Mesothelioma Diagnosis

Determining Diagnosis of Mesothelioma

To determine a mesothelioma diagnosis, doctors first have to rule out other, more common conditions that may be causing the symptoms. If doctors still suspect that mesothelioma could be present, they will do more in-depth tests to see if cancer cells are present.

Mesothelioma is diagnosed by:

• Monitoring initial symptoms: Initial symptoms of mesothelioma, such as a dry cough, chest pain, shortness of breath, or loss of weight and appetite, are typically mild and mimic symptoms of other more common health issues. These symptoms only worsen as the cancer grows.
• Conducting early tests: To rule out other possible diseases, doctors may use imaging tests, such as an X-ray or a computed tomography (CT) scan, and take blood samples to look for signs of cancer.
• Confirming a diagnosis: The only way to completely confirm a mesothelioma diagnosis is by taking a biopsy (samples of fluid and/or tissue) of the affected area. Biopsies allow doctors to study the samples under a microscope to see if malignancies are present.

If you suspect that mesothelioma may be the cause of your symptoms, follow up with your doctor and talk to them about your history of asbestos exposure. Early detection and diagnosis are key to receiving potentially life-saving treatment.

Quick Facts About Diagnosing Mesothelioma

• Mesothelioma is not usually diagnosed until 20-50 years after exposure to asbestos.
• Approximately 3,000 people are diagnosed with mesothelioma each year, according to information from the American Society of Clinical Oncology (ASCO).
• Most people diagnosed with mesothelioma are 65 years old or older.
• Mesothelioma can sometimes be diagnosed in younger adults, including teenagers and children, as noted in case studies from the Journal of Pediatric Surgery and the peer-reviewed journal Digestive Diseases and Sciences.

Life Expectancy After a Mesothelioma Diagnosis

The average life expectancy after a mesothelioma diagnosis depends on how early or late the cancer is diagnosed. The type of mesothelioma a patient is diagnosed with also affects their life expectancy.

Below, get a breakdown of life expectancy by mesothelioma diagnosis.

Pleural Mesothelioma

Life Expectancy of Pleural Mesothelioma

A 2017 study published in the medical journal Lung Cancer International found 46% of men aged 50-79 were still alive one year after a malignant pleural mesothelioma diagnosis.

Peritoneal Mesothelioma

Life Expectancy of Peritoneal Mesothelioma

According to the ASCO, peritoneal mesothelioma typically grows slower than other mesothelioma types. For this reason, patients with peritoneal mesothelioma may live longer than those with other types of the cancer. A 2017 study reported that patients lived a median of 53 months with this type of cancer, provided they sought treatment.

Pericardial Mesothelioma

Life Expectancy of Pericardial Mesothelioma

According to the Moffitt Cancer Center, those with pericardial mesothelioma often have shorter survival times than people with pleural or pericardial mesothelioma. Only a handful of victims survive more than a year after being diagnosed.

An early mesothelioma diagnosis is key to a longer life expectancy. If the cancer is diagnosed early on, it has not spread throughout the body. This typically means it is easier to treat because more of the cancerous tumors can be removed, potentially helping patients live longer.

Mesothelioma Diagnostic Tests

A mesothelioma diagnosis is made through several tests, which examine different parts of a person’s body to determine if cancerous tumors may be present.

The five most common types of mesothelioma diagnostic tests are:

• Medical history and examination
• Imaging scans
• Blood samples
• Fluid and/or tissue biopsy
• Pulmonary function tests

Each test has its own distinct advantages and disadvantages, and not every test may be used to confirm a mesothelioma diagnosis depending on where the cancer develops and how far it has spread by the time someone undergoes testing.

Medical History Examination

The first step in diagnosing any form of cancer is gathering a medical history and conducting a full physical exam. A doctor will review their patient’s health and ask questions about their work and medical history.

During this stage, it’s crucial for patients to note any past exposure to asbestos to their doctor. Those who worked in certain industries — such as mining, construction, or the military — when asbestos was widely used are at a significantly higher risk of developing mesothelioma.

