Mesothelioma is a rare, aggressive form of cancer that develops primarily in the lining of the lungs (pleura), of the abdomen (peritoneum) or of the heart (pericardium). The only known cause of mesothelioma is exposure to asbestos. Visible symptoms of the disease generally do not occur until 15-50 years after exposure. Patients with mesothelioma typically present with advanced symptoms, including shortness of breath, lower back pain, trouble swallowing, swollen arms and face, pain in the chest or abdomen or some combination thereof. Often, patients present with an effusion, which is an abnormal build-up of fluid between the two thin layers of the lining of the lung or the abdomen. Diagnosis of mesothelioma is complex and generally involves a series of testing procedures before the cancer is confirmed.
Initial Tests of Patients With Abnormal Lung or Abdominal Symptoms
Typically, when a patient presents with these symptoms (which are also common to the flu, pneumonia or other respiratory or abdominal ailments), a doctor will put the patients through a series of tests. Usually the first will be some form of imaging study such as an X-ray, CT scan or a PET scan. A radiologist cannot definitively diagnose mesothelioma from any type of imaging study. However,imaging will often reveal some occlusion or abnormal build-up of fluid (an effusion) in the chest cavity or abdomen that a radiologist may consider to be suspicious of mesothelioma, particularly if the patient presents with difficulty breathing or pain in the abdomen.
Because a persistent effusion with atypical mesothelial cells is generally suggestive of mesothelioma, the radiologist or the doctor in charge will initiate the next diagnostic step, usually cytopathological testing (also known as cytology). Cytology is the study of cell structure and their function. Mesothelioma cytology, therefore, is a procedure to evaluate the behavior of mesothelioma cells that are in an abnormal fluid build-up. To perform cytology, a doctor withdraws a sample of the abnormal fluid. Using a minimally invasive biopsy procedure called a thoracentesis (the removal of fluid in the lung lining) or paracentesis (the removal of fluid in the abdominal lining), the doctors use a small needle to collect samples of the fluid. Both procedures are relatively quick and virtually painless. Typically, patients can resume their normal activities immediately after either procedure.
A pathologist prepares slides from the fluid samples. He then dips the slides into a collection of stains, or chemical dyes. Each type of stain causes a reaction that changes the cell’s color. When a pathologist examines the cells on the slides under the microscope and compares them to samples of confirmed cancerous cells, he is able to determine whether the fluid sample contains, or does not contain,cancerous mesothelioma cells,thereby reaching a differential diagnosis.
However, because each cancerous mesothelioma cell type can have a different shape, size and appearance, the diseased cells can often resemble cancers other than mesothelioma. For this reason, cytology is not always a means of definitively diagnosing mesothelioma. Only by conducting a full out biopsy of the affected tissue can a pathologist definitively identify mesothelioma cells. Even so, cytology is a frequently sufficient to reach a diagnosis without a biopsy, particularly where the patient has epithelial mesothelioma.
There are three types of mesothelioma that a patient can have–epithelial, biphasic and sarcomatoid. Epithelial mesothelioma is the most common, making up about 50% to 70% of the approximately 3,000 mesothelioma cases that are diagnosed each year. The second type of mesothelioma, biphasic, consists of a varying combination of epithelial cells and sarcomatoid cells. Biphasic mesothelioma make up approximately 20% of those that present every year. The third type, sarcomatoid, is the less common, constituting 5% to 10% of all mesotheliomas diagnosed in any year. It is the most virulent and is fatal, with some cases being more aggressive with patients having shorter life-expectancies. Published studies reveal that patients with epithelial mesothelioma have a better prognosis that either of the other two types. Sarcomatoid has the worst prognosis and is usually the most difficult to treat.
Contact Stern Law, PPLC
At Stern Law, PPLC we appreciate how difficult a diagnosis of mesothelioma can be. We can help. For decades, we have successfully represented other mesothelioma victims and want to help you as you deal with this disease. To schedule a free consultation, contact us at (844) 808-7529 to learn more about available legal rights and options. You and your loved ones may be entitled to significant compensation. We are ready to make a difference, so don’t wait-pick up the phone and call us.