Mesothelioma diagnosis involves imaging scans, blood tests, and biopsies. Mesothelioma is rare and difficult to diagnose, so many people initially receive a misdiagnosis. Early diagnosis is essential for effective treatment and a better patient outcome.
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What Are the Early Warning Signs of Mesothelioma?
Mesothelioma tends to sneak up on people. It develops over many years after asbestos exposure. Often, the symptoms are mild or non-existent for decades.
If you know or suspect you may have been exposed to asbestos, it is essential to watch out for early signs. Some early symptoms of pleural mesothelioma include:
- Chest pains
- Coughing
- Shortness of breath
- Fatigue
Early symptoms of peritoneal mesothelioma include:
- Abdominal pain and discomfort
- Abdominal swelling
- Decreased appetite and weight loss
- Diarrhea or constipation
- Fatigue
Early symptoms of pericardial mesothelioma include:
- Difficulty breathing
- Chest pains
- Fatigue
- Heart murmurs
The first step in diagnosing mesothelioma is recognizing symptoms and talking to your doctor about them.
How Is Mesothelioma Diagnosed?
Mesothelioma is a challenging diagnosis. The symptoms of mesothelioma are similar to many more common illnesses. Doctors don’t often consider mesothelioma until they have ruled those out. If you have symptoms consistent with mesothelioma, your diagnosis will likely follow several steps:
Medical History and Physical Exam
The first step is to discuss your medical history with your doctor. This is a good time to inform your doctor of any asbestos exposure in your past or any suspected asbestos exposure.
Your doctor will conduct a physical exam, during which they might be able to identify:
- Fluid around the lungs
- Abdominal swelling due to fluid buildup
- Difficulty breathing
- A cough
Imaging Tests
If your doctor is concerned about your symptoms and physical exam, they will likely order imaging tests. For respiratory symptoms, they will probably begin with a chest X-ray. This can rule out common respiratory conditions, like pneumonia.
A chest X-ray can also find areas of thickening on the pleura, fluid between the two layers of the pleura, and some abnormalities in the lungs. If your doctor still doesn’t have a diagnosis or suspects cancer, they will order additional imaging tests, such as a CT scan, to get a closer look.
Biopsy
If the imaging scans show abnormal areas of tissue, the next diagnostic step is to take a biopsy. This involves taking a sample of tissue, either with a thin needle or surgically. A pathologist examines the tissue to look for cancer cells, and if present, to identify the type.
Blood Tests
Blood tests can be useful for identifying the cancer type. Specific molecules in the blood, known as markers, are often characteristic of certain types of cancer.
Mesothelioma cannot be diagnosed by a blood test alone, but it is a useful tool for confirming a diagnosis.
What Tests Do Doctors Use to Diagnose Mesothelioma?
Oncologists and other specialists use a variety of imaging, biopsies, and blood tests throughout the mesothelioma diagnostic process:
- Chest Computed Tomography (CT): Similar to a conventional chest X-ray, this is a non-invasive test that involves taking detailed pictures of a patient’s lungs. Normally used to look for emphysema, pneumonia, excess fluids in the lungs, or tuberculosis, it can also be used to detect tumors. This type of testing is being used more and more for victims who may have an asbestos-related disease.
- Conventional Chest X-ray: This procedure is used to take pictures of the pleural regions in order to detect visual changes in the lungs and other vital organs. It is usually carried out in conjunction with other tests, such as biopsies and cytology of pleural fluids.
- Needle Biopsy: The least invasive way to get a tissue sample for testing is a needle biopsy. The doctor inserts a long, hollow needle through the skin and tissue to remove a small piece of tissue from the suspected tumor. This does not require general anesthesia. It can also be used to remove fluid from around the lungs for testing.
- Open Lung Biopsy: An open lung biopsy involves removing a small amount of tissue from the lung to see if it exhibits any signs of infection, injury, or cancer. The tissue is examined for signs of the disease and infection once removed. A small incision is made in the chest area in order for the physician to remove the tissue. A chest tube is typically left in the lungs for a few days after the biopsy is performed to ensure that the lungs don’t collapse.
