Since symptoms of mesothelioma are non-specific, meaning these symptoms could be associated with other forms of diseases, diagnosing this form of cancer is often not easy. Due to lack of awareness of this fatal form of cancer a timely mesothelioma diagnosis cannot be accomplished easily.
Unfortunately, mesothelioma is mistaken for other forms of diseases since mesothelioma symptoms mimic those of more common conditions. For instance, pleural mesothelioma could be mistaken for pneumonia or peritoneal mesothelioma might be qualified as a common bowel disorder.
When symptoms are already at the onset it is important that the patient immediately checks with a physician. A detailed enumeration of symptoms and experiences of pain must be done. He or she must also share his case history of work experience or if possible, share the case history of those he/she has resided with. This must be done to check if the patient was exposed to asbestos. The doctor must also find out the timeframe of exposure.
How to Diagnose Mesothelioma
Because the latency period, diagnosing mesothelioma immediately is not always possible. Symptoms of this form of cancer only appear after 30 to 50 years after exposure to asbestos.
The doctor will ask the patient to subject himself to a series of tests. Some of which are the following:
This is the preliminary step in diagnosing mesothelioma. When a doctor suspects mesothelioma in the lungs he would advise the patient to get a chest x-ray. X-rays cannot normally show mesothelioma but it can show the following: pleural effusions (or collection of fluid around the lung), pleural thickening (thickening of the lining of the lung) and pleural-based masses (masses extending from the lung lining). A person suspected of peritoneal mesothelioma will be asked to get an abdominal x-ray.
CT SCAN (Computed Topography)
This type of scan is especially useful in determining the location, size, and extent of mesothelioma. This gives a more detailed picture of the insides of the body compared to x-rays. Combining x-rays and computers, CT scans have a rotating beam that takes a series of pictures of the body at different angles. This scan allows the radiologist to have a clearer view of the lungs and pleura.
MRI (Magnetic Resonance Imaging)
This machine uses a strong magnetic field, radio waves to scan the body. No radiation is involved in this type of test. A computer is used to generate the images of selected areas of the body. This test is used to determine ‘soft tissues’ in the body and it can show the extent of mesothelioma. It is considered to be quite clear and more superior to routine x-rays.
PET SCAN (Positron Emission Tomography)
It uses cameras and tracers that produce powerful images of the body’s biological functions. Cancers process sugars at a very high metabolic rate. PET scans are able to indicate abnormal metabolic activity and can identify exact locations of the diseases. It can also detect small cancer cells, and indicate whether it’s benign or malignant. Furthermore, it can determine if therapies are actually working.
A pathologist is performing the biopsy when tissue samples are obtained from areas of the body where cancer is suspected. These samples are examined under a microscope. There are different types of biopsies.
Thoracoscopy is done when the pericardial tumor is detected. Tissue samples are obtained from the chest cavity. When samples are obtained from the abdomen using an instrument called peritoneoscope, it is called peritoneoscopy. Pleural mesothelioma biopsies are called bronchoscopy.
Mesothelioma Life Expectancy After Diagnosis/Mesothelioma Diagnosis to Death
Mesothelioma is among the most aggressive and challenging to treat cancers, which has a poor outlook. The survival rate among those diagnosed with mesothelioma is between 12 to 21 months for most, though there are some long-term survivors. Around one fifth may live up to two years from diagnosis, while 5-10% can expect to live longer than five years. Predicting lifespan on diagnosis is difficult as several factors have to be taken into consideration.
Perhaps the most important predictor is the stage at the time of diagnosis, as the earlier it is discovered, the better the treatment can help. Thus the majority of those diagnosed at stage 1 may expect to live longer than two years, while very few would live up to 12 months if diagnosed with stage 4 mesothelioma.
Location of mesothelioma may also affect the survival rate. Individuals diagnosed with pleural (the outer layer of lungs) have a better prognosis than those diagnosed with peritoneal (abdominal), though things are changing fast.
On average those diagnosed with mesothelioma are above the age of 55 years. Usually, the prognosis is much better if diagnosed before the age of 55, while life expectancy is much shorter when the age at the time of diagnosis is older. Thus very few can expect to live longer than one year if diagnosed at the age of 65 or above.
The Most important factor in prognosis is the cell type of mesothelioma. There are three cell types of mesothelioma (confirmed by biopsy); epithelioid, sarcomatoid, and biphasic (mixed). The epithelioid form has the best prognosis, especially epithelioid mesothelioma of the peritoneal cavity (with most expected to survive more than 50 months). Sarcomatoid has the worst prognosis with the lowest chances of surviving for more than one year since the diagnosis.
Mesothelioma is more common among the men when compared to women, further, statistics also show that females have much better chances of long-term survival, they live 5-6 months longer than men.
Other factors that affect the prognosis are; history of smoking, comorbidities, the severity of symptoms.
Early Diagnosis of Mesothelioma
Early diagnosis of mesothelioma is associated with a better survival rate; however, in most cases, the disease is diagnosed in the later stages. Most of these cancers are non-symptomatic in the early stages. Thus the diagnosis is often missed, and by the time symptoms arise it is already at the 3rd or 4th stage.
Another reason for the delay in diagnosis is the rare nature of mesothelioma. It is an extremely rare form of cancer, meaning that reliable tests for early diagnosis are not available. Moreover, rare cancer means that mass screening of the population is not practicable.
However, since the introduction of “National Cancer Moonshot” by President Obama, efforts are being made to find early detection tests for mesothelioma. Several biomarkers that may help in early diagnosis have been identified, though none are yet available in the clinics for mass screening. In recent years there has been a tremendous focus on a breath test for cancer diagnosis, as it can be utilized for mass screening. There are perspectives that such tests could soon be available.