Diagnosis of
Mesothelioma
Only
a physician can properly diagnose mesothelioma.
A review of the patient's medical history, including any past exposure to asbestos, should be conducted for any
patient displaying dyspnea, chest pain, fluid build-up, or pain and/or swelling
in the abdomen. This review is followed up with a complete physical examination, which should involve the use of imaging
techniques. X rays, computed tomography (CT) scans, and magnetic resonance
(MRI) scans of the chest and/or abdomen, as well as lung function, can provide
the doctor with critical diagnostic information. Although positron emission
tomography scans are expensive and not covered under most insurance, this
diagnostic tool has proven very useful in determining tumor sites and staging
of the disease.
If
indicated, the doctor may wish to internally examine the patient's chest and/or
abdominal cavity. These diagnostic procedures, known as thoracoscopy (chest) and peritoneoscopy (abdomen), are usually
conducted in a hospital setting. Both procedures involve a fiber-optic imaging
tool being inserted into the patient through an incision. These endoscopic
tools will provide the doctor with a closer look at the body cavity, and any
abnormal tissue or fluid build-up found therein. Excess fluid can be suctioned
out through a needle or tube, in a process known as thoracentesis (for the chest) or paracentesis (for the abdomen). Additionally, the doctor may
perform a biopsy of any abnormal tissue they discover during this time.
Pathological examination of abnormal tissue, as well as fluid, remains the only
effective method of confirming the diagnosis
of mesothelioma. Biopsy will also assist the doctor in properly staging the
disease's progression.
Once
a confirmation of malignant mesothelioma has been established, the doctor will
conduct further tests to determine the extent to which the primary disease has
spread. This diagnostic process is known as "staging." Malignant pleural mesothelioma of can
be broken into four stages:
- Localized Malignant Mesothelioma (Stage 1)—Cancer is present in the right or left
pleura. May involve the lung, the pericardium, or diaphragm on that side.
- Advanced Malignant Mesothelioma (Stage 2)—Cancer has spread beyond the right or left
pleura to lymph nodes on that side. May involve the lung, the pericardium,
or diaphragm on that side.
- Advanced Malignant Mesothelioma (Stage 3)—Cancer has spread into the chest wall,
diaphragm, ribs, heart, esophagus, or through the abdominal lining. Nearby
lymph nodes may or may not be involved.
- Advanced Malignant Mesothelioma (Stage 4)—Cancer shows evidence of metastasis or
spread through the bloodstream to distant organs and/or tissues.
Recurrent malignant
mesothelioma may also occur, where the cancer returns in its original
location or elsewhere in the body even after treatment.
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