- Pleural Biopsy: As with an open lung biopsy, a pleural biopsy involves the surgical removal of a small amount of tissue from the pleural cavity. The tissue is then examined for signs of infection or disease. The difference is that various tissues are usually removed during a pleural biopsy as opposed to just a small amount of tissue during an open lung biopsy. Additionally, the ribs are usually separated in order to remove tissue.
- Cytology of Pleural Fluid: During a procedure called thoracentesis, a small amount of fluid from the chest cavity is extracted with a needle that is inserted into the patient’s back. A local anesthetic is used in conjunction with this procedure to prevent discomfort. The fluid is then examined in a laboratory for signs of cancer.
- Biomarker and Blood Tests: A biomarker is a test that’s used to help doctors find and diagnose a particular disease. For mesothelioma, there are several different diagnostic biomarkers and blood tests used to detect the disease, including Fibulin 3 and MESOMARK.
- Fibulin 3: Fibulin 3 is a relatively new biomarker that works by testing the Fibulin 3 in the patient’s bloodstream. Fibulin 3 is a protein found in the body, and in patients with mesothelioma, the protein can be significantly higher. For testing purposes, the protein is extracted via the body’s lung fluids.
- MESOMARK: MESOMARK, also known as MESOMARK assay, is an in vitro test that’s used to test and monitor the soluble mesothelin-related peptides (SMRP) in a patient’s bloodstream. Mesomark will then determine if the patient has a high amount of SMRP, which may indicate pleural mesothelioma. In 2007, Mesomark was approved by the Federal Drug Administration (FDA) as a laboratory test used to detect malignant mesothelioma.
- SOMAmer Test: SOMAmer is highly accurate and detects more than 1,000 different cancer biomarkers. Researchers found that the test could correctly diagnose mesothelioma in 90% of people already known to have it.
- PET Scan Imaging: PET scan imaging works by scanning the body to determine how the organs are working together and if there are any problems. A radiopharmaceutical material can be inserted into the bloodstream or inhaled before imaging, which will help to detect cancer spots on various organs.
- Thoracoscopy and Laparoscopy: Thoracoscopy and laparoscopy are methods of detecting cancer via a small camera inserted into the body. The difference is that a thoracoscopy involves scanning and detecting abnormalities through tissue samples, whereas a laparoscopy detects abnormalities via the body’s stomach organs.
- Mediastinoscopy: A mediastinoscopy involves inserting a small camera into the lung area in an attempt to examine the tissues on the front of the lungs.
- Lipid Profiling: Recent studies have found that lipids could prove to be another useful biomarker in mesothelioma diagnosis. Lipids are fat molecules necessary for cell structure. Researchers compared lipid profiles in blood samples between healthy controls and mesothelioma patients. They found different patterns between the groups. Although not used currently, this could be a useful diagnostic tool for the future.
After the Diagnosis: Staging Mesothelioma
A diagnosis of mesothelioma is followed quickly by staging. Specialists use the diagnostic information to determine the stage of the cancer, from 1 through 4.
Information from biopsies and imaging scans tells specialists where the tumors, their size, and their number. The farther tumors have spread from the initial location, the more advanced the stage is.
The Importance of Early Diagnosis in Mesothelioma
Most asbestos exposure victims don’t receive a diagnosis until decades later—the earlier the diagnosis, the better the prognosis.
Early detection makes it easier for medical professionals to provide mesothelioma treatments to remove cancer from the body. Although mesothelioma is incurable, an early diagnosis will help prolong life spans and help victims deal more effectively with pain.
Why Is Mesothelioma Difficult to Diagnose?
Mesothelioma is notoriously difficult to diagnose for several reasons:
- Mesothelioma is rare, so doctors do not often think of it as a possibility until they have ruled out other illnesses.
- Mesothelioma symptoms are similar to more common illnesses. This can lead to a misdiagnosis that delays an accurate diagnosis.
