Mesothelioma Diagnosis

Because mesothelioma's symptoms are not unique to it and the disease's relative rarity, cases of mesothelioma misdiagnosed are not uncommon. A review of the patient's medical history is an important part in assessing the risk of mesothelioma.

Mesothelioma: Diagnosis and Differentiation Journal Articles
12.02.08 - Monitoring of Chemotherapy Response in Malignant Pleural Mesothelioma Using Fluorodeoxyglucose Positron Emission Tomography
We report a 56-year-old man who underwent monitoring of the response to chemotherapy of malignant pleural mesothelioma (MPM). 8F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) and [...]
11.27.08 - The Role of Podoplanin in Tumor Progression and Metastasis
In the last decade, much data has been generated concerning the molecular mechanisms of lymphangiogenesis and its significance in pathological conditions. This was mainly due to the discovery of lymphatic endothelial cell (LEC)-specific [...]
11.27.08 - Clinicopathologic and prognostic significance of overexpression of her-2/neu and p53 oncoproteins in gastric carcinoma using tissue microarray
Background: The aim of the study was to verify the frequency of the immunohistochemical overexpression of her-2/neu and p53 in gastric carcinoma and their relation to the [...]
11.26.08 - Malignant pleural mesothelioma: biology and diagnosis
Malignant pleural mesothelioma (MPM) is a serious issue worldwide because of its increasing incidence and poor prognosis despite real recent improvements in the disease management. Most of the patients [...]
11.26.08 - Comparison of semiquantitative fluorescence imaging and PET tracer uptake in mesothelioma models as a monitoring system for growth and therapeutic effects
Introduction: Various techniques are available for in vivo imaging, and precise understanding of their characteristics is essential for effective use of the imaging results. We established human mesothelioma cell lines [...]As a first step in diagnosing the disease, the doctor may order an x-ray of the chest or abdomen or a CT (or CAT) scan or MRI may be performed. Although mesothelioma typically cannot be seen on an x-ray, the tumor often causes a pleural effusion, or fluid collection between the lung and chest wall. This abnormal finding is associated with shortness of breath and warrants clinical follow up. Lung function tests may also be completed.

The doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test, called thoracoscopy, is usually done in the hospital. Before the test, the patient will be given a local anesthetic (a drug that causes a loss of feeling for a short period of time). Some pressure may be felt, but usually there is no pain.

The doctor may also look inside the abdomen (peritoneoscopy) with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is also usually done in the hospital. Before the test is done, a local anesthetic will be given.

If tissue that is not normal is found, the doctor will need to cut out a small piece and have it reviewed under a microscope to see if there are any cancer cells. This is called a biopsy. Biopsies are usually done during the thoracoscopy or peritoneoscopy.

Diagnosing mesothelioma is very difficult, and cases of mesothelioma misdiagnosed are unfortunately not uncommon. It is important to share your case history of work experience (especially in shipyards and at construction sites) and asbestos exposure potential with your physicians if you feel mesothelioma is a risk. Asbestos fibres can also be carried into the home on clothing, inadvertently exposing the deadly fibres, and the risk of mesothelioma, to family members.

A mesothelioma diagnosis is serious, but treatments are available. The chance of recovery (prognosis) depends on the size of the cancer, where the cancer is, how far the cancer has spread, how the cancer cells look under the microscope, how the cancer responds to treatment, and the patient's age. As with most types of cancer, early diagnosis is an excellent first step in fighting the disease.

Mesothelioma Symptoms
If you are wondering "do I have mesothelioma?" you should seek the guidance of your physician as early detection is a powerful asset during treatment. Malignant mesothelioma may not become apparent until 20 to 30 years after the first exposure to asbestos, but can be very aggressive once it takes hold. Because the symptoms of mesothelioma are not unique to the disease a mesothelioma diagnosis can be difficult to determine.

Symptoms of Pleural Mesothelioma
Symptoms of pleural mesothelioma (mesothelioma of the lining of the lung, known as the pleura) may include, but are not limited to, the following:

•shortness of breath (dyspnea) - hoarseness, difficulty swallowing, and/or coughing up of blood.
•pleural effusion - a build up of too much fluid between the pleura (linings of the lungs and chest); a pleural effusion may cause chest pain and difficulty breathing (dyspnea), however, many cause no symptoms and are first discovered during the physical examination or seen on a chest x-ray.
•pain in the chest - may sometimes be felt in upper abdomen, shoulder, or arm.
Patients diagnosed with diffuse pleural mesothelioma exhibited the following symptoms
(source: "Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients." P Ruffie et al. Journal of Clinical Oncology Aug 1 1989: 1157-1168.) Symptom % exhibiting
Shortness of breath and/or chest pain 90%
Weight loss 29%
Cough, weakness, fever, loss of appetite 3%
Hemoptysis (coughing up blood), hoarseness, dysphagia (difficulty swallowing), Horner's syndrome less than 1%
Pleural Effusions 84%
Asymptomatic 3%

Symptoms of Peritoneal Mesothelioma
Symptoms of peritoneal mesothelioma (mesothelioma of the abdominal lining which is known as the peritoneum) may include, but are not limited to, the following:

•weight loss - but waist may increase in size.
•pain or swelling in the abdomen - fluid retention or tumor growth.
•bowel obstruction - blockage in the small or large intestine.
•anemia - a reduction in the number of red blood cells to below normal; this forces the heart and other organs to work harder to get oxygen where it's needed.
•fever
Patients diagnosed with peritoneal mesothelioma exhibited the following symptoms
(source: "Peritoneal Mesothelioma: A Review." Bridda A, Padoan I, Mencarelli R, Frego M. MedGenMed 2007 May 10;9(2):32.) Symptom % exhibiting
Abdominal pain 35%
Abdominal swelling 31%
anorexia, marked weight loss, and ascites percentage not given
less frequently night sweats and hypercoagulability percentage not given
Clinical presentation with fever of unknown origin, intestinal obstruction, or surgical emergency due o acute infalmmatory lesions have also been reported percentage not given

These symptoms can accompany many other, less serious medical conditions; if you are experiencing any of these symptoms, and have been exposed to asbestos, you should see a doctor immediately. Asbestos exposure may have taken place 20, 30, even 50 years prior to symptoms appearing, but is a major risk factor; exposure is reported in between 70-80% of all mesothelioma cases.

Very often, asbestos exposure was second hand through a family member. Clothes dirtied with asbestos dust have carried fibers into homes, affecting spouses and children. Workers handling asbestos are now required to change their clothing before leaving work. If you see your physician because you are experiencing any of the mesothelioma symptoms listed above, please make sure to make them aware for any prior exposure, either first- or second-hand.