A recently published case study of a 56-year-old mesothelioma patient has highlighted the importance of informing healthcare professionals about occupational history. Lack of knowledge of the patient’s occupational asbestos exposure combined with his history of hypertension distracted emergency department personnel from his other symptoms, delaying diagnosis and treatment of his mesothelioma.
Mesothelioma Diagnosis Delayed by Multiple Symptom Presentation
The mesothelioma patient’s case history was recently published in the online medical journal Cureus as documented by medical students and staff at the Medical College of Wisconsin. The patient, who died months after his initial presentation at the hospital’s emergency department, originally complained of tongue swelling and a minor cough. The staff noted a medical history that included hypertension and ulcerative colitis, diagnosed him with a side effect from his medications, and treated him for that and for anxiety.
Ten days later the patient reported to the emergency department again with a worsening cough, tachycardia, and shortness of breath, and noted that when he’d told his primary care physician of these symptoms and others, his symptoms had been blamed on his anxiety. He informed the emergency department team of an 8-pound weight loss, night sweats, chest pain upon deep inhalation, and fatigue. His smoking history was noted, as well as other concerning signs on physical exam. He was admitted to the hospital for further tests and inpatient care.
Mesothelioma Diagnosis Delayed
Though the workup from the patient’s six-day stay revealed mesothelial proliferation, it was not until after he was discharged and then presented again later the same month that his malignant mesothelioma diagnosis was made. The diagnosis was based on biopsies taken previously, and a hematology/oncology specialist later noted his prior work in heating, ventilation, and air conditioning which had exposed him to asbestos. The patient was not a candidate for surgery. After palliative chemotherapy, his condition deteriorated: he requested enrollment in hospice and died at home.
In their discussion of the case, the Wisconsin team noted both the aggressive nature of malignant mesothelioma and the importance of taking a complete history that includes occupational history. They wrote, “While it may be difficult given the demands of the healthcare systems, this case was a call for taking a complete history as opposed to a focused history for initial presentations. The case certainly highlighted the importance of taking occupational history, as the patient’s prior asbestos exposure as an HVAC worker may have led to earlier confirmation of diagnosis and treatment plans.”
If you or someone you love has a history of exposure to asbestos, it is essential that this information be included in your medical history and in every interview with a healthcare professional. For more information, contact the Patient Advocates at Mesothelioma.net today at 1-800-692-8608.
