DIAGNOSIS OF MESOTHELIOMA
Mesothelioma is often diagnosed after a person visits their doctor due to symptoms they are experiencing. The symptoms of mesothelioma can vary depending on the type, and they often don't appear until the disease is at an advanced stage. If you have a history of asbestos exposure and are experiencing symptoms such as shortness of breath, chest pain, or abdominal discomfort, it is important to contact your doctor. Early diagnosis is crucial to improving your treatment options and overall prognosis.
During an initial evaluation, your physician will take a detailed medical and work history, including any known asbestos exposure, and conduct a physical exam. Since mesothelioma is rare and shares symptoms with many other conditions, it is essential to inform your doctor about your asbestos exposure history. Without this information, the possibility of mesothelioma might not be considered early on.
If your doctor suspects mesothelioma, they may refer you to a specialist, such as a pulmonologist or oncologist, for further evaluation. This evaluation typically involves imaging tests, such as X-rays or CT scans, and possibly blood tests. If these initial tests suggest mesothelioma, a biopsy will be ordered to confirm the diagnosis and determine the best course of treatment.
Imaging Tests
Imaging tests such as x-rays, CT scans, PET scans and MRIs, are used to take pictures of the inside of your body. These tests can be used to look for cancer, find out how far the cancer has spread, and determine whether cancer treatment is working. If an abnormal mass that resembles mesothelioma is detected, your doctor will order a biopsy.
Blood Tests
Blood tests for mesothelioma include the MESOMARK test, SOMAmer test and Human MPF test. These blood tests cannot confirm a diagnosis of mesothelioma, however, there are 3 substances in the blood which may be elevated (fibulib-3, osteopontin, and soluble mesothelin-related peptides (SMRPs) in individuals who have mesothelioma, therefore, high levels of these substances can make a mesothelioma diagnosis more likely.
Biopsy
Only a biopsy can determine a mesothelioma diagnosis. It is the last stage of the diagnostic process. It involves removing cells from an abnormal area in the body and examining the cells under a microscope. There are three types of biopsies that are used for mesothelioma: fine-needle biopsies, endoscopic biopsies, and open surgical biopsies.
Fine Needle Biopsy
A fine needle biopsy involves inserting a long, thin, hollow needle directly into the mass to collect tissue samples. The procedure is relatively quick with minimal downtime. However, in some cases, the sample may be too small to confirm a diagnosis, and a more invasive procedure—such as a surgical biopsy—may be required.
Endoscopic Biopsy
An endoscopic biopsy involves the use of a narrow, flexible tube called an endoscope, equipped with a tiny camera and a light. This tool is inserted through a small incision in the body to obtain tissue samples. The procedure is typically performed in an operating room under general anesthesia, ensuring precision and patient comfort. There are 3 different types depending on the type of mesothelioma:
Laparoscopy for peritoneal mesothelioma
Laparoscopy is a minimally invasive procedure in which small incisions are made in the abdomen. This allows doctors to examine abdominal organs and collect tissue samples from suspected peritoneal mesothelioma tumors.
Mediatinoscopy for pericardial mesothelioma
Thoracoscopy for pleural mesothelioma
A thoracoscopy involves making a small incision in the chest wall to directly view the pleura. This procedure is used to obtain tissue samples from suspected pleural mesothelioma tumors and helps confirm a diagnosis.
During a mediastinoscopy, a small incision is made at the base of the neck to access the area between the breastbone and the lungs (the mediastinum). This procedure allows doctors to examine this region and collect tissue samples from suspected pericardial mesothelioma tumors.
Open Surgical Biopsy
Sometimes, when a needle or endoscopy biopsy is not able to confirm a diagnosis or the location of the tumor is too hard to reach using a needle or endoscope, a more invasive open surgical biopsy may be needed to obtain a tissue sample. In this case, an open surgical biopsy will take a larger sample of the tumor or, in some cases, remove the entire tumor entirely. There are 2 types of open surgical biopsies depending on the type of mesothelioma:
Thoracotomy
A thoracotomy is performed on patients who may have either pleural mesothelioma or pericardial mesothelioma. It is an open-chest surgical procedure.
A laparotomy is performed on patients who may have peritoneal mesothelioma. It is an open abdominal procedure.