Mesothelioma Misdiagnosis

Mesothelioma can be misdiagnosed as lung cancer, pneumonia, and other common diseases because it’s so rare and the symptoms are often vague. A mesothelioma misdiagnosis can lead to delayed treatment and a poorer prognosis. U.S. veterans who may have mesothelioma should promptly see a specialist to get an accurate diagnosis.

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Can Mesothelioma Be Misdiagnosed?

Yes, doctors may misdiagnose malignant mesothelioma as other types of cancers or even less serious health problems like the flu.

Nearly 1 in 4 (22.6%) of pleural mesothelioma cases are misdiagnosed in the United States, according to a report from Open Epidemiology Journal.

Only around 1,000 veterans are diagnosed with mesothelioma each year, and since the symptoms are shared with many other health problems, it’s easily misdiagnosed without care.

A mesothelioma misdiagnosis could include the wrong:

  • Illness: Mesothelioma is often mistaken for more common types of cancer or even minor illnesses like the flu
  • Stage: Cancer stage is how far it has spread at the time of diagnosis. Misdiagnosing the stage can impact which treatments you receive.
  • Cell type: There are three different mesothelioma cell types, some of which are easier to treat than others. The correct type must be diagnosed or it could negatively impact your overall survival.

A misdiagnosis can worsen your mesothelioma prognosis (health outlook) and prevent you from getting the treatments needed to potentially live longer.

To lower your risk of misdiagnosis, work with skilled oncologists (cancer doctors) who know what to look for when making a mesothelioma diagnosis. You can also get a second opinion if you think you’ve been misdiagnosed.

Use our Free Doctor Match now to find specialists who may be able to provide you with an accurate mesothelioma diagnosis.

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U.S. Veterans at Risk of a Mesothelioma Misdiagnosis

U.S. veterans are at a high risk of mesothelioma due to the widespread use of asbestos, the only known cause of this cancer, by the military between the 1930s and early 1980s.

Roughly 1 in 3 mesothelioma patients today is a U.S. veteran — but in far too many cases, veterans get an incorrect or inconclusive diagnosis at first.

U.S. Army veteran Ernie Conry suffered from strange symptoms like shoulder pain for over 5 years before doctors finally diagnosed him with mesothelioma.

“Various doctor visits could prove nothing. I can’t blame them, because it’s a hard disease to diagnose.”

— Ernie Conry, U.S. Army veteran with mesothelioma

3 Factors That Lead to a Mesothelioma Misdiagnosis

There are three main factors that make mesothelioma hard to diagnose. Learn about each below.

1. Mesothelioma Is Rare

Mesothelioma is a very rare type of cancer, so doctors may not think to check for it when you report your symptoms.

Number of Annual Diagnoses in the U.S.

Heart failure 550,000
Lung cancer 228,820
Ovarian cancer 21,750
Mesothelioma 3,000
*Sources: American Cancer Society, National Institutes of Health

For this reason, you need to advocate for yourself and tell your doctor if you’re worried you could have mesothelioma — especially if you were exposed to asbestos in the past.

2. Mesothelioma Has a Long Latency Period

Mesothelioma usually doesn’t develop until 10-50 years after exposure to asbestos. This long gap between exposure and symptoms is called the latency period.

At first, you or your doctors may not think that your symptoms are related to asbestos exposure that happened decades ago. You may not even remember where or how your exposure occurred.

3. Mesothelioma Has Vague Symptoms

Symptoms of mesothelioma are mild at first and shared by many other health problems, so doctors may not immediately suspect that you have this cancer.

Common mesothelioma symptoms include:

  • A cough
  • Difficulty breathing
  • Fatigue
  • Fever
  • Loss of appetite
  • Weight loss

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Pleural Mesothelioma Misdiagnosis

Pleural mesothelioma is the most common type of this cancer, and it forms in the lining of the lungs (pleura).

Pleural mesothelioma may be misdiagnosed as:

  • Chronic obstructive pulmonary disease (COPD)
  • Emphysema
  • Influenza
  • Lung cancer
  • Pneumonia
  • Pulmonary fibrosis
  • Other respiratory conditions

Pleural mesothelioma shares many symptoms with the health problems listed above, like shortness of breath, a dry cough that won’t go away, and fluid buildup in the lungs (pleural effusion).

Because of this, and since it is less common than those other conditions, doctors may not accurately diagnose it at first.

Art’s Pleural Mesothelioma Misdiagnosis
Military BranchU.S. Army & U.S. Air Force
Civilian JobMechanic
MisdiagnosisPneumonia

Art Putt developed a cough decades after working with asbestos brakes as a mechanic. After performing an X-ray, his doctor thought he had pneumonia. However, more tests revealed he had pleural mesothelioma. Fortunately, Art has become a long-term survivor with treatment.

Peritoneal Mesothelioma Misdiagnosis

Peritoneal mesothelioma forms in the lining of the abdomen and is the second-most common mesothelioma type.

