First Mesothelioma Symptom for Some May Be Shoulder Pain

If you don’t yet have pleural mesothelioma, the symptom you’re likely to experience first is pain in your chest. But it’s possible you’ll experience pain in your shoulder before you feel it in the region around your lungs.

So suggest researchers from Central Clinical Hospital in Warsaw, Poland, who recently found evidence linking shoulder pain to the onset of mesothelioma.

They wrote about this evidence in last month’s issue of the journal Advances in Experimental Medicine and Biology. The title of the article is “Shoulder Ring Complaints as a Rare First Symptom of Malignant Pleural Mesothelioma.”

The authors reassured readers that shoulder pain is a rare symptom of mesothelioma.

However, they indicated that shoulder pain represents a diagnostic dilemma for doctors unfamiliar with mesothelioma.

The dilemma is that the doctors might presume the shoulder pain to be an orthopedic problem, rather than an oncologic-pulmonary one, and then proceed with a workup on that basis.

As a result, much time will be lost in arriving at the correct diagnosis — mesothelioma.

Evidence Linking Shoulder Pain and Mesothelioma

To develop their evidence of shoulder pain as a mesothelioma symptom, the researchers conducted a retrospective review of patient medical records culled for the period between 2006 and 2012.

The researchers found 49 mesothelioma cases qualifying as suitable candidates for this study’s purposes.

Of these 49 cases, seven of them involved a report of shoulder pain as the first mesothelioma symptom. That represented 14.3 per cent of the total cases.

None of the patients in the remaining 42 mesothelioma cases complained of shoulder pain at all. The researchers included these patients in the study because they needed a reference cohort.

Among the tasks performed by the researchers was an assessment of the shoulder pain’s intensity.
On a scale of one to 10, 10 being worst, the researchers determined that a pain score of four was the average.

Another task involved checking to see how difficult it was for the shoulder-pain group to move their shoulders.

The researchers found that five of the seven did in fact experience a loss of shoulder function due to the pain. In two of the cases, the presence of shoulder pain was accompanied by neuralgia in the upper arms.

The researchers concluded that mesothelioma “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.”

Shoulder Pain Linked to Mesothelioma Earlier

Notably, this is not the first time researchers have linked shoulder pain to mesothelioma.

In 1999, Belgian doctors writing in the journal Monaldi Archives for Chest Disease told of a case in which a patient presented with pain in his right shoulder and it turned out he had mesothelioma.

According to mesothelioma doctors, the first symptom is usually chest pain. However, chest pain can be non-specific — meaning, it can occur in the general region of the lungs and might manifest itself as anything from discomfort to a stabbing sensation.

You should see your doctor immediately if you have any of the signs or symptoms of mesothelioma, whether they are in the chest, shoulder or someplace else.

Also, when you see the doctor — for a mesothelioma workup or for any other reason — be sure to point out if you’ve been exposed to asbestos at some point in your life.