Written by Jenna Campagna, RN
If a patient experiences mesothelioma symptoms, there are several tests and procedures to determine the cause. However, a specialist is not normally required for a mesothelioma diagnosis. If you notice symptoms commonly associated with mesothelioma, contact a doctor immediately for mesothelioma testing.
How Is Mesothelioma Diagnosed?
Mesothelioma is diagnosed through a number of imaging and blood tests, followed by a biopsy. General doctors sometimes examine how to test for mesothelioma without a biopsy. Receiving a tissue biopsy is the most definitive diagnostic method.
People with a history of asbestos exposure are at risk of developing mesothelioma. However, not everyone who interacted with the mineral will end up with the rare cancer.
Patients experiencing mesothelioma symptoms such as coughing, shortness of breath or chest pains should visit their doctor and explain the symptoms along with their asbestos exposure incidents. After seeing a physician, the mesothelioma testing process determines the causes of these symptoms and a treatment plan.
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Imaging tests are the first step in a mesothelioma diagnosis. These mesothelioma tests show the presence of abnormalities. This helps doctors know the tumor location, size and level of advancement. Each imaging mesothelioma test has its own purpose and helps doctors make an accurate mesothelioma diagnosis.
Blood Tests and Biomarkers
Blood and biomarker tests allow physicians to test the blood levels of a patient. They are a different type of mesothelioma testing. While these tests are not usually used in a mesothelioma diagnosis, they can help monitor the efficacy of treatment.
The levels of fibulin-3, cancerous antigen 125, osteopontin and soluble mesothelin-related peptides (SMRP) are commonly higher in mesothelioma patients than they are in people without the cancer. Doctors compare the levels of these substances in people who have mesothelioma to that of baseline levels, information which could impact future treatment.
Some physicians use the Mesomark test, which is a blood test used to monitor a patient’s SMRP level. When the SMRP level is higher than the baseline level or has not decreased since the last Mesomark test, it's likely that treatment for the patient has not worked. However, if the SMRP level decreased since the most recent mesothelioma test, then doctors likely will continue with the treatment used to that point.
A biopsy involves the extraction and examination of tissue or fluid from the body. By examining this sample, doctors can determine if cancer cells are present. This is the only way doctors can make a conclusive mesothelioma diagnosis. It’s considered the final mesothelioma test in the diagnostic process.
The histological makeup of the cancer can also be determined by examining the microscopic structure of the tissue. Certain cellular makeups respond differently to different treatment plans. There are also different types of biopsies, such as surgical biopsies or needle biopsies.
Doctors use surgical biopsies to extract tissue from a patient. The tissue sample is sent to a pathologist to examine for the presence of mesothelioma. This procedure is done using traditional surgical methods, needle biopsy or camera-assisted surgery. The various biopsy procedures include:
Non-surgical biopsies take built-up fluid samples from the lungs, abdomen or heart. Doctors use a needle to extract the fluid and examine it for the presence of mesothelioma cells. If cancer exists, the fluid may also determine the type of cancer. This method is less invasive than surgical biopsies, but it is not as conclusive and does not allow doctors a firsthand look at the tumor.
Histopathology and Cytology Reports
Due to mesothelioma’s rarity, many doctors have not encountered the cancer and can’t give an accurate mesothelioma diagnosis. This results in a high percentage of misdiagnosis when compared to other cancers. It is commonly misdiagnosed because the symptoms are typical to illnesses such as the common cold, flu and pneumonia. To prevent misdiagnosis, patients should seek a second opinion from a doctor or contact a mesothelioma specialist.
Misdiagnosis also occurs in two other ways. Pathologists with limited or no experience in distinguishing cancer types may mistake mesothelioma for other lung or abdominal-region cancers. Even if a patient has a history of asbestos exposure along with the symptoms of mesothelioma, their doctor may say the patient does not have mesothelioma.
Mesothelioma is also often staged incorrectly, resulting in limited treatment options for patients. If this occurs, the patient should consider getting a second opinion.
Multi-year survivor Alexis Kidd was almost diagnosed with a terminal prognosis until seeing additional specialists. They revealed that her mesothelioma diagnosis was treatable. She was initially staged at Stage 4.
However, the team of doctors determined it was not Stage 4 and that her case was unusual. This change opened up new treatment options. Since mesothelioma is such a unique illness, many doctors don’t have the experience needed to treat it.
“For me, having it diagnosed was just the first step, and getting a second opinion gave me new options as I entered treatment.”
— Alexis Kidd
Alexis Kidd received a mesothelioma diagnosis and followed up with a second opinion. She put herself in a better position by staying on top of her own health care and requiring confirmation from a specialist. Take control of your health care and get a second opinion from a specialist by using our free Doctor Match program.
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Mesothelioma Diagnosis for Veterans – Getting a Second Opinion
Most veterans will see a general oncologist within the Veterans Affairs (VA) system first. Since these doctors aren’t experienced in distinguishing mesothelioma from other diseases, it is important that veterans using the VA get a second opinion from a mesothelioma specialist. A general oncologist may consider a veteran’s disease to be inoperable or suggest the wrong treatment because of a lack of experience with mesothelioma.
Many times, once a veteran sees a specialist, they learn they are eligible for more treatments than they previously thought. Additionally, there are two top mesothelioma treatment centers in the VA health system that rival the best treatment centers in the country. These centers are located at the Boston VA and Los Angeles VA.
Treatment After Mesothelioma Diagnosis
After doctors have confirmed a mesothelioma diagnosis, they create a treatment plan for the patient. This mesothelioma treatment plan is tailored to each patient and their unique diagnosis. Surgery is usually used in patients with early stage mesothelioma.
Even if a patient has late-stage mesothelioma, the surgeon may feel confident they can remove all of the cancer without any life-threatening side effects. One major issue with surgery for late-stage mesothelioma patients is the tumor has likely spread beyond the point of origin and to other vital organs. Attempting to remove the tumor in this scenario would require removing the affected organs, which is not doable.
Chemotherapy and radiation are also common treatment options. Multimodal treatment involves multiple types of treatment methods and has shown promising results.
In most cases where a mesothelioma patient survives beyond the expected prognosis, their treatment involved a combination of chemotherapy, radiation and surgery. Learn more about how you can beat the odds after your mesothelioma diagnosis in our free Mesothelioma Survivor’s Guide.
Last Edited: June 22, 2020.