Mesothelioma Information

How do you know if you have Mesothelioma?

Symptoms of mesothelioma often do not appear until twenty to as much as fifty years after exposure to asbestos.  Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space are often symptoms of pleural mesothelioma.

Symptoms of peritoneal mesothelioma include weight loss and cachexia (loss of body weight and muscle mass, and weakness that may occur in patients with cancer, AIDS, or other chronic diseases), abdominal swelling and pain due to ascites (a buildup of fluid in the abdominal cavity).  Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever.  If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.  These symptoms may be caused by mesothelioma or by other, less serious conditions.

Diagnosis

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions.  Diagnosis begins with a review of the patient's medical history.  A history of exposure to asbestos may increase clinical suspicion for mesothelioma so be sure to mention it to your doctor when the doctor asks you questions about your health.  A physical examination is performed, followed by chest X-ray and often lung function tests.  The doctor will ask you about symptoms that you have been experiencing.

The X-ray may reveal pleural thickening commonly seen after asbestos exposure and increases suspicion of mesothelioma. A CT (or CAT) scan or an MRI is usually performed.  If a large amount of fluid is present, abnormal cells may be detected by cytology if this fluid is aspirated with a syringe.

For pleural fluid this is done by a pleural tap or chest drain, in the abdomen with an paracentesis or ascitic drain and in a pericardial effusion with pericardiocentesis.

While an absence of malignant cells on cytology (looking for cancer cells under a microscope) does not completely exclude mesothelioma, it makes it much more unlikely, especially if an alternative diagnosis can be made (e.g. tuberculosis, heart failure).

If cytology is positive or a plaque is regarded as suspicious, a biopsy is needed to confirm a diagnosis of mesothelioma.  A doctor removes a sample of tissue for examination under a microscope by a histopathologist.

A biopsy may be done in different ways, depending on where the abnormal area is located.  If the cancer is in the chest, the doctor may perform a thoracoscopy.  In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs.  Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples.

If the cancer is in the abdomen, the doctor may perform a laparoscopy.  To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument into the abdominal cavity.  If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.