About 3,000 new cases are reported each year of mesothelioma. It originates in cells that line certain parts of the body, especially the chest and abdominal cavities.
Mesothelioma is difficult to treat because it typically does not grow as a single tumor mass. It instead tends to spread along nearby surfaces, nerves and blood vessels, which makes it hard to remove completely with surgery and radiation.
Still, a prompt diagnosis followed by immediate treatment can lead to an improved prognosis. Unfortunately for many individuals, by the time symptoms appear and mesothelioma is diagnosed, the cancer is already in its advanced stages.
At Powers & Santola, LLP, we have a proven record of putting our skill, experience and resources to work to help victims of a delayed or misdiagnosis of cancer, including mesothelioma. Our firm serves clients throughout Albany, Syracuse, Rochester, and surrounding areas in New York State.
To discuss how we can assist you, call or contact us online today. We can provide a free consultation about your case.
What Is Mesothelioma?
A layer of specialized cells – known as mesothelial cells – lines the inside of the chest, abdomen, heart and the other surfaces of most internal organs. Mesothelium, the lining formed by the cells, generates a lubricating fluid that allows our internal organs to move.
There are two predominant types of mesothelioma:
- Pleural mesothelioma – This type forms in the chest cavity. In fact, about three out of every four mesothelioma cases involve this area of the body.
- Peritoneal mesothelioma – The cancer originates in the abdominal cavity
Rare cases involve the lining around the heart (pericardial mesothelioma) and testicles (mesothelioma of the tunica vaginalis).
This illness is also grouped by how the cancer cells are arranged. These groups are:
- Epithelioid – 50 to 60 percent of cases and generally a better prognosis of recovery.
- Sarcomatoid – 10 to 20 percent of cases and more fibrous in nature.
- Mixed biphasic – 30 to 40 percent of cases, exhibiting characteristics of epithelioid and sarcomatoid conditions.
Exposure to airborne asbestos fibers is the leading risk factor for mesothelioma.
Asbestos is a naturally occurring group of minerals resistant to heat and fire. For decades, it was widely used in industrial, manufacturing and construction applications. However, once the dangers of asbestos exposure came to light, its use in the U.S. essentially stopped in the late 1980s.
Millions of workers in certain industries are at a particular risk of having been exposed to asbestos, including those in industries such as:
- Heavy manufacturing
- Insulation manufacturing
- Automotive manufacturing.
Family members may have also been potentially exposed to the asbestos fibers on their loved one’s work clothing.
Inhaled asbestos fibers lodged in the lungs can travel to the ends of small airways and penetrate the pleural lining of the lung and chest wall. This process can injure the cells of the pleura and eventually cause mesothelioma. Asbestos fibers that are ingested – such as coughing up and swallowing inhaled asbestos fibers – can become lodged in the abdomen and eventually penetrate and damage cells in the peritonea lining in the abdominal cavity.
Symptoms of Mesothelioma
Mesothelioma often takes decades to form following first exposure to asbestos, anywhere from 15 to 50 years.
Symptoms of pleural mesothelioma (chest cavity) are often mistaken for common, minor ailments, such as pain in the lower back or on the side of the chest, persistent cough and fever. Other symptoms include:
- Fluid around lungs causing shortness of breath
- Excessive sweating
- Unexplained weight loss
- Trouble swallowing
- Swelling of the face and arms.
Symptoms of peritoneal mesothelioma (abdominal cavity) include:
- Abdominal pain
- Swelling or fluid in the abdomen
- Unexplained weight loss.
How Is Mesothelioma Diagnosed?
Doctors will typically take a detailed medical history and conduct a physical examination. They should inquire about work history and any potential exposure to asbestos.
If mesothelioma is suspected, doctors will usually order imaging tests such as an X-ray, CT scan, PET scan or MRI. These tests may show abnormal thickening of the pleura, calcium deposits on the pleura, fluid in the space between the lungs and chest wall or changes in the lung.
Doctors do not use blood tests to diagnose mesothelioma, but high levels of osteopontin and soluble mesothelin-related peptides in the blood signal that mesothelioma may be present.
