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Mesothelioma Diagnosis

A mesothelioma diagnosis can be tough to nail down.

For starters, symptoms emerge decades after to the catalyst, which is exposure to asbestos. Secondly, symptoms of mesothelioma are often non-descript, mirroring other relatively minor conditions, such as a common cold or a respiratory infection. Thirdly, mesothelioma is a relatively rare form of cancer, and it’s not often at the top of the doctor’s checklist.

At the Law Offices of Jeffrey S. Glassman, our Boston mesothelioma attorneys understand that early diagnosis is paramount for patients hoping to optimize their remaining time. Sadly, mesothelioma has a poor prognosis. However, with early diagnosis, swift intervention and localized, aggressive treatments can extend both length and quality of life for sufferers.

What is Mesothelioma?

Malignant mesothelioma is an aggressive tumor that originates in the serosal membranes lining the lungs or abdominal cavities. As noted by research published in the Journal of Thoracic Disease, about 90 percent of these cases occur in the lungs, while about 7 percent occur in the peritoneum (stomach) and a very small portion occur in the heart, testicles or ovaries.

Mesothelioma is caused by exposure to asbestos, usually in the course of one’s occupation.

The World Health Organization has recognized asbestos as one of the most serious occupational carcinogens, and notes that it accounts for nearly 110,000 deaths a year globally. An estimated 125 million people in the world are exposed to asbestos at work. Approximately half of all deaths from occupational cancers are reportedly caused by asbestos.

When making a diagnosis, physicians will often ask patients to recount their known history of exposure to asbestos. In some cases that involve direct exposure with asbestos mines or asbestos-laden products, this is easy to uncover. However, in cases where individuals have suffered secondary exposure (i.e., via the clothing or vehicle of a loved one transporting it home from work), or where exposure occurred in the home, it can be less obvious. That makes diagnosis that much more difficult.

How is Mesothelioma Diagnosed?

Mesothelioma can be challenging to diagnose. Although there are variations of approaches depending on the situation, the patient and the doctor, most diagnoses of mesothelioma are going to involve:

  • A detailed medical history.
  • A thorough physical examination.
  • Several imaging scans.
  • Blood tests.
  • Tissue biopsies.

It’s unlikely a diagnosis will be made in a single visit.

Diagnosis will begin with ascertaining whether a node is cancer. If it is cancer, the doctor will determine the degree to which the cancer has spread (metastasized). Based on this, the doctor will ascertain its stage.

Malignant mesothelioma is grouped into two stages:

  • Localized (Stage I). Cancer is found in the lining of the organ.
  • Advanced (Stage II, III or IV). The higher the stage, the more advanced the cancer, and the farther it has spread.
Imaging Tests

One of the standard tests that will be involved in a mesothelioma diagnosis is an imaging test.

As the American Cancer Society reports, imaging tests – also known as radiology tests – allow doctors to take pictures of the inside of your body. They allow physicians to identify if cancer is present, determine how far it has spread and ascertain whether a cancer treatment may be working.

Imaging tests can help:

  • Identify cancer in early stages.
  • Find a mass or lump (tumor) if a person has symptoms.
  • Sometimes help opine whether the tumor is likely to be cancerous or benign, and whether a biopsy is necessary. (There is no benign form of mesothelioma, unfortunately.)
  • Helps to determine what stage the cancer has reached.
  • Determine whether a cancer has recurred.

Some examples of imaging tests include:

  • X-Ray. For a mesothelioma diagnosis, this will involve an x-ray of the chest or abdomen. X-rays an help identify key early signs of mesothelioma, like fluid in the lungs.
  • CT Scan. Formally, this is called a computerized tomography scan. It involves a series of x-ray images that create a 3D image in detail. It’s considered 90 percent sensitive in discovering pleural mesothelioma.
  • MRI. Magnetic resonance imaging technology uses magnets to create a 3-D, high-resolution image of a patient’s anatomy.
  • PET Scan. This nuclear medicine imaging technic, formally called a positron emission tomography, can help to distinguish from a tumor that is benign or malignant.
Blood Tests

Like many other types of cancers, mesothelioma produces byproducts one would not normally find in the bloodstream. Doctors looking to make a diagnosis of cancer may be able to detect it by conducting a series of blood tests.

Often, doctors conducting blood tests are trying to rule out mesothelioma, because it’s of the rarer types of cancer. There isn’t yet a definitive biomarker for mesothelioma, though researchers believe they are getting closer.

Tissue Biopsies

At this point, tissue biopsies are the only sure way to diagnose mesothelioma in patients who:

Biopsies involve collecting a sample of tissue and then testing it to determine if a tumor is cancerous, and if so, whether it is mesothelioma or some other form.

A biopsy can also tell doctors what stage of disease the cancer is, which will determine the appropriate course of treatment.

There are three basic types of tissue biopsies:

  • Needle biopsies. This is where a needle is used to withdraw fluid, tissue fragments or cells. This is considered the least invasive method of analysis, but it’s not always the most accurate.
  • Camera-assisted biopsies. This is a surgery that is considered minimally-invasive and allows doctors to insert a small tube with a camera to collect sample tissues.
  • Surgical biopsies. Surgical biopsies under general anesthesia may be necessary in situations where the tumor is in a location that makes it impossible for a surgeon to conduct either of the first two.
Why Mesothelioma is Often Misdiagnosed

There are several reasons why mesothelioma might be misdiagnosed.

First, the condition is relatively rare. There are about 3,000 new cases diagnosed in the U.S. every year. By comparison, as the American Cancer Society reports, there are an estimated 223,000 new cases of lung cancer reported every year.

The second reason is that mesothelioma, particularly when symptoms first start to appear, can look a lot like other conditions. Some symptoms include fatigue, general malaise, cough or shortness of breath. Doctors may mistake it for a standard respiratory infection, particularly if they aren’t aware or don’t bother to ask about the patient’s prior history of asbestos exposure.

That brings us to the third reason. Mesothelioma has a latency period of between two and five decades between asbestos exposure and the first symptoms of illness. That’s why typically, patients are caught completely off-guard. They may have long ago forgotten or not thought of their exposure to asbestos.

Doctors may mistake pleural mesothelioma (of the lungs) for:

  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Pneumonia
  • Influenza
  • Adenocarcinoma

Similarly, they could misdiagnose peritoneal mesothelioma as:

  • Crohn’s disease
  • Ovarian cancer
  • Irritable bowel syndrome
  • Hernia

They could wrongly diagnose pericardial mesothelioma as:

  • Heart failure
  • Coronary artery disease
  • Constrictive pericarditis
  • Tuberculosis pericarditis
  • Pericardial synovial sarcoma

Each of these conditions is generally more common than mesothelioma, so doctors may not recognize at first what it truly is. If you are diagnosed with mesothelioma, our experienced asbestos injury lawyers can help.

Contact the Law Offices of Jeffrey S. Glassman today for a free and confidential consultation.

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