• Abdominal pain
• Abdominal weakness
• Weight loss
• Loss of appetite
• Nausea
• Abdominal swelling
• Swelling of the feet
• Fever
• Impaired bowel function

Fluid often accumulates in the peritoneal space, a condition known as ascites. Over time, symptoms can become more and more severe. The growing peritoneal mesothelioma tumor can exert increasing pressure on the organs in the abdomen, leading to bowel obstruction and distention. If the peritoneal mesothelioma tumor presses upward, it can impair breathing capacity. If it pushes against areas with many nerve fibers and the bowel distends, the amount of pain can increase.

Pleural Mesothelioma
Pleural mesothelioma (pleura mesothelioma or malignant pleural mesothelioma) is mesothelioma cancer in the lining of the lungs. Pleural mesothelioma is the most common form of mesothelioma accounting for 80-90% of mesothelioma cases. At least 10,000 people worldwide are diagnosed with malignant pleural mesothelioma each year, according to conservative estimates. This is different from lung cancer, which refers to any type of malignant tumor that originates in the lungs.

The pleura are fibrous sheets creating the tissue lining that surrounds and protects the lungs. There are 2 pleura (sometimes called pleural membranes) which form a gap between them called the pleural space. They produce a lubricating fluid that fills the gap helping the lungs to move smoothly in the chest when they are inflating and deflating as we breathe.

Pleural Plaques
Pleural plaques are the most common manifestation of asbestos exposure and considered by most as a radiologic hallmark. Pleural plaques are usually first identified approximately 20 years following initial asbestos exposure. There appears to be little association between pleural plaques and total fiber burden and, in fact, pleural plaques are associated with remote non-occupational exposure.

Pleural plaques are thought to be the result of a pleura inflammatory response caused by small asbestos fibers that migrated from the respiratory tract. The plaques rarely cause signs of symptoms alone and they are usually just an incidental finding on a chest x-ray. Pleural plaques are not unique to asbestos exposure. They have been reported in tuberculosis, empyema and hemothorax. However, in these conditions, the plaques are seen only on one side, not bilaterally as in asbestos exposure.

Pleural Thickening
In the laboratory, pleural thickening appears as a thin, milky discoloration of the lung surface to a thick, white "peel," encasing much of one or both lungs. It is usually an incidental finding. The individual's history often includes asbestos exposure - a remote and brief experience but with heavy exposure.

Pleural Fibrosis
Pleural fibrosis is seen as bilateral thickening in the lower lung zones, often in association with pleural plaques or calcification. When pleural fibrosis is extensive, lung movement may be restricted. Heart function can be impaired with even mild exertion. Occasionally, the restrictive impairment leads to potential respiratory and cardiac failure, necessitating a procedure known as pleurectomy, in which the covering of the lung, the pleura, is removed. The degree of impairment on pulmonary (heart) function is in direct proportion to the extent of fibrosis and the existence and extent of parenchymal disease.

Symptoms
Symptoms of pleural mesothelioma include:

• Chest pain
• Lower back pain
• Cough
• Shortness of breath, difficulty breathing
• Difficulty sleeping
• Pain in the chest and abdominal regions, which is
  generally unresponsive to analgesics
•Progressive loss of appetite
•Weight loss
•Swelling of the face and arms
•Muscle weakness and sensory loss
•Hoarseness
•Coughing up blood

Because pleural mesothelioma has been better studied than peritoneal mesothelioma, we know more about factors associated with prognosis for pleural mesothelioma. Younger age at diagnosis, performance status, functional status, and absence of weight loss are associated with a more favorable prognosis.