Mesothelioma is infamously hard to diagnose. There are several reasons for this, including the disease’s long latency period and extensive rarity. However, it is the nature of the symptoms that is most responsible for late stage diagnosis.
The symptoms of mesothelioma make it hard to recognize the disease for what it is early on. Distinguishing mesothelioma from other diseases requires a biopsy and pathology report to make a definite diagnosis. At this point, the minor symptoms of earlier stages have usually developed into the more serious metastatic symptoms.
First Signs of Symptoms
Initially, symptoms of mesothelioma can be relatively tame. A patient may ignore his or her symptoms until they become too unbearable, interfering with even day-to-day activities. Minor symptoms, such as shortness of breath, are often attributed to causes other than mesothelioma.
Since the disease often doesn’t develop until the age of 70, some patients may attribute their symptoms as the result of old age. Sometimes, patients don’t have any noticeable symptoms in the earlier stages of mesothelioma.
General practitioners seeing patients for the first time are unlikely to suspect mesothelioma due to the non-specific symptoms and rarity of the disease. With so many other illnesses sharing the same symptoms, the probability of symptoms being attributed to mesothelioma are extremely rare.
Imaging tests don’t always differentiate malignancies in the chest and abdomen very well, but technology has advanced in recent years. Symptoms used to be so hard to distinguish as mesothelioma that often many patients weren’t diagnosed with mesothelioma until an autopsy report was made.
Misconceptions and Misdiagnoses
When it comes to symptoms, mesothelioma mimics many other diseases and illnesses. Sometimes the symptoms are the same as a generally common, and minor, problem. For example, gas pains are similar to the abdominal pains caused by peritoneal mesothelioma.
Those with pleural mesothelioma develop a cough and shortness of breath as their first symptoms because of the scarring of the lining of the lungs. This causes the lungs to become more rigid, not expanding and contracting normally, which directly affects how much air can be breathed in.
“Part of the difficulty in making a diagnosis of mesothelioma are the subtle symptoms that a patient exhibits,” says Dr. Alexander Farivar of the Swedish Cancer Institute in Seattle. “Dyspnea, or difficulty with breathing, is the most common symptom [of mesothelioma] and that is usually due to the presence of a pleural effusion.”
It takes significant further investigation to determine exactly why these symptoms are occurring. Early on, the symptoms of pleural mesothelioma are almost the same as symptoms associated with pneumonia, COPD and even the common cold.
Pulmonary fibrosis is another ailment that can cause confusion due to the similarities between its symptoms and those of mesothelioma. Pulmonary fibrosis is the scarring and thickening of the tissue in the lungs that makes it hard to breathe.
It is caused by cigarette smoking and viral infections, among other things. It causes shortness of breath in the same way mesothelioma does, by scarring of the lung tissue, but it affects the air sacs in the lung opposed to the lining of the lung.
Peritoneal mesothelioma, which is mesothelioma of the lining of the abdomen, is also difficult to diagnose because of its symptoms. The abdominal pain caused by the disease is often confused for something like irritable bowel syndrome or gallstones. When these symptoms don’t go away, imaging tests can reveal there is more going on than what appears.
General Symptoms are the Culprit in Advanced Mesothelioma
Unfortunately, most mesothelioma diagnoses are made when the disease has already progressed to later stages. The early stage symptoms of the disease are so like other non-life threatening illnesses that it is often misdiagnosed. Despite this, patients diagnosed at a later stage still have treatment options.
New treatment options for advanced mesothelioma, those in stages 3 and 4, are being developed as part of clinical trials. The majority of these trials are designed to prevent the cancer from spreading, allowing patients to live longer with the disease.
Advances in Early Diagnosis?
The rarity of mesothelioma makes it unlikely that doctors and patients will suspect mesothelioma as the cause for their early stage symptoms. Patients who are aware of their exposure to asbestos may be able to protect themselves by informing their doctor of the exposure.
Most people aren’t aware they were exposed to asbestos. The development of early diagnoses may combat this issue. Blood and biomarker tests are slowly advancing the early diagnosis of mesothelioma.
Osteopontin and soluble mesothelin-related peptides (SMRPs) have been found in higher concentrations in the blood of mesothelioma patients and can sometimes be revealed through simple blood tests.
A biopsy is always required to get a definite mesothelioma diagnosis, but the development of accurate blood tests could change that.
“If doctors could use a diagnostic marker based on a simple blood test to help with diagnosis,” suggests Dr. Michaela Kirschner of the Asbestos Diseases Research in Sydney, “it could circumvent the problem of availability of tumor tissue and help to accelerate the diagnostic process.”