From the blog

Improving Mesothelioma Diagnosis

Published: January 24, 2025

Malignant mesothelioma, an aggressive cancer mainly caused by asbestos exposure, mostly affects the pleura.  The pleura is the membrane that surrounds the lungs. It can also harm tissues like the peritoneum, which is a membrane that surrounds the abdomen. Due to its rare nature and shared symptoms with other illnesses, diagnosing mesothelioma is very tough. This leads to underdiagnosis. A recent study in Brazil aimed to find hidden, undiagnosed cases of mesothelioma. This could possibly lead to better diagnosis of patients in the future. The article tries to figure out why mesothelioma is hard to spot and shows the value of early detection and pathologists’ roles.

Diagnosing mesothelioma is difficult for multiple reasons. Symptoms of mesothelioma like chest pain, breathing difficulties, and belly swelling are vague and cannot specifically be tied to mesothelioma. They are often mistaken for other common issues, delaying someone’s diagnosis. It takes years for mesothelioma to develop after exposure to asbestos. It is also difficult to diagnose because it can look like other cancers. A keen eye and specialized techniques are needed to tell the difference between mesothelioma and other cancers. Mesothelioma is also overlooked as a viable option as a diagnosis for patients because it is rare. It is also not diagnosed because of a lack of equipment. In certain areas with limited resources, advanced diagnostic tools are hard to access.

The study from São Paulo looked to improve mesothelioma diagnosis. Cases from the Hospital-Based Cancer Registry between the years 2000 and 2012 were reviewed. Expert pathologists relooked at reports, looking at immunohistochemical markers to confirm or reject the diagnoses. The study team examined 482 cases. Of these cases, 130 needed extra analysis. Seventy-three blocks were suitable for reevaluation. Nine more cases were diagnosed as mesothelioma, which improved the rate by 12 percent. In addition, they dismissed two previous diagnoses. The findings suggest that incomplete or wrong diagnoses are a key reason for mesothelioma underdiagnosis in Brazil.

The early diagnosis of mesothelioma is crucial for patient survival. It does this by making treatment easier and boosting survival rates. Surgery, chemotherapy, and radiation work better in early stages. Early diagnosis offers more treatment choices including surgeries aiming to cure the disease and new treatments like trials. Quick detection of mesothelioma allows for early action, easing of symptoms, and enhancing quality of life.

Randomized clinical trials are crucial for finding and enhancing treatments. They are able to compare different techniques, to find the best one available. The first step is that new treatments are tested thoroughly. This is to hopefully extend survival and improve quality of life. Randomized clinical trials also give researchers information on safety and effectiveness. This helps to ensure that only the best treatments enter clinical use. Finally, results from clinical trials shape clinical guidelines, ensuring patients only receive the most effective treatments.

Diagnosing mesothelioma is hard. This is due to vague symptoms, long delays, and complex features of the disease. A São Paulo study highlighted the need for careful pathology reviews and expert diagnosis. Early spotting is crucial due to it boosting chances of survival and opening more treatments for the disease. Clinical trials are key in the treatment of mesothelioma. They help develop and prove new therapies. Using mesothelioma research like this, mesothelioma patients could be better helped.

Source:
Fabiola Del Carlo Bernardi et al., “Identifying malignant mesothelioma by a pathological survey using the São Paulo state hospital cancer registry, Brazil” Brazilian Journal of Pulmonology (2024). [Link]
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