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People who have mesothelioma sometimes notice pain or a sensation of heaviness or fullness in their chest or abdomen. There is typically shortness of breath if the pleural tissue is involved, and swelling of the abdomen if the peritoneal tissue is involved. Weight loss may be present, as may pain in the shoulders.
In the early stages, the symptoms may be confused with other illnesses, or simply attributed to lifestyle issues such as obesity, smoking or physical inactivity. If your physician does not know of your history of exposure to asbestos, they may therefore misinterpret the symptoms of mesothelioma. In addition, some physicians may not be fully aware of mesothelioma and may misdiagnose these symptoms as those associated with another illness.
If you are experiencing these symptoms, you should see your doctor as soon as possible. You should make sure that your doctor knows of your history of working with or around asbestos.
There is not currently a standard screening test for mesothelioma, as is the case with many other diseases. Your doctor may order a number of tests to help in determining whether your symptoms are the result of mesothelioma or some other condition.
Diagnostic radiology (such as x-rays and CT scans) is often the first step in revealing mesothelioma. Radiological films may reveal buildup of fluid on the lung, and may also show a mass that is suspected of being mesothelioma÷but to rely on diagnostic radiology alone can sometimes result in misdiagnosis with other cancers, including lung cancer and sarcoma. A biopsy or exploratory surgery is typically needed to confirm a mesothelioma diagnosis.
A simple pleural biopsy typically cannot go deep enough into the lung to supply the type of tissue needed to confirm the presence of mesothelioma. Needle aspiration using CT or ultrasound is generally needed÷but this type of procedure yields only a small amount of tissue, so it too is often regarded as an inferior diagnostic method to exploratory thoracoscopy.
Exploratory thoracoscopy is an endoscopic technique typically performed under local anesthesia.
Some characteristic physical findings that may help in defining mesothelioma are:
Rind-like thickening of greater than 1 cm around the circumference of the pleura;
Nodular masses on the lower parietal, diaphragmatic, pericardial or mediastinal pleura;
Volume loss in the involved hemithorax;
Involvement of the visceral pleura in the main lung fissure.
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