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Mesothelioma Diagnosis

Quick Summary

Early and accurate diagnosis is key for those who develop mesothelioma from asbestos exposure. Getting 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 are used to 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. 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.

Make sure to mention your asbestos exposure history to your doctor. Since it is extremely rare, doctors often miss the early warning signs of mesothelioma. Many doctors only come across 2-3 patients with mesothelioma over the course of their medical career. Once you have spoken to your doctor, they may recommend a mesothelioma specialist who can help make a diagnosis.

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 and order several tests. These tests allow doctors to distinguish mesothelioma from other cancers or diseases.

These tests include:

  • Biopsies
  • Blood work
  • CT scans
  • Echocardiograms
  • 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.

Imaging Tests for Diagnosing Mesothelioma

Imaging tests take pictures of the inside of a patient’s body and can be an effective way for doctors to find tumors and to 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 abnormal thickening, fluid, 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 (computerized 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 pinpoint the location of tumors and help determine the stage of the cancer. This test takes less than 1 hour.
  • Echocardiogram: This test is likely to be ordered 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, 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 a patient’s 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 and emerge, they may become useful tools to diagnose mesothelioma and track its progression. This is hopeful news, as an early diagnosis opens the door for more treatment options.

Biopsies for Diagnosing Mesothelioma

A biopsy is a sample of the fluid or tissue either in or surrounding a tumor. It is then examined under a microscope and tested for the presence of cancer cells.

Seeing the cancer cells beneath a microscope is the only definitive way doctors can confirm mesothelioma. Even then, the diagnosis can be tricky, because mesothelioma cells can look a lot like other types of cancer cells. For example, 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. Doctors use long and hollow tubes to extract tissue. The most commonly used needle biopsy is the fine needle aspiration. This procedure also allows doctors to take samples from hard-to-reach areas of the body, such as the heart, lymph nodes, or lungs.

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 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 uses a powerful microscope to magnify fluid and tissue samples. This makes the smallest parts of cancer cells visible.

Once a diagnosis of mesothelioma is confirmed, 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 compounds in the breath could be a sign, or “biomarker,” for 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 and is best treated when an early diagnosis is made. However, mesothelioma can often be mistaken for other conditions. Symptoms of mesothelioma can even resemble that of a common cold or the flu, making them easier to dismiss.

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, 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 consult 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.