired and malnourished. They may experience significant weight loss and have difficulty performing even basic tasks. This is because the body is no longer focused on absorbing nutrients from any food that the patient does consume. Instead, its energy is spent on fighting to keep affected organs alive as they undergo attack from mesothelioma cells.

Because stage 3 and 4 pleural mesothelioma patients are in such severe pain and discomfort, pain management is a crucial component of treatment and helping to improve quality of life.

Pleural Mesothelioma Symptom Management

No matter which stage the disease is at, symptom management is extremely important in treating pleural mesothelioma patients, especially in late stages when symptoms have worsened.

Doctors help manage, reduce or mitigate symptoms in a few ways, including:

  • Drain pleural effusions
  • Remove and debulk tumors
  • Shrink tumors
  • Remove diseased pleura and/or lung
  • Control or stop metastasis
  • Provide pain-relief with medications

Various treatments can accomplish these symptom-management goals. Depending on what stage your condition is diagnosed at, specialists will recommend a multimodal approach, which combines multiple treatment forms.

The most common symptom management treatments for pleural mesothelioma include:

  • Chemotherapy: Doctors administer chemotherapy (anti-cancer drugs) to virtually all pleural mesothelioma patients to slow down metastasis.
  • Radiation Therapy: Radiation therapy targets tumors and shrinks them in size to help reduce painful metastasis and improve breathing.
  • Palliative Surgery: Surgeons perform minimally invasive surgical procedures that drain fluid buildup from the chest cavity, helping to reduce pain and improve breathing.
  • Radical Surgeries: In some cases, doctors will recommend radical surgeries such as an extrapleural pneumonectomy or a pleurectomy with decortication to remove tumors and improve breathing.

Clinical trials that test out new drug combinations or novel therapies can also help alleviate certain symptoms. All pleural mesothelioma patients are encouraged to inquire about participating in clinical trials, which can improve quality of life and possibly extend life expectancy.

Seeing a Specialist About Pleural Mesothelioma Symptoms

Pleural mesothelioma patients often experience worsening symptoms as their condition advances. However, all patients should be aware of important and effective treatments provide significant symptom-relief to improve quality of life.

If you have a history of asbestos exposure and you suspect you may have pleural mesothelioma symptoms, then it’s important to obtain an accurate diagnosis from a mesothelioma specialist. Only specialists have the experience required to properly diagnose and stage this rare cancer type.

Contact one of our Patient Advocates today to find out how to work with top pleural mesothelioma specialists in the country.

View Author and Sources

  1. Cancer, American Cancer Society, “Pleural Mesothelioma”. Retrieved from:;2-9/epdf. Accessed on December 20, 2017.
  2. European Respiratory Review, “Malignant pleural mesothelioma: an update on investigation, diagnosis and treatment.”
    Retrieved from: Accessed on December 20, 2017.

Last modified: April 4, 2019