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Mesothelioma Diagnosis

Within the last several years, it seems that the subject of asbestos has been in the news a great deal. One reason is that asbestos-related diseases are now prevalent, due to their long latency periods. Individuals who may have been exposed to asbestos during the 1960's and 1970's, before asbestos was banned from new construction, are only now starting to recognize unusual symptoms. It is the time when the asbestos-related illnesses of lung cancer, asbestosis and mesothelioma are starting to appear world-wide.

Initial Fears are Common

Should a person who has previously worked around asbestos experience physical signs that something is not right, their first reaction may be that they may have a fatal disease, but that's not always the case. One of the problems with diagnosing mesothelioma, or cancer of the lung lining, is that other diseases reflect the same symptoms, and an individual's symptoms may not necessarily mean cancer; their coughs, respiratory problems, stomach upset, fatigue and other symptoms may be signs of other problems. It's impossible to know without a battery of medical tests.

However, the individual should make an appointment with their primary physician as soon as it becomes clear that any unusual symptom is not going away or getting worse. Time may be of the essence, since it could take weeks to complete all doctor requested tests for a diagnosis. It could then take a few more weeks for a treatment plan to be devised, which may affect the patient's work or travel schedule, family obligations, current prescription protocol, and other factors.

The Testing Process

The preliminary visit will be like any other physical; information will be noted about the symptoms' severity and duration, and the patient's medical history, and exposure to toxic substances (such as asbestos). An exam will be done, weight and vital signs checked, and a lung capacity test may be performed. After this, the patient is usually sent for an X-ray and a few pulmonary tests.

People who are experiencing breathing problems may have abnormalities on their X-rays such as spots, fluid, calcifications, spaces between the lobes, or a thickening of the lung wall. In such cases, they are sent for a more sophisticated, 2 dimensional test called a CT scan, which stands for computer topography. With its cross sectional images obtained by rotating 180 degrees around the patient, the CT process will give the doctor a more detailed view of the varying thicknesses of bones and tissues, and can establish if the condition is due to a malignant tumor.

Should a tumor be seen on the results, or if the pictures are inconclusive, the patient is usually scheduled for an MRI, or Magnetic Resonance Imaging scan. Displaying a very detailed, 3 dimensional image, it can more clearly pinpoint the actual location of any growths, especially in the lungs. It can also be used later in a treatment plan to ascertain if a disease has continued to spread.

Both of these diagnostic tests are handled on an outpatient basis at a hospital or facility that specializes in medical imaging. Neither requires any patient preparation or anesthesia, and both are done while the patient rests on a table for about 30-90 minutes. These tests are painless, although the room may be quite chilly and noisy. (Sedatives are given if a patient has a fear of closed-in spaces, such as the typical MRI tube-like structure.)

When Abnormalities Are Found

Depending on the results of the scans, a biopsy will be performed as the final step before diagnosis. For patients who are suspected to have mesothelioma, this is usually done by inserting a long, thin needle into the lung lining and extracting fluid for examination by a pathologist under a microscope. However, some doctors skip this step and proceed right to an actual tissue sample in the belief that it's more accurate and time-saving. The tissue is obtained in one of two ways: either through a small incision called a laparoscopy (or thorascopy), or through an open lung surgical procedure. The first type of biopsy is done under local anesthesia, but the second uses general anesthesia and may require a chest tube to prevent lung collapse, as well an overnight hospital stay. Many physicians believe that the open lung biopsy allows the best tissue samples and thus the most accurate diagnosis. If mesothelioma is present, it is also much easier to determine the stage of the disease progression and the overall condition of the patient.

In some situations, there are very small tumors that are difficult to reach for analysis or removal. For these cases, Positron Emission Tomography (PET) scans can provide accurate and dependable results. It relies on tracers and cameras for a highly complex and sophisticated imaging process.

Regardless of the tests used for diagnosis, it often takes several days or longer to receive results. Yet, the reason is due to several medical professionals becoming involved with the analyzing process. Because of this teamwork, test thoroughness and accuracy can be assured. Armed with the most up to date and detailed knowledge of a patient's situation, doctors are thus better able to treat the patient as well as the disease.