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Mesothelioma Diagnosis

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It is thought that around eight million people in the United States have been exposed to asbestos over the past half a century, and many more cases - are expected to be reported in the next 25 years.

How is Mesothelioma diagnosed?

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, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.

Your doctor will review your work history, especially whether you have worked in an industry in which you may have been exposed to asbestos.

The diagnosis of malignant mesothelioma begins with a thorough medical history to document the patient's symptoms and any possible asbestos exposure, followed by a complete physical examination. These steps generally are followed by a chest or abdominal X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) scan. The imaging studies allow the physician to assess the size, location and extent of the tumor in the chest or abdomen.

If fluid is present in the pleura or peritoneum, a thin needle may be used to collect a small sample of the fluid for examination. This procedure, called fine-needle aspiration, also may be used to drain the fluid to relieve symptoms such as chest pain and shortness of breath that can result from an effusion. Occasionally, mesothelioma can be diagnosed with this fluid sample alone, but usually a tissue sample (biopsy) is required. The tissue sample can be obtained via thoracoscopy (for a pleural tumor) or via laparoscopy (for an abdominal tumor). In both procedures, a tubelike instrument inserted through a small incision allows the physician to view the tumor and collect a tissue sample. Patients suspected of having pleural mesothelioma also may need a procedure called bronchoscopy .

Mesothelioma Staging

Once the diagnosis of malignant mesothelioma has been confirmed, the next step is determining the extent of the disease (called staging). Imaging studies, such as computed tomography (CT) and magnetic resonance imaging (MRI), allow physicians to assess the stage of the disease and determine the most appropriate treatment. The stages of malignant mesothelioma are:

  • Mesothelioma Stage I - The tumor is found in the pleura with or without some involvement of the lung, pericardium (lining of the heart) or diaphragm.
  • Mesothelioma Stage II - The tumor is found in a stage I location, plus there is involvement of some lymph nodes in the chest.
  • Mesothelioma Stage III - The tumor has extended into the chest wall, ribs or heart, through the diaphragm or into the peritoneum (the abdominal lining). There also may be involvement of the lymph nodes.
  • Mesothelioma Stage IV - The tumor has spread through the bloodstream to distant sites (that is, it has metastasized).
  • Recurrent mesothelioma - The tumor has recurred after treatment.

Stage I also is called localized disease, whereas stages II to IV are called advanced disease. Stage I disease generally has the best prognosis, particularly when the tumor is of the epithelial type.

Mesothelioma Expected Duration

Once it develops, this type of cancer will continue to grow and spread until treatment is provided.

Mesothelioma Prevention

To reduce your risk of malignant mesothelioma , you should reduce your exposure to asbestos. Because there is no safe level of asbestos exposure, any asbestos exposure is too much. Especially if you have an older home, check for areas of exposed asbestos-containing insulation or other areas of deteriorating asbestos. These areas must be removed professionally or safely sealed off. Workers who routinely deal with asbestos-containing materials should use approved measures to limit their exposure and to keep from bringing asbestos dust home on their clothing.

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