How to Diagnose Mesothelioma
Mesothelioma is a cancer with symptoms that can easily be mistaken for other ailments. Sometimes there are no symptoms at all. Pleural Mesothelioma found in the lungs and the linings of the lungs is the most common form of mesothelioma and the symptoms of this type of mesothelioma is often mistaken for pneumonia. The right lung is more often affected than the left one in this deadly cancer.
Pleural effusion occurs as the main symptom of pleural mesothelioma. An effusion occurs when there is too much liquid forming in the lungs and surrounding areas. The cancer cells cause this excess fluid in the lungs. The fluid in the pleura can either be clear or cloudy. If it is clear it is called transudate effusion caused simply by the imbalance of fluid. If it cloudy it is exsudate effusion and this is the type associated with pleural mesothelioma. This cloudy color is a result of cancer cells and proteins in the diseased pleura.
There could also be fluid buildup in the abdomen as a result of Peritoneal Mesothelioma. The symptoms of this disease would include swelling of the abdomen, feet, ankles, abdominal pain, nausea, weight loss and bowel obstruction.
If a doctor suspects mesothelioma he/she will start with taking the patient’s medical history as well as work history and any other information concerning possible exposure to asbestos or asbestos products. He/she will do a complete physical and order standard tests. He will start with listening to the chest with a stethoscope. Mesothelioma patients have different responses to exam. If the chest is tapped it will produce a shallow sound indicating fluid in the lungs and the heartbeat will be muffled rather than clear.
Standard exrays will reveal tumors in the lungs, and an exray called a lateral decubitus film will indicate effusion and also reveal how much liquid is present.
A needle biopsy called a Thoracentesis will extract some of the fluid to determine if it is a transudate or exsudate effusion in the pleura, while the same procedure can be done for peritoneal mesothelioma using a peritoneoscope. These types of needle biopsies do not conclusively proof the cancer is present and biopsies to remove tissue samples for further analysis is often required.
After the biopsies are taken they are sent on to pathology labs for analysis. These expert mesothelioma pathologists must first rule out any other form of cancer before given the diagnosis of mesothelioma.
Computed Tomography (CT scans) are used not only used to reveal the presence of effusion but to locate fissures, scar tissue, calcification of tissue, tumors, and any protrusions in the cell walls.
Magnetic Resonance Imaging (MRI) can calculate the size of the tumors, and lymph nodes. They can view different images in layers and are more refined at distinguishing tumors from other structures in the body. MRI’s are also used to determine if a patient is a good candidate for surgery.
Positron Emission Tomography (PET) will tell you how far advanced, and what stage the tumor is. It is the most sophisticated imagining tool but it is also the most expensive.
Staging:
Mesothelioma staging analyzes various factors of the tumor present. It will take into account the size of tumors, the numbers of tumors present, the location of tumors in relation to the its point of origin, if there are lymph nodes present, and cancer cell formation. They will also predict if the cancer will spread to other parts of the body.
There are 5 cancer-staging classifications:
In situ – the cancer has remained in its original location, in the same layer of cells
Localized – the cancer stays in the original organ
Regional – the cancer has spread to the nearby organs or lymph nodes
Distant – the cancer has spread to other parts of the body
Unknown – not enough information is available to access the cancer at this time.
Besides the above mentioned testing, additional tests such as urine samples, blood tests, tissue samples, and pathology reports will all be used to determine the cancer staging.
The three staging systems in use today are the Butchart system, the TMN system and the Brigham System. The TMN, surpasses the older Butchart system because it not only measures the size and location of the tumor, it determines lymph node involvement and predicts if the cancer has the ability to travel. The Brigham System will analyze the lymph nodes to determine if surgery will be suitable for the patient at this time.
Staging is very crucial to aid the doctors in determining the proper treatment plan needed in each individual case.
Treatment can mean simply draining the fluid, to provide symptom relief, radiation and chemotherapy, surgery to remove part of, or the whole tumor, or palliative care, when the patient is terminal and no treatment can cure the disease or arrest the disease.
Newer treatments offered today include acupuncture in conjunction with standard treatment, drug therapy, immunotherapy (treating the immune system), Photodynamic therapy (PDT) a type of light therapy designed to destroy the cancer cell with light, gene therapy, and more.
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