Mesothelioma Diagnosis
If you or a loved one are concerned about mesothelioma; a diagnosis (plural, diagnoses) is the process of identifying the disease by its signs, symptoms, and from results of the diagnostic procedures outlined below. The conclusion reached through the below process is called a diagnosis. "Diagnostic criteria" are the combination of signs/symptoms, and test results that allow a doctor to ascertain the diagnosis of mesothelioma.
1. Physical Examination
As with all diseases, a doctor begins the mesothelioma diagnosis by doing a complete physical exam and reviewing your medical history. Because mesothelioma is almost always caused by breathing in asbestos(see Causes of Mesothelioma), you should tell your doctor about your exposure to asbestos if you suspect you may have mesothelioma.
After performing the physical exam, a doctor should have x-rays of the chest performed and, in some cases, pulmonary function tests to determine if the symptoms are consistent with malignant mesothelioma.
After performing the physical exam, a doctor should have x-rays of the chest performed and, in some cases, pulmonary function tests to determine if the symptoms are consistent with malignant mesothelioma.
2. CT Scans and MRI’s
In many cases, a doctor may order CT scans and/or MRI’s to aid in the mesothelioma diagnosis. These tools allow a doctor to assess the size, location, and extent of the mesothelioma tumor in the chest or abdomen.
3. Blood Test
A new and promising method to detect mesothelioma is MESOMARK assay. This is a blood test used to detect peptides realeased into the blood stream by mesothelioma cells. Mesothelioma patients usually have an elevated MRP in their blood stream years before actual diagnosis is made. This test is only FDA approved for humanitarian use. It only used to follow someone already diagnosed with mesothelioma (of an epitheloid type) to give an indication of whether or not the cancer is growing.
To read more please see the MESOMARK news story and more detailed information on MESOMARK. Please also see section on FDA humanitarian use devices.
To read more please see the MESOMARK news story and more detailed information on MESOMARK. Please also see section on FDA humanitarian use devices.
4. Biopsy to Diagnose Mesothelioma
All of the steps described above are only preliminary indications of mesothelioma. If, after performing these tests, a doctor suspects mesothelioma, a biopsy should be taken to confirm the mesothelioma diagnoses.
A biopsy is the procedure used for obtaining a tissue sample of the tumor. The two most common methods for removing tissue samples are a thorascoscopy and a broncoscopy. Others may include: needle biopsy of the pleura, Video-assisted thoracic surgery, Mediastinoscopy, and Laparoscopy
A thoracoscopy is obtained by inserting a telescope-like instrument connected to a video camera (thoracoscope) through a small incision in the chest. The doctor then removes samples of the tumor using special forceps with the aid of the camera. This procedure can be used for diagnosing both pleural mesothelioma and pericardial mesothelioma.
A bronchoscopy involves inserting a flexible lighted tube through the mouth, through the trachea and into the bronchial tubes to remove tissue in the airway. This procedure is used for diagnosing pleural mesothelioma.
If peritoneal mesothelioma is suspected, a laparoscope similar to a thoracoscope can be used to look and take samples of the tumor from inside the abdomen.
To do a mediastinoscopy, the instrument goes into the chest behind the breast bone. This may allow for sampling of the lymph nodes, needed to know if the tumor is spreading.
If these less invasive procedures to not allow specimens to be collected because of the position of the tumor, more aggressive procedures may be used. A surgeon can open the chest cavity by doing a thoracotomy, and directly visualize tissue for biopsly, or even complete removal of the tumor if it is small. A surgeon can also cut open the abdomen for a direct look and biopsy or removal of a mesothelioma in the abdomen,
Although a biopsy is the most effective procedure for diagnosing mesothelioma, malignant mesothelioma cells can look like other types of cancer. Therefore, special laboratory tests are sometimes performed or electron microscopes are used to confirm a diagnosis of mesothelioma.
A biopsy is the procedure used for obtaining a tissue sample of the tumor. The two most common methods for removing tissue samples are a thorascoscopy and a broncoscopy. Others may include: needle biopsy of the pleura, Video-assisted thoracic surgery, Mediastinoscopy, and Laparoscopy
A thoracoscopy is obtained by inserting a telescope-like instrument connected to a video camera (thoracoscope) through a small incision in the chest. The doctor then removes samples of the tumor using special forceps with the aid of the camera. This procedure can be used for diagnosing both pleural mesothelioma and pericardial mesothelioma.
A bronchoscopy involves inserting a flexible lighted tube through the mouth, through the trachea and into the bronchial tubes to remove tissue in the airway. This procedure is used for diagnosing pleural mesothelioma.
If peritoneal mesothelioma is suspected, a laparoscope similar to a thoracoscope can be used to look and take samples of the tumor from inside the abdomen.
To do a mediastinoscopy, the instrument goes into the chest behind the breast bone. This may allow for sampling of the lymph nodes, needed to know if the tumor is spreading.
If these less invasive procedures to not allow specimens to be collected because of the position of the tumor, more aggressive procedures may be used. A surgeon can open the chest cavity by doing a thoracotomy, and directly visualize tissue for biopsly, or even complete removal of the tumor if it is small. A surgeon can also cut open the abdomen for a direct look and biopsy or removal of a mesothelioma in the abdomen,
Although a biopsy is the most effective procedure for diagnosing mesothelioma, malignant mesothelioma cells can look like other types of cancer. Therefore, special laboratory tests are sometimes performed or electron microscopes are used to confirm a diagnosis of mesothelioma.
Anna L. Kaplan, M.D.