Diagnosing Mesothelioma
Many patients are just not aware that they may have developed the disease, or they haven't requested their physician conduct an examination to determine its presence.
Mesothelioma might require ten to twenty years or more incubation in the body before symptoms appear. Mesothelioma represents a most difficult challenge to the doctors and medical community which are tasked with diagnosing this illness.
Even without symptoms, it's important that patients report any exposure to asbestos contaminates so a doctor can begin looking for indications of the disease early on, as well as to monitor patient health long term. If a person has a history of working around asbestos, the doctor can quickly check for signs of mesothelioma, especially in the tissues around the heart, lungs and stomach while noting any pain, discomfort, or breathing difficulties.
How Mesothelioma Is Diagnosed
As with any disease, mesothelioma diagnosis requires a physical examination of the patient. A complete medical history is needed together with any history of asbestos exposure. After the initial physical exam, a doctor might order pulmonary (lung) function tests, chest x-rays, a CT scan, or an MRI to determine if mesothelioma is present. If preliminary testing and symptoms indicate mesothelioma, a biopsy is sometimes necessary to confirm diagnosis.
Diagnostic Imaging : Methods & Benefits
When mesothelioma is suspected, there are certain imaging methods that are useful when assessing a possibility of this cancer. While helpful, a more accurate diagnosis will be achieved through diagnosis of fluids or tissue biopsy.
Some common imaging techniques:
- X-rays
Chest x-rays can show fluid build up in the lungs, or reveal presence of a mass. Other asbestos diseases such as non-cancerous pleural plaque, scarring, or calcification from asbestosis may also be revealed.
- CT Scans
While unable to detect differences between benign asbestos disease, or adenocarcinoma in the lung, CT scans can define fluid build up, as well as pleural calcification, pleural thickening, or invasion of the chest wall.
- MRI Scans
An MRI is usually used prior to any aggressive treatments to help determine what extent a tumor has reached. MRI scans can more accurately identify tumors and assess enlargement of lymph nodes between the lungs.
- PET Scans
PET imaging is becoming an integral part of mesothelioma diagnosis. While more expensive and sometimes not covered by insurance, PET scans are best in tumor diagnostic and determining stages of mesothelioma.
Stages Of Mesothelioma
"Staging" is a standard used by doctors to determine whether malignant mesothelioma cells have spread to another part of the body. The following stages of a cancer must be known before any treatment regimen is started.
- Localized mesothelioma (malignant)
Stage I - The cancer is situated in the lining of the chest cavity close to the heart & lungs. It may also be located in the lungs or the diaphragm.
- Advanced mesothelioma (malignant)
Stage II - Mesothelioma has now spread and gone into lymph nodes beyond the chest's lining.
Stage III - Mesothelioma has invaded the chest wall, the heart, abdominal lining and perhaps into nearby lymph nodes.
Stage IV - The cancer has already dispersed to various major organs or tissues.
- Recurrent mesothelioma (malignant)
This indicates that the cancer returned after therapy.
Diagnosis Pathology
Studying cells, fluids, or tissue samples plays an inherent role in mesothelioma diagnosis. If mesothelioma is suspected after imaging tests, it is finally confirmed by a pathological exam. Surrounding tissue is removed and carefully examined under a microscope. This is the phase where a qualified pathologist makes a definitive diagnosis of benign versus malignant cancer cells -- thus the type of cancer is determined and a pathology report will be issued.
While most patients have had numerous tests that led to a diagnosis of mesothelioma, a tissue biopsy is usually the last determining factor. The following are several tests that your doctor might recommend - with varying results.
• Cytology - Testing pleural fluid to find malignant cancer cells is regarded as having little value for diagnosing mesothelioma. Inconclusive or negative test results account for almost 85% of cases tested. Even with positive fluid reports, many doctors still prefer a tissue biopsy so long as it doesn't compromise a patient's health.
• Needle Biopsy - Performed under local anesthetic, this test consists of inserting a hollow needle into the chest cavity to collect a tissue sample. Since sample size is small, this type biopsy is considered to be only 25% - 60% accurate. Local radiation therapy is sometimes used along with the test to prevent tumor seeding around the needle's tract.
• Open Biopsy - Regarded as the most accurate for mesothelioma, this diagnostic procedure is chosen most often since it affords pathologists a larger sample of tissue resulting in better accuracy. The test is performed under general anesthetic in a hospital. Like a needle biopsy, local radiation may be used to prevent tumor seeding.
This is the conclusion of a diagnostic process that commonly starts with symptoms which send people to their doctor: a fluid build-up in the lungs (pleural effusions), chest pains, shortness of breath, or swelling and pain in the abdomen.
The physician who renders a diagnosis of mesothelioma will invariably refer their patient to an oncologist for treatment. The oncologist will usually suggest treatment options that she feels are best suited for the individual patient, or if her knowledge of asbestos cancer is limited, she may refer the patient to a specialist for mesothelioma.