Peritoneal mesothelioma may be misdiagnosed as:

  • Crohn's disease
  • Gallstones
  • Hernia
  • Irritable bowel syndrome (IBS)
  • Ovarian cancer

The symptoms of peritoneal mesothelioma include pain in the abdomen, swelling, and nausea — the same symptoms caused by a variety of abdominal conditions.

“I went back to have another X-ray and another CT scan, and they also drew blood to make sure that it was peritoneal mesothelioma because they said it could be that, or I could have Crohn's disease.”

– Brenda, peritoneal mesothelioma patient

Call (877) 450-8973 now for free help finding mesothelioma doctors who can make sure you get an accurate diagnosis.

Mesothelioma Misdiagnosis of Rarer Types

Pericardial mesothelioma (cancer of the heart lining) and testicular mesothelioma (cancer of the testes lining) are two of the rarest forms of this cancer, with both types accounting for around 1% of all mesothelioma cases.

These types can also be easily misdiagnosed, considering how rare they are.

Pericardial Mesothelioma Misdiagnosis

Pericardial mesothelioma may be misdiagnosed as:

  • Angiosarcoma
  • Congestive heart failure
  • Coronary artery disease
  • Heart disease
  • Late-stage lung cancer

Pericardial mesothelioma symptoms include chest pain, coughing, and difficulty breathing, which are often mistaken for other heart and lung issues. Up to 90% of patients actually aren’t diagnosed until they’ve passed away.

Testicular Mesothelioma Misdiagnosis

Testicular mesothelioma may be misdiagnosed as:

  • Epididymitis
  • Hernia
  • Infection
  • Physical trauma
  • Testicular cyst

Testicular mesothelioma can cause swelling in the scrotum (hydrocele), which is often mild and rarely caused by cancer in general. For this reason, doctors may not think to test patients with this symptom for any kind of cancer.

Misdiagnosis of Mesothelioma Stages

The four mesothelioma stages allow doctors to classify how far the cancer has spread through the body, and an incorrect diagnosis could negatively impact your treatment plan.

Common misdiagnoses by mesothelioma stage include:

  • Early stages (1 and 2): Flu, pneumonia, other respiratory illnesses
  • Late stages (3 and 4): Late stages of other cancers

Even if a doctor is able to identify mesothelioma right away, they can still make mistakes when staging the cancer.

Did you know?

Between 70% and 80% of stage 1 and 2 pleural mesothelioma patients are “upstaged” during surgery, according to a 2022 report published in the Journal of Clinical Oncology. This means their initial stage was higher than originally thought.

Mesothelioma can also be misdiagnosed as a different stage of cancer. Over 40% of misdiagnosed mesothelioma cases were mistaken for metastatic (advanced late-stage) carcinoma, according to a 2024 report from the Annals of Diagnostic Pathology.

Misdiagnosing Mesothelioma Cell Type

Besides assessing if a patient has mesothelioma and the cancer’s stage, doctors also need to avoid misdiagnosing your mesothelioma cell type.

There are three mesothelioma cell types: epithelioid, sarcomatoid, and biphasic. The epithelioid cell type is the easiest to treat.

Doctors can misdiagnose mesothelioma cell type because:

  • They might mistake mesothelioma cells for normal cells or the cells of other cancers like adenocarcinoma.
  • In cases of biphasic mesothelioma, tumors have both epithelioid and sarcomatoid cells. When doctors take a sample of the tumor and study it, they might only see one of the two cell types.

For these reasons, pathologists (who study fluid and tissue samples to make a diagnosis) need to take extra care to avoid misdiagnosing the cell type.

“It’s common for a mesothelioma diagnosis to either not be established the first time or to be the wrong diagnosis since it can look like other diseases. So, it is important that the pathology be reviewed by a pathologist in a center where there’s knowledge and experience in looking at this cancer.”

— Dr. Joseph Friedberg, mesothelioma specialist

Use our Free Doctor Match for help finding local specialists who can accurately diagnose you.

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Second Opinions for Mesothelioma Misdiagnosis

One of the best ways to prevent a mesothelioma misdiagnosis is to get a second opinion. This is where another doctor will review your original diagnosis to ensure it’s accurate.

Getting a second opinion is important because:

  • If your doctor confirms the initial findings, you can have peace of mind knowing you were accurately diagnosed.
  • It could result in a different diagnosis with a better prognosis.
  • You may qualify for more mesothelioma treatment options, resulting in a better outcome

Don’t feel embarrassed about getting a second opinion — your doctors won’t be offended and may even encourage you to do so.

Use our Free Doctor Match for help getting in touch with a mesothelioma specialist for a second opinion.

Free Mesothelioma Doctor Match for Veterans
  • Find top mesothelioma doctors near you
  • File for VA health care to cover costs
  • Get advice on the best treatments

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How to Get the Right Mesothelioma Diagnosis

You have a better chance of getting an accurate mesothelioma diagnosis by working with a doctor who specifically treats this cancer.

