The clinical presentation of mesothelioma is rather insidious and a very late diagnosis is made in most patients due to the nonspecific nature of complaints [1] [2]. It is established that up to 4 months pass from the onset of symptoms before the tumor is recognized [3], which significantly reduces survival rates. Mesotheliomas are much more likely to occur in men, primarily due to its association with occupational exposure to asbestos and other known carcinogens (the male-to-female ratio is established at 5:1) [2] [4]. The clinical presentation depends on the location of the tumor, with the two main locations being the pleura (the most common) and the peritoneum [1] [2] [3] [4]. In the majority of cases suffering from pleural mesothelioma, a nonproductive cough that is often accompanied by dyspnea, fatigue, diaphoresis, and focal chest pain in some people are notable complaints [1] [2] [5]. Rarely, scoliosis toward the ipsilateral side or splinting may develop due to the expansive nature of the tumor [1]. Conversely, abdominal pain, swelling, anorexia, profound losses in body weight, as well as ascites are manifestations of peritoneal mesothelioma [3]. In some patients, the diagnosis is made incidentally [3].

• Pain

  Typical symptoms are nonspecific, such as a nonproductive cough, dyspnea, and localized chest pain in the case of pleural mesothelioma, whereas abdominal pain, anorexia, weight loss, and swelling of the abdomen are reported with peritoneal tumors. [symptoma.com]

  Persistent pain in the chest and shortness of breath are the most common symptoms of mesothelioma. [msdmanuals.com]

  The procedure involves heating some of the pain nerves in the spinal cord that transmit pain information to the brain. [mesothelioma.uk.com]

  Over half of patients with pleural mesothelioma have pain in the lower back or at the side of the chest. An increase in waist size or abdominal pain may be a symptom of the growth of cancer cells in the abdomen and peritoneal mesothelioma. [asbestosnetwork.com]

• Fever

  Familial Mediterranean fever (FMF) is an inherited disorder characterized by episodes of fever, and abdominal, chest and/or joint inflammation. [ncbi.nlm.nih.gov]

  Learn About Mesothelioma Mesothelioma, unlike other cancers, tends to grow mainly along the surface of the lung and other surfaces of the chest resulting in breathing difficulties, chest pain and fever. [lung.org]

  Pericardial mesothelioma symptoms include the following: Heart palpitations, irregular heartbeat Pain in the chest Inexplicable difficulty breathing (dyspnea) Sweating or fever Fatigue Because this form of mesothelioma so rarely affects patients, its [mesotheliomasymptoms.com]

  Symptoms of peritoneal (abdominal) mesothelioma can include: Weight loss Swelling and pain in the abdomen Blood clotting abnormalities Bowel obstruction Anemia Fever If cancer has spread to other parts of the body, symptoms may include pain, swallowing [webmd.com]

• Inflammation

  Familial Mediterranean fever (FMF) is an inherited disorder characterized by episodes of fever, and abdominal, chest and/or joint inflammation. [ncbi.nlm.nih.gov]

  Possible co-factors in the pathogenesis of asbestos-related mesothelioma include genetic predisposition, diets poor in fruit and vegetables, viruses, immune impairment, recurrent serosal inflammation. [doi.org]

• Fatigue

  Early signs of pleural mesothelioma include: Trouble breathing Long-lasting cough Pain under the rib cage or in the abdomen Pain while breathing Weight loss and fatigue Diagnosis Images may be taken of your bodily structures. [uvahealth.com]

  In the majority of cases suffering from pleural mesothelioma, a nonproductive cough that is often accompanied by dyspnea, fatigue, diaphoresis, and focal chest pain in some people are notable complaints. [symptoma.com]

  […] symptoms: Abdominal pain, bowel irregularity, general fatigue, seizures Pericardial Symptoms include: Irregular heartbeat Shortness of breath Chest pain General fatigue Weight loss Diagnosis Many patients are diagnosed with mesothelioma after exhibiting [mesotheliomaguide.com]

  Pericardial mesothelioma symptoms include the following: Heart palpitations, irregular heartbeat Pain in the chest Inexplicable difficulty breathing (dyspnea) Sweating or fever Fatigue Because this form of mesothelioma so rarely affects patients, its [mesotheliomasymptoms.com]

  Temporary side effects include nausea, vomiting, hair loss, and fatigue. The physician may prescribe medication to reduce the nausea and vomiting. [asbestosnetwork.com]

