The following is a guest post by Richard Moyle.

Mesothelioma Often Mistaken for Less Serious Ailments

Mesothelioma is a type of cancer that affects the lining of organs, most often the lungs (pleural) but sometimes the stomach (peritoneal) or even the heart (pericardial). The only known cause of malignant mesothelioma is exposure to a toxic mineral known as asbestos. [Editor’s note: Asbestos can be contained in such materials as insulators, furnace/pipe coverings, fireproof gloves, brake linings, and asbestos cement products. Additionally, significant occupational exposures to asbestos can occur from building demolition and mining].

Unfortunately, this type of cancer is rarely diagnosed early enough for treatment to be effective. There are two reasons for this. First, mesothelioma has a very long latency period and symptoms do not begin to show until about 25 to 50 years after exposure. Second, early symptoms and warning signs of the disease are very non-specific and often resemble symptoms of other conditions that are less serious. For example, the early symptoms of pleural mesothelioma may be mistaken for influenza or pneumonia, and this can result in misdiagnosis.

In most cases this misdiagnosis is by no means the doctor’s fault. If someone comes into an emergency room complaining of shortness of breath or painful breathing, mesothelioma is probably not one of the things that an emergency physician might suspect. Unless the doctor is informed of any previous asbestos exposure, he obviously has no reason to believe someone is suffering from an asbestos-related disease. If you have any of the following symptoms and you are aware that you have been exposed to asbestos in the past, it is very important that you inform your doctor:

  • Persistent dry or raspy cough (typically non-productive, meaning there is little or no phlegm)

  • Coughing up blood (hemoptysis)

  • Difficulty in swallowing (dysphagia)

  • Night sweats or fever

  • Unexplained weight loss of 10 percent or more

  • Fatigue

  • Persistent pain in the chest or rib area, or painful breathing

  • Shortness of breath (dyspnea) that occurs even when at rest

  • The appearance of lumps under the skin on the chest

Mesothelioma can only be officially diagnosed after a series of imaging, blood and tissue tests have been performed. Statistics show that most mesothelioma patients are diagnosed within 3 to 6 months after their first doctor visit with complaints about breathing problems or chest and abdominal pain.

If you are diagnosed with mesothelioma, your doctor will recommend an “oncologist” (a cancer doctor), who is well-versed in treating the disease and will help determine the best options for treatment.

More information about mesothelioma is available from the National Cancer Institute and from the Mayo Clinic.


  1. What the heck is this, an “sponsored” ad for “The Peterson Firm, Licensed to practice in Florida,” who sponsors Come on, WhiteCoat. The post isn’t even written for EM physicians, it’s written for patients. This reeks of blogging Pay for Play.

    • Dude, not all my posts are for docs.
      This fellow offered to write a post and we let him. I though it would be a public service announcement. No, we didn’t get any cash for it, nor do we get money for clickthroughs or any type of compensation for the post.
      I admit that I didn’t notice the site was sponsored by a law firm before I OK’d the post, but I don’t know that it would have changed my mind. The site has links to treatment options, addresses of medical centers that treat mesothelioma, and provides a free informational packet.
      That being said, let me ask you this: Is the issue that the information on the site is bad or is the issue that someone might find out that they have mesothelioma and seek treatment (which is why I put up the post) but then they might think about hiring an attorney afterwards?

  2. I don’t doubt the above message is important, but I cringe at the thought that the website is sponsored by a law firm, rather than a medical institution.

    Sponsored by The Peterson Firm, with offices at 2317 North Wickham Road Melbourne, FL 32935. Licensed to practice in Florida.

    • If we pull the post, other people won’t be able to see what Richard is up to.
      I can delete all the links in the post and add a few neutral ones, though.

      Just to show you what we got, here is the initial e-mail that was sent to EP Monthly.


      On Wed, May 6, 2009 at 2:16 PM, Richard Moyle wrote:


      My name is Richard Moyle and I’m the National Awareness Coordinator for the Mesothelioma Cancer Center ( I was browsing through a number of health/medical blogs when I came across your website and was very impressed by the content of your blog.

      Mesothelioma is an extremely aggressive cancer that’s only known cause is exposure to asbestos. Right now we are trying to raise awareness about this type of cancer by contacting health/medical blogs to see if they’d be willing to post an article about mesothelioma and asbestos exposure.

      We have a full writing staff here and I could have a custom article for your blog out to you in a couple of days. Please let me know if you’re interested.

      Richard Moyle
      National Awareness Coordinator
      Mesothelioma Cancer Center

      • I got the same letter about 3 weeks ago. I went to the site, saw the sponsor, and ignored the e-mail as SPAM.
        If you google his name, you’ll notice you weren’t the first to post this material.
        Seems to me Richard is just that much more SPAM.

  3. Leave it in. I’m in health care, and it does not hurt for us all — doctors, nurses, patients — to be reminded of what mesothelioma can do to our dads and uncles and favourite neighbours who worked for so many years in construction, demolition and so on.

    I’m still holding my breath for myself and my brothers, who spent so many hours rolling in asbestos, playing in it, when helping a construction-worker family member a few summers. Can’t believe how little people knew a few short decades ago.

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