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Mesothelioma Diagnosis

By the time patients are finally diagnosed with mesothelioma, it's likely they've already been through a battery of tests to rule out all other diseases. Many times, these same patients are initially told they have other, less severe diseases before tests conclusively reveal a diagnosis of mesothelioma.

Because cases of misdiagnosed mesothelioma are common, patients often lose precious time to treat the disease. Often, the patients themselves unknowingly ignore the symptoms, again losing time to treat the disease.

Getting Diagnosed

The key to successful mesothelioma treatment is getting an early diagnosis. Often, patients who are diagnosed in the earlier stages of the disease, stages I and II, may be eligible for aggressive treatments. There are a number of useful tools used to determine if the patient has mesothelioma and the stage of the disease:

Imaging Tests

This allows physicians to get a closer look at the patient's internal organs in a noninvasive manner. Often, all four of these tests are used in conjunction to allow for a more accurate diagnosis.

  • X-Ray -- This is used to detect fluid in the chest cavity, called a plural effusion, which is symptomatic of mesothelioma. This can also detect cases of bronchitis or pneumonia, which have similar symptoms to mesothelioma.
  • MRI -- When an X-ray reveals abnormalities, doctors will prescribe a magnetic resonance image. This uses a magnetic field and radio frequency pulses to create and transmit images to a computer.
  • CT Scan -- Called a Computer Tomography scan or a cat scan, this uses computer technology to create cross-section images of the internal body structures. It is commonly used for detecting tumors and determining the progress of the disease.
  • PET Scan -- A Positron Emission Tomography uses a small amount of radioactive materials to determine the function of the internal organs. It is often used to determine if the disease has metastasized, or spread.

Biopsies

Often, physicians will order a small sample of the internal tissue be removed for further study, called a biopsy. This allows for a more accurate diagnosis and staging of the disease.

  • Surgical Biopsy -- In this invasive procedure, doctors surgically examine the suspected area for damaged tissue.
  • Needle Biopsy -- Fluid or tissue is removed via a fine needle for further examination.

Blood Work

The newest in the arsenal for testing and early detection, advanced blood tests are being created and seeking approval from the U.S. Food and Drug Administration today. Currently, there is only one on the market specifically geared to mesothelioma.

  • Mesomark Assay -- This is used as a monitor and possibly early detection tool for pleural and peritoneal mesothelioma. It measures the level of soluble mesothelin-related proteins (SMRPs) in the blood, which are released by diseased mesothelioma cells.

Stages of Mesothelioma

After a confirmed diagnosis of mesothelioma, doctors will use a staging system to better identify the level of the disease and the best treatment options. The stage of the disease determines how it will be treated. There are several commonly used staging systems:

Butchart Staging System

Created in 1976, this is the oldest staging method for pleural mesothelioma, the most common form of mesothelioma. This helps doctors identify a patient's prognosis but is limited in scope. It ranges from stage I, which means the tumors are confined to one side of the body, to stage IV, which means the tumors have metastasized through the abdominal cavity.

TNM Staging System

Created in 1995, this staging system is also called the IMIG (International Mesothelioma Interest Group) staging System or International TNM system. It allows for a more universal and accurate approach to mesothelioma staging. It describes the location and size of the tumors (T), whether there is lymph node (N) involvement and whether the cancer has metastasized (M).

Brigham System

Created by the famed mesothelioma specialist Dr. David Sugarbaker in 1996, this staging system is used to predict whether a patient would benefit from surgical procedures. It takes lymph node involvement into consideration and uses it as a determining factor for future treatment success. This staging system ranges from stage I to stage IV, with the latter being the most severe.

Life After a Diagnosis

After receiving a mesothelioma diagnosis, your doctor will likely want to begin treatment immediately. It's up to you to determine the next steps. Because mesothelioma is so rare and there are a limited number of specialists in this area of study, patients often seek out a second opinion. There are a select few mesothelioma cancer centers nationwide that handle such special cases.

From there, many patients will undergo a series of treatments that are determined by you and your medical team. Often, these treatments include surgery, chemotherapy and radiation therapy. There are also many types of experimental treatments and complementary and alternative medicines (CAM) used to lessen the disease or the symptoms.

Sources:

  1. Mayo Clinic. Mesothelioma -- Tests and Diagnosis. Retrieved from http://www.mayoclinic.com/health/mesothelioma/DS00779/DSECTION=tests%2Dand%2Ddiagn…
  2. WedMD. Mesothelioma: Tests, Diagnosis and Treatments. Retrieved from http://www.webmd.com/lung/mesothelioma-tests-diagnosis-and-treatments.
  3. American Cancer Society. How is Malignant Mesothelioma diagnosed? Retrieved from http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-diagnosed
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