Mesothelioma - A difficult disease to diagnose

The initial symptoms of mesothelioma are fairly non-specific in nature and can be mistaken for other conditions such as persistent pneumonia or gastronomical disorders.  Some patients exhibit no symptoms at all so evaluation and diagnosis is often delayed.   When diagnosing mesothelioma, physicians need to use a review of the patient’s medical history and must taken into account any past exposure to asbestos.

A complete physical examination, including the use of imaging techniques, x-rays, CT scans and MRI scans, is necessary for a firm diagnosis.  It will often be necessary for a thoracoscopy or peritoneoscopy to be performed.  These procedures involved the use of a fibre optic imaging tool which is inserted into the patient through a small incision and will give a closer look at the body cavity and any abnormal tissue of fluid build up.

In addition to this, a doctor may perform a biopsy of any abnormal tissue discovered during investigations.  Pathological examination of the abnormal tissue and fluid can then take place and this is still the only effective method of confirming the diagnosis of mesothelioma.

Mesothelioma is most commonly found in those who worked in industries which had heavy exposure to asbestos up until the 1980s (engineering, shipbuilding and power generation).  However, because asbestos was not totally banned in the UK until 1999 and was widely used in the construction industry, construction workers are also at risk of developing the disease.

Once a confirmation of malignant mesothelioma is established, physicians will need to conduct more tests to determine the extent to which the disease has spread.  This is known as a staging process and the disease can be broken down into four distinct stages:

• Stage 1:  localised malignant mesothelioma in which cancer is present in either the right or left pleura and may involve the lung, the pericardium or diaphragm on that side.
• Stage 2:  advanced malignant mesothelioma in which cancer has spread beyond the right or left pleura to the lymph nodes on that side – this may also involved the lung, pericardium or diaphragm on that side.
• Stage 3: advanced malignant mesothelioma in which cancer has spread into the chest wall, diaphragm, ribs, heart, oesophagus or through the abdominal lining.  Nearby lymph nodes may or may not be affected.
• Stage 4: advanced malignant mesothelioma in which cancer shows evidence of metastasis or spread through the bloodstream to distant organs or tissues.

Because asbestos still remains in so many buildings constructed before the total ban, asbestos still presents a real risk in all parts of the UK.  The health industry is forecasting a peak in the diagnosis of mesothelioma due to asbestos exposure over the coming 20 years, so asbestos is sure to hit the headlines again in the future.  However, with increasing awareness and government legislation, compensation claims for those affected by this deadly disease are becoming easier to administer.