Sarah B. Goldberg, MD, MPH, assistant professor of medicine, Yale School of Medicine and Yale Cancer Center, discusses the diagnosis of mesothelioma.
This is an extremely rare disease that is usually seen in patients with prior asbestos exposure, Goldberg says. However, mesothelioma can be seen occasionally in patients without prior exposure to the carcinogen. This disease can be difficult to diagnose because sometimes patients will have shortness of breath or experience pulmonary symptoms and be found to have pleural effusions.
Sometimes, Goldberg adds, draining the pleural effusion does not show any evidence of cancer and patients can go for many months without a [ diagnosis of mesothelioma ]. Often, diagnosing the disease requires a biopsy of the pleura itself. Because the disease typically presents in the advanced stage, it cannot be treated with curative surgery. The standard frontline chemotherapy for these patients is cisplatin plus pemetrexed.