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Mesothelioma Diagnosis

After analyzing patient symptoms and medical history, doctors will use imaging scans, blood tests, biomarkers and biopsies to diagnose mesothelioma. Due to the typical aggressive nature of mesothelioma, early detection and avoiding misdiagnosis are key to ensuring the best prognosis for the patient.

Imaging scans are used to identify tumors and potential metastasis, while blood tests look for biomarkers that could suggest the presence of mesothelioma. However, biopsies are the only definitive method to diagnose mesothelioma.

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How Is Mesothelioma Diagnosed?

When a patient presents symptoms of mesothelioma, doctors will conduct a physical exam, look at the patient’s medical history and begin to rule out more common diseases and conditions. Physicians will then order a series of tests and procedures to identify the cause of symptoms.

Mesothelioma Imaging Scans

Imaging tests help identify tumors, tumor location and metastasis of cancer during the diagnostic process. The most common scans used for diagnosing mesothelioma include X-rays, MRI scans, CT scans, PET scans and ultrasounds.

Mesothelioma Blood Tests and Biomarkers

Blood tests can be used to look for mesothelioma biomarkers, or substances in the blood that can suggest the presence of malignant mesothelioma. For example, healthy mesothelial cells produce normal levels of mesothelin, but malignant mesothelial cells produce higher levels of the protein, which may be detected during blood tests, aiding diagnosis.

There are a variety of blood tests that can be used to identify particular byproducts common for mesothelioma patients, as well as many biomarkers that continue to emerge. Biomarkers may suggest the presence of mesothelioma that may then lead to further evaluation and earlier diagnosis. Biomarkers can also be used to track how well treatments have worked. Currently, there is no blood test that can definitively diagnose mesothelioma.

Mesothelioma blood tests and biomarkers that have shown utility include:

Mesothelioma Biopsies

Biopsies are the most important step in a mesothelioma diagnosis and the only way to confirm the cancer. Mesothelioma biopsies remove cancerous fluid or tissue for analysis that will then be used to confirm the diagnosis and histologic type of mesothelioma, as well as determine treatment options. There are four types of biopsies that are common for mesothelioma, including needle biopsies, camera-assisted biopsies and surgical biopsies.

Mesothelioma Pathology

Mesothelioma pathology describes the microscopic appearance of mesothelioma within a tissue sample or fluid. Histology and cytology are two types of pathology specimens created from a biopsy procedure which are then microscopically evaluated by a pathologist to confirm a mesothelioma diagnosis, providing information that will guide staging and diagnosis, while helping prevent misdiagnosis.

Common Mesothelioma Misdiagnoses

Mesothelioma is a rare cancer often mistaken for more common diseases and conditions. Each step of the diagnostic process, especially a biopsy, is crucial to preventing misdiagnosis. If mesothelioma is mistaken for another condition, treatment will be delayed, which can worsen a patient’s prognosis. Misdiagnoses vary by type, as listed below.

Importance of Early Detection of Mesothelioma

Malignant mesothelioma is an aggressive cancer that spreads quickly. While there is no cure for this cancer, mesothelioma treatment may be able to extend life expectancies for patients, especially if the disease is caught early.

Patients diagnosed at stage 1 or stage 2 are typically able to undergo aggressive surgeries and multimodal treatment, which have shown success in extending survival. Those diagnosed at stage 3 or stage 4 have more limited treatment options and a worse prognosis.

Resources Available for Mesothelioma Patients and Their Families

Mesothelioma has a long latency period, and it can take decades for symptoms to emerge, making an early diagnosis difficult. Misdiagnosis is also common due to the rarity and nonspecific symptoms. However, awareness of a prior history of asbestos exposure coupled with improvements in diagnostic tools offer hope that the cancer can be caught early, presenting patients with the best prognosis possible.

Author: Linda Molinari

Editor in Chief, Mesothelioma Cancer Alliance

Linda Molinari

Reviewer: Dr. James Stevenson

Medical Reviewer and Thoracic Medical Oncologist

Dr. James Stevenson
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Sources

American Cancer Society. Early Detection, Diagnosis, and Staging.

American Cancer Society. How Is Malignant Mesothelioma Diagnosed? Updated February 2016.

American Cancer Society. Types of biopsies used to look for cancer. Updated July 2015.

American Lung Association. Diagnosing and Treating Mesothelioma. Updated April 2018.

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