The symptoms of mesothelioma can be misleading, making accurate and timely diagnosis a challenge. This is especially true for medical professionals with little experience in evaluating patients that have been stricken with the rare cancer—not an uncommon trend among physicians, as only about 3,000 cases are diagnosed in the U.S. each year. And because the spike in mesothelioma cases has occurred primarily in the last few decades, older physicians may be even less likely to have actually seen a case over the course of their practice.
Symptoms of Mesothelioma—Cancer Hidden in Common Form
Symptoms of the two most common types of the disease—plural and peritoneal mesothelioma—can look a lot like relatively harmless and common conditions. In the case of the former, persistent wheezing and coughing is often the most predominant sign and may continue for sometime before a patient even visits a doctor for evaluation. Pericardial mesothelioma is most often associated with gastrointestinal upsets and weight loss—symptoms that can occur from non-life-threatening conditions like lactose intolerance and irritable bowel syndrome—leaving many patients and doctors alike to misinterpret their presentation and severity, easily resulting in misdiagnosis.
When a patient has a history that includes known exposure to asbestos, symptoms are taken much more seriously. Without knowledge of that predominant risk factor, however, the average general practitioner or internal medicine specialist is not likely to immediately suspect mesothelioma as an apt diagnostic possibility. Its general rarity continues to make the illness a diagnostic improbability for the average physician—though general public awareness may be helping to improve this dilemma.
Common Screening Methods in Patients Presenting Symptoms of Mesothelioma
Once mesothelioma is suspected, a doctor will typically order a chest x-ray or CT scan. These tests can show change in lung tissue that could indicate the presence of malignancies, but evidentiary data is unclear on the true accuracy of these methods in precipitating findings of mesothelioma.
In recent years, top cancer specialists at world-renowned treatment facilities like M.D. Anderson Center in Houston have been developing better early screening tests for mesothelioma. These include testing patients’ blood for a bone protein called osteopontin or elevated levels of a serum called soluble mesothelin-related peptides. Both have been closely connected with the presence of mesothelioma and other lung-related malignancies.
Reaching a Conclusive Diagnosis—Proving Malignancies Generally Requires Semi-Invasive Procedure
In order to conclusively determine that symptoms of mesothelioma are in fact indicative of an actively present malignancy, the common medical standard is a positive biopsy result. A biopsy is the removal of tissue or fluid from the affected region, which is then run through multiple pathology tests to not only confirm the presence of cancer but also to pinpoint the type and stage.
There are three types of biopsies used in diagnosing mesothelioma: needle biopsies, surgical biopsies and mediastinoscopy. Which method is used depends on the location of the tumor, in addition to whether or not the cancer is suspectedof having spread to the lymph nodes.
Surgical biopsies are the most invasive but offer the possible benefit of allowing surgeons to retrieve a tissue sample, receive pathology results and then remove the tumor and any necessitated surrounding tissue—all in one procedure.