Monday, October 15, 2007

How is a Mesothelioma Diagnosis Determined?

If you've been exposed to asbestos and suspect that you may have asbestosis or mesothelioma, it's very important that you see a doctor who has experience dealing with asbestos related diseases as soon as possible. The doctor will determine a mesothelioma diagnosis by taking a full medical history and performing a series of diagnostic tests.

One of the reasons that mesothelioma is so deadly is that it is often not diagnosed until it has reached late stage malignancy. New tests and more sensitive instruments have made it possible to get a mesothelioma diagnosis earlier in the progress of the disease. As with most types of cancer, the earlier that it's caught, the more treatment options you'll have. The sooner you have a mesothelioma diagnosis, the sooner treatment can begin. Here's what you can expect if you see a doctor to pursue a mesothelioma diagnosis.

Medical History
The doctor or a nurse will take a complete medical history to determine the symptoms you're experiencing and discover any risk factors. The history will include questions about when and where you might have been exposed to asbestos in the past. Among the symptoms the doctor will be looking for are frequent, painful cough, difficulty breathing and a history of lung function problems like pneumonia, emphysema and bronchitis.

Physical Examination
The doctor will also do a physical examination to discover any symptoms of mesothelioma. The examination will include listening to your breathing and heartbeat, as well as feeling (palpating) your abdomen. Patients with mesothelioma often have fluid buildups, known as effusions, in the tissues and cavities around the heart, lungs or in the abdomen.

X-rays and Imaging Tests
The next step in making a mesothelioma diagnosis is usually a series of chest X-rays. The X-rays may show any thickening of the lung tissues, irregularities in and around the lungs and mineral deposits or calcifications on the lung or pleural tissues. X-rays will also show any fluid buildup around or in the lungs. Any of these can suggest a mesothelioma diagnosis.

The doctor may then order other imaging tests, specifically CT scans and MRI scans. Together, the CT and MRI can help doctors to locate any lesions or tumors, and determine the extent and stage of the cancer. The imaging tests will tell the doctors what they need to know to suggest a course of treatment or further diagnostic testing.

Tissue and Fluid Samples
Your doctor may also want to take samples of fluid from around your lungs, heart or abdomen to determine if there are cancerous cells in it. This is usually done by inserting a needle into your chest cavity and withdrawing a small amount of the fluid for testing. The doctor may also recommend doing this to relieve uncomfortable pressure on the lungs and make breathing easier.

If the X-rays or other images show abnormal areas, your doctor may also want to take a tissue sample to examine for cancerous cells. Getting a sample for biopsy used to invariably involve surgery, but newer methods and equipment make it possible to obtain tissue samples without actually opening your chest. Only your doctor can determine if these methods will be appropriate in your case.

A thoracoscopy is performed with the help of an instrument called a thoracoscope - a telescope like instrument connected to a video camera. The doctor will make a small incision in your chest and insert the thorascoscope through it into your chest cavity. The video camera will allow the doctor to view and examine the tumor without opening your entire chest. He or she can then use a small, specially designed forceps to collect tissue from the tumor for testing. Doctors may also use the occasion of a thoracoscopy to remove fluid surrounding the lungs or pericardium.

Two other methods use similar instruments to obtain tissue samples and view close-ups of tumors and tissue. In a bronchoscopy, the doctor will insert a flexible, lighted tube through your mouth and thread it down through your trachea into the bronchia to find any masses or growths that may indicate pleural mesothelioma. Mediastinoscopy uses a lighted tube that is inserted beneath the sternum and into the chest cavity to view the lymph nodes in that area and examine them for growths abnormal appearance. In both of those procedures, doctors can remove tissue samples for testing.

Surgery is the most invasive method used in determining a mesothelioma diagnosis, but is sometimes the only way to remove a larger sample of the tumor. In some cases, if the cancer is still localized enough, the doctors may remove the entire tumor.


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