Challenges of Diagnosing Mesothelioma: Importance of Early Detection and Insights from a Cancer Registry

ByHolly Zink
Challenges of Diagnosing Mesothelioma: Importance of Early Detection and Insights from a Cancer Registry

Malignant mesothelioma, an aggressive cancer from asbestos, mainly affects the pleura. However, it also harms other tissues like the peritoneum. Diagnosing it is very tough, leading to underdiagnosis.

A recent study in Brazil’s São Paulo State Hospital Cancer Registry aimed to find hidden cases. It also sought to improve diagnosis. This article looks at why mesothelioma is hard to spot. It also shows the value of early detection and pathologists’ roles.

Why Is Mesothelioma Difficult to Diagnose?

Diagnosing mesothelioma is tough for several reasons. Symptoms like chest pain, breathing difficulties, and belly swelling are vague. They can be mistaken for common issues, delaying diagnosis.

The cancer can develop years after asbestos exposure. This gap makes it hard to link symptoms to the initial exposure. Mesothelioma has different types that look similar to other cancers. Specialized techniques are needed to tell them apart.

Being rare, mesothelioma is often overlooked by doctors. In places with limited resources, advanced diagnostic tools are hard to access.

The São Paulo Study: Enhancing Diagnostic Accuracy

The São Paulo study aimed to improve mesothelioma diagnosis. It reviewed cases from the Hospital-Based Cancer Registry (HBCR) between 2000 and 2012. Expert pathologists re-evaluated reports and blocks. They used immunohistochemical markers to confirm or reject the diagnoses.

The study team reviewed 482 cases. Among these, 130 needed extra analysis. Seventy-three blocks were suitable for re-evaluation. They diagnosed nine more cases as malignant mesothelioma. This improved the rate by 12%. Additionally, they dismissed two previous diagnoses.

These findings suggest incomplete or wrong diagnoses are a key reason for mesothelioma underdiagnosis in Brazil.

Importance of Early Detection

Detecting mesothelioma early is crucial. It makes treatment easier and can boost survival rates. Surgery, chemotherapy, and radiation work better in the early stages.

Early diagnosis offers more treatment choices. These can include surgeries aiming to cure and new treatments in trials. Quick detection allows for early action, easing symptoms and enhancing life quality.

Randomized Clinical Trials Advance Treatment

Randomized clinical trials (RCTs) are crucial for finding and enhancing treatments. They compare methods to identify the best. For mesothelioma, RCTs are vital.

First, they test new treatments thoroughly. This effort aims to extend patient survival and improve their quality of life. Second, RCTs provide strong evidence on safety and effectiveness. This ensures only the best treatments enter clinical use.

Finally, results from RCTs shape clinical guidelines. These guidelines ensure patients receive the most effective treatments.

Diagnosing mesothelioma is hard. It’s due to vague symptoms, long delays, and complex features. A São Paulo study highlighted the need for careful pathology reviews and expert diagnosis. Early spotting is crucial. It boosts chances and opens more treatments. Clinical trials are key. They help develop and prove new therapies. By tackling these obstacles and using research, we can better help mesothelioma patients.

Source:

Bernardi, Fabiola Del Carlo, Eduardo Algranti, Marisa Dolhnikoff, Clóvis Antônio Lopes Pinto, Ivanir Martins de Oliveira, Ester Nei Aparecida Martins Coletta, Eduardo Caetano Albino da Silva, et al. “Identifying Malignant Mesothelioma by a Pathological Survey Using the São Paulo State Hospital Cancer Registry, Brazil.” Jornal Brasileiro de Pneumologia 50 (May 13, 2024): e20230343. https://doi.org/10.36416/1806-3756/e20230343.

