Malignant Mesothelioma Diagnosis

Since there are no symptoms of malignant mesothelioma in the early stages, early detection of mesothelioma is uncommon, although it is sometimes found when doctors are looking for something else. No effective common screening process exists for malignant mesothelioma. Doctors sometimes recommend an X-ray or CT scan to monitor changes in the lungs, but early stage malignant mesothelioma tumors can be so small that they often go undetected.

As the cancerous tumors grow, they begin to press on nerves, block airways, and cause fluid buildup in the lungs or abdomen, which can affect the breathing or cause noticeable distention of the abdomen. It is these symptoms that usually lead to a malignant mesothelioma diagnosis. Symptoms do not usually appear until the late stages of the disease.

Testing for Malignant Mesothelioma

When a patient visits the doctor complaining of symptoms associated with malignant mesothelioma, the doctor will often begin narrowing down the diagnosis by asking questions. It is helpful if the patient is aware of asbestos exposure and communicates this to the doctor. Once the doctor has enough information to suspect malignant mesothelioma, the patient may be referred to a hospital or a cancer specialist, called an oncologist.

The oncologist will begin a series of tests designed to verify the diagnosis, determine what type of mesothelioma it is and what stage the disease is in. Since malignant mesothelioma can be difficult to diagnose, the patient may be subjected to a number of tests, including X-rays, a CT scan, a thoracoscopy or laparoscopy with a biopsy, and fluid drainage from the affected area, either lungs or abdomen.

X-Rays and CT Scans

Most people are familiar with X-ray, a scan that reveals the inside of the body. An X-ray can show fluid in the lungs or abdomen. A CT scan is a more detailed way to image the inside of the body. A CT scan will indicate abnormal swelling present in lymph nodes or organs. Patients are usually injected with a dye prior to the test to help the doctor interpret the results.

Fluid Drainage

Fluid buildup around the lungs is common in peritoneal mesothelioma victims. This is called pleural effusion.  Peritoneal mesothelioma victims may have fluid buildup inside the abdominal cavity, called peritoneal effusion. Fluid builds up when cancer cells inflame the pleura or the peritoneum. Fluid in the pleura—the protective sac around the lungs—squeezes the lungs, making breathing difficult. Fluid buildup in the abdomen makes the abdomen appear swollen and feel tight and uncomfortable.

The doctor will drain the fluid using a long needle attached to a tube that connects to a collection bag. Once the fluid is drained into the bag, a sample is sent to the lab for analysis. If the fluid contains cancerous cells, this is the first step in verifying a malignant mesothelioma diagnosis. The procedure is called thoracocentesis or pleural aspiration if fluid is drained from the chest, and adoparacentesis or peritoneal aspiration if it is drained from the abdomen.

Thoracoscopy and Pleural Biopsy

The most reliable way to determine whether a patient has pleural mesothelioma is to biopsy the pleura. After a local or general anaesthetic is administered, a surgeon makes a tiny incision in the chest and inserts a thoracoscope, which is a flexible device with a light and a video camera attached. The video sends images back to a screen in the room to help the surgeon find the affected area. The surgeon uses forceps to snip a small sample of the pleura for testing.

Laparoscopy and Peritoneal Biopsy

A laparoscopy is a similar operation used to diagnose peritoneal mesothelioma. The same procedure is used to examine and biopsy the abdomen. For either operation, only a few stitches are required to close the wound.

The Results

Test results can take two to four weeks. Due to the overwhelming number of tests sent to the lab every day, this kind of wait is normal and to be expected, although knowing that does not make the wait any easier on the patient and his family. When the results are in, the patient will return to the hospital or doctor’s office to visit with the oncologist. The oncologist informs the patient of the diagnosis and discusses treatment options, details of the disease, what will happen, and the prognosis – how long the patient can reasonably expect to live.