A biopsy is the only way to confirm a diagnosis of mesothelioma. One method involves removing fluid from the suspected area of the body with a thin, hollow needle for microscopic examination. However, mesothelioma cancer may be present even if no cancer cells are found in the fluid. In many cases, doctors need to obtain an actual sample of the mesothelium to determine if cancer is present.
A doctor may use a needle to remove a tissue sample (needle biopsy), although a risk associated with this method is that the sample size may not be large enough to make an accurate diagnosis, especially since mesothelioma tends to be diffuse rather than concentrated in one single area. An endoscopic biopsy is a common method used for diagnosing mesothelioma. An endoscope is a thin tube with a light and lens (tiny video camera) inserted inside the body. It often has a tool to remove tissue samples.
When an endoscopic biopsy is not enough to determine if mesothelioma is present, physicians can make an incision in the chest (thoracotomy) or an incision in the abdomen (laparotomy) to remove a larger sample of tumor or even the entire tumor.
It is sometimes difficult to diagnose mesothelioma by looking at cells from fluid around the lungs, abdomen or heart, or even small tissue samples. Under the microscope, mesothelioma can often look like other types of cancer. Lab tests can help determine if mesothelioma is present, such as an immunohistochemistry, DNA microarray analysis or electron microscopy.
Once a diagnosis of mesothelioma is made, additional tests are conducted to determine the location of the cancer and whether it has grown into other areas of the body (staging).
Missed or Delayed Diagnosis of Mesothelioma
Time is paramount in treating mesothelioma. It is important not to waste time on treating the wrong disease or one that is far less urgent. Patients with Stage I or Stage II mesothelioma are much more likely to qualify for potentially surgeries like pneumonectomy (removal of an entire lung).
Physicians can misdiagnose mesothelioma for a number of reasons. For example, early symptoms are typically mild and easily confused with more common ailments and diseases such as pneumonia, emphysema or tuberculosis. A doctor might mistakenly believe symptoms like shortness of breath, coughing, high fever and night sweats are caused by an infection.
Because mesothelioma usually takes years to develop, symptoms in a younger person may be confused with other illnesses. Another potential mistake: Excessive build up of fluid between lungs and their protective membrane (pleura) may be diagnosed as pleuritis (a noncancerous irritation of the pleura).
Other potential missteps by medical professionals include the failure to:
- Consider occupational risks of a patient for exposure to asbestos
- Refer a patient to a specialist
- Order lab tests, imaging tests or blood tests
- Notice lesions on an imaging test
- Follow up on abnormalities noted on an imaging test
- Order a biopsy.
Other mistakes that can lead to a mesothelioma misdiagnosis or a delayed diagnosis of mesothelioma:
- Improperly performed biopsy
- No follow up on a biopsy that was negative
- Radiologist’s failure to clearly or accurately report noted findings to primary care physician
- Lab error related to biopsy
- Failure to accurately read the results of test or biopsy report, or take appropriate steps when a report reveals an abnormality
- Failure to recommend a follow-up appointment within an appropriate time period.
Surgery for treating mesothelioma is an option for Stages I-III of the disease, depending on how far a tumor has grown into nearby tissues, the type of mesothelioma, where it is located, and if a patient is healthy enough to have surgery.
Surgery is often combined with radiation or chemotherapy to make sure all cancer cells not surgically removed are killed. Because mesothelioma is hard to remove completely, surgery will most likely not cure mesothelioma but can extend a patient’s life. The five-year survival rate for mesothelioma is 5-10 percent, according to the National Cancer Institute. People diagnosed at a younger age tend to survive longer, as do individuals diagnosed with earlier stages of the cancer.
Treatments for later-stage mesothelioma typically involve palliative surgery with the goal of removing as much of the cancer as possible to relieve symptoms of the disease, such as removing fluid and preventing fluid buildup. Radiation and chemotherapy therapies are often undertaken as well to minimize the extent of the cancer.
Our Delayed Mesothelioma Diagnosis Attorneys Can Help You
Powers & Santola, LLP, has the skill, experience and resources to assist you or a family member after a delayed or missed diagnosis of mesothelioma has occurred. To learn more, please contact us today by phone or through our online form.