How Is Mesothelioma Diagnosed And Staged?

   How Is Mesothelioma Diagnosed And Staged?

Mesothelioma is a rare and dangerous cancer that originates in the mesothelium, the thin layer of tissue that surrounds your organs. 

Mesothelioma is primarily caused by asbestos exposure, and diagnosis is frequently delayed owing to the cancer's mild early signs. 

 If you're concerned about mesothelioma, knowing the diagnostic and staging procedure is critical for early discovery and effective treatment. 

 This comprehensive guide will cover every element of mesothelioma diagnosis and staging, arming you with knowledge and assisting you in navigating this difficult road.

How Is Mesothelioma Diagnosed And Staged?

Diagnosis is the process of determining the source of a health condition. Mesothelioma is commonly diagnosed during a visit to the family doctor. Your doctor will question you about your symptoms and may do a physical exam. Based on this information, your doctor may send you to a specialist or request testing to diagnose mesothelioma or other health issues.

The diagnostic process can be time-consuming and irritating. It's understandable to be concerned, but keep in mind that other health disorders might present symptoms similar to mesothelioma. Before diagnosing mesothelioma, the healthcare team must rule out other possible causes of the health condition.

The following tests are commonly used to rule out or diagnose mesothelioma. Many of the tests used to diagnose cancer are also used to determine the stage. Your doctor may also request further tests to assess your overall health and arrange your therapy.

Symptoms of Mesothelioma

Early mesothelioma symptoms can be ambiguous and readily confused for other illnesses. However, being aware of these potential symptoms may lead you to seek medical assistance sooner:

Shortness of breath: This is a common symptom that is frequently linked to aging or lung disease. However, chronic or increasing shortness of breath, particularly during exertion, should be investigated for mesothelioma.

Chest pain: Mesothelioma can produce aching or intense discomfort in the chest, especially if it affects the pleura (lung lining). Coughing or hard breathing may make the discomfort worse.

Cough: A chronic cough that does not respond to medicine or home cures may indicate mesothelioma. Sometimes the cough produces bloody mucous.

Fatigue: Feeling particularly fatigued and lacking energy can be caused by a variety of illnesses, including mesothelioma.

Unexplained weight loss: Mesothelioma can cause unintentional weight loss owing to exhaustion, trouble eating, or the malignancy impacting metabolism.

Fluid buildup around the lungs (pleural effusion) or abdomen (ascites): Mesothelioma can cause fluid to accumulate in the areas surrounding the lungs or belly (pleural effusion or ascites). This can lead to shortness of breath, abdominal swelling, and pain.

Mesothelioma Diagnosed

Health history and physical exam

If you have any of the symptoms listed above, especially if you have a history of asbestos exposure, you should visit your doctor for a comprehensive assessment. The first diagnostic procedure may include:

Detailed medical history: Your doctor will ask about your symptoms, previous medical history, and occupational history, with an emphasis on probable asbestos exposure.

Physical examination: The doctor will listen to your lungs for any abnormalities and look for symptoms of fluid buildup in the chest or belly.

Diagnostic Tests

Following the initial evaluation, your doctor may recommend further investigations to confirm or rule out mesothelioma.  These may include:

Chest X-ray: This basic imaging test can reveal abnormalities in the lungs or pleura, such as pleural effusion or masses. However, it may not be definitive for diagnosing mesothelioma.

Computed tomography (CT) scan: A CT scan provides detailed cross-sectional images of the chest and abdomen, aiding in visualizing tumors and fluid buildup. It can also help determine if the cancer has spread to nearby lymph nodes.

Positron emission tomography (PET) scan: A PET scan uses a radioactive tracer to identify areas of increased metabolic activity, which can indicate cancerous cells. It's often used in conjunction with a CT scan (PET/CT) to assess mesothelioma spread.

Magnetic resonance imaging (MRI): An MRI scan can provide detailed images of soft tissues, which can be helpful in differentiating mesothelioma from other conditions.

Pleural fluid analysis: If fluid is present around the lungs (pleural effusion), a sample may be withdrawn and analyzed for the presence of mesothelioma cells. This can involve a procedure called thoracentesis, where a needle is inserted into the chest cavity to collect the fluid.

