Mesothelioma Misdiagnosis

Summary

Mesothelioma is a rare disease located in the lining of the lungs (pleural) and stomach (peritoneal). This type of cancer doesn't always have specific symptoms, and due to the rarity of the condition, it is often misdiagnosed. As the ingestion or inhalation of asbestos fibers causes mesothelioma, doctors are unlikely to suspect this form of cancer unless the patient worked in construction, manufacturing or the military. Many doctors will never see a case of mesothelioma in their career, so visiting a mesothelioma specialist is the best way to ensure a thorough examination and confident diagnosis.

Mesothelioma Misdiagnosis Overview

If you suspect you have mesothelioma here is what you need to know about a possible mesothelioma misdiagnosis:

  • Pleural mesothelioma symptoms are often similar to pneumonia, so it is easy for doctors to conclude that the illness is respiratory related.
  • When it comes to abdominal symptoms, peritoneal mesothelioma is frequently confused with the common, less severe condition of irritable bowel syndrome (IBS).
  • If you suspect that you have mesothelioma, we recommend getting a second opinion. Failing that, contact a mesothelioma specialist if you have been around asbestos and your symptoms are not improving.
  • The only way to confidently diagnose mesothelioma is by doing a biopsy to test the cancerous tissue.
  • During a scan, tumors can appear as a buildup of fluid in the lungs (pleural effusion) or abdomen (ascites). Again, this does not immediately point to mesothelioma as fluid build-up can be a contribution of factors, but if fluid is found, then you may wish to see a specialist.

Common Mesothelioma Misdiagnoses

Mesothelioma is often misdiagnosed as a more common illness, such as types of lung cancer and ovarian cancer. By process of elimination, doctors looking at X-rays and CT scans will notice the tumor but possibly diagnose it as something else. Biopsies (testing tumor tissue samples) are the only way to know for sure to diagnose any type of cancer.

Pathologists examine the biopsy samples and look at the cellular structure for signs of mesothelioma. As it is such a rare disease, many pathologists will never have come across a case in their careers. This is why it is beneficial to see a mesothelioma specialist if you suspect you may have the disease.

Fluid build-up can occur as a mesothelioma symptom, and a fluid biopsy is easier to take than a tissue biopsy. However, the fluid samples are harder to decipher under the telescope, which may lead to inaccurate cytology (fluid testing) results.

Misdiagnosing Mesothelioma Cells

Mesothelioma cells resemble adenocarcinoma cells—a type of cancer that affects the glandular (secretory) cells. As this is a more common type of cancer than mesothelioma, doctors may be more likely to make an adenocarcinoma diagnosis. To ensure your doctor gives a through diagnosis, it’s important to see an experienced pathologist to test the cells with an electron microscope.

Misdiagnosing Mesothelioma Stage

Even if a doctor identifies mesothelioma, there can still be inaccuracies when it comes to determining the stage of the disease. There are four official mesothelioma stages, and each stage has different treatment options.

  • Stage 1: The earliest stage of mesothelioma shows that it has not spread to the lymph nodes, and the cancer is localized to just one side of the body.
  • Stage 2: Mesothelioma is localized to one side of the body, but the lymph nodes are showing signs of metastasis.
  • Stage 3: Significant signs of metastasis have occurred, and mesothelioma has spread to the lymph nodes and surrounding organs.
  • Stage 4: Mesothelioma is present on both sides of the body and metastasized (spread) to distant sites.

Patients with mesothelioma at stage 1 and 2 are the best candidates for surgery, whereas options become limited at stage 3. Stage 4 patients are often too late for surgery, and their treatment is limited to merely relieving symptoms.

Sometimes doctors will incorrectly determine the stage of the disease, believing that the cancer is more localized than it is, or vice versa. Diagnosing mesothelioma at the correct stage is crucial, as it means that early-stage patients can be pushed through for surgery before the tumors spread too far to be resected (removed).

Again, a second opinion is strongly advised. Be sure to see a surgeon who specializes in mesothelioma to be 100% confident in your diagnosis.

Factors Contributing to a Mesothelioma Misdiagnosis

As mesothelioma symptoms can vary from patient to patient, it is often difficult for doctors to make a thorough diagnosis. As the disease affects a tiny percentage of people, it’s not the first thing that comes to mind when a patient explains their ailments.

When a mesothelioma diagnosis is based on histological features (how the cancer cells look under the microscope), the mesothelioma may resemble other metastatic cancers. Because the disease lacks a distinctive pattern of elements, a diagnosis is difficult to attain.

When fluid samples are tested (cytology), doctors use specialized stains to indicate whether cancer is present. Cytology features in mesothelioma cells can be stained positively or negatively towards the disease, but staining patterns alone can lead to misdiagnosis without considering other features of the tumor and the patient’s medical history.

Despite CT scans and X-rays being generally reliable when identifying common cancers, mesothelioma is so rare that a biopsy is needed to see the full picture. A tissue biopsy is the best option for the most accurate results.

Why is a Correct Mesothelioma Diagnosis Important?

If a patient has been diagnosed with mesothelioma, they must see a specialist or visit another doctor for a second opinion. Each case of mesothelioma is unique, so patients must ensure that the pathologists know what they are dealing with so that there is time to tailor the treatment to the patient’s condition.

Getting the correct, most effective treatment is the number one priority, and as mesothelioma tumors can spread quite rapidly, the doctors must perform the right tests (CT scans, X-Rays, and biopsies) to ensure that they diagnose the exact stage. If mesothelioma is found at stage 1 or 2, the patient will have a much better chance of survival. The pathologists must move quickly with these tests to avoid the tumors spreading to stage 3 or 4, as surgery is no longer an option when the cancer is this advanced.

Aside from the health of the patient, a precise, timely diagnosis is critical for pursuing legal action. There is a statute of limitations (a time limit) on pursuing legal action against asbestos manufacturers, and that time limit starts at the date of diagnosis. If an accurate diagnosis takes too long, it limits the patient’s ability to obtain the financial compensation necessary to cover the costs of treatment and other expenses.

Getting the Best Treatment Options Possible

Not all patients will be suitable for surgery, but they may be eligible to take part in a clinical trial. Clinical trials give the patient access to cutting-edge treatments, and also take into consideration the unique traits of the patient. By taking part in a clinical trial the patient may not only increase their life expectancy, but they may also benefit from improved quality of life.

If you suspect that you have mesothelioma (or that your current diagnosis is incorrect), we urge you to visit a mesothelioma specialist to gain access to the treatment required before the disease progresses.

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Last modified: March 2, 2018