Mesothelioma is not only a difficult cancer to treat. It’s also notoriously difficult to diagnose. Because there are no definitive biomarkers that can quickly reveal if a patient has this aggressive cancer, diagnosing mesothelioma typically involves a combination of different techniques. A new article in the Archives of Pathology and Laboratory Medicine highlights some of the most useful and important diagnostic tests for mesothelioma. Pathologists Qudsia Arif, MD, and Aliya Husain, MD, of the University of Chicago used peer-reviewed publications, text books, and consensus among their fellow pathologists to compile their recommendations. According to the report, among the possible diagnostic biomarkers for mesothelioma, four of the most reliable are the proteins calretinin, WT-1, cytokeratin 5/6, and podoplanin. These, say the … Continue reading A New Look at the Complex Process of Mesothelioma Diagnosis
A group of medical researchers has just released an updated set of clinical practice guidelines for treating patients with malignant pleural mesothelioma, one of the rarest and most treatment-resistant forms of cancer. The guidelines, released by the European Society for Medical Oncology and published in the newest issue of the Annals of Oncology, contain six sets of recommendations designed to support clinicians in the management of mesothelioma from diagnosis to treatment and follow-up. Recommendation for Mesothelioma Diagnosis The updated ESMO mesothelioma guidelines recommend that all patients undergo a thorough occupational history with emphasis on asbestos exposure and a CT scan of their chest. They also recommend that all patients with pleural thickening have a biopsy but do not recommend routine … Continue reading European Group Issues Updated Treatment Guidelines for Mesothelioma
Could the BRCA-1 associated protein 1 (BAP1) gene offer a more accurate way to identify malignant pleural mesothelioma? New research in Italy suggests that the answer might be yes. Mesothelioma is a cancer that occurs in the cells of the mesothelium, a membrane that surround the lungs and other organs. Because there are also benign conditions that can effect mesothelial cells and cause similar symptoms, mesothelioma is often difficult to identify. To date, there are no definitive biomarkers, though the list of markers that can help with diagnosis and prognosis is growing. In the latest biomarker study, researchers in Italy evaluated BAP1 expression in 266 patients with different mesothelial conditions. A total of 212 patients had mesothelioma, 12 had benign … Continue reading Gene Test May Lead to More Accurate Mesothelioma Diagnosis
Patients who are suspected of having mesothelioma often want to know whether there is a test to determine for certain if they have the disease. Unfortunately, no such test exists. Instead, mesothelioma diagnosis typically involves a complex combination of work and family history, symptoms, scans, biopsies and, often, a test for a protein called mesothelin. While mesothelin is not a perfect biomarker for malignant mesothelioma, a team of Australian mesothelioma researchers has confirmed that it is probably still the best one available. Biomarkers are measurable substances that can help indicate whether a patient has a particular disease. As the search for the most effective mesothelioma biomarkers continues, doctors at the University of Western Australia’s National Center for Asbestos Related Diseases … Continue reading Mesothelin Flawed But Still the Best Mesothelioma Biomarker
Researchers in Japan have come up with what they say is the most up-to-date way to accurately predict outcomes in newly-diagnosed malignant pleural mesothelioma patients. Many factors can affect mesothelioma prognosis. Some of them are related to the patient’s overall health and disease stage or type while others have to do with the type of therapy the patient undergoes. Scientists at Kyoto University, Hyogo College of Medicine, and Fukushima Medical University analyzed the outcomes of 283 mesothelioma patients between 2007 and 2013 to determine which factors were most likely to impact their outcomes and to what degree. “Existing prognostic indices for malignant pleural mesothelioma do not incorporate the recent advances in oncology care,” notes study author Yoshiko Kataoka with Kyoto … Continue reading A New Prognostic Index for Mesothelioma?
Positron emission tomography (PET) is a nuclear medicine imaging technique that highlights metabolic activity in the body. PET scanning detects gamma rays emitted by a tracer that is delivered into the body via a biologically active molecule, typically FDG, a form of glucose. FDG PET is one of the imaging tests sometimes used to help diagnose and monitor mesothelioma cancer on the pleural membrane around the lungs. Now, nuclear medicine specialists in Milan say FDG PET may be even more valuable than clinicians realize for predicting outcomes – especially in mesothelioma patients who are responsive to chemotherapy. The study involved 131 mesothelioma patients, most of whom were men, with a median age of 66. Study subjects were treated for mesothelioma … Continue reading PET Supports Mesothelioma Diagnosis and Prognosis
People suspected of having pleural mesothelioma often have some type of intervention that involves inserting a needle into the pleura. This can happen in order to obtain a tissue sample for diagnosis or to place a catheter to drain off fluid that can accumulate around the lungs. Unfortunately, mesothelioma patients who have these types of interventions are also prone to developing tiny tumors along the path where the needle was inserted. These tumors are usually assumed to be metastatic mesothelioma that was “seeded” by the needle, and are typically treated with targeted radiation. But doctors at the University of Western Australia say clinicians should not be too quick to treat such tumors without confirming the diagnosis with a biopsy. Dr. … Continue reading Catheter Path Tumors in Mesothelioma Patients May Be Benign
The diagnosis of malignant mesothelioma can be a complicated process, but a team of Japanese scientists says it can be greatly simplified by the right kind of test at the right time. In an article in the journal Pathology, the team claims that a definitive diagnosis of mesothelioma can be made from a sample of excess lung fluid. Excess fluid collection around the lungs, called pleural effusion, is common in people with mesothelioma and several other kinds of cancer. Approximately 70 percent of people with mesothelioma develop pleural effusions. Because effusion is often one of the earliest signs of the disease, the Japanese doctors maintain that this fluid could be useful for making an early mesothelioma diagnosis. “Early in the incidence … Continue reading Can Mesothelioma Be Diagnosed with Lung Fluid Alone?
A team of researchers in the UK say doctors may be relying too heavily on the results of CT scans to determine which patients should have invasive biopsies for suspected pleural mesothelioma. Examining tumor cells under a microscope is currently the only way to definitively diagnose malignant pleural mesothelioma. However, because getting a cell sample means that a patient has to undergo surgery, doctors typically use non-invasive tests like CT first. CT scans have become an important part of the diagnostic process for malignant pleural mesothelioma. To see how valuable these tests really are for respiratory patients, experts from the Oxford Centre for Respiratory Medicine and the Lancashire Chest Centre in Preston, UK analyzed the CT scans and final diagnoses … Continue reading Do Mesothelioma Doctors Rely Too Much on CT?
The developers of a new blood test for mesothelioma say it is much more accurate than previous tests and could improve diagnosis and disease monitoring. The new test is an enzyme-linked immunosorbent assay (ELISA) system designed to detect the protein N-ERC/mesothelin. N-ERC/mesothelin is overexpressed in mesothelioma and some other types of cancer. ELISA tests use antibodies that change color when they come in contact with a particular substance such as N-ERC/mesothelin. According to the Japanese researchers who developed and tested the new assay, the previous ELISA system developed in 2008 to detect N-ERC/mesothelin has been “unsatisfactory” and test results were difficult to reproduce. In contrast, the new 7-20 ELISA system produced more accurate positive mesothelioma diagnoses and fewer false negatives. … Continue reading New Blood Test May Improve Diagnostic Accuracy for Mesothelioma