DIAGNOSIS, STAGES & PROGNOSIS

Diagnosis
Stages of Mesothelioma
Types of Mesothelioma
Prognosis

DIAGNOSIS OF MESOTHELIOMA
Like most cancers, malignant mesothelioma is best treated when it is diagnosed early.
Diagnosing mesothelioma can be very difficult. Because the onset of the disease is very slow and the symptoms are not specific to mesothelioma, frequent and in-depth testing must be done before a solid diagnosis is reached. As a first step in diagnosing the disease, the doctor will ask for your complete medical history to check for risk factors and symptoms, and then a physical exam will be given. Your doctor may order a number of different tests to help discover if and where mesothelioma is growing.

Symptoms of Mesothelioma
The symptoms of this disease are not specific, so doctors often have a hard time diagnosing mesothelioma. Therefore, they rely on a patient’s history to lead them toward a correct diagnosis. If you have ever been exposed to asbestos, no matter how long ago, you should be tested regularly for mesothelioma. Any one of the following symptoms, or combination of, could mean you have contracted the disease:

Diagnostic Tools
An x-ray is often the first indication of mesothelioma. Although mesothelioma typically cannot be seen on an x-ray, the tumor often causes a pleural effusion, or fluid collection between the lungs and chest wall. This abnormal finding is associated with shortness of breath and warrants clinical follow-up. For confirmation of the disease a pathology specimen from a biopsy or operation is usually required.

Some examples of other diagnostic tools used:

Peritoneoscopy
The doctor may look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is also usually done in the hospital. Before the test is done, a local anesthetic will be given.

Thorascopy
A test called a thorascopy uses an instrument called a thorascope to look inside the chest cavity. A cut is made through the chest wall and the thoracoscope is then put into the chest between two ribs. Before the test, the patient will be given a local anesthetic (a drug that causes a loss of feeling for a short period of time). Some pressure may be felt, but usually there is no pain.

Biopsy
If tissue that is not normal is found, the doctor will need to cut out a small piece and have it reviewed under a microscope to see if there are any cancer cells. This is called a biopsy. Biopsies are usually done during the thoracoscopy or peritoneoscopy.

Digital Imaging
X-rays, chest CT-scans and MRIs are common tools doctors use for diagnosis of mesothelioma.

One reason mesothelioma is such a dangerous form of cancer is because by the time it is diagnosed, it has often progressed rapidly. That is why it is so important to see a doctor as soon as possible if you have been exposed to asbestos, or experience any of the common symptoms.

STAGES OF MESOTHELIOMA
Staging is the process of finding out how far the cancer has spread. The treatment and outlook for patients with mesothelioma largely depends on the stage of their cancer.
Mesothelioma advances in 4 main stages:

Stage I: The cancer is found in the lining of the lung and usually limited to only one side of the chest
Stage II: The cancer has spread to other organs within the chest cavity, such as the heart or lymph nodes
Stage III: The cancer expands to the other side of the chest, or it spreads into the abdominal organs. The lymph nodes outside the chest affected.
Stage IV: The cancer spreads to different parts of the body beyond the chest area (liver, brain, bone, etc…)

TYPES OF MESOTHELIOMA
The three types of mesothelioma are labeled as pleural, peritoneal, and pericardial. By far the most common mesothelioma is diffuse malignant pleural mesothelioma. The pleura is a thin membrane found between the lungs and the chest cavity. It provides a lubricated surface so that the lungs do not chafe against the chest walls. A pleural mesothelioma is often referred to as a "lung" cancer. This type of tumor is invasive and very aggressive. It spreads quickly over the surface of the lungs, abdominal organs or heart. Life expectancy for victims of this disease typically ranges between four and twenty-four months, depending on the stage at which the disease is detected, the relative health and strength of the patient, and a variety of other factors.

Another form of mesothelioma is peritoneal mesothelioma. The peritoneum is the membrane that encloses the organs of the abdomen. While peritoneal mesothelioma is less common than pleural mesothelioma, it tends to be more invasive and usually results in a shorter life expectancy for the patient. In pericardial mesothelioma, the least common form of the disease, the cancer cells attack the lining of the patient’s heart.

PROGNOSIS:
Mesothelioma is a terminal disease and there is currently no cure. Because of the rapid spread of this type of cancer, the estimated life span is typically 24 months after diagnosis. If the cancer is detected early and treated aggressively, about 50% of those patients reach the two-year mark, and about 20% survive five years. Factors such as the health of the patient, amount of asbestos exposure, and the stage of the disease are factors in the progression of the disease.

When a person is diagnosed with mesothelioma, he or she should begin to learn all they can about their disease and the treatments available so they can take an active part in decisions about their care. Your doctor is the best person to answer questions and concerns about treatment, such as what the treatment options are, how well they might work, and what the risks and side effects may be. You can also visit our Resources page for a list of links that can help you learn about mesothelioma and your treatment options.

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