Mesothelioma Imaging Tests

Imaging tests are usually the first diagnostic tool used to detect possible signs of mesothelioma, including fluid buildup and cancerous growths. Doctors may use the following imaging tests to identify possible cancerous tumors or other masses within the body.

X-Rays

An X-ray uses electromagnetic radiation to create a picture of the inside of the body. It is typically the first test a doctor will use to see if a patient has mesothelioma.

Chest X-rays can reveal:

• Calcium deposits
• Thickening of the lining of the lungs (pleura) or abdomen (peritoneum)
• Fluid buildup in the lungs (pleural effusion)
• Other abnormalities that may indicate mesothelioma

X-rays do not require surgery to perform and can be done relatively easily by doctors.

CT Scans

Similar to X-rays, a CT scan creates a comprehensive image of that body that can locate potentially cancerous growths.

The CT scan takes numerous images, creating a computerized view of the body from multiple angles and components inside of it. CT scans for cancer usually require contrast to outline different body organs.

PET Scans

Positron emission tomography (PET) is a type of imaging scan that uses a low-dose of a sugary radioactive substance to detect cancer cells. This substance will be injected into the patient’s body about one hour before the scan.

Cancer cells grow at a rapid pace, which causes them to consume a larger quantity of sugar than other cells. The PET scan uses the injected radioactive material to observe which cells (if any) are consuming more sugar — and, in turn, may be cancerous — and where these cells are located.

The scan can also show if these cells have begun to spread throughout the body.

PET-CT Scans

Some facilities have machines that are capable of performing a CT scan and a PET scan at the same time.

Because the two types of scans perform slightly different functions, a PET-CT scan can help doctors diagnose mesothelioma with greater accuracy. The CT scan component of this combination of imaging tests is usually non-contrast.

MRI Scans

A magnetic resonance imaging (MRI) scan is similar to a CT scan in many ways, but it uses radio and magnetic waves instead of light waves to see if cancerous tumors may be present.

If you receive an MRI, you can expect to lay inside a tube-like scanner for up to an hour while the scan occurs.

Echocardiogram

An echocardiogram is a specialized form of ultrasound that uses sound waves to take an image. After a gel is placed on the chest, a wand sends sound waves into the body to create a picture on a monitor.

Echocardiograms are frequently used to help confirm a pericardial mesothelioma diagnosis. A doctor may request an echocardiogram to see how well the heart is functioning or if they suspect fluid buildup around the heart.

While all the imaging tests listed above are important, the American Cancer Society (ACS) notes that these tests alone cannot confirm if someone has cancer.

Mesothelioma Blood Tests and Biomarkers

Mesothelioma increases the levels of certain substances within the blood, including fibulin-3, soluble mesothelin-related peptides (SMRPs). and other substances. These substances can be detected through various tests, in which blood samples are sent to a laboratory.

Blood tests are a cost-efficient and minimally invasive way to test for mesothelioma, which is why many cancer researchers are working on methods for improving blood tests as a diagnostic tool.

However, like imaging tests, blood tests alone are not able to diagnose mesothelioma, and they are not used as part of the diagnostic process in every case. If a blood test suggests a victim has this cancer, additional tests will be administered to confirm a mesothelioma diagnosis.

Researchers are also looking into new biomarkers and other genetic factors as mesothelioma diagnostic tools.

Mesothelioma Biopsy

The only conclusive way to make a mesothelioma diagnosis is by performing a biopsy of tissue or fluid cells.

All biopsies follow the same general process: tissues or fluids are collected, sent to a laboratory, and then reviewed under a microscope.

Doctors typically start by taking a fluid sample from the affected mesothelium to look for cancer cells in this fluid, as fluid buildup is a common symptom of mesothelioma.

This still might not be enough to conclusively diagnose mesothelioma, though, as cancer cells may not be found in this fluid. The ACS notes that doctors usually need a tissue sample to confidently make a mesothelioma diagnosis.

From there, lab tests will be conducted by pathologists to see if the victim has mesothelioma and, if so, what type they have.

Pulmonary Function Tests

If a patient has been diagnosed with pleural mesothelioma, their doctor may request pulmonary function tests to determine how well their lungs are currently functioning.

