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Diagnosing Mesothelioma

As advocates for victims of mesothelioma, the lawyers at Brookman, Rosenberg, Brown & Sandler not only provide legal representation, but often support their clients and their loved ones through the physically- and emotionally-draining progression of the disease. We understand the importance of early diagnosis and proper treatment to improve survival rates and the quality of life for those suffering from this devastating cancer. Our firm provides the information below about diagnosing mesothelioma, but researchers and scientists are continually working to develop new diagnostic tools as well as treatments, and individuals with a history of asbestos exposure should consult with a physician. Steps to Take After a Diagnosis of Mesothelioma

Early Diagnosis of Mesothelioma is Critical

Mesothelioma is a difficult disease to diagnose because the symptoms mimic those of so many other illnesses.  There is a long latency period associated with mesothelioma that also makes it difficult to diagnose in its early stages.  Patients may not experience any symptoms of the disease for 20 to 50 years after the initial exposure to asbestos.  Typically, when patients begin to experience signs of the disease, the mesothelioma has already progressed to more advanced stages.  Symptoms include shortness of breath, chest pain, lower back pain, persistent cough, fever, nausea, difficulty swallowing, heart palpitations, loss of appetite, night sweats and weight loss.

Patients being evaluated for a potential mesothelioma diagnosis will often undergo several the procedures  in order to make a definitive diagnosis.  Theses diagnostic tests are often used in conjunction with one another to give physicians a clear and accurate picture .  Early detection of mesothelioma gives patients the best chances for survival by increasing the opportunities for effective treatment and improving their quality of life while battling this horrible disease.   Like most other cancers, mesothelioma is diagnosed in stages that are defined by the extent of the disease.  There are four stages with stage 1 being considered a localized cancer that has not spread leading up to stage 4 that indicates an advanced case of cancer with extensive metastasis.  These stages help to determine which treatment options are available to the patient.

Diagnostics Tests and Procedures

Physical Examination and Complete Medical History

One of the most important diagnostic tools for making an accurate diagnosis of mesothelioma is a detailed medical and occupational history provided by the patient.  This would include any past history of asbestos exposure and all the details surrounding that exposure including when and where it occurred as well as the duration of exposure.  A thorough physical examination is also necessary to look for any signs and symptoms of the disease including examinations of the lungs, heart and abdomen.

Imaging Studies

Traditional X-rays:  This is often the first imaging study that is utilized when diagnosing mesothelioma.  An x-ray can reveal the presence of fluid in the lungs or the existence of a tumor.  These x-rays usually focus on one specific area of the body and cannot show the full extent of tumor growth.

Positron Emission Tomography Scans (PET):  In this nuclear medicine procedure, patients are given an injection of a small amount of a radiotracer, which is a type of radioactive material.  PET scans are useful at differentiating cancerous from noncancerous cells because the cancer cells will absorb the radiotracers and show up on the scan as bright white hot spots.  PET scans can detect cancer including mesothelioma in its early stages, sometimes before a patient shows any signs of illness, and will show evidence of metastasis.  The images from a PET scan are not as detailed as those of the CT scans and MRIs; therefore, they are used as a supplement to those tests.

Computed Tomography Scans (CT):  CT scans  show more detailed internal images of the body when compared to the traditional x-rays.  The exact location of a tumor can be determined as well as the size of the tumor.  The CT scan images can also reveal whether mesothelioma has metastasized or spread to other parts of the body.  Undergoing a CT scan is a noninvasive and painless procedure that only takes a short amount of time but can provide valuable information.  Patients are sometimes asked to drink a contrast dye several hours before the procedure, and may be asked to hold their breath for a few seconds during the procedure in order to improve the quality of the images.

Magnetic Resonance Imaging (MRI):  During this scan some  patients are given some contrast prior to the test to enhance the images. The MRI images allow physicians to differentiate cancerous tissue from normal tissue and also help to establish the staging of the mesothelioma. Determining the stage is important medical evidence that allows physicians to determine the proper course of treatment and  if surgery is an option.


This is a diagnostic procedure in which a surgeon removes a small amount of fluid or tissue from the tumor site.  The cells are then analyzed under a microscope to determine whether the tumor is cancerous or noncancerous as well as what specific type of cancer the patient has.  There are various methods in which a biopsy can be performed.

