DIAGNOSIS OF MESOTHELIOMA
Confirming a diagnosis of mesothelioma may be a multi-step process, made difficult because symptoms of mesothelioma are similar to other diseases. According to the
American Cancer Society, the first step in the diagnostic process is recognizing the symptoms of mesothelioma.
A patient’s medical history is a critical first step in the diagnostic process. This helps to determine a history of symptoms. Gathering information on any exposure the patient may have had to asbestos is important as a risk factor for potential mesothelioma diagnosis.
Physical exams, chest x-rays, CT and MRI will follow if the preceding exam indicates further testing is required. PFTs (pulmonary function tests) may be performed to check for lung problems as a further indication for a diagnosis of mesothelioma.
X-ray results displaying a thickening of the pleural lining can occur after asbestos exposure and may also be a symptom of mesothelioma. CT scans and MRIs can detect fluid buildup in the body to help with the diagnosis. If there is a fluid buildup, a syringe may be used to collect some of the fluid to check for cancerous cells.
If the fluid is in the lungs, a local anesthetic is used and then a needle is inserted into the thorax to collect the sample. This is called a pleural tap or chest drain. For fluid in the abdominal cavity, a topical anesthetic is applied and a large needle and a sheath are inserted into the abdomen. The needle is pulled out, leaving the sheath behind to allow the fluid to drain out. For fluid around the heart, a surgeon used ultrasound to help perform this potentially dangerous test. Care must be taken not to puncture the lungs. These are all methods of diagnosing mesothelioma.
Once these fluids have been collected, they are tested for abnormal cells. If no malignant cells are found, mesothelioma is less likely to be the diagnosis. If malignant cells are present, the next step is a biopsy. In a biopsy, a small piece of tissue is removed and examined by a pathologist. Biopsies differ by the area of the body. If a tissue sample from the abdomen is needed, the doctor may perform a laparoscopy, typically through a small slice in the belly button or abdominal region. A thoracoscopy is performed for sampling chest tissue. In this case, the doctor would enter the chest through the throat while the patient is mildly or deeply sedated.
Some, many or all of these tests may be required for an accurate diagnosis of mesothelioma. An oncologist will typically oversee the diagnostic and treatment process for this disease.