Biopsy: A biopsy is the definitive way to diagnose mesothelioma. During a biopsy, a tissue sample is obtained from the suspected tumor and examined under a microscope for the presence of cancerous cells. 

There are different types of biopsies used for mesothelioma diagnosis, including:

Needle biopsy: A thin needle is inserted through the chest wall or abdomen to collect a tissue sample.

Surgical biopsy: In some cases, a more extensive surgical procedure may be necessary to obtain a larger tissue sample.

Video-assisted thoracoscopic surgery (VATS): This minimally invasive surgical procedure uses a camera and small instruments inserted through a chest incision to visualize the area and collect a tissue sample.

Blood Chemistry Tests

Blood chemistry tests detect particular substances in the bloodstream. They demonstrate how effectively specific organs work and can aid in the detection of problems. LDH is a type of blood chemistry test that can be used to identify mesothelioma.

Lactate dehydrogenase (LDH) is an enzyme present in cells. Higher levels of LDH may indicate tissue or cell damage anywhere in the body, which might be an indication of cancer. LDH does not diagnose mesothelioma, however it does serve as a predictive factor.

Video: How is Mesothelioma Diagnosed?

Staging Mesothelioma

Once a mesothelioma diagnosis is confirmed, doctors will determine the stage of the cancer. Staging helps determine the extent of cancer spread and guides treatment decisions. 

The most commonly used staging system for pleural mesothelioma (the most frequent type) is the American Joint Committee on Cancer (AJCC) TNM staging system. 

This system considers three key factors:

T (Tumor): This refers to the size and location of the primary tumor.

N (Nodes): This indicates whether cancer has spread to the lymph nodes.

M (Metastasis): This determines if the cancer has spread to distant organs beyond the lungs and nearby lymph nodes.

Based on these factors, mesothelioma is assigned a stage ranging from I (early stage) to IV (advanced stage). 

Here's a breakdown of the typical staging system for pleural mesothelioma:

Stage I: The cancer is confined to the pleura lining the lungs.

Stage II: The cancer has spread to nearby lymph nodes.

Stage III: The cancer has spread to more extensive lymph nodes or involves the diaphragm or chest wall.

Stage IV: The cancer has spread to distant organs, such as the liver, bones, or other parts of the lining of the organs (peritoneum).

Other Staging Systems

It's important to note that other staging systems may be used for mesothelioma in some cases, such as the Butchart system.  Your doctor will explain the specific staging system used for your diagnosis and its implications.

Importance of Staging

Staging plays a crucial role in mesothelioma management for several reasons:

Treatment Planning: Knowing the stage of mesothelioma helps doctors tailor treatment options to your specific needs. Treatment options for early-stage mesothelioma may differ significantly from those for advanced-stage disease.

Prognosis: Staging can provide an estimate of your prognosis, which is the predicted course of the disease. This information can help you make informed decisions about your treatment plan and future care.

Clinical Trials: Participation in clinical trials for newer treatment approaches may be an option depending on the stage of your mesothelioma.

Additional Tests for Staging

Following the initial diagnosis and biopsy, your doctor may recommend additional tests to determine the stage of mesothelioma. These may include:

Blood tests: Certain blood tests can help assess your overall health and identify potential complications.

Bone scans: If there's a concern about mesothelioma spreading to the bones, a bone scan can be used for detection.

Coping with a Mesothelioma Diagnosis

A mesothelioma diagnosis can be overwhelming and frightening.  However, there are resources and support systems available to help you navigate this challenging journey. 

Here are some tips for coping:

Educate yourself: Learn as much as possible about mesothelioma, including treatment options and support services. This knowledge can empower you to make informed decisions about your care.

Seek support: Talk to your family and friends about your diagnosis. Support groups specifically for mesothelioma patients can connect you with others who understand what you're going through.

Consider counseling: A therapist or counselor can help you cope with the emotional impact of a mesothelioma diagnosis.

Maintain a healthy lifestyle: Eating a balanced diet, exercising regularly, and getting enough sleep can help you manage the physical and emotional challenges of mesothelioma.