• Surgical Procedure

  A repeat laparotomy for a debulking surgical procedure confirmed a recurrence of BPCM. Our current case represents a woman with a remote recurrence of BPCM after initial optimal debulking surgery. [ncbi.nlm.nih.gov]

  Some have survived this deadly disease through surgical procedures. It is the stories of these heroes who help us see hope in the face of a grim diagnosis. [mesotheliomahelpnow.com]

  HIPEC stands for hyperthermic intraperitoneal perioperative chemotherapy which basically means flushing the surgical area with heated chemotherapy during the surgical procedure. [survivingmesothelioma.com]

  Pleurodesis : A surgical procedure that uses chemicals or drugs to make a scar in the space between the layers of the pleura. Fluid is first drained from the space using a catheter or chest tube and the chemical or drug is put into the space. [cancer.gov]

• Dyspnea

  In the majority of cases suffering from pleural mesothelioma, a nonproductive cough that is often accompanied by dyspnea, fatigue, diaphoresis, and focal chest pain in some people are notable complaints. [symptoma.com]

  […] care and relief of pain and dyspnea. [merckmanuals.com]

  Palliative care aims to relieve the patient s discomfort caused by dyspnea and pain. [encyclopedia.com]

  Typical presenting features are chest pain and dyspnea. Breathlessness due to a pleural effusion without chest pain is reported in about 30% of patients. [orpha.net]

• Nausea

  Temporary side effects include nausea, vomiting, hair loss, and fatigue. The physician may prescribe medication to reduce the nausea and vomiting. [asbestosnetwork.com]

  Other symptoms may include weakness, abdominal pain and nausea. Mesothelioma can occur as the result of very low levels of exposure to asbestos fibers. It often takes several decades for signs of the disease to surface. [mesothelioma-attorney.com]

  The most common AEs in the mesothelioma cohort were grade 1/2 fatigue and nausea (reported in six patients each) and grade 1/2 arthralgia (five patients). [curetoday.com]

  Treatment options at this point may include medications to relieve pain, nausea and vomiting. The Cancer Council Victoria booklet called Living with advanced cancer may be helpful to read. [betterhealth.vic.gov.au]

  The combination of cisplatin and pemetrexed can lead to hair loss, nausea, a loss of appetite and acute kidney damage. As a result, variations of these drugs with less serious side effects were developed. [asbestos.net]

• Abdominal Pain

  Typical symptoms are nonspecific, such as a nonproductive cough, dyspnea, and localized chest pain in the case of pleural mesothelioma, whereas abdominal pain, anorexia, weight loss, and swelling of the abdomen are reported with peritoneal tumors. [symptoma.com]

  Herein, we present a case of BFM in a 2-year-old male child, who presented to our hospital with abdominal pain and a lump in the abdomen. [ncbi.nlm.nih.gov]

  A chest wall mass, weight loss, sweating, abdominal pain and ascites (due to peritoneal involvement) are less common presentations. [orpha.net]

• Loss of Appetite

  Symptoms of mesothelioma in the lining of the lungs include: chest pain shortness of breath fatigue (extreme tiredness) a high temperature (fever) and sweating, particularly at night a persistent cough loss of appetite and unexplained weight loss clubbed [nhs.uk]

  The treatment team will discuss with the person, suitable treatment options to assist with other symptoms such as sleeplessness, pain, fatigue, loss of appetite and weight loss. [cancer.org.au]

  Mesothelioma Symptoms Symptoms of mesothelioma include shortness of breath, a chronic cough, chest and back pain, loss of appetite, difficulty sleeping and weight loss. Other symptoms may include weakness, abdominal pain and nausea. [mesothelioma-attorney.com]

• Diarrhea

  Symptoms of peritoneal mesothelioma include abdominal bloating, nausea, constipation and diarrhea. These common symptoms start off mildly, but as the lining of the abdomen thickens, tumors develop and symptoms become more noticeable. [asbestos.net]

  Symptoms of a pleural (lung) mesothelioma: Shortness of breath Chest pain Fatigue Night sweats Unexplained weight loss Symptoms of a peritoneal (abdomen) mesothelioma: Abdominal pain or bloating Constipation or diarrhea Nausea and vomiting A pericardial [loyolamedicine.org]

  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) Anemia Fatigue Diarrhea, constipation [mesotheliomasymptoms.com]

