Mesothelioma is a very difficult cancer to detect early on. The biggest reason for this is that early mesothelioma symptoms tend to be generic and in some cases non existent until much later on. When symptoms do occur chest pain and shortness of breath are the most common. These respiratory symptoms occur because of a fluid build up in the pleura (the layers of the membrane that lines the lungs and chest cavity). This build up is called pleural effusion.
Patients who have peritoneal mesothelioma (a less common form of mesothelioma that affect the peritoneal membrane lining of the abdomen) generally experience abdominal pain, loss of appetite, nausea and abdominal swelling, often in addition to the symptoms of pleural mesothelioma. These symptoms are the result of tumors that press against the abdominal wall. In advanced cases of peritoneal mesothelioma, a patient may also develop bowel obstruction or further breathing obstruction due to tumor expansion.
Eventually, in both types of mesothelioma, the symptoms become more acute, breathing becomes more restricted and severe chest pain develops. In the case of peritoneal mesothelioma, the patients appetite often diminishes radically, and nausea intensifies.
When symptoms do become much more acute and mesothelioma is suspected the treating doctor will usually order a MRI, CT scan or X-ray to determine if there is any pleural build up in the chest cavity. If it turns out that the peritoneum or pleura are congested with pleural fluid the physician will generally perform a "fine needle aspiration".
The "fine needle aspiration" is conducted by inserting a needle into the chest cavity in order to gather the extra pleural effusion. This is done for two reasons: 1) to clear the chest and/or abdominal cavity of pleural build up so that symptoms are reduced and 2) to gather a fluid sample in order to determine if in fact the build up is a result of mesothelioma.
Usually doctors need more than a fluid sample to make a definitive diagnosis and if the fluid sample suggests that mesothelioma is present, doctors will attempt to obtain a tissue sample (or a biopsy). For pleural mesothelioma this procedure is called a thoracoscopy, for peritoneal mesothelioma this procedure is called a laparoscopy. If pleural mesothelioma is suspected but not confirmed by the biopsy, an accurate diagnosis may also require an additional procedure called a bronchoscopy. Sometimes a larger sample of tissue is required than can be gathered by either a thoracoscopy or laparoscopy. In these instances a surgeon may open the chest or abdominal cavity. The procedure for the chest cavity is known as thoracotomy and the procedure for the abdominal cavity is known as a laparotomy.
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