The Accuracy of Mesothelioma Diagnoses and Treatment Options

Posted on Friday, October 14, 2016

Mesothelioma is a rare and aggressive form of cancer that develops in the mesothelial tissue lining the lungs, abdomen, or heart. The only scientifically established cause of mesothelioma in the United States is exposure to asbestos. Long-term occupational exposure in the petro-chemical industry, shipyards, steel mills and foundries and the construction industries leads to a greater risk of developing the deadly cancer, but even short-term and household exposures to asbestos can cause mesothelioma. Asbestos use in the United States has dropped dramatically in recent decades, and yet a steady number of people continue to be diagnosed with mesothelioma each year due to the lengthy latency period. It can take anywhere from 20 to 50 years after a person’s last asbestos exposure for symptoms to appear. Roughly 3,400 Americans are diagnosed with mesothelioma each year in the United States, with the disease occurring more often in men than in women.

It is critical that a definitive diagnosis of mesothelioma is confirmed as opposed to lung cancer. Lung cancer develops within the lungs while mesothelioma is found most often in the pleural lining outside the lung. Traditionally, doctors have had only a few basic methods to test for mesothelioma. Most patients initially undergo a basic chest x-ray to check for abnormalities, with more detailed imaging scans (such as a PET, CT, or MRI scan) being recommended if any growth is detected. If cancer is suspected, a surgeon will perform a biopsy of the growth in order to obtain a tissue sample. The tissue sample is then studied by a pathologist who conducts certain tests, referred to as stains, to confirm the presence of mesothelioma cells. Blood tests have been available as well, but the tests could not confirm the presence of mesothelioma to the same degree of accuracy as imaging scans and biopsies. Due to the limitations of these tests, it has been estimated that up to 10 percent of mesothelioma cases are being misdiagnosed in the United States each year.

However, researchers at the University of Hawaii Cancer Center have recently identified another tool for diagnosing pleural mesothelioma. Dr. Michele Carbone and his research team have discovered that a tumor-suppressing protein called BAP1 can help oncologists accurately differentiate mesothelioma from other lung cancers, insofar as people lacking the BAP1 protein are more likely to develop mesothelioma than the general population. Specifically, the study found that all 45 non-small lung cancer samples tested positive for normal BAP1 expression, whereas only half of the 35 pleural mesothelioma samples tested positive for BAP1.

Based on these results, researchers believe that the diagnostic accuracy of mesothelioma tests would be better if BAP1 were included in the recommended panels. Given that the inability to diagnose mesothelioma in the earliest stages is a major reason why the life expectancy of a mesothelioma patient is so short (6-18 months), better early detection accuracy could greatly expand a patient’s treatment options.

Provost Umphrey has been assisting the victims of asbestos exposure and their families for fifty years. If you would like more information about these cases, please contact Bryan Blevins at 409-838-8858 or submit a contact form here.

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