Getting an accurate diagnosis early on is key for those who develop malignant mesothelioma from asbestos exposure. A diagnosis confirms what type of disease a person has and how best to treat it. Doctors diagnose mesothelioma through a few different tests that can rule out other potential conditions.
How Is Mesothelioma Diagnosed?
If you have been exposed to asbestos and are experiencing worrying symptoms that are associated with mesothelioma, it’s vital to see a medical professional as soon as possible. Once you have spoken to your doctor, they may recommend a radiologist, oncologist, or mesothelioma specialist who can help make a diagnosis.
Whatever the malignancy (cancer) or disease, early diagnosis is the best defense against a deadly illness. When diagnosed, your medical care team will devise a mesothelioma treatment plan tailored to your specific circumstance.
Because mesothelioma develops slowly after asbestos fibers have irritated specific protective linings (mesothelium) within the body over a series of decades, the sad reality is that mesothelioma diagnoses often come too late.
Given this disease’s slow development, it’s important to remember that mesothelioma symptoms are often mistaken for other, less-serious illnesses. Left undetected, the disease spreads and worsens, decreasing your survival odds.
To diagnose mesothelioma, doctors will conduct a physical exam, review your medical history, and order several tests. These tests allow doctors to distinguish mesothelioma from other cancers or diseases.
These tests include:
- Blood work
- CT scans
- MRI scans
- PET scans
- X-rays of chest
Mesothelioma is a rare disease, which means not all doctors are qualified to diagnose and treat it. However, a mesothelioma specialist can do both. They can also give you a second opinion if you were diagnosed already.
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Imaging Tests for Diagnosing Mesothelioma
Imaging tests take pictures of the inside of a patient’s body. These tests can help doctors find tumors and see if the cancer has spread.
There are different types of imaging tests, which include:
- Chest X-ray: This is often the first test doctors use to explore the causes of a bad cough or shortness of breath. An X-ray creates a two-dimensional image of the area in question. It can reveal abnormalities like thickening of the pleura, fluid buildup in the chest (pleural effusion), or calcium deposits, any of which could be signs of mesothelioma. This test takes about 30 minutes, which includes the time to process the X-rays and retake any images.
- CT scans (computed tomography scans): A CT scan is more involved than an X-ray. During this test, the patient lies still on a narrow table while a scanner rotates around them and takes pictures. A computer merges these pictures to create a detailed image of the body's soft tissues. This test can help locate tumors and determine the stage of the cancer. This test takes less than 1 hour.
- Echocardiogram: This test may be used if a doctor suspects there is fluid buildup around a patient’s heart. This fluid may be a sign of pericardial mesothelioma. The test will also reveal how well the patient’s heart is pumping. This test can take anywhere from 15 minutes to 1 hour.
- PET scan (positron emission tomography scan): For this test, mesothelioma patients are injected with radioactive material. While this may sound alarming, the amount of radioactive material used is very small. Any existing cancer cells will absorb the radioactive material faster than healthy cells. This reaction highlights the area where the cancer is located. This test takes about 30 minutes, and is useful in both finding and staging the cancer.
- MRI scan (magnetic resonance imaging scan): This scan provides detailed images of the body’s soft tissue. An MRI can reveal the precise location and size of a tumor. This test helps doctors decide if surgery is an option because it can show how much damage the cancer has done. This test can take up to 1 hour.
Blood Tests for Diagnosing Mesothelioma
Mesothelioma can alter the makeup of a person’s blood. High levels of certain proteins and amino acids often show that mesothelioma is present in the body.
Blood tests are not specifically used to diagnose mesothelioma. However, they can help a doctor see the extent of the patient's disease. A blood test can also help predict the long-term outlook of the disease. Blood tests take just a few minutes.
As newer blood tests are developed, they may become useful tools to diagnose and track mesothelioma. This is hopeful news, as early detection opens the door for more treatment options.
Biopsies for Diagnosing Mesothelioma
A biopsy is a sample of the fluid or tissue from possibly cancerous masses. The sample is examined under a microscope and tested for the presence of cancer cells.
Finding cancer cells with a biopsy is the only definitive way doctors can confirm a diagnosis. Even a biopsy can be tricky, because mesothelioma cells can look like other types of cancer cells.
For example, malignant pleural mesothelioma cells can appear similar to lung cancer cells. In women, peritoneal mesothelioma resembles some cancers of the ovaries.
Common ways doctors collect tissue samples for biopsies include:
- Endoscopy: Doctors will make an incision and guide tiny cameras attached to tubes to biopsy areas. There are different types of endoscopies depending on the location from which doctors need to collect the sample. The most common type is a thoracoscopy, which investigates the chest and lung linings.
- Needle Biopsy: A needle biopsy is a less invasive way to get a sample. It also allows doctors to take samples from hard-to-reach areas of the body, such as the heart, lymph nodes, abdominal cavity, or lungs. Doctors use long and hollow tubes to extract tissue. The most commonly used needle biopsy is the fine needle aspiration.
The time frame for each test varies. A needle biopsy takes just a few minutes. A surgical biopsy takes several hours, and you may need to stay overnight in the hospital.
Other Tests to Diagnose Mesothelioma
To be certain of a diagnosis, doctors often order specialized lab tests to distinguish the types of mesothelioma from other cancers.
Those tests can include:
- Immunohistochemistry: Immunohistochemistry helps distinguish mesothelioma from lung cancer.
- DNA Microarray Analysis: DNA microarray analysis looks at patterns of genes in the cells. Mesothelioma cells have different gene patterns from other cancer cells.
- Electron Microscopy: Electron microscopy examines fluid and tissue samples under a high-powered microscope. This makes the smallest parts of cancer cells visible.
Once you have been diagnosed, doctors may recommend more tests to determine the stage of the cancer. From there, they can develop a personalized treatment plan.
New tests to diagnose mesothelioma are being developed every year. For example, researchers from France are studying if certain breath compounds could be a sign of mesothelioma. As of 2019, these trials have shown promise but are still under investigation.
Mesothelioma Misdiagnosis and Second Opinion
Mesothelioma is a rare and deadly disease, so it is best treated when diagnosed early on. However, mesothelioma can often be mistaken for other conditions. Its symptoms can often resemble that of a common cold or the flu. Because of this, it can be hard to properly diagnose it.
The big difference is that when a person has mesothelioma, those symptoms persist and worsen. Mild symptoms often grow into severe wheezing, coughing, loss of appetite, extreme weight loss, and general fatigue. The longer it takes to make an accurate diagnosis, the lower a person’s chances are for an extended life.
Remember: If in doubt, or if you have any questions about symptoms you are experiencing, contact a doctor right away.
If you have already been diagnosed, try your best to follow up with a mesothelioma specialist. A specialist can confirm or refute your initial diagnosis with better accuracy. In addition, they can recommend treatments of which you may not have been aware.