Chest pain, shortness of breath, body aches, abdominal pain, weight loss, abdominal swelling or tenderness, fatigue, and bowel obstruction are some of the symptoms experienced by patients who suffer from mesothelioma. But coughing up blood, also known as hemoptysis, is one of the most distressing symptoms of the disease, often causing fear in patients. If mesothelioma is a rare disease, coughing up blood is even more uncommon, but it can occur in some cases.

Mesothelioma is an aggressive type of cancer developed due to exposure to asbestos. There are four types of the disease, defined according to its locations. When it occurs in the lungs, it is known as pleural mesothelioma. Coughing up blood is a symptom associated with pleural mesothelioma, which is the most common form of the disease, accounting for about 75% of the cases.

Coughing Up Blood As a Mesothelioma Symptom

Asbestos, which is a natural mineral widely used in construction and other industries for over a century, can remain harmless for years, but fibers are released into the air as it interacts with other materials. These fibers are inhaled or swallowed, and the body has difficulties in expelling them. In the case of pleural mesothelioma, the asbestos fibers stay trapped in the pleura, the name given to the lining of the lungs, and irritate the mesothelial cells, causing the formation of tumors. This is a process that can take decades.

The majority of the symptoms of mesothelioma are interconnected and hemoptysis can originate in the trachea, bronchi or lungs. There are different levels of hemoptysis, and a minor event occurs when a patient has persistent coughing and a blood vessel ruptures, which causes a small amount of blood to be expectorated. However, major or massive hemoptysis refers to coughing up more than six hundred milliliters or two-and-a-half cups of blood in a typical period of time of a day. In this case, the situation is more concerning since it can result in asphyxiation or in the lungs full of blood. Regardless of the amount, coughing up blood should be reported to a physician, who can analyze the causes for it.

Coughing Up Blood Treatment in Mesothelioma

Early detection and monitoring the symptoms of mesothelioma is the first step to prevent a massive event of hemoptysis. In the case of minor hemoptysis, it is usually a one-time event that resolves itself without the need of medical intervention. However, more severe cases need examination. First of all, other causes need to be excluded since there are numerous reasons for coughing up blood, which can come from either the respiratory or digestive tracts. For patients with pleural mesothelioma, massive hemoptysis may indicate a rapid transformation of normal cells into cancerous cells, a process known as carcinogenesis. In order to address the symptom, physicians most likely treat the underlying disease.

There is currently no cure for mesothelioma, but treatments are available to help ease the symptoms and improve patients’ quality of life and life expectancy.  The surgical options to treat pleural mesothelioma include extra pleural pneumonectomy (EPP), during which the lining of the heart, half of the diaphragm and affected lymph nodes are removed, and pleurectomy/decortication (P/D) surgery, which is an aggressive approach based on the removal of the lining surrounding one lung (pleurectomy) as well as removal of any tumor masses growing inside the chest cavity (decortication). Chemotherapy and radiation therapy are also options and can be administered alone, before, after or during the surgery.

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