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Diagnosis and Treatment of Mesothelioma

written by: Emma Lloyd • edited by: Leigh A. Zaykoski • updated: 6/30/2009

Mesothelioma is difficult to diagnose, due to the latency of the cancer and the non-specificity of symptoms. This type of cancer spreads aggressively and is resistant to many types of chemotherapy, which both limits treatment options and makes effective treatment difficult.

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    Mesothelioma Diagnosis

    The latency period of mesothelioma is commonly between three and five decades. This means it can take up to fifty years for symptoms to appear after initial exposure to asbestos. This fact alone can make mesothelioma diagnosis difficult, and the problem is compounded by the fact that many symptoms of mesothelioma are non-specific. As a result, pleural mesothelioma, for example, can be misdiagnosed as lung cancer or even pneumonia.

    The advent of diagnostic tests that specifically test for mesothelioma has made diagnosis of the cancer easier and less prone to error, but these tests themselves are still not entirely foolproof. In the absence of specific mesothelioma tests, diagnosis is made on the basis of symptoms and medical history. Most important is whether or not a patient can remember a history of asbestos exposure. Often this is a simple matter, as certain types of jobs are risk factors for exposure. Sometimes, however, determining a history of exposure is not so easy, as in cases where secondary asbestos exposure has occurred.

    Symptoms of pleural mesothelioma include pain in the chest wall, fluid in the lungs, shortness of breath, wheezing or coughing, fatigue and anemia, and blood in the sputum.

    In the case of peritoneal mesothelioma, symptoms often do not appear until the cancer is at a late stage. Possible symptoms include pain in the abdomen, abdominal swelling, unexplained weight loss, and bowel function problems. In later stages masses may be palpable in the abdomen.

    Pericardial mesothelioma is particularly difficult to diagnose due to the rarity of the condition and the fact that symptoms are similar to those of other cardiac conditions. Possible symptoms include heart arrhythmia or palpitations, chest pain, cough, fatigue, night sweats, and difficulty breathing.

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    Treatment for Mesothelioma

    Mesothelioma treatment falls into three categories: surgery, chemotherapy, and radiotherapy. Typically at least two of these treatments are carried out in conjunction with one another. This usually involves surgery to remove tumors, followed by radiotherapy or chemotherapy to remove any remaining cancer cells.

    In general, pleural mesothelioma is the least problematic to treat, simply because this is the most common type of mesothelioma, and more is known about the condition. In contrast, pericardial mesothelioma is the most difficult to treat. This is partly due to its rarity, but is also simply because the heart is involved, making surgery and radiotherapy risky.

    For all three types of mesothelioma, however, the prognosis is generally poor. Mesothelioma spreads aggressively, and in many cases diagnosis is made too late for curative treatment to be possible.