Initial Evaluation

Your physician will complete a medical history that includes questions to help determine when and where an exposure to asbestos may have occurred. Clear communication between you and your doctor is crucial to the earliest possible detection of mesothelioma. Make certain that you have shared all relevant information regarding your previous work history and possible asbestos exposure.

In addition to constructing a medical profile and detailed medical history, your doctor will perform a complete physical examination and may look for the following:

• Breath Sounds: when listening to the chest cavity as you inhale and exhale, your doctor may note an absence of breath sounds or may find that these sounds are muted. The absence of, or muted nature of, breath sounds may be a sign of fluid in the chest cavity or of pleural effusions.
• Your doctor may listen to your chest cavity while having you make vowel sounds. He or she may compare the sound resonance in the right and left chest cavities. Muted or dull sounds between the cavities could be an indicator of a buildup of fluid.
• By percussing, or tapping, on the chest area your doctor may notice a dull, solid thumping sound, rather than a hollow resonance. This may indicate the presence of fluid, or a mass, in the chest cavity.
• Your doctor may also check for enlarged lymph nodes.

The initial physical exam may turn up very few signs that point to the presence of mesothelioma. However, your doctor may evaluate your symptoms, medical history, and the presence of specific risk factors (work environment, asbestos exposure) in combination with one or more of the methods described below to determine if the disease is present.

Diagnostic Tests

Imaging Techniques

Imaging technologies allow doctors to view, or image, organs and tissue that might show the presence of fluid or tumors.

A chest x–ray may show an unusual thickening of the pleura, lowering of the lung fissures (spaces between the lobes of the lungs), and fluid in the lungs (pleural effusion), or an irregular mass in the chest cavity.

A CT (computed tomography) scan uses x-ray and computers to give more sophisticated and detailed pictures than conventional x-rays. A rotating x-ray beam is used to take a series of pictures of the body from different angles. A computer combines the series of pictures to produce a detailed cross-sectional image of a specific area of the body. Using the CT scan, a radiologist can see distinct aspects of the lungs and pleura.

Positron Emission Tomography (PET) scans use a camera that produces powerful images of the body’s biological functions. Because cancers and other disease processes metabolize sugars at a higher rate than normal tissues or organs, the PET scan uses tracers to indicate where there is abnormal metabolic activity and can pinpoint the regions of active disease. PET scans can also identify extremely small cancerous cells, show whether cells are benign or malignant, and help doctors determine whether treatment therapies are working.

Magnetic Resonance Imaging (MRI) uses a strong magnetic field and radio waves to scan the body without the use of radiation. An MRI produces a series of cross-sectional pictures useful for viewing “soft tissues” in the body and revealing the extent of mesothelioma, if any. New MRI techniques have been developed that detect tumor growth in the pleura and thoracic wall better than previous methods.

Pathology Tests

In a pathological examination, tissue or fluid is removed and put under the microscope. A pathologist makes a definitive diagnosis and issues a pathology report.

A tissue sample of a pleural or pericardial tumor can be obtained using a relatively new technique known as a thoracoscopy. A thoracoscope is a telescope-like instrument that is connected to a video camera and inserted through a small incision in the chest. The doctor is able to see the tumor through the thoracoscope. He or she uses special forceps to gather a tissue biopsy.

A laparoscopy can be used to see and obtain a biopsy of a peritoneal tumor. In this procedure, a flexible tube is attached to a video camera that is inserted into the abdominal cavity via small incisions.

A bronchoscopy may be performed if pleural mesothelioma is suspected. The doctor inserts a flexible, lighted tube down the trachea and into the bronchi to check for masses in the airway. Small samples of abnormal-appearing tissue may also be removed for testing.

Lymph nodes are collections of immune system cells that help the body fight infection. A doctor examines the lymph nodes to determine if the cancer has spread. During a mediastinoscopy, a patient has a lighted tube inserted under the sternum (chest bone) at the neck level and then moved down into the chest. The surgeon can see the lymph nodes and take tissue samples to check for cancer. This procedure can also help the physician determine whether a patient has lung cancer or mesothelioma.

Pulmonary Function Tests (PFTs)

Pulmonary Function Tests encompass a wide variety of tests that evaluate the entire respiratory system. The tests are used to assess and diagnose pulmonary disease and aid in determining a course of treatment. PFTs can also be useful in monitoring a patient’s response to treatment. PFTs can be a simple peak flow measurement, or complex body plethysmography and ventilation/perfusion scans which are performed in hospitals and clinics.

Although mesothelioma can often be difficult to initially detect, the above medical procedures and diagnostic tests can lead to a clear diagnosis. Click here to learn more about treatment options.

Staging is a method of evaluating the progress of cancer in a patient. It looks at the mesothelioma and the extent to which it has developed and its possible spread to other parts of the body. Click here to learn more about the staging of mesothelioma.

If you have been diagnosed with mesothelioma, or are worried that you might have mesothelioma, you may be eligible for compensation. Medical treatment is your primary concern but knowing your legal rights can help protect you and your family. Click here to learn more about your legal options.

To learn more about your legal rights, and to receive a free confidential consultation, please contact us.