How will I learn about my biopsy results, and how can I be sure the diagnosis is mesothelioma?
Biopsies are the only method to confirm a certain cancer-related diagnosis. Tissues update doctors about the type as well as stage of cancer cells and can help create a more specific treatment plan. The exact process utilized depends on the type of cancer cell involved, but medical professionals routinely utilize anesthesia to keep pain in control.
Advice on Preparing for the Biopsy
Finding out that you need a biopsy is often a scary experience. With adequate planning, however, a biopsy is nothing to worry about. Some of the steps that you should take in navigating a biopsy include:
- Avoiding eating or drinking any substance six hours before the biopsy
- Discontinue taking blood-thinning medication at least five days before undergoing the biopsy
- Wearing loose clothing to the biopsy
- Make sure you have a designated driver to take you home
- Anticipate that the biopsy will take several hours. Remember, however, that some biopsies require a one-night stay at a medical facility.
What You Should Know in Advance of Receiving a Biopsy
A pathologist plays a critical role in performing cancer diagnosis and if necessary can help you with cancer care. A medical professional will examine the tissue extracted during a biopsy and perform an appropriate diagnosis. Some of the things that anyone who receives a biopsy including one for mesothelioma should know include:
- The exact size and location of where the biopsy is taken matter. Pathologists are taught to examine various types of discussion and rely on a microscope to assess cells within samples. Sometimes, biopsy samples are not large enough to evaluate. In other cases, pathologists locate samples that were not removed from the appropriate area. Pathologists will request that your medical provider repeat the biopsy so a sufficient diagnosis can be performed.
- The length required for biopsies varies. Some biopsies can be conducted in a medical provider’s office or outpatient including shave biopsies, cervical biopsies, fine needle biopsies, pap tests, and punch biopsies. In most cases, these procedures go quickly and take anywhere from 15 to 30 minutes to conduct based on the area of the body subject to biopsy. Often, the samples removed during biopsy are then transported to the pathologist’s lab for processing. The processing of tissue takes several steps but begins with making sure that the appropriate test was performed on the appropriate patient. Based on the evaluation required, the steps that follow can take hours or days. If a pathologist believes in mesothelioma, he or she will likely take additional steps to assess the sample. This process takes anywhere from 24 to 96 hours based on the complexity of the illness. It’s often difficult to wait for the results of a biopsy, but you should take comfort in knowing that the pathologist is utilizing years of experience to make sure an accurate diagnosis is received.
- Pathologists oversee tissue samples and must utilize appropriate judgments. Samples let pathologists perform subsequent tests which determine where tumors originated. This can prove helpful in treating metastatic cancer that spreads from one part of the body to another. Your pathologist can make sure that biopsy samples are utilized to distinguish other factors that influence your recovery. Pathologists often assess genetic changes that could influence treatment options that could shape your recovery changes. As we distinguish more aspects of cancer from biopsies, we can distinguish an increased number of patients who stand to gain from advanced targeted therapy.
- Biopsy samples are stored in a secure location to help future treatment. Federal regulation requires laboratories to safely store samples for a fixed time. By holding onto tissue samples for an extended period, pathologists can assess the primary tumor if a patient with cancer experiences a recurrence later on. By reviewing the sample, a pathologist can determine if the original tumor has returned or if new cancer has occurred. We also assess samples if new treatments for a tumor become available.
- Both pathologists and patients can pursue multiple opinions. Pathologists routinely share cancer diagnoses with associates, particularly if a patient experiences cancer that is either difficult to treat or diagnose. Additionally, pathologists routinely participate in boards that review tumors. This team approach helps to make sure that patients receive accurate and detailed diagnoses.
While less accurate than other biopsies, medical professionals sometimes perform fine-needle aspiration or liquid biopsies referred to as cytology tests for tumor tissue, which can be challenging to biopsy. During cytology tests, a medical provider removes fluid from the site of what is believed to be a tumor. Pathologists then examine the liquid under a microscope to look for the presence of cancerous cells. In the case of solid tissue samples, medical providers remove a section of the suspected tumor during a biopsy. A pathologist next looks under a microscope to assess the types and characteristics of cancer cells.