  Symptoms expressed by a peritoneal mesothelioma patient include diarrhea or constipation, nausea, fever, swelling or pain in the abdomen and anemia. [canceractive.com]

  Symptoms Symptoms of Pleural Mesothelioma Shortness of breath due to pleural effusion (accumulation of fluid between the lung and the chest wall) Chest pain Weight loss More Symptoms Symptoms of Peritoneal Mesothelioma Abdominal pain and/or swelling Diarrhea [survivingmesothelioma.com]

• Night Sweats

  The most common symptoms include: Chest pain Fatigue Night sweats Pleural effusion, or accumulation of abnormal amounts of fluid around the lung Shortness of breath Weight loss Risk Factors The single most important risk factor is being exposed to asbestos [utswmed.org]

  Non-specific symptoms include fevers, night sweats, fatigue and weight loss. Patients may also be asymptomatic and present with a chest wall mass, pleural effusion or other pleural pathology on imaging. [cancertherapyadvisor.com]

  As the disease advances to its final stage, symptoms can become more severe and typically include severe chest and lung pain, bloating, fatigue, skin rashes, nausea, vomiting, abdominal pain, night sweats, and fever. [mesotheliomalawyercenter.org]

• Suggestibility

  These relationships provide a simple basis for risk assessment, and support the suggestion that mesotheliomas may constitute a high proportion of cancer deaths resulting from early exposure to asbestos. [ncbi.nlm.nih.gov]

  The work is the first ... read more Study Suggests Improvements in How Mesothelioma Is Staged Feb. 2, 2016 — A new study suggests that significant improvements could be made in the scoring system physicians use to estimate the stage (severity) of mesothelioma [sciencedaily.com]

• Fear

  […] investigators have found previously unknown genetic alterations, including some that may be clinically actionable, as well ... read more Mesothelioma Surgery Improves Quality of Life, Study Finds June 9, 2016 — Many mesothelioma patients avoid surgery for fear [sciencedaily.com]

  Tell your doctor beforehand if you have any of these worries or fears. If you have any metal in your body, you cannot have an MRI scan. Bronchoscopy This is a test that looks at the inside of the airways. [ww2.mc.vanderbilt.edu]

• Neglect

  Because asbestos companies acted with neglect, mesothelioma victims and their families have legal options. [mesothelioma.com]

  But they neglected to warn their employees. Filing a lawsuit can help mesothelioma patients cover lost wages, medical expenses and other costs. [asbestos.com]

  Since then, many lawsuits have been filed against asbestos manufacturers and employers, for neglecting to implement safety measures after the links between asbestos, asbestosis, and mesothelioma became known (some reports seem to place this as early as [en.wikipedia.org]

The diagnostic workup should start with a meticulous clinical assessment. A detailed history must cover the onset of symptoms and their progression, as well as occupational details and whether exposure to asbestos or other harmful chemicals exists. During the physical examination, dullness on percussion due to a pleural effusion or diminished breathing sounds may be detected in the case of pleural mesotheliomas [1], in which case imaging studies need to be employed. Although plain radiography is a useful first-line study for the evaluation of the chest, more advanced studies, such as computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS), mediastinoscopy, laparoscopy, and positron emission tomography (PET) are recommended, primarily because they are able to determine the stage and aid in designing the optimal therapeutic strategy [1] [2] [3] [6]. To make a definite diagnosis, however, a sample of the tumor must be obtained for a histopathological examination. Because pleural cytology is not useful in the case of mesothelioma, fine-needle aspiration biopsy (FNAB), often guided by CT, or video-assisted thoracoscopy (which shows superior results compared to FNAB) are viable techniques that are used in practice [1] [2]. Immunohistochemical staining should include calretinin, as it carries a sensitivity rate of 95% and a specificity rate of 87% [2]. Other important markers are cytokeratin, mesothelin, and D2-40 [1] [2] [7].

