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Mesothelioma Misdiagnosis

Quick Summary

Generally speaking, mesothelioma is not the first disease an oncologist considers. Misdiagnosis is a serious issue because it affects a patient’s health and delays life-saving treatment. Seeing a mesothelioma specialist is the best way to protect yourself. Finding a specialist or getting a second opinion can prevent misdiagnosis and lead to better, faster treatment.

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Understanding A Mesothelioma Misdiagnosis

Mesothelioma doesn’t always have specific symptoms. Its symptoms are often the same as pneumonia. At first, doctors rarely suspect mesothelioma.

Doctors may write off symptoms as some other respiratory illness rather than cancer of the pleural lining. For symptoms in the abdomen, the doctor may be more likely to suspect irritable bowel syndrome.

Did you know?

Your chances of getting a completely wrong diagnosis are lower if you have a history of asbestos exposure. Doctors rarely suspect mesothelioma if the patient has no asbestos exposure history. Most veterans with mesothelioma have a solid exposure history. This history is often from military service, working construction and manufacturing jobs, or both.

Even patients who have already been diagnosed with mesothelioma can have an incorrect diagnosis. Doctors could mistake your disease as stage 3 when it’s actually stage 2. Or your cell type diagnosis could be wrong.

Diagnosing Mesothelioma

Mesothelioma is hard to diagnose. The symptoms mimic other, more common diseases. And it isn’t something an ordinary doctor comes into contact with on a regular basis.

According to the American Cancer Society, “Under the microscope, mesothelioma can often look like other types of cancer.”

It is helpful for patients to get a second opinion if their symptoms are not improving or regressing. Another doctor may be more suspicious of cancer. Or the condition may have spread, making it easier to identify.

Abdominal or chest pain may be so minor that it is written off as musculoskeletal pain or pleurisy. You should never be afraid to seek a second opinion if you aren’t getting better or feel your diagnosis may have been incorrect.

The only true way of diagnosing mesothelioma is by doing a biopsy and taking a sampling of the cancerous tissue. Doctors look at your imaging scans before doing a biopsy. If they see potential tumors on the image, they can take tissue or fluid samples from that area.

Sometimes the tumor shows itself by developing a buildup of fluid. Fluid in the chest or lungs is called a pleural effusion. It’s called ascites when it’s in the abdomen.

Many things can cause fluid buildup in the chest or abdomen. So a doctor may not immediately make the connection between the presence of fluid and possible cancer.

There are many common diseases that have symptoms of chest pain and shortness of breath. Even if a doctor makes the connection between the symptoms and some kind of lung cancer, a mesothelioma tumor can resemble other types of lung or metastatic cancer. The diagnosis of mesothelioma is far down on the list of possibilities due to its rarity. It is unusual for a doctor to identify it right away.

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Difficulties With Diagnosing Mesothelioma

With the symptoms of chest pain and shortness of breath, a doctor may order a CT scan or X-ray of the chest. If a lesion is seen, adenocarcinoma of the lung would be the most likely diagnosis. Adenocarcinoma has a different treatment regime from mesothelioma. The doctor will likely have to have a surgeon perform a biopsy of the tissue to see what kind of cancer is present in the lesion.

Even when a biopsy is done, there can be difficulties in making the diagnosis. When investigated under a microscope, the cancer cells can resemble other types of cancer. Because mesothelioma is such an unusual condition, the pathologist may not recognize mesothelioma and diagnose it as some other kind of lung cancer.

Did you know?

Mesothelioma cells look a lot like adenocarcinoma. This is another type of cancer that takes place in the lungs. Adenocarcinoma is more common than mesothelioma. Doctors may suspect this type of cancer before suspecting mesothelioma. Pathologists can tell the difference between these cancers with an electron microscope.

Sometimes the doctor will attempt to make a cancer diagnosis by taking a fluid sample. Fluid samples are much easier to take than a tissue sample. Doctors just need to extract some fluid buildup from the trouble area with a needle. Sometimes this works, and mesothelioma cells are found in the fluid. But this isn’t as conclusive as a tissue biopsy. Cancer cells are hard to detect in a fluid sample. An actual tissue biopsy is often necessary.

Misdiagnosis of a Patient’s Disease Stage

Sometimes a pathologist is able to identify mesothelioma quickly and efficiently. But doctors can still make mistakes in the staging of the disease. Pleural mesothelioma has four stages, each with specific characteristics. And each stage offers the patient a different set of treatment possibilities.

Sometimes a doctor will determine that the mesothelioma is in the advanced stages of the disease. But it could be more localized. The opposite can also be true. The doctor may feel that the cancer is localized when it has actually spread or metastasized to distant parts of the body.

A patient’s stage plays a large role in treatment. Patients won’t get the best treatment if they aren’t staged properly.

Consider Getting a Second Opinion

If your doctor diagnoses you as having an advanced case of mesothelioma, you should get a second opinion. Your second opinion should come from a mesothelioma specialist. Specialists have more experience correctly staging mesothelioma patients.

Misdiagnosing mesothelioma can mean that you don’t get the right treatment. This is another reason why getting a second opinion is important.

If a second opinion shows your diagnosis was correct, you might want to consider enrolling in a clinical trial. Clinical trials use novel therapies like immunotherapy. This is helpful for patients who don’t have many other options. Clinical trials offer treatment that isn’t available to people outside the trial. Being in a clinical trial can prolong your life by providing you with a better treatment regime than is currently available.

Did you know?

Late stage pleural mesothelioma patients prolonged their survival time to three years in a clinical trial. The results were published in 2017. All patients had surgery with an experimental treatment called photodynamic therapy. Photodynamic therapy uses light to kill mesothelioma cells during surgery.

Misdiagnoses don’t have to be the end of the world. Many people with mesothelioma are misdiagnosed in the early stages. Some are misdiagnosed as having advanced disease when the mesothelioma isn’t as bad as they thought.

When the correct diagnosis is finally made, you can start on a path with the right treatment that could prolong your life. You can ensure you have the right diagnosis by seeing a mesothelioma specialist.

Preventing a Misdiagnosis

Knowing the difficulties of diagnosing mesothelioma is important. You may even prevent misdiagnosis in some cases. Getting an accurate diagnosis is crucial to getting the best treatment possible. Accuracy means knowing the cell type and the correct stage of your disease.

Some things to keep in mind about mesothelioma misdiagnosis are:

  • A conclusive diagnosis is only possible with a biopsy.
  • Mesothelioma looks like some other more common cancers.
  • Your cell type or disease stage can be misdiagnosed.

If you have any doubts about your mesothelioma diagnosis, it’s a good idea to get a second opinion. Another opinion from a mesothelioma specialist could produce a new outcome for you. It could mean more treatment options or new eligibility for surgery. At the least, it can lead to peace of mind that you are doing everything you can.

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.

View Sources

American Cancer Society. “How is Malignant Mesothelioma Diagnosed?” Retrieved from: Accessed on August 28th, 2017.

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