Mesothelioma, a form of cancer caused by asbestos exposure, is typically diagnosed with a person goes to a doctor because of symptoms. If there is any reason to suspect asbestos exposure or mesothelioma, a doctor will perform several tests to determine a diagnosis. While symptoms such as fluid around the lungs or abdomen, unintentional weight loss, and pain around the lungs or abdomen are indicators, a thorough diagnosis depends on medical tests.
History And Physical Exam
The initial procedure performed is taking a complete medical history to learn about a patient’s symptoms and risk factors including asbestos exposure. A physical exam will also be performed to determine the presence of fluid around the lungs or abdomen. A physician may listen to several areas of the body using a stethoscope as an initial step. In some cases, mesothelioma may be diagnosed as pneumonia, but when it persists, a doctor will then look for other possible causes.
An imaging test uses x-rays, magnetic fields, or radioactive particles to create pictures of a person’s organs and can be used to diagnose mesothelioma. A chest x-ray is typically the first test done when a patient experiences lung-related symptoms. Calcium deposits on the pleura, fluid surrounding the lungs, or an abnormal thickening of the pleura may suggest mesothelioma. A CT scan is also an x-ray test that produces cross-sectional images of the body and can be used to determine the presence and location of mesothelioma. In some cases, an MRI may be used. MRI scans use radio waves instead of x-rays and provide extremely detailed images of tissues so this may be used when other imaging tests have not been effective.
Mesothelioma can cause levels of certain substances in the blood to rise and may be used as part of a diagnostic tool. These substances include osteopontin and soluble mesothelin-related peptides. These blood tests are not used exclusively to diagnose mesothelioma but may be used to help in making a diagnosis.
Fluid And Tissue Samples
While symptoms and tests may indicate a person has mesothelioma, the actual diagnosis is only verified by removing cells from the abnormal area and then looking at them under a microscope in a procedure known as a biopsy. In some cases, fluid may be removed from the chest, abdomen or heart and then tested to check its chemical makeup and determine if it contains cancer cells. If cancerous cells are detected, the lab will then perform further tests to determine if the cancer is mesothelioma or a different type of cancer.
Other biopsies include endoscopic or open surgical. Endoscopic procedures insert a needle into the mass to obtain a tissue sample which is then tested. Only when endoscopic are unable to make a diagnosis are open surgical biopsies used, but they are rare.
All of the biopsy and fluid samples are sent to a pathology lab where a doctor looks at the samples under a microscope and performs tests to determine if they contain cancerous cells and, if so, what type of cancer is present. The tests done in a pathology lab may include an immunohistochemistry, DNA microarray analysis, and electron microscopy. If these tests indicate mesothelioma, a doctor will determine the type of mesothelioma based on the patterns of cells seen through the microscope.
Diagnosing mesothelioma is a lengthy process that may take several months. Patients typically see a variety of medical professionals and have a series of tests run before a positive diagnosis can be made. However, through the advanced diagnostic tools available, doctors can more easily test for mesothelioma and determine the presence or absence of this cancer.
Each patient’s prognosis varies depending largely on the the cancer’s stage. Cancer staging is based on a physical exam, biopsies, and imaging tests. The staging system in place is a formal way for doctors to explain the extent of a cancer. One system is known as the TNM system because it is based on three pieces of information: the spread of the tumor, how much the cancer has spread to the lymph nodes, and whether the cancer has spread to other organs in the body. Higher numbers mean that the cancer is more advanced while lower numbers indicate that mesothelioma has been diagnosed early on.
Mesothelioma also has its own staging system from 1-4 with lower numbers indicating a better prognosis and rate of recovery. Patients with stages 1 and 2 typically have more treatment options while patients with stage 3 or 4 may have limited treatment options and an overall survival rate.
The current survival rates for people diagnosed with mesothelioma are small, with only 5-10% of patients living five or more years. However, with recent advances in diagnostic tests and more aggressive treatment options, these numbers are increasing and patients may have a better prognosis. Research in this area is ongoing since mesothelioma is a fairly rare type of cancer.
Receiving a mesothelioma diagnosis and mesothelioma prognosis are difficult for patients and their families. Always talk to a doctor about individualizing treatment and discuss all possible treatment options to determine the best option. In addition to traditional treatments such as surgery, chemotherapy, and radiation, new drugs and procedures are constantly being developed. They offer patients a greater number of options and can increase life expectancy significantly. Experimental treatments may also be an option, especially when the initial prognosis is negative. To improve their prognosis, patients should look for education on mesothelioma and seek out the medical experts in this field.