Patients go under general anesthesia during thoracoscopy. During this procedure, a medical provider places a tiny camera between the patient’s ribs to assess whether a chest cavity exists. A thoracoscope, a type of camera equipped with a scope, also pulls out excess fluid and gathers small tissue samples as biopsies. Thoracostomies are a common type of mesothelioma biopsy because thoracotomies are the most detailed type of mesothelioma biopsy because they gather soft tissue samples from the primary tumor. Patients fall asleep during the procedure, and then take several weeks to recover. Thoracoscopy also carries a risk of pneumonia.
Physicians perform a mediastinoscopy to assess if cancer can be found in the central chest region, which is referred to as the mediastinum. The patient receives general anesthesia during the procedure, during which time the medical provider places a small camera into the basis of the neck to receive biopsies of the lymph node collected around the windpipe. Similar to thoracoscopy, devices utilized in this process let surgeons assess the area while removing surplus fluid and receiving biopsy samples. Medical providers utilize the samples to assess the cancer stage based on the degree of cancer found within the lymph nodes.
Thoracentesis needs only local anesthesia and is less invasive than either mediastinoscopy or thoracoscopy. Medical providers engage in these procedures utilizing an ultrasound probe, and the ordeal only takes 15 minutes. The physician places a small needle in the ribs on either the side or back to drain pleural fluid that collects around the lungs. Thoracentesis is valuable because it is utilized to assess pleural effusion, but biopsy samples from this procedure are routine of lesser quality.
Aspiration with a Needle
Aspiration with a needle involves a tiny needle placed between the ribs. Compared to other types of biopsies like thoracentesis, the goal of a final needle biopsy is to sample a mass while a patient remains in the CT scan machine. Even though it is not as accurate as solid tissue biopsy, a needle biopsy can eliminate other illnesses as well as confirm a diagnosis of mesothelioma in combination with radiology imaging.
In 2016, medical professionals relied on endobronchial ultrasound to perform biopsies and distinguish tumor samples. This strategy relies on a bronchoscope to assess the bronchi, which play a critical role in the upper respiratory tract. Medical professionals combine transbronchial needle aspiration with endobronchial ultrasound to receive tissue samples from the thoracic area. This process bears a resemblance to fine-needle aspiration.
Advice for During the Procedure
Based on the part of your body that is biopsied, you might need to lie on your stomach or other times sit up during a procedure. For certain types of biopsies, you might need to hold your breath while the needle is placed inside your body. You can expect your medical team will let you know before the biopsy how the process will develop.
Before most biopsies, a person will receive anesthesia, which is valuable to block the pain that a person experiences during the procedure. What anesthesia is utilized is influenced by the kind of procedure and what part of the body is biopsied. Some of the types of anesthesia that might be utilized include:
- Local anesthesia. An injection of this medication numbs the location where a procedure is performed. You might experience some stinging when a medical professional injects anesthesia
- through the use of a needle.
- Conscious sedation or monitored anesthesia utilizes medications to help the patient relax. It is often administered intravenously and is frequently combined with either local or regional anesthesia.
- General anesthesia leaves a person unconscious during a major medical procedure. If a person receives general anesthesia, the individual will not be aware of the procedure.
Following a Biopsy
The amount of time a person takes to recover after a biopsy depends on various factors, which include:
- The invasiveness of the biopsy. The least invasive procedures do not require recovery time. Many people can resume normal activities promptly following the procedure. More invasive biopsies frequently require greater recovery time. If you receive sedation during anesthesia, you will often need someone to take you home following the procedure.
- Following a biopsy, you should speak with a medical professional about the area where the biopsy is performed. You should be aware of the various complications that can result from the biopsy. Some symptoms you watch out for include fever, infection, bleeding, and substantial pain.
- If you discover yourself bleeding after your biopsy, you should not hesitate to contact your medical provider. If you have a bandage, you should do your best to keep the bandage on. Many people are permitted to take showers 24 hours following their biopsy. Do your best to keep the area both clean and dry. If you encounter any bruising or swelling, you should place ice on the area.
What Makes Diagnosis of Mesothelioma Difficult
Mesothelioma is a rare and nuanced illness. Performing a mesothelioma diagnosis is difficult because a large number of general practitioners and other medical professionals have never encountered the illness or understood its complexities.
Asbestos-associated illnesses including mesothelioma take approximately 20 years to develop and symptoms often resemble other more common illnesses. In most situations, only a medical professional can perform an early diagnosis of mesothelioma as well as offer timely treatment and an improved prognosis.