This test is important because pleural mesothelioma makes up around 80% of all diagnosed cases and it is often treated through lung removal surgery. If a pulmonary function test shows that both lungs are strong, the patient may be better able to undergo surgery that could extend their life.

Diagnostic Tests by Mesothelioma Location

Doctors require specific tools and techniques to make a mesothelioma diagnosis in different areas of the body.

Here are the common tests and tools used for each mesothelioma location:

• Pleural mesothelioma: A variety of tests, including a CT scan, an ultrasound, or an MRI, can be used to help determine if cancer may be present and if it has begun to spread. A PET scan may also be used to help see if the cancer has spread throughout the body in some cases.
• Peritoneal mesothelioma: Doctors typically start with a CT scan of the abdomen. Blood samples then may be taken to help rule out other conditions.
• Pericardial mesothelioma: Tests such as an X-ray of the chest and an echocardiogram may be used to see if cancer tumors have started to develop around the heart. Unfortunately, due to its rarity, most cases of this type of mesothelioma are only diagnosed after the patient has died.
• Testicular mesothelioma: Doctors may use X-rays and ultrasounds to diagnose this type of cancer. Testing for biomarkers can also help determine if it is present.

Biopsies are always performed after these tests are conducted, no matter what type of mesothelioma is suspected. As previously noted, a mesothelioma diagnosis can only be confirmed by taking a biopsy.

Preparing for Mesothelioma Diagnostic Tests

Each mesothelioma diagnostic test will require different preparations. While some tests (such as an X-ray) require little to no preparation, others (such as a blood test or an MRI) may require that patients do not eat for several hours beforehand.

For some tests, like a CT scan, patients will be asked to drink an oral contrast solution. They may also receive an IV contrast to help outline organs on the scans.

Before each diagnostic test, doctors will explain how a patient should prepare for each test and when they can expect to get their results back.

Diagnosing Mesothelioma in Veterans

33% of all people diagnosed with mesothelioma are veterans, as every branch of the U.S. military relied on asbestos-containing products until the early 1980s.

If a veteran displays common mesothelioma symptoms, they should tell their doctor if they served in the military when asbestos was widely used. From there, doctors can help them to narrow down the patient’s condition and make a proper mesothelioma diagnosis.

Further, veterans who receive VA Health Care may be able to access top mesothelioma specialists to figure out their treatment plan after a mesothelioma diagnosis.

Mesothelioma Diagnosis Challenges

Even for experienced doctors, making a mesothelioma diagnosis is challenging since the symptoms can often mimic other diseases. Other factors, including the length of time it takes mesothelioma to develop, can also make it harder to diagnose this cancer.

Learn more about potential mesothelioma diagnostic challenges below.

Latency Period

Mesothelioma is unusual in that it takes 20-50 years after someone has been exposed to asbestos before noticeable symptoms arise.

This long time-lapse means that victims may not even remember being exposed to asbestos-containing products. Also, they may not initially realize that their mild, vague symptoms are related to mesothelioma.

Patients should always tell their doctor if they were exposed to asbestos, even if their symptoms are mild.

Misdiagnosis

Doctors may initially mistake mesothelioma for a wide range of more common, less dangerous diseases since each type of mesothelioma develops in a different part of the body.

Mesothelioma may be misdiagnosed as:

• Bronchitis
• Coronary artery disease
• Chronic obstructive pulmonary disease (COPD)
• Emphysema
• Crohn’s disease
• Irritable bowel syndrome (IBS)
• Testicular infection
• Other forms of cancer

This is why doctors use so many tests when making a mesothelioma diagnosis — they want to be completely sure of the disease so they can properly treat it. A mesothelioma misdiagnosis can have dangerous outcomes, including death.

If you believe you were misdiagnosed, seek a second opinion from an experienced mesothelioma specialist.

Next Steps After a Mesothelioma Diagnosis

If you or a family member has been diagnosed with mesothelioma, you likely have questions about treatment options, top doctors, and more. Contact us today to discuss your next steps and how you can access life-extending mesothelioma treatments.