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

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.


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.

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