- The latency period from asbestos exposure to diagnosis is long, so many people forget or do not realize that they were once exposed to asbestos.
- Even when cancer is detected, mesothelioma if often mistaken for lung cancer.
The Problem of Misdiagnosis in Mesothelioma
Physicians can sometimes misdiagnose mesothelioma. Keep in mind that mesothelioma is considered a rare form of cancer in the medical world. Many doctors don’t consider it a possibility until they have ruled out more common illnesses.
For example, since the symptoms of mesothelioma closely mimic the common cold and the flu, patients have often been diagnosed with mesothelioma prematurely or not diagnosed with mesothelioma at all. In other instances, pathologists confuse mesothelioma with other similar cancers.
Don’t hesitate to seek the opinion of another mesothelioma doctor if you have questions or concerns about your diagnosis
Mesothelioma Diagnosis Statistics
Although it is theoretically possible for just about anyone exposed to asbestos to be diagnosed with asbestos-related cancer, 80% of mesothelioma cancer victims are men who suffered prolonged exposure to asbestos at work.
Many job sites previously used asbestos in machinery, equipment, and various products. Typical occupations included steel mills, power plants, paper mills, the automotive industry, the military, and different kinds of factories.
Detecting Mesothelioma
It is not uncommon for a patient to go for years with undetected mesothelioma. The long period of dormancy is one factor as the symptoms of mesothelioma can take decades to appear.
When doctors make a connection between a patient’s exposure to asbestos and symptoms that align with an asbestos illness, they can order mesothelioma-specific tests.
Anyone who has worked around asbestos should always get regular check-ups. Let your doctor know that you have a history with asbestos.
Those exposed to second-hand asbestos or who worked in an occupation not generally associated with asbestos should also get regular screenings. Women and younger people are two groups that are often overlooked, although anyone at any age can develop the disease.
Women and Mesothelioma
Women have a lower risk of being diagnosed with mesothelioma. Most of the job sites that used asbestos were in fields that were employed by a majority of males.
Yet, since asbestos can be found in schools, hospitals, and homes built between 1930 and the early 1970s, women, too, are at some risk of being afflicted by mesothelioma. Additionally, women who worked in aircraft factories or shipyards during the Second World War are the most likely to be diagnosed with asbestos-related cancer.
Further, family members and loved ones who come into contact with someone who worked around asbestos run a small risk of contracting an asbestos-related illness.
For example, a wife who washed her husband’s asbestos-contaminated clothing may be susceptible to secondary asbestos exposure.
Young People and Mesothelioma
Mesothelioma isn’t typically diagnosed in younger patients since the disease is more prevalent in older adults. According to a study by New York City’s Mount Sinai Hospital, results showed that out of 110 mesothelioma victims, only ten were under the age of 39.
These patients had the usual symptoms of mesothelioma, such as coughing and difficulty with breathing, but because of their age, doctors didn’t diagnose the disease until months later.
Again, it’s imperative to discuss your work history and any form of asbestos exposure with your physician as soon as possible. Testing to diagnose asbestos-related diseases will be much quicker if a physician knows that you’ve worked around asbestos.
What to Do After a Mesothelioma Diagnosis
A diagnosis of mesothelioma can be shocking and overwhelming. One of the most important things you can do after receiving a diagnosis of mesothelioma is start treatment. The earlier you begin aggressive treatments, the better the prognosis is.
Seek out a specialist team for treatment, so you get the best options and most advanced care. Talk to your family about how you want to proceed.
You might also want to take legal action against the companies that exposed you to asbestos. Mesothelioma is almost always caused by negligent workplace exposure. Those companies can be held to account, and you can seek compensation.
Contact an experienced mesothelioma lawyer to learn about your legal options. You are likely entitled to compensation through a lawsuit or an asbestos trust fund claim. A lawyer should offer a free consultation to answer your questions.
Legal Assistance
Don’t forget to fill out our form to get our free Financial Compensation Packet, filled with information on skilled asbestos and mesothelioma attorneys in your area. For questions and assistance, feel free to contact us at 800-793-4540.