Similar Posts

Mesothelioma Blood Test May Be Possible
|

Mesothelioma Blood Test May Be Possible

ByAlex Strauss

An international team of researchers is studying the proteins found on the surface of cancer cells in an effort to improve mesothelioma diagnosis. The team, made up of scientists from the US, Switzerland, Italy and Chile, has just published their findings on a new kind of test to identify protein-derived mesothelioma biomarkers in blood serum. Mesothelioma is an aggressive cancer of the membranes around organs. Because the most common mesothelioma biomarker, mesothelin, is also overproduced by other kinds of cancer cells, it has only limited diagnostic value. A test to identify a set of proteins produced specifically by mesothelioma cells could greatly improve diagnostic accuracy. Led by Ferdinando Cerciello and Bernd Wollscheid of the Institute of Molecular Systems Biology in…

geriatrics
| |

Needle Biopsy “Simple, Safe & Accurate” for Mesothelioma

ByAlex Strauss

Mesothelioma researchers in China say a biopsy method that involves a single skin puncture can produce good diagnostic results for mesothelioma patients with little pain or risk. The study focused on percutaneous (through the skin) biopsy in patients who had unexplained fluid buildup or swelling in their abdomens. Abdominal distension and fluid buildup (called ascites) can be signs of peritoneal mesothelioma, a rare but aggressive cancer of the abdominal lining caused by exposure to asbestos. Peritoneal mesothelioma accounts for less than 30% of all mesothelioma cases. Because the symptoms may be vague and often develop many decades after asbestos exposure, peritoneal mesothelioma can be especially challenging to diagnose.  Misdiagnosis and under-diagnosis are not uncommon. In the newest study on percutaneous…

Respiratory Disease
| |

Inflammation Both “Friend and Foe” in Mesothelioma

ByAlex Strauss

An immune system response that causes mesothelioma symptoms such as fever, fatigue, and weight loss may also be helpful to clinicians as a way to find and treat the disease. Scientists with The Asbestos Diseases Research Institute in Sydney, Australia make that case that both systemic inflammation (throughout the body) and at the site of a tumor – has long been associated with mesothelioma and other cancers. Inflammation results when the body attempts to address the imbalances of cancer by producing more of certain immune system cells. Some inflammatory markers, such as CD+8 T-cells and C-reactive protein, have been linked to better prognosis in mesothelioma. Other inflammatory markers, such as certain macrophages and a high neutrophil-to-lymphocyte ratio, can signal the…

patient
| |

FDG PET-CT Results Could Lead to Improved Mesothelioma Treatment

ByAlex Strauss

In a recent study, researchers say a better understanding of certain diagnostic criteria could result in more targeted treatments for malignant mesothelioma. In a recent published report, doctors from the medical school at Dicle University in Diyarbakir, Turkey measured the relationship between PET-CT scan results and survival in 177 patients with malignant pleural mesothelioma. The patients were diagnosed between April 2007 and April 2011. They had a mean age of 55.4 and most (56%) were male. Patients in the study all had FDG PET-CT scans before beginning their mesothelioma treatment. FDG PET-CT scanning is a powerful imaging tool for mesothelioma and other cancers that combines a radioactive tracer with a combination of positron emission tomography and computed tomography scanning.  Because…

doctor
| |

Mesothelioma Surgeons Report New Biopsy Technique

ByAlex Strauss

A team of surgeons in Maryland have demonstrated how using a standard biopsy tool in a new way could improve the biopsy process for certain mesothelioma patients. An aggressive cancer of the pleural lining around the lungs, malignant pleural mesothelioma usually requires a tissue biopsy to make a definitive diagnosis. Often this is done using a rigid tool called a thoracoscope inserted into the chest wall while the patient is under general anesthesia. However, mesothelioma doctors at Walter Reed National Military Medical Center detail the case of a 79-year-old suspected mesothelioma patient whose biopsy was done in a minimally-invasive way, under conscious sedation, thanks to the novel use of a standard tool. Although the patient had several of the common signs…

serum
|

New Serum Marker Could Improve Mesothelioma Diagnosis

ByAlex Strauss

Japanese researchers believe they have found a way to diagnose a rare form of mesothelioma earlier using a simple blood test. Diffuse malignant peritoneal mesothelioma (DMPM), which represents about a fourth of all mesothelioma cases, is an aggressive malignancy that spreads across the lining of the abdomen. In most cases, DMPM is lethal within a year. The standard treatment for diffuse malignant peritoneal mesothelioma is cytoreductive surgery to remove as much of the mesothelioma as possible, followed by intraperitoneal chemotherapy to destroy residual cancer cells. In some studies, this approach has resulted in 5-year survival rates of 30 to 60 percent. However, it is most successful when it is performed early, while the primary mesothelioma tumor is more easily removed. Like all forms of…