Diagnosing mesothelioma in the early stages of the disease has proven to be a difficult task, and to better improve chances of survival from this aggressive cancer, the cancer needs to be found and treated quickly. Typical first steps in diagnosing mesothelioma are imaging techniques such as an x-ray, CT (CAT) scan, or an MRI. A CT scan is most common and works by taking x-ray- type images that create 3-D pictures from different angles. These pictures are then combined to determine where abnormalities in the body are located, tumor size, and metastasis.
However, sometimes CT scans can be ineffective as a diagnostic tool due to the characteristics of the tumor itself. Tumor density in those with pleural mesothelioma is often times no different than the surrounding pleural fluid, so the tumors are usually not apparent after CT scans until the cancer has fully developed.
Researchers from the University of Western Australia recently found that CT scans may be able to be improved upon by creating intraplueural airflow, which would make these tumor nodules visible in the early stages of cancer. Using six test subjects, these individuals were given CT scans and results showed that their pleural abnormalities were undetectable. In normal cases, this would mean that the individual would most likely be given a clean bill of health, as the hidden cancer continues to develop over the span of 20 to 50 years. However, in this study, patients’ chest cavities were then drained of fluid and filled with air (pneumothorax), revealing tumor cell growth (after an additional scan). The CT scans were able to show the different densities of the tumor and surrounding pleural fluid that was always so difficult to distinguish before. Pneumothorax is also a term used to describe a medical condition in which air leaks into the lungs.
The study, which was recently published in Chest Journal, outlined specific test cases that yielded positive results in initial cancer diagnoses. In one such case, a 45-year-old female’s initial CT scan only showed pleural thickening, but after fluid was drained and pneumothorax occurred, a second CT scan revealed a number of tumors which were eventually confirmed to be mesothelioma after a biopsy. In a similar case, a 61-year-old man received a CT scan before and after fluid had been drained. The second CT scan revealed numerous cancerous tumors that were previously undetected by the first scan.
An early diagnosis of any disease is usually favorable over a late diagnosis, but this is especially so in malignant mesothelioma because there is no cure and the disease is often fatal. Mesothelioma takes years to develop, but once the cancer does and becomes apparent, it is aggressive and unresponsive to most cancer treatments. With early detection of this disease, not only will patients have a better chance of responding to chemotherapy and other treatment, they will be able to explore other treatments – such as surgery – that wouldn’t be possible if the cancer was discovered fully formed.
Surgery is one of the more successful treatments for removing the deadly cancer cells, but more often than not, patients suffering from mesothelioma do not qualify for surgery because the surgery is generally only successful in the early stages of the disease. With this new airflow technique, the possibility of being able to effectively treat mesothelioma when it is just developing is a massive step forward in finding a cure.
Source:
Edward T.H. Fysh, “Air in the Pleural Cavity Enhances Detection of Pleural Abnormalities by CT Scan,” Chest Journal (June 2018). [Link]