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Pleural Mesothelioma Symptoms

Common pleural mesothelioma symptoms include fluid buildup around the lungs, difficulty breathing, and chest pain. It’s important to know the signs and symptoms of pleural mesothelioma if you or a loved one have ever been exposed to asbestos, which is the only known cause of this cancer. Learn when you should see a doctor and how our team can help you get an accurate diagnosis.

Fact-Checked and Updated by: Jenna Tozzi, RN

Last updated:

What Are the Symptoms of Pleural Mesothelioma?

Pleural mesothelioma is a rare cancer of the lung lining (pleura) that’s caused by asbestos exposure. Because of how slowly the disease develops, patients may not have any symptoms for 10 to 50 years after they’re exposed to asbestos.

An older man coughsThe most common symptom is fluid buildup around the lungs, also known as pleural effusion. More than 80% of pleural mesothelioma cases start with pleural effusion, according to a 2022 report in Pathology International.

People with pleural effusion usually experience shortness of breath that gets worse when lying down or during physical activity.

Other common pleural mesothelioma symptoms include:

  • Chest pain
  • Dry cough
  • Difficulty swallowing (dysphagia)
  • Fatigue
  • Night sweats
  • Weight loss

Symptoms of Pleural Mesothelioma vs. Other Types

Although there may be some overlap, pleural mesothelioma symptoms usually differ from those of peritoneal mesothelioma and pericardial mesothelioma.

Peritoneal mesothelioma affects the lining of the abdomen and commonly causes stomach pain, constipation, and a feeling of fullness.

People with pericardial mesothelioma, which affects the lining of the heart, typically experience symptoms like irregular heartbeat, right shoulder pain, and heart palpitations.

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Pleural Mesothelioma Symptoms by Cancer Stage

Pleural mesothelioma progresses through four different stages as it spreads beyond the lung lining to other areas of the body. Symptoms worsen as the cancer stage increases.

Here’s an overview of how symptoms of pleural mesothelioma can vary by stage.

Early Pleural Mesothelioma Symptoms (Stages 1 and 2)

In the early stages of pleural mesothelioma, symptoms are often mild and non-specific, making them easy to overlook or attribute to more common conditions. Some patients may not have any symptoms at all.

Patients who do have symptoms commonly experience these symptoms:

  • Chest pain or discomfort: Often described as a dull ache located on one side or the center of the chest.
  • Fatigue: General feeling of tiredness or lack of energy.
  • Persistent cough: A dry cough or coughing that doesn’t seem to go away.
  • Pleural effusion: Buildup of excess fluid in the pleural space, either due to tumor presence or irritation of the pleura.
  • Shortness of breath: May occur due to fluid buildup or tumor growth putting pressure on the lungs.
  • Unexplained weight loss: Losing weight rapidly without changes in your diet or exercise routine.

Being able to promptly recognize these symptoms can lead to an earlier diagnosis and more effective treatment options.

Advanced Pleural Mesothelioma Symptoms (Stages 3 and 4)

As the cancer spreads to distant organs in the later stages, symptoms become more pronounced and may start to significantly impact your daily life.

  • Abdominal pain and swelling: Occurs when the cancer reaches the abdominal cavity, potentially affecting organs like the liver and intestines.
  • Bone pain or headache: Indicates tumors have spread to bones or the nervous system.
  • Intense chest pain: May radiate from the chest to the shoulder or back due to tumors invading the chest wall and ribs.
  • Lumps under the skin of the chest: Caused by cancer spreading to the skin or lymph nodes in the chest area.
  • Night sweats and fever: Can be signs of the body’s response to cancer, known as tumor fever, or may indicate an infection.
  • Pleural thickening: Refers to the thickening and hardening of the pleural layers, which can cause drops in oxygen levels and other respiratory complications.
  • Severe shortness of breath: Typically caused by extensive pleural effusion or tumors compressing the lungs.
Have questions about pleural mesothelioma symptoms?

Our team of registered nurses and Patient Advocates are here to help. Contact us today to get answers.

When Should I See a Doctor for Pleural Mesothelioma Symptoms?

An older man speaks with a doctorYou should see a doctor if you have ongoing symptoms that don’t improve with time or typical treatments for more common respiratory conditions.

It’s especially important to see a doctor if you or a loved one has any possible symptoms and might have been exposed to asbestos.

“An unresolved cough or an unresolved episode of shortness of breath and fever, chills, and weight loss should warrant someone to seek testing by a doctor.”

- Quote from Amy Fair, RN, Mesothelioma Hope Patient Advocate

It takes 10-50 years for symptoms of pleural mesothelioma to appear after asbestos exposure.

Those at the highest risk of developing this cancer include blue-collar workers and veterans, since the military and private industries used products containing asbestos from the 1930s to the early 1980s.

It’s always better to consult a health care professional if you have concerns about symptoms that could be related to pleural mesothelioma. Early diagnosis is crucial, as you may have more treatment options available to help you live longer.

If you’re experiencing symptoms of pleural mesothelioma, we can help you find a doctor for an accurate diagnosis. Use our Free Doctor Match to get started.

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How to Manage Malignant Pleural Mesothelioma Symptoms

There are various treatment options, lifestyle changes, and complementary therapies that can help patients manage their pleural mesothelioma symptoms.