When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. [web.archive.org]

As a result, multimodality treatment regimens have been developed. [doi.org]

How can I improve my prognosis? Where can I find a specialist? A prognosis is the most likely course the disease will take. A prognosis helps doctors and patients set reasonable goals they can target together. [mesotheliomahelpnow.com]

Prognosis, symptoms and treatment options vary by type. [asbestos.com]

For more information, view Malignant Mesothelioma Symptoms, Tests, Prognosis, and Stages. [cancer.gov]

Patients should discuss their individual case with a mesothelioma specialist to better understand their prognosis. Prognosis How a disease will progress. A prognosis can be good or bad and may have a survival time estimate. [mesothelioma.com]

A patient’s prognosis is often based on stage, cell type and their overall health. Women and younger patients have a better life expectancy than older men. There are several steps patients can take to improve their prognosis. [mesotheliomaguide.com]

Etiology and pathogenesis of BCM remain unclear. Familial Mediterranean fever (FMF) is an inherited disorder characterized by episodes of fever, and abdominal, chest and/or joint inflammation. [ncbi.nlm.nih.gov]

[…] mesothelial cyst, reactive mesothelial hyperplasia, adenomatoid tumor, benign cystic mesothelioma and benign papillary mesothelioma Epidemiology Exceedingly rare (less common than tumors of pleura and peritoneum) Most occur between ages 55 - 75 years Etiology [pathologyoutlines.com]

Key Words Asbestos Malignant Mesothelioma Chrysotile Asbestos-Related Diseases Environmental Epidemiology Occupational Epidemiology Selected Abbreviations and Acronyms SMR standardized mortality ratio View full text Copyright © 2011 Elsevier Inc. [annalsofepidemiology.org]

Although SV40 can induce mesotheliomas in animals, in humans the epidemiologic data are against a causative role. [ncbi.nlm.nih.gov]

Although asbestos has been known for several decades to cause peritoneal mesothelioma, in addition to the pleural form of the disease [ 4 ], no detailed review of the epidemiological features of this disease has been published recently. descriptive epidemiology [web.archive.org]

Epidemiology of malignant mesothelioma- -an outline. Ann Occup Hyg 2010;54:851-7. McDonald C. eds. Epidemiology of Work Related Diseases. London: BMJ Books, 2000. Virta RL. [doi.org]

Pathophysiology Eighty percent of MPM arises from the mesothelial lining of the parietal pleura. It is specifically unknown how asbestos induces MPM at the molecular level. [cancertherapyadvisor.com]

Assessment of its results would provide solid evidence about the value of this approach in early diagnosis, and possibly stratification based on pathophysiological condition and cancer risk. [doi.org]

Includes causes, prevention, genetics, treatment options and clinical trials. Mayo Clinic: Mesothelioma Includes a description of mesothelioma and provides information about symptoms, causes, risk factors, complications, treatments and drugs. [curlie.org]

The only known way to prevent this cancer is to avoid asbestos or other fibers. [uvahealth.com]

Control of asbestos exposure remains the main approach to prevent peritoneal mesothelioma. [ncbi.nlm.nih.gov]

Treatment Pleural mesothelioma is usually treated with: Chemotherapy —use of drugs to kill cancer cells Radiation —use of radiation to kill cancer cells and shrink tumors Surgery Combination of these three treatments Prevention The only known way to prevent [web.archive.org]

Causes, Risk Factors, and Prevention Learn about the risk factors for malignant mesothelioma and what you might be able to do to help lower your risk. Early Detection, Diagnosis, and Staging Know the signs and symptoms of malignant mesothelioma. [cancer.org]

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2. Porpodis K, Zarogoulidis P, Boutsikou E, et al. Malignant pleural mesothelioma: current and future perspectives. J Thorac Dis. 2013;5(Suppl 4): S397-S406.
3. Bridda A, Padoan I, Mencarelli R, Frego M. Peritoneal Mesothelioma: A Review. Medscape General Medicine. 2007;9(2):32.
4. Nasreen N, Khodayari N, Mohammed KA. Advances in malignant pleural mesothelioma therapy: targeting EphA2 a novel approach. Am J Cancer Res. 2012;2:222-234.
5. Muers MF, Stephens RJ, Fisher P, et al. Active symptom control with or without chemotherapy in the treatment of patients with malignant pleural mesothelioma (MS01): a multicentre randomised trial. Lancet 2008;371:1685-1694.
6. Pickhardt PJ, Bhalla S. Primary neoplasms of peritoneal and sub-peritoneal origin: CT findings. Radiographics. 2005;25:983–995.
7. Husain AN, Colby TV, Ordóñez NG, et al. Guidelines for pathologic diagnosis of malignant mesothelioma: a consensus statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med. 2009;133(8):1317–1331.