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80-year-old deceased mesothelioma victim (Florida resident) who was exposed to asbestos through his work for several decades as a water sewer-works pipe layer and fitter

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Mesothelioma Diagnosis

How Is Mesothelioma Diagnosed?

It is important to talk with an medical professional if you believe you have symptoms of mesothelioma. This rare, potentially deadly cancer is caused by exposure to asbestos fibers. Until the 1980s when asbestos was finally banned from U.S. manufacturing, many were exposed to large quantities of asbestos in their workplaces.

Even today, construction workers and others working around pre-1980s products could be exposed to asbestos. It is important to speak with your doctor if you or a loved one has been exposed.

Doctors can use various tests to diagnose mesothelioma, in addition to a thorough physical. These tests vary in effectiveness.

Tissue Biopsy

A tissue biopsy involves removing a sample of a suspicious area to be tested for risk of cancer in a laboratory. It is a very common form of cancer testing.

Doctors utilize three different types of biopsies to confirm or eliminate the possibility of mesothelioma:

  • Open biopsies are conducted under general anesthesia. Your doctor will remove tissue from the area of concern.
  • Closed biopsies involve a tiny cut through which the doctor inserts a scope. There is a very short recovery time in these types of procedures.
  • Needle biopsies require removal of tissue through a syringe using X-ray imaging / CT scans for precision.

Effusions / Cytology

Cytology is the section of pathology dealing with diagnoses of conditions and diseases based on the study of cells based on tissue samples. In a traditional biopsy, a sample of tissue up to several inches long is taken. Cytology specimens are typically much smaller and may consist of as little as a single drop of tissue fluid or blood. These samples are used for diagnosis and screening purposes.

A cytology specimen can reveal mesothelioma before symptoms have begun, which is important for two reasons:

  • Typically, by the time symptoms develop, the mesothelioma has already advanced dangerously.
  • Treatment for mesothelioma cancer is much more effective if the cancer is caught early.

Cytology vs. Biopsy

There are many benefits in favor of cytology screenings:

  • They are less expensive
  • They are much less difficult to obtain than biopsies
  • They are less painful
  • They have less risk of injury or side effects

However, cytology is not has accurate as a traditional biopsy. It’s important to speak with your doctor about your individual needs and what is best for you.

PET Scans

PET scans are most effective tools for staging the development of the mesothelioma and determining how effective treatment will be. Images from a PET scan will show metastasizing or malignant mesothelioma tumors, including developing cancer on the lymph nodes. This form of imaging can be used to determine if chemotherapy or other forms of treatment are working.

CT Scans

A computed tomography scan (CT scan or CAT scan) is a three-dimensional image of the inside of your body. An X-ray takes one image, but a CT scan compiles numerous cross-sectional pictures that are then combined by a computer to create a fuller picture. It provides views of any unusual, abnormal, or concerning growths, including cancer.

For pleural mesothelioma, CT scans are the preferred test, as these images can pick up evidence of pleural thickening.


Mesomark is a tool that can be used in diagnosing and monitoring the development of mesothelioma. It is a blood test that measures soluble mesothelin-related peptides or SMRPs, in an individual’s blood. SMRPs can be used as a telltale sign of malignant pleural mesothelioma. Mesomark is available commercially and was the first blood serum-based test designed with mesothelioma sensitivity to receive approval from the United States Food & Drug Administration (FDA).

Not all mesothelioma tumors release SMRPs. For this reason, doctors typically will use a secondary form of testing in conjunction with the Mesomark test, as per FDA recommendations. Mesomark can also be effective in staging mesothelioma.

In addition to SMRPs, other biomarkers that may be used by a doctor to monitor mesothelioma include:

  • Estrogen Receptor-β, or ER-β
  • Epidermal Growth Factor Receptor, or EGFR
  • 80HdG
  • Platelet Derivative Growth Factor, or PDGF

Early Diagnosis Is Key

Symptoms of mesothelioma may not become apparent until as much as 50 years post-exposure. The important thing is to make sure that you are taking action to protect your health. Diagnosis of mesothelioma can be difficult. Other, common forms of cancer can easily be mistaken for mesothelioma. You should be sure to tell your doctor about your history of asbestos exposure so that your doctor is aware of the option of mesothelioma from the start.

Doctors use four stages to determine the progression of mesothelioma cancer and its severity:

  • Stage I Mesothelioma – The earliest, least serious stage. At this, point tumors have not spread too far, only reaching one layer of the pleura and potentially the lining of the heart and diaphragm on that side. Stage I is difficult to catch because symptoms have not developed in most cases. Doctors will usually recommend curative surgery followed by aggressive chemotherapy / radiation treatment.
  • Stage II Mesothelioma – Even at this stage, symptoms are hard to catch, and may easily be mistaken for other respiratory conditions. Tumors have begun to spread.
  • Stage III Mesothelioma – By Stage III, the cancer has most likely reached several locations in the body—muscles, ribs, heart, chest wall, lymph nodes—but all on the same side of the body where it was originally developed. Doctors will recommend, in most cases, palliative options at this advanced point.
  • Stage IV Mesothelioma – Due to the difficulties inherent in diagnosing mesothelioma, unfortunately one in three mesothelioma patients will not be diagnosed until Stage IV. At this point, the cancer has advanced severely and surgery will most likely not be an option.

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