Why Diagnosing Mesothelioma Is Often Difficult

Diagnosing mesothelioma early is one of the biggest hurdles in treating this rare and aggressive cancer.

A recent case study highlights the many challenges patients and doctors face, from vague symptoms to inconclusive test results. This particular case followed a 58-year-old woman who eventually received a pleural mesothelioma diagnosis after months of uncertainty.

“Malignant pleural mesothelioma is notoriously challenging to diagnose early, as initial symptoms like chest pain, dyspnea [shortness of breath], and pleural effusions are often nonspecific and mimic other pulmonary conditions.”

– Authors of “Diffuse Pleural Mesothelioma: A Challenge in Early Diagnosis”

While the road to diagnosis was far from smooth, her treatment team’s efforts extended her life well beyond the average prognosis for mesothelioma patients.

Learn more about her story, why mesothelioma is so difficult to diagnose, and some key lessons that can benefit other patients and caregivers.

Why Is Diagnosing Mesothelioma Harder Than Other Cancers?

Mesothelioma is a rare and aggressive cancer, which means most doctors don’t see it often enough to catch it right away. On top of that, its symptoms can easily be mistaken for more common illnesses like pneumonia, asthma, or even a bad cold.

This particular patient reported:

Chest pain
Ongoing low-grade fever
Worsening shortness of breath

Her medical history — which included high blood pressure and a history of smoking — made things even more complicated.

To make matters worse, she got COVID-19 soon after arriving at the clinic, which delayed her diagnosis even longer.

Understanding mesothelioma and navigating the path to diagnosis can feel overwhelming. Get our Free Mesothelioma Guide for helpful information about symptoms, diagnostic tests, and treatment options.

The Tests That Didn’t Provide Clear Answers

One of the most frustrating parts of this patient’s story was how many tests her doctors had to complete before getting an answer.

Here’s what they tried:

A thoracentesis found abnormal cells that suggested cancer, but it wasn’t enough to confirm a mesothelioma diagnosis.
A chest CT scan was done, which showed significant fluid buildup around the right lung (pleural effusion).
A biopsy was taken, but it couldn’t provide a clear diagnosis due to inflammation in the lungs.
A bronchoscopy was performed to look inside the lungs, but it showed a normal larynx and no visible signs of cancer.
They ran microbiological tests, but they didn’t find any evidence of cancer-causing organisms.

The specialists also wanted to perform a thoracoscopy to examine the inside of the chest cavity, but the patient postponed the procedure after her follow-up imaging scans.

The Turning Point: Diagnosis and Treatment

More than three months later, a thoracoscopy and biopsy confirmed the patient had pleural mesothelioma (cancer of the lung lining).

Her treatment plan consisted of:

Pleurectomy surgery to remove the pleura (lung lining)
Six cycles of post-surgery chemotherapy with cisplatin and pemetrexed
Immunotherapy with Keytruda®
Maintenance chemotherapy with pemetrexed

Despite her delayed diagnosis, she responded favorably to treatment for 33 months before signs of the cancer returned. Her care team started radiation therapy in June 2024 to target the new lesion.

Multimodal therapy played a key role in extending this patient’s life expectancy far beyond the average prognosis for mesothelioma patients, which is 12-21 months.

“The continued resistance of malignant pleural mesothelioma to standard treatments signals a critical need for research into targeted therapies and immunotherapy, which could ultimately reshape the survival landscape for patients.”

– Authors of “Diffuse Pleural Mesothelioma: A Challenge in Early Diagnosis”

What Can We Learn From This Patient’s Story?

This patient’s journey wasn’t easy, but it offers important takeaways for anyone facing mesothelioma.

Early Detection Is Key. As with any type of cancer, the difference between catching mesothelioma early versus when it’s in stage 3 or 4 is massive in terms of increasing your survival time.
Multiple Tests May Be Needed. Mesothelioma doesn’t always show up clearly on the first (or even second) round of tests. It may take time, but persistence pays off.
Work With a Team. A collaborative team of mesothelioma specialists played a crucial role in this patient’s care. By combining their expertise, they were able to interpret complex test results and recommend effective treatments.
Consider All Your Treatment Options. In this case, a combination of chemotherapy and immunotherapy helped the patient live over 2 years in remission before her cancer returned. Staying open-minded can make a big difference.

For patients and caregivers, understanding the challenges of getting a mesothelioma diagnosis can help you advocate for the best possible care.

Get Help With a Mesothelioma Diagnosis

If you or a loved one has been diagnosed with mesothelioma, you don’t have to face this journey alone. Our team is here to support you every step of the way.

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