Malignant mesothelioma is a rare and aggressive form of cancer caused by exposure to asbestos. Though the disease is always considered fatal, early detection significantly improves treatment effectiveness and overall survival time and often improves quality of life. People with known exposure to the toxic material are at high risk, but regular screening before symptoms develop can lead to earlier diagnosis, more options for intervention, and better outcomes.
What is Mesothelioma Screening?
Cancer screening describes the process of looking for cancer before a person has any symptoms. The idea is that by performing screening tests, physicians can help find cancer when it’s at an early stage, before symptoms appear, with the hopes that doing so will make it easier to treat or cure. If cancer isn’t diagnosed until symptoms appear, it may have grown and spread to a point where doctors have fewer treatment options.[1]
For people at risk for malignant mesothelioma, early detection is critical. The disease has an extremely long latency period, and by the time symptoms appear, the disease is generally at an advanced stage. Because of this, doctors who specialize in asbestos-related diseases and cancers recommend that people with known exposures to the toxic material schedule regular imaging tests, including chest X-rays or computed tomography (CT) scans to see whether there have been any changes in their lungs.[2] and recent advances in mesothelioma biomarkers have provided the opportunity for people to submit blood samples for testing. Some researchers are also working on tests that analyze the breath of those at risk for the disease.[3]
While mesothelioma screening cannot prevent a person from getting the disease, it can speed diagnosis, providing those who are at high risk based on their known asbestos exposure with significant advantages. The earlier a mesothelioma diagnosis is made, the more opportunities there are for targeted treatment based on the patient’s unique disease characteristics and genetic makeup, as well as for enrollment in innovative clinical trials.
Asbestos Exposure and Mesothelioma
Being exposed to asbestos is the primary risk factor for malignant mesothelioma and other asbestos-related diseases including asbestosis and asbestos-related lung cancer. Of all of these illnesses, mesothelioma is the deadliest, as well as the most difficult to diagnose. The disease has a latency period of 20 to 60 years, meaning it can take decades between the time of exposure and when symptoms appear. The resemblance between mesothelioma symptoms and those of other, benign diseases can delay diagnosis, allowing the disease to progress even further. For this reason, it is essential for those who have known exposure to asbestos to educate themselves about mesothelioma warning signs and to notify their physician so that they can provide appropriate monitoring of their health.
Mesothelioma screening is appropriate for those with known occupational or environmental asbestos exposure, as well as anybody who may have suffered secondary exposure to family members or friends who unknowingly carried asbestos fibers into their environment on their hair, skin, or clothing.
Screening is meant to provide an early warning. If these tests indicate the potential of mesothelioma, the next step is to undergo more in-depth and specific diagnostic tests including more comprehensive imaging studies, blood tests, and biopsies to confirm the presence of mesothelioma and assess how far the disease has progressed.
Mesothelioma Screening Options
Mesothelioma is so rare and so similar to other diseases in its presentation that even when symptoms appear, it can be challenging to diagnose. For this reason, most physicians run a combination of tests to confirm its presence. For screening done at an early, pre-symptomatic stage, doctors have a choice of imaging scans, blood tests, and pulmonary function tests.
Imaging Scans
Imaging tests are extremely helpful in identifying any abnormalities associated with mesothelioma and can be extremely useful as a screening test. Physicians can get nearly immediate results from these tests and compare new tests to previous studies to see whether there have been any changes. Certain tests can also differentiate malignant pleural diseases from benign lung conditions.[4]
Though chest X-rays are the most accessible imaging tool, they have shortcomings for early diagnosis. X-rays demonstrate malignant pleural mesothelioma best in the later stages of the disease and are not suitable for an early sensitive and specific diagnosis. The better choices are generally computed tomography (CT scans) which can distinguish between different forms of pleural abnormalities, and contrast-enhanced magnetic resonance imaging (MRI), which can also differentiate pleural mesothelioma from other malignancies as well as from benign pleural diseases. MRIs can also provide information about the specific location of tumors in relation to other organs to help physicians plan or avoid surgery. PET scans can also be helpful: they excel at identifying cancer cells, but they may miss tiny lesions.[4]
Biomarker Tests
Biomarkers are chemical substances in the body that can signal the presence of disease. Although no single biomarker has yet been able to definitively diagnose mesothelioma, certain proteins, and genetic markers have proven helpful in early detection. These include:
- Soluble Mesothelin-Related Peptide (SMRP): SMRP, or soluble mesothelin-related protein, is one of the most specific biomarkers for mesothelioma. These proteins are produced and released by cancer cells of the mesothelium. SMRP is normal in mesothelium cells but often overproduced in cancerous cells. The MESOMARK assay is a blood test that measures SMRP levels.
- Osteopontin and BAP1: These markers also support mesothelioma screening. The BAP1 gene, a tumor suppressor, is linked to higher mesothelioma risk, especially in individuals with genetic mutations.
