The Process of Diagnosing Mesothelioma

Early detection is critical

The best hope for effective treatment of mesothelioma is a diagnosis of the disease in its earliest stages. Unfortunately, this almost never occurs, for many reasons:

• Mesothelioma is a rare disease and most doctors have never seen a case
• Early mesothelioma symptoms are vague, mild, and identical to those that result from more common and less serious disorders
• No sign of mesothelioma may appear for decades after the exposure to asbestos, so the connection is not made

Despite these difficulties, procedures are available for accurately diagnosing mesothelioma.

The initial evaluation

The process begins with a thorough initial evaluation by a physician, preferably one who is familiar with the disease. To identify risk factors and symptoms, the doctor asks questions about your medical and occupational history and any asbestos exposure you may have had. The physical examination should include:

• Listening for muted breath sounds, which may indicate fluid in the chest cavity
• Comparing sound resonance between the two sides of the chest, which may also indicate a build-up of fluid
• Tapping on the chest to identify any areas that make a dull, thumping sound that could indicate presence of a mass
• Manual examination of lymph nodes for swelling

Diagnostic tests

Several medical tests are available for distinguishing mesothelioma from other possible causes of the symptoms and for diagnosing the presence and extent of mesothelioma.

Imaging techniques

These imaging techniques allow doctors to view organs, tissues, and excess fluid or tumor indicators:

Pathology tests

Doctors use various kinds of instruments to look inside the body and to take biopsies of tissues or fluids suspected of mesothelioma. The samples are examined by a pathologist who can make a definitive diagnosis of mesothelioma cells. To obtain the sample, the doctor inserts a lighted tube through the trachea or a small incision, depending upon the area of concern:

• Thoracoscopy to see and biopsy a chest tumor
• Bronchoscopy to check for masses in the airway
• Laparoscopy to obtain a biopsy of a peritoneal tumor and collect fluid
• Mediastinoscopy to visualize lymph nodes and take tissue samples

Pulmonary function tests

These tests evaluate the respiratory system. They range from simple peak airflow measurements to complex body plethysmography and ventilation/perfusion scans performed in a hospital.