Symptoms of malignant pleural mesothelioma may be managed with:

  • Alternative treatments like acupuncture, yoga, and massage therapy
  • Light exercise to improve mood and boost overall health and immune system function
  • Mesothelioma diet plans to help counteract weight loss or loss of appetite
  • Pleural mesothelioma surgery can help reduce symptoms while potentially increasing life expectancy
  • Pleurodesis, which permanently seals the layers of the lung lining (pleura) to prevent future fluid buildup
  • PleurX catheters, which are type of device inserted into the lung lining that allows the patient to drain recurrent pleural effusions at home
  • Thoracentesis, a surgical procedure that temporarily removes excess fluid buildup in the chest cavity

A patient’s pleural mesothelioma symptoms may lessen or go away entirely depending on the treatments they receive.

Pleural mesothelioma survivor John Stahl and his wife Dee Stahl
4+ year pleural mesothelioma survivor John Stahl and his wife Dee

Pleural mesothelioma treatments like surgery, chemotherapy, and radiation all work to destroy or remove cancer tumors and cells. After recovering from these treatments, patients may notice a decrease in their symptoms.

For example, stage 4 pleural mesothelioma survivor John Stahl said he was “pretty well back to normal” after undergoing chemotherapy. Prior to treatment, John felt fatigued, couldn’t catch his breath, and had severe pleural effusion — over 2 liters of fluid surrounded his left lung.

Get Help With Pleural Mesothelioma Symptoms

Knowing the symptoms of pleural mesothelioma is critical if you or a loved one was exposed to asbestos.

You should see a mesothelioma doctor as soon as possible if you have symptoms like a persistent cough, shortness of breath, or fatigue — even if you aren’t sure they’re related to asbestos exposure.

Mesothelioma Hope has helped thousands of patients and families get the medical attention and support they need.

Call (866) 608-8933 to speak with us or find a doctor in your area now.

Symptoms of Pleural Mesothelioma FAQs

Where does pleural mesothelioma start?

Pleural mesothelioma starts in the pleura, which is the thin membrane of tissue that lines the lungs.

Exposure to asbestos fibers can lead to inflammation and scarring in the pleura. Over time, this damage can cause healthy cells in the pleura to mutate into cancerous ones.

As the cancer progresses, it may invade nearby tissues and organs and spread further to other parts of the body. When this happens, symptoms tend to become more pronounced and severe. Pleural effusions may worsen, causing significant shortness of breath and making daily activities increasingly challenging.

When do pleural mesothelioma symptoms start?

The symptoms of pleural mesothelioma don’t start until 10 to 50 years after you’re exposed to asbestos.

This delay is due to the long latency period of mesothelioma, which is the time between asbestos exposure and the onset of symptoms.

What is the most likely characteristic of pleural mesothelioma?

Pleural effusion (fluid buildup around the lungs) is a hallmark feature of pleural mesothelioma and causes many of the disease’s initial symptoms. These include shortness of breath and a feeling of tightness or heaviness in the chest.

Other common symptoms can include a persistent dry cough, fatigue, and weight loss. Due to the common nature of these symptoms, they can be easily mistaken for less serious illnesses, which is why pleural mesothelioma is frequently misdiagnosed.

If you’re experiencing pleural mesothelioma symptoms, our Patient Advocates can help you get a second opinion from a specialist. Reach out to us at (866) 608-8933 now.

What are common pleural mesothelioma stage 4 symptoms?

In stage 4 of pleural mesothelioma, symptoms become more severe as the cancer affects the entire body.

Pleural mesothelioma stage 4 symptoms may include:

  • Bone pain or headache
  • Intense chest pain
  • Lumps under the skin of the chest
  • Night sweats and fever
  • Severe shortness of breath
  • Weight loss and loss of appetite

If you’re having any of the above symptoms, you should visit a mesothelioma doctor right away for a physical exam and diagnosis.

How can you manage pleural mesothelioma symptoms?

You can manage the symptoms of pleural mesothelioma with palliative care, which focuses on increasing quality of life and reducing discomfort.

Examples of palliative care for pleural mesothelioma include pleurodesis to permanently prevent fluid from building up around the lungs.

Many patients receive palliative care for their symptoms in addition to standard life-extending treatments for mesothelioma. In fact, pleural mesothelioma surgeries such as pleurectomy with decortication (P/D) can also help to ease symptoms while potentially extending survival.

Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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  1. American Cancer Society. (2018, November 16). Signs and Symptoms of Mesothelioma. Retrieved February 2, 2024, from
  2. American Lung Association. (2023, August 7). Mesothelioma Symptoms and Diagnosis. Retrieved February 2, 2024, from
  3. Cleveland Clinic. (2022, December 16). Pleural Mesothelioma. Retrieved February 2, 2024, from
  4. Medscape. (2022, April 28). Mesothelioma. Retrieved February 2, 2024, from
  5. Mesothelioma Applied Research Foundation. (n.d.). Mesothelioma Symptoms. Retrieved February 2, 2024, from
  6. Nabeshima, K., Hamasaki, M., Kinoshita, Y., Matsumoto, S., & Sa-Ngiamwibool, P. (2022). Update of pathological diagnosis of pleural mesothelioma using genomic-based morphological techniques, for both histological and cytological investigations. Pathology international, 72(8), 389–401. Retrieved February 2, 2024, from
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