The Misdiagnosis of Mesothelioma
Mesothelioma is sometimes misdiagnosed as a less deadly illness or cancer. The initial stages of mesothelioma can appear like other cancers, heart issues, or even pneumonia. Sometimes, the diagnosis of peritoneal mesothelioma misdiagnosis can also include irritable bowel syndrome and various types of cancer.
In one study published by the Journal of Thoracic Oncology, medical researchers studied the rate of mesothelioma misdiagnosis in over a thousand patients. Misdiagnosis happened in approximately half of the mesothelioma patients. Over 80% of patients with stage 1 mesothelioma received an incorrect diagnosis before a medical provider later diagnosed them with a developed condition.
Detailing a person’s history of asbestos exposure and working with a well-known cancer center focused on mesothelioma is critical to making an appropriate diagnosis. Medical professionals at cancer centers of this kind often have the skill and experience necessary to perform adequate diagnoses of these conditions.
Adequately Staging Mesothelioma
Adequately staging mesothelioma is a critical but difficult part of the diagnosis. Staging determines the degree to which cancer has progressed, which is the most substantial factor in assessing what treatment is adequate for a patient.
Staging depends on a patient’s symptoms, physical exams, and radiology determinations to assess a preliminary stage. Surgical staging involves solid tissue samples but offers a definitive diagnosis. Staging also helps distinguish the life expectancy of a person with mesothelioma.
Clinical staging relies on the use of imaging scans as well as biopsies to assess the stage. Imaging tests including PET scans are the preferable strategy that medical professionals rely on to distinguish the stage of mesothelioma.
Surgical staging procedures including mediastinoscopy and thoracoscopy are more invasive procedures and involve less extensive surgery. These procedures are valuable to assess with greater detail the degree of cancer and whether tumors have dispersed past the pleural lining or even into the lymph nodes.
During clinical staging, if a scan shows tumors have spread to other organs, which is referred to as late-stage mesothelioma, the medical provider can utilize a needle biopsy to establish this diagnosis.
The Latency Period
The lengthy period of latency connected with asbestos-associated illnesses equates to decades elapsing before patients end up facing symptoms. This lengthy time makes prompt diagnosis challenging because patients often fail to realize that they are sick unless they have a recorded history of asbestos exposure. Patients sometimes forget or fail to state details about their history of asbestos exposure. As a result, medical professionals might fail to consider mesothelioma as a potential diagnosis. Not properly communicating about a person’s condition can result in diagnosis delays and subsequently let cancer progress without sufficient treatment.
A Few Reasons Why a Mesothelioma Diagnosis is So Challenging
Some noticeable factors make a mesothelioma diagnosis especially difficult. Some of these factors include:
- Many people are not aware that they are still at risk of being diagnosed with mesothelioma. Instead, most people are under the impression that asbestos has been prohibited and no longer places people in danger. In reality, this is not the case. Asbestos is prohibited in over 60 countries but is legal in the United States. While more regulations exist addressing asbestos, individuals are still in danger of being exposed to asbestos.
- Mesothelioma has an especially long latency period. After asbestos enters the body, it can take several decades before symptoms of the illness become bad enough to pursue medical treatment. This extended latency period makes it more challenging to realize what’s going wrong. Many people do not immediately think of exposure that occurred long ago when they first experience these symptoms.
- People are not aware they were exposed. Years of research associate high-risk asbestos occupations with the danger of mesothelioma. Individuals who performed jobs directly exposed to the toxic substance place themselves in danger of inhaling mesothelioma.
- The symptoms of mesothelioma are difficult to recognize. The first signs of mesothelioma are often similar to various non-life-threatening diseases. People often ignore the symptoms of mesothelioma or associate them with more routine illnesses like the common cold. Other people associate the signs of mesothelioma with aging.
- Many medical professionals have not seen mesothelioma. Mesothelioma is especially rare, which means most medical professionals have limited experience in diagnosing the illness. As a result, misdiagnosis of mesothelioma is especially common.
Prognosis of Mesothelioma
When a medical professional makes a diagnosis of mesothelioma, the medical professional also sometimes describe the patient’s condition as well as prognosis. A prognosis refers to a description of how the patient is likely to respond to treatment. Some medical providers hypothesize prognosis following diagnosis, while other medical providers wait to analyze the patient’s reaction to the beginning stages of therapy. Medical providers experience difficulty predicting mesothelioma in patients because no cases are the same. To make a prognosis, medical professionals rely on various factors including mesothelioma stage, cell type, location as well as the patient’s condition, age, and wellbeing.