- Calretinin: Calretinin is a protein that binds calcium and plays a role in calcium signaling pathways in the body. The gene known as CALB2 codes for calretinin. A calretinin-positive test usually indicates the presence of mesothelioma in a biomarker stain, though it is not true in 100% of cases.
- High Mobility Group Box Protein-1 (HMGB1): HMGB1 is a mediator between asbestos-related inflammation and the development of mesothelioma. Monitoring these levels can help identify people with asbestos exposure, which could increase screening and treatment options.
If patients’ bloodwork or other tests indicate the potential for malignant mesothelioma, physicians may move on to test fluid from pleural effusions for high SMRP levels. This is often the first confirmation of the rare disease. Still, while these biomarkers provide valuable insights, they are not foolproof. SMRP levels, for instance, can rise due to other asbestos-related conditions, underscoring the importance of comprehensive testing.
Who Should be Screened for Mesothelioma?
Screening is most important for individuals with a known history of exposure to asbestos. Occupational exposure remains the most common cause of mesothelioma and all other asbestos-related diseases, with certain industries and environments posing significant risks to the workers themselves as well as any family members. All of these individuals should consider regular screening for mesothelioma. These include:
- Demolition workers
- Plumbers and pipefitters
- Insulation installers
- Roofers
- Carpenters
- Remodelers and renovators
- HVAC workers
- Construction workers
- Shipyard workers
- Ship repair
- Steel mills
- Industrial workers
- Cement plant workers
- Boiler workers
- Power plant workers
- Firefighters
- Transportation industry
- Automotive workers
- Railroad workers
- Aircraft mechanics
- Tire and rubber workers
- Sheet metal workers
- Oil refineries
- Mining
- Paper mill workers
- Machine operators
- Textile workers
- Electricians
- Engineers
- Chemical plant workers
- Bricklayers, stone masons
- Welders
- Painters
- Aluminum plant workers
- Merchant mariners
- Farmers and agricultural workers
- Linotype and printing press workers
- Hairdressers and barbers
- Warehouse workers
- Teachers and school staff
Individuals living near asbestos mines or natural deposits, or in communities where asbestos processing has been conducted, are also at risk for environmental exposure and should consider mesothelioma screening.
When to See a Mesothelioma Specialist
Individuals who have a known history of asbestos exposure or who manifest symptoms such as persistent cough, shortness of breath, chest pain, or unexplained weight loss should immediately consult with their primary care physician. Depending on the severity of your symptoms and your exposure history, it may also be a good idea to seek a consultation with a mesothelioma specialist. These experienced practitioners generally work in cancer centers and teaching hospitals equipped with the sophisticated diagnostic tools needed to meticulously evaluate your symptoms and conduct comprehensive diagnostic tests.
The more quickly you can see a specialist about your symptoms, the better, especially if you are a high-risk individual with known exposure to asbestos. Early diagnosis can significantly improve your outcome and give you many more options regarding treatment.
Legal Help for Those Who’ve Been Diagnosed with Mesothelioma
If you’ve been diagnosed with malignant mesothelioma, you have several options for claiming compensation.
Mesothelioma Settlement and Lawsuit Claims
Filing a personal injury lawsuit against the company or companies responsible for your exposure and illness can result in a jury awarding you compensation for your costs and the harm that you’ve suffered. A settlement agreement is also possible and is the most common outcome of these types of lawsuits.
Asbestos Trust Funds
Asbestos trust funds were set up by the companies that went bankrupt over asbestos and mesothelioma lawsuits. The bankruptcy courts required them to establish funds specifically for the compensation of those harmed by their negligence. You may be qualified to file a claim against one or more of these funds.
Veterans’ Claims
Veterans of the U.S. military can seek compensation through the U.S. Department of Veterans Affairs (VA). Many military members, especially those who worked on ships and in shipyards, experienced asbestos exposure during their time on active duty.
Veterans benefits can include disability, special compensation, benefits for dependents, and free health care.
Insurance Claims
You may be eligible for one or more types of insurance benefits. You may also have access to workers’ compensation or Social Security Disability Insurance.
How Can a Mesothelioma Lawyer Help?
An experienced mesothelioma lawyer can provide you with more information on all of the options listed above, and help you decide how and where to claim. Their services will include:
- Explain your options for obtaining compensation. An asbestos lawyer can identify the types of compensation for which you’re eligible, explain the choices, and help you decide which to pursue.
- Research your asbestos exposure. One of the requirements for getting compensation is connecting your illness to exposure to a specific product or place. An asbestos lawyer has access to years’ worth of research and case histories that will help them identify the companies and products that caused your exposure and ensure your claim or lawsuit has the best chance of succeeding.
- Law firms that specialize in asbestos cases have substantial resources. In addition to determining the source of your exposure, they can also collect evidence, get samples of old products, subpoena employment records, and identify witnesses from your workplace to support your claim.
More than anything, speaking with an asbestos lawyer will give you the benefit of their experience and knowledge. They have worked with many asbestos victims and understand the emotion, the process, and how to get the maximum compensation for the harm that you’ve suffered.
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