Imaging scans are the initial step in the process of diagnosis of mesothelioma cancer. It will search for abnormalities or tumors in the body. The doctors will perform blood tests to find bio-markers that might propose a diagnosis reveal symptoms or reveal asbestos exposure history. Both these tools cannot diagnose Mesothelioma definitively, which leads to the requirement of a biopsy.
Biopsy in a tissue sample or fluid form from the patient to analyses and confirm cancer, decide its cell type and type of cancer.
Diagnosis for this disease is a bit poor, with the majority of patients living a minimum of one year. The mesothelioma type, patient health and the cancer stage are the three significant factors that help in determining prognosis. The diagnosis can be enhanced by getting treatment in a centre that possesses a multidisciplinary doctor team that has plenty of experience in assessing and treating this cancer.
The disease stage is based on tumor size. It is crucial to know whether it has spread further than the original site and whether cancer cells are present in the lymph nodes. Other factors that affect the diagnosis are as follows:
- Mesothelioma size
- Whether it can be eradicated with surgery
- The fluid amount in the abdomen or chest
- The patient’s health and age
- Mesothelioma cell type
- Whether the disease was diagnosed now or has been treated already and reappeared
The physician, when determining a diagnosis of this cancer, consider five factors. Though these factors aid the doctors in offering the patient diagnosis, the progression of the disease will differ for every patient.
This is the most significant factor that determines the prognosis of a patient. Patients who find the diagnosis in the early stage of this cancer will possess more treatment alternatives and an improved prognosis compared to patients who are diagnosed later on. Twenty-one months is the average life expectancy for patients who belong to this stage, while 19 months is the typical expectancy of stage 2 patients.
When patients reach the stage 3 and 4, they have only palliative treatment alternatives to extend and improve life quality. On average, patients belonging to stage 3 and stage 4 have 16 months and 12 months survival period post-diagnosis.
Doctors usually use systems like- TNM, Butchart, and Brigham. Use of different criteria depends on the stages of cancer.
- Stage 1- In this stage, the tumor only affects the area of the Mesothelium originated. Getting treatment in this stage will work positively and avoids getting the patient in the next stage.
- Stage 2- In this stage, the tumor grows larger and spreads in different organs where it first appeared in the Mesothelium. Depending on the overall health, curative surgery is an option. There is not much difference between stage-one and stage-two patients.
- Stage 3- In this stage, the tumor has spread other part of the body, including lymph node, chest and heart. Tumors, at this stage, will not respond to curative treatment. However, the doctor may also recommend other palliative treatment for faster improvement.
- Stage 4- In this stage, the tumor spreads to both sides of the body. It many cases, the tumor may invade the brain, bone cells and lymph nodes. In this stage, curative treatment options like surgery and chemotherapy is not much effective. The doctor will opt for a clinical trial to use new and improved treatment for this stage.
Type of cells
Out of the three major mesothelioma types of cells, epithelioid cells have a better prognosis. They spread less assertively and are receptive to treatment. Biphasic cells have an imperfect diagnosis due to the presence of the sarcomatoid cell. Sarcomatoid cells have the smallest amount of favorable diagnosis, as they spread very aggressively and are non-responsive to treatments.
In rare cases, the patient might have other cell types too, which possess prognoses that range from a few months to ten years or more.
The typical life expectancy of patients with different kinds of mesothelioma cancer varies. Testicular mesothelioma patients possess a favorable prognosis with a survival period of 20 to 23 months. Peritoneal mesothelioma patients survive one year more, and pleural patients possess a typical prognosis of nearly 6 months to 1 year. Patients with pericardial type cancer possess the slightest favorable prognosis with many people diagnosed posthumously.
In case, the cancer cell extends to various body parts from its original place the diagnosis becomes weaker. Once it starts to spread, it is harder to eliminate cancer by surgery or use chemotherapy to kill the cells. Localized Mesothelioma is much easier to treat aggressively using multimodal treatments that produce a better diagnosis and a much longer lifespan.
Patients who are healthy and young can possess a better diagnosis since their bodies will be able to deal with aggressive treatments in a better way. Older patients might not be capable of withstanding the surgery side effects, radiation or chemotherapy side effects. They tend to possess other conditions as well that might worsen cancer or restrict treatment alternatives.
Overall, poor overall health will limit treatment options and lead to a drop in life expectancy for mesothelioma patients.