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First Symptoms of Mesothelioma: Shoulder Complaints

symptoms of mesothelioma including shoulder pain

Every doctor that treats mesothelioma knows the physical symptoms of the disease. The symptoms of mesothelioma may include:

            • wheezing or dry cough

            • shortness of breath

            • pain in the chest

            • pain with coughing

            • unusual lumps of tissue under the skin on the chest

            • unexplained weight loss

            • pain in the abdomen

            • nausea

            • abdominal swelling

            • fever or night sweats

            • fluid around the lungs

            • muscle weakness

            • respiratory complications

            • fatigue

By the way, chest x-rays don’t always show mesothelioma tumors on the lungs but they may show a build-up of fluid. It’s then up to the doctor to discover where the fluid is coming from.

Patients Often Don’t Have All the Symptoms of Mesothelioma

This list of physical symptoms isn’t one that has to show up in every patient. What your doctor is looking for is a combination of several of the symptoms on the list to form a pattern. This pattern would be considered a “pattern of symptoms for mesothelioma”.

New Symptom Should Be Added to the List of Mesothelioma Symptoms

In Poland, doctors at the Department of Orthopedics and Traumatology in the Central Clinical Hospital of the Ministry of Interior in Warsaw reported on a new symptom that should possibly be added to the list of symptoms of mesothelioma.

They confirm that generally speaking, the symptoms of mesothelioma usually correspond to the areas of the body where the asbestos first contacts were. For example, if asbestos fibers were breathed in, then symptoms in the lung such as shortness of breath, dry cough, pain with coughing, chest fullness because of fluid around the lungs, and pain in the chest would be common.

If asbestos fibers were consumed in foods or beverages, then abdominal swelling, nausea, and pain in the stomach would be commonly seen.

Because these doctors were orthopedic specialists, they focus on a lot of joint issues, such as shoulder, knee, back, elbow, hip and other joints of the body. They don’t see a lot of patients for mesothelioma, although patients may have co-existing conditions that are both orthopedic and affect the respiratory system.

What the Orthopedic Doctors Found

The doctors ran what’s called a retrospective review of 49 patients who had a co-existing diagnosis of mesothelioma over the time period between 2006 and 2012. This means they went back into the file case histories of those patients long after they had originally seen the patients. They were searching for any types of orthopedic symptoms that may have given a clue that the patient had mesothelioma.

Seven patients of the 49 – or a percentage of 14.3% of them – had shoulder pain that actually had been a first symptom of mesothelioma. The patients had rated their shoulder pain 4 out of 10 on an analog scale.

How the Pain Scale Works

Pain is subjective and a doctor never really has a way of verifying a patient’s amount of pain that he or she is feeling. The analog pain scale is set up like this: 0 = no pain at all and 10 = the worst pain ever possible.  It’s up to the patient to then determine how severe or intense the pain and consider the amount of emotion that the pain conjures up when the pain hits as well as the disability due to the pain.

Some doctors will add a few other descriptors to this 0-10 pain scale, with a rating of 2 for “hurts a little bit”, 4 as “hurts a little more”, 6 as “hurts even more”, 8 as “hurts a whole lot” and 10 as “hurts worse”. On this descriptor scale, moderate pain is rated between 4 and 6 so the patients have a way to gauge their pain. This scale may also be accompanied by faces that show various degrees of happiness and sadness.

Additional Co-Existing Symptoms for the Mesothelioma Patients

Five of these seven patients also had a limited amount of mobility in the shoulder joint. And in one case, the limitation was at a very advanced stage.

Two of the cases had neuralgia in the upper limbs. Neuralgia is defined as a burning, stabbing, shooting and mild to severe pain that is from a nerve that has been irritated or damaged. It’s pain that occurs along a whole nerve pathway. Neuralgia is a symptom of something else occurring in the body, and is not an illness of its own.

The doctors concluded that “shoulder pain may be a manifesting symptom of malignant pleural mesothelioma” and that “the neoplasm appears to have a pleiotropic effect on the human body, reflected in different ways of its primary manifestation, which may also include the motor system.”

What this medical report tells us is that doctors now should add shoulder pain to the list of symptoms that signals that mesothelioma may be present.


Lorkowski, J., et al. Shoulder ring complaints as a rare first symptom of malignant pleural mesothelioma. Adv Exp Med Biol 2015:852;5-10. Doi:10.1007/5584_2015_113.

Haefeli, M. and Elfering, A. Pain assessment. Eur Spine J 2006 Jan;15(Suppl 1): S17-S24.

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