Needle Biopsy:  During this procedure, a long, thin hollow needle is inserted through the skin into the chest or abdomen to obtain a fluid sample that is then analyzed in a pathology lab.  Any excess or build-up of fluid can also be drained.  This is considered a non-invasive procedure with patients  requiring a local anesthetic.  This diagnostic test can be done in a physician’s office or the hospital and does not require a hospital stay.  There are several different needle biopsies depending on which form of mesothelioma is suspected:

  • Thoracentesis:  performed when patients show signs of pleural mesothelioma.  This procedure involves the removal of excess fluid from the space between the lungs and chest wall called the pleural space.  The fluid is sent to the lab for testing.
  • Paracentesis:   performed when doctors suspect that a patient may have peritoneal mesothelioma.  This procedure involves the removal of excess fluid from the abdominal cavity which is then analyzed in a lab.
  • Pericardiocentesis:  performed when patients show symptoms of pericardial mesothelioma.  Fluid is removed from the sac that surrounds the heart and sent to the lab for tests.

Endoscopic Biopsies:  Endoscopic biopsies involve the process in which small surgical incisions are made in the chest or abdomen and a fiber-optic imaging scope or tube is inserted to allow physicians to get an inside view of the chest or abdomen.  A sample of tissue is obtained for further analysis.  A thoracoscopy refers to the process of examining the tissue in the chest and a peritoneoscopy or laparoscopy refers to the method of examining tissue from the abdomen.  A mediastinoscopy looks at the center of the chest around the heart, the area in front of the lungs and lymph nodes located in the mediastinum.  These diagnostic procedures are done in the operating room under general anesthesia.

Open Biopsies:  Open or surgical biopsies are extensive and invasive procedures performed under general anesthesia when a large sampling of tissue or even a portion of the tumor is needed to confirm a diagnosis.  When an incision is made in the chest wall to acquire a tissue sampling, the procedure is called a thoracotomyIf the incision is made in the abdomen, it is known as a laparotomy.

Blood Tests

Blood tests can be used in conjunction with other diagnostic tests to monitor the progression of the disease and to determine if the disease is responding to treatment.  Much research is being directed at further developing blood tests so they can be used as diagnostic and screening tools.

Biomarker Technology:  There is a new non-invasive technology that is showing promising results in its ability to detect and identify the presence of cancer.  (Read our blog.) Biomarkers are proteins that are found in or on cells in the body.  Researchers have discovered that specific biomarkers are present in the blood when a certain disease exists in the body.  Research has found that patients suffering from mesothelioma have high levels of specific biomarkers in their blood and are often formed before symptoms appear.

  •  Fibulin-3:  Recent studies have shown that Fibulin-3 levels in blood and pleural fluid may help doctors differentiate the presence of mesothelioma from other medical conditions.  It may also help distinguish patients who have been exposed to asbestos from patients who actually have mesothelioma.  Current studies are underway to determine if Fibulin-3 can be used for the diagnosis and monitoring of mesothelioma.
  • Soluble Mesothelin-Related Peptides (SMRP):  The MESOMARK assay is the first FDA approved blood test for mesothelioma.  It is used in combination with other tests to confirm an accurate diagnosis.  It is the hope that someday it could serve as a screening tool for patients who are at increased risk of developing mesothelioma.  Cancerous mesothelial cells such as those in the linings of the chest and abdominal cavities release proteins known as soluble mesothelin-related peptides (SMRP).   These protein markers can be measured in the blood by the MESOMARK assay blood test. If there are elevated levels, a diagnosis can be confirmed.
  • SOMAscan:  A team of researchers recently discovered a panel of 13 blood proteins that are linked to mesothelioma in its earliest stages.  This test would allow individuals who have been exposed to asbestos to potentially get a diagnosis of mesothelioma in stage 1 or stage 2 of the disease thereby having the opportunity to start treatment sooner.  Ongoing research and testing is underway to improve and validate the accuracy of the test.

Contact the Philadelphia Mesothelioma Lawyers at Brookman, Rosenberg, Brown & Sandler – Dedicated to Supporting Victims Suffering from Mesothelioma

If you or someone you love has been exposed to asbestos, it is essential to not only contact a medical professional to seek a diagnosis and treatment, but also to obtain legal support from an experienced  lawyer.  The dedicated legal team of Brookman, Rosenberg, Brown & Sandler in Philadelphia can assist you in filing a mesothelioma lawsuit in Pennsylvania or New Jersey in order to obtain the financial compensation that you will need to cover the cost of treatments and to give you peace of mind in maintaining financial stability for yourself and your family.  Call our Philadelphia mesothelioma lawyers today at 1-800-369-0899 (toll free) to schedule a free, confidential consultation or contact us online.

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