Diagnosing mesothelioma can indeed by a tricky process. Because the symptoms are similar to those of so many other common diseases, this aggressive form of cancer can often be mistaken for something else. An accurate diagnosis largely depends on the patient providing a complete history - both medical and occupational. This may indicate any past exposure to asbestos which may have caused the disease.
Often, if the patient was exposed for just a short period of time many years ago, he/she views it as unnecessary to mention. The fact remains that ever brief exposure to asbestos may cause the disease, so it's always important to mention any situations which may have put the patient at risk.
What's the First Step?
Usually, a potential mesothelioma victim will visit their family doctor or general practitioner with complaints about a number of ailments, which often include chest pain, shortness of breath, and coughing. These are the most prevalent signs of the disease and usually the ones that appear first and that are most bothersome.
After the doctor takes a detailed history of the patient - even if meso is not yet suspected - he/she will most likely order a diagnostic test or two to further investigate the cause of the problems.
Often, the first test ordered is a traditional x-ray, which can identify pleural effusion (fluid in the lungs) or the presence of a tumor or pleural plaques or calcification. This typically indicates pleural mesothelioma.
What Comes Next?
If the x-ray shows suspicious spots or fluid retention, the doctor will probably decide to order a more sophisticated test that can help him get a better look at the affected organs. These tests might include:Computed Tomography (CT) Scans
The CT scan will provide your doctor with a more detailed picture of areas in question. While conventional x-rays focus beams of radiation towards one part of the body, the CT scan machine consists of an x-ray-generating device that rotates around the entire body. The device, which is connected to a high-tech computer, provides cross-section images (or "slices") of the inside of the body.
No preparation is necessary for a CT scan, which will be performed at either a hospital or an outpatient facility. These scans are painless and require no anesthesia. You'll simply lie on a table, which may be raised, lowered, or tilted in order for the technician to get the most accurate pictures possible. You will be provided with a pillow for your head and technicians will be sure that you are as comfortable as possible during the procedure.Magnetic Resonance Imaging (MRI)
Even more accurate than the CT scan is the MRI, a diagnostic tool that uses a magnetic field and radio waves to create cross-sectional images of the head or body. This test has proven especially successful in detecting tumors in or around the lungs, which makes it especially useful for diagnosing mesothelioma. It provides extremely clear pictures and is often the most successful of all the imaging processes in diagnosing the disease.
No preparation is needed for the MRI unless your doctor recommends that the test be done using a contrast dye. If so, you'll need to drink the harmless dye prior to the test being administered. Patients will simply lie on the table that moves through the MRI machine, which directs radio waves towards the body. Clicking and other noises may occur during the procedure but patients should be assured that they're harmless and are no indication of a problem. Most MRIs last from 30 to 90 minutes and many people fall asleep during the test. If you have a fear of closed-in spaces, some hospitals and other facilities offer open MRIs or you will be offered a sedative before the test.
The Final Step to Diagnosis
Such sophisticated imaging procedures as MRIs and CT scans usually offer a fairly clear diagnosis, but doctors almost always recommend one more test before coming to a definitive conclusion about any type of cancer. That test is known as a biopsy.
A biopsy, derived from the Greek word meaning "view of the living", involves removing a sample of fluid or tissue from the affected area and sending it to a pathologist for examination. The biopsy is done by inserting a thin needle into the area in question.
With potential mesothelioma patients, the first biopsy usually performed is one which removes fluid from around the lungs. Other doctors, however, might prefer to proceed directly to the tissue biopsy, deeming the fluid biopsy inconclusive. Still, other physicians may opt for a laparoscopy or thoracoscopy, which involves making a small incision and using a tiny camera to look at the affected area. A tissue sample can be taken during this procedure. These procedures will probably involve a local anesthetic.
Most recently, however, mesothelioma specialists have concluded that the open lung biopsy is the most reliable in making an accurate diagnosis. Akin to surgery and done under general anesthesia, an incision will be made and a small piece of lung tissue removed. The tissue will then be sent to a pathologist for examination and the doctor will receive the results at a later date. The surgeon may leave a chest tube in place for a few days to prevent the lung from collapsing.
Receiving the Diagnosis
In most cases, it will take several days or longer to receive the results of many of these tests. While it may be difficult to be patient during the waiting period, patients should be assured that doctors are offering the best tools available for an accurate diagnosis and will deliver the diagnosis as soon as possible. A proper diagnosis will help your doctor to determine the best mesothelioma treatment available.
- American Cancer Society. Detailed Guide: Malignant Mesothelioma http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_malignant_mesothelioma_diagnosed_29.asp?sitearea=
- The Mayo Clinic http://www.mayoclinic.org/mesothelioma/diagnosis.html
- U.S. National Library of Medicine and National Institutes of Health. Medline Plus. http://www.nlm.nih.gov/medlineplus/ency/article/000116.htm
Last modified: December 28, 2010.