How Is Mesothelioma Diagnosed?
Although early detection is a key to successfully treating malignant mesothelioma, this is difficult for two main reasons. First of all, when the disease is in its latency stage, there is a lack of symptoms. Secondly, when symptoms do appear, they are similar to the symptoms of numerous other lung ailments; this makes it easy to misdiagnose and attribute the mesothelioma symptoms to some other ailment.
Early Detection of Mesothelioma
Because mesothelioma is so rare, there are no standard screening tests that allow doctors to detect its early onslaught. However, if you inform your physician that you have a history of exposure to asbestos, it is possible to arrange for regularly scheduled imaging tests with a view to locating irregularities in the lungs that may indicate mesothelioma. These tests may include chest x-rays or CT (computed tomography) scans. It has not yet been definitively established, though, that these early detection procedures are effective.
Doctors are also looking into spotting early stage mesothelioma through blood tests to detect high levels of substances such as fibulin-3 and SMRPs, or soluble mesothelin-related peptides. However, these tests are still in the research stage.
Mesothelioma continues to be detected mainly when patients with symptoms approach their health care providers. As mentioned above, many of these symptoms are also caused by conditions other than mesothelioma. However, if you have been exposed to asbestos in the past, it is imperative that you are aware of these symptoms so that you can visit your doctor as soon as possible for treatment.
Symptoms and Indications of Mesothelioma
Because the early symptoms of mesothelioma are also indicative of other minor ailments, the first tendency of most people is to ignore them. However, this allows the disease to progress for crucial months before diagnosis and treatment begin. If you have dealt with asbestos in the past, even the distant past, it is important for you to be aware of mesothelioma symptoms.
Symptoms for pleural mesothelioma, or mesothelioma in the chest, include coughing, hoarseness, and shortness of breath. You may experience pain on the side of the chest or in your lower back. You may have difficulty swallowing or have the sensation that food is getting stuck in your throat. Your face and arms may become swollen.
For peritoneal, or abdominal, mesothelioma, symptoms include stomach pain, nausea, and vomiting. You may become constipated, and your stomach may swell as fluid accumulates in the abdomen.
If you have pericardial mesothelioma, or mesothelioma in the lining of the heart, you may experience chest pains and shortness of breath. You may develop an irregular heart rhythm or heart murmur.
The symptoms of testicular mesothelioma include pain in the testicles, a mass on the testicles, and swelling of the scrotum.
General symptoms that may appear with any of these forms of mesothelioma include fever, extreme tiredness, loss of appetite, involuntary weight loss, excessive sweating, and blood clots. Many other conditions manifest these symptoms as well, but be particularly mindful of them and consult a health care provider if you have a history of asbestos exposure.
Risk Factors for Mesothelioma
When you approach a health care provider with symptoms that may indicate mesothelioma, the doctor will first have a discussion with you to assess your symptoms and also your risk factors. The primary risk factor for mesothelioma is, of course, exposure to asbestos. You may have been exposed to asbestos in the workplace if you have been involved in mining, shipbuilding, insulation manufacturing, plumbing, construction, railroad work, or auto manufacturing. You could have had secondary exposure to asbestos even if you are only a family member of someone who worked in these industries. Asbestos exposure might also have come about through living in an older home or going to school or work in an older building that was constructed with asbestos materials.
The amount of asbestos you were exposed to and the length of exposure are also important when determining risk factors. Your age is a factor, as mesothelioma generally takes decades to develop. The time period between first exposure and diagnosis is typically 20 to 50 years. It is rare for people under the age of 45 to be diagnosed with the disease, and most diagnosed patients are 65 or older. Mesothelioma is also found much more often in men than in women, probably because in the past jobs with high asbestos exposure were usually held by men.
Tests for Mesothelioma
Your health care provider will initially look for other conditions that display symptoms similar to mesothelioma symptoms. For pleural mesothelioma, these may include pneumonia, lung cancer, or asbestosis, which is nonmalignant scar tissue on the lungs. During a physical exam, your doctor will use a stethoscope to listen to possibly affected areas and draw blood for testing. Your provider will also check for fluid buildup around the lungs, abdomen, or heart. Although blood tests cannot detect mesothelioma, they can indicate the general state of your health and detect the presence of other conditions with similar symptoms.
If further diagnosis is necessary, your doctor will next use imaging tests to locate suspicious areas that may indicate cancer and determine how far it has spread. To locate mesothelioma in the lungs, these may include a chest x-ray and a computed tomography (CT) scan. If your health care provider thinks that you may have fluid around the heart, an echocardiogram, or ultrasound of the heart, may be called for. Other imaging tests that help to find more precisely where mesothelioma has spread include a positron emission tomography (PET) scan and a magnetic resonance imaging (MRI) scan.
Once initial examinations and imaging tests have detected the probably presence of mesothelioma, a biopsy is necessary. This involves removing cells for analysis under a microscope.
If your doctor has detected fluid buildup that might be a result of mesothelioma, some of the fluid may be extracted for analysis. Your skin is numbed, and then a long thin needle draws out fluid from around the chest, abdomen, or heart. This fluid is then tested to see if it contains cancerous cells. However, the testing of a fluid sample is not always definitive. Usually doctors need a sample of tumor tissue.
In a needle biopsy, a doctor inserts a long hollow needle into the pleura through the chest and ribs to obtain a sample of tissue. An imaging test such as a CT scan guides it to the tumor. However, in mesothelioma diagnoses, sometimes needle biopsy samples are not large enough.
Endoscopic biopsies use thin tubes with lights and lenses to probe inside the body, locate, and extract appropriate tissue samples. During this procedure, the patient is asleep with general anesthesia. Finally, under certain circumstances, an open surgical biopsy is necessary, in which a doctor removes a larger piece of tumor or sometimes removes the tumor entirely.
Even with tissue samples, mesothelioma is hard to detect, and special tests are need for a definitive diagnosis.