How Specialists Diagnose Mesothelioma

Physical Exam1

Physical Exam

A specialized mesothelioma doctor begins by performing a physical exam, looking for symptoms that can rule out other conditions.

Imaging Tests2

Imaging Tests

Diagnostic tests such as X-rays, CT scans, and MRIs may be ordered to look inside your body for possible mesothelioma tumors or abnormalities.

Biopsy3

Biopsy

Doctors can collect tissue or fluid samples from a suspected tumor through a biopsy. They then send the biopsy samples to a lab to look for mesothelioma cells.

A biopsy is the only way to confirm a mesothelioma diagnosis.

Connect With a Mesothelioma Doctor to Avoid Misdiagnosis

You need a prompt and accurate diagnosis if you want to improve your chances of becoming a mesothelioma survivor.

If you or a U.S. veteran you love may have been misdiagnosed, make sure to connect with a specialist as soon as possible.

A mesothelioma specialist can:

  • Review your diagnosis to make sure it’s accurate
  • Offer their own opinion if they think you’ve been misdiagnosed
  • Provide guidance on the best treatments for you

If you’re a veteran with mesothelioma, we can help you find top cancer doctors in the U.S. Department of Veterans Affairs (VA) health care network — or ones that are closer to home.

Call (877) 450-8973 now or use our Free Doctor Match for help finding a mesothelioma doctor who can diagnose you correctly.

Mesothelioma Misdiagnosis FAQs

Can mesothelioma be mistaken for something else?

Yes. 22.6% of mesothelioma cases are misdiagnosed as other health problems like lung cancer, pneumonia, or the flu.

Many patients require a second opinion (where another doctor reviews an initial diagnosis) to determine the correct type and stage of their cancer.

Why is mesothelioma so hard to diagnose?

Mesothelioma is hard to diagnose for three main reasons:

  1. The cancer is very rare, affecting roughly 3,000 people per year
  2. It develops 10-50 years after asbestos exposure, so you or your doctor may not suspect it at first
  3. Initial symptoms are often mild and similar to those of other diseases

Be sure to share any history of asbestos exposure with your doctor, as this is the only known cause of mesothelioma. Doing so can increase your odds of getting a correct diagnosis faster.

What cancer mimics mesothelioma?

Doctors can mistake pleural mesothelioma for late-stage breast or lung cancer that has metastasized (spread) to the lung lining, according to a report from the Archives of Pathology & Laboratory Medicine.

Peritoneal mesothelioma, which forms in the lining of the abdomen, could be mistaken for ovarian cancer on imaging scans.

For this reason, doctors rely on biopsies to avoid a mesothelioma misdiagnosis. With a biopsy, a sample of possibly cancerous fluid or tissue is removed and studied under a microscope to see what type of cancer (if any) is present.

How do you rule out mesothelioma?

A biopsy is the only way to completely rule out mesothelioma. With this test, doctors can see if any tumors you have are made up of mesothelioma cancer cells.

Doctors may also perform X-rays, CT scans, or other imaging tests as part of the diagnosis process.

How long can you live with untreated mesothelioma?

Most patients only live a few months with mesothelioma if they don’t get treated.

Pleural mesothelioma patients typically live 4-12 months, while peritoneal patients have an average survival of 6-12 months in cases where treatment isn’t sought. A mesothelioma misdiagnosis can delay your treatment and worsen your life expectancy.

It’s important to get an official diagnosis quickly if you think you may have mesothelioma, so you can get the treatments needed to live longer.

Veterans Support Team
Todd Gersten, MD PhotoReviewed by:Todd Gersten, MD

Double Board-Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Todd Gersten, MD, is a double board-certified medical oncologist and hematologist specializing in general adult oncology and hematologic disease. He is a physician partner with the Florida Cancer Specialists and practices in Wellington, Florida.

Dr. Todd Gersten is an independently paid medical reviewer.

Christopher Dryfoos PhotoWritten by:

Contributing Author

Christopher Dryfoos is a journalist and member of the American Medical Writers Association (AMWA). As the grandson of the U.S. Navy’s first forensic pathologist, he aims to help veterans with mesothelioma access needed care.

  1. American Cancer Society. (2018, November 16). Test for Malignant Mesothelioma. Retrieved April 29, 2024, from https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/how-diagnosed.html
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  3. Carney, J. et al. (February 2024). The over diagnosis of diffuse mesothelioma: An analysis of 311 cases with recommendations for the avoidance of pitfalls. Retrieved April 29, 2024, from https://www.sciencedirect.com/science/article/abs/pii/S1092913423001466
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  9. University of Maryland Medical Center. (2016, February 16). How is Mesothelioma Diagnosed? https://www.youtube.com/watch?v=kL_cUs6xAr8