Blood Tests
In recent years, researchers have spent a considerable amount of time developing mesothelioma blood tests.
These tests analyze your blood for proteins and other substances
(biomarkers) that are present in mesothelioma patients. Early studies
suggest these blood tests have the potential to play a role in testing
for mesothelioma, but they are not yet reliable enough to confirm a
diagnosis on their own.
All of the mesothelioma blood tests are ELISA-based, meaning enzyme-linked immunosorbent assay, and they use enzymes to detect protein antibodies in blood samples.
The FDA-approved MESOMARK test can detect soluble mesothelin-related peptide (SMRP), a protein and mesothelioma biomarker. Extensive research shows that SMRP is helpful to monitoring tumor response to treatment, but it cannot definitively diagnose mesothelioma.
Too many false positives are recorded and some cases of cancer go undetected using MESOMARK. The test’s potential to screen for mesothelioma among people exposed to asbestos is questionable as well; one study found it helpful at identifying persons at risk of mesothelioma and another study did not.
The SOMAmer test can detect more than 1,000 proteins in blood serum, and these proteins may have diagnostic value in identifying mesothelioma. A 2012 study analyzed blood serum samples from 117 malignant mesothelioma cases and 142 people exposed to asbestos. These samples detected 13 protein biomarkers that helped to accurately identify malignant mesothelioma.
The test accurately detected malignant mesothelioma in 90 percent of cases and ruled out the cancer in 95 percent of people without the cancer. The biomarker levels correlated with cancer stage, indicating the test may have value in monitoring the progress of mesothelioma. Continued analysis of more cases of mesothelioma is needed to validate the worth of the SOMAmer test.
The Human MPF test measures a protein called megakaryocyte potentiation factor (MPF), which is produced by a mesothelin precursor protein. MPF levels increase as mesothelioma tumors grow and are detected in about 91 percent of late-stage patients. The test can rule out mesothelioma in 95 percent of people who don’t have the cancer, but it accurately identifies the cancer in only 64 percent of people with mesothelioma. The test isn’t sensitive enough to help with diagnosis, but it could help doctors monitor the cancer’s progression and response to treatment.
All of the mesothelioma blood tests are ELISA-based, meaning enzyme-linked immunosorbent assay, and they use enzymes to detect protein antibodies in blood samples.
The FDA-approved MESOMARK test can detect soluble mesothelin-related peptide (SMRP), a protein and mesothelioma biomarker. Extensive research shows that SMRP is helpful to monitoring tumor response to treatment, but it cannot definitively diagnose mesothelioma.
Too many false positives are recorded and some cases of cancer go undetected using MESOMARK. The test’s potential to screen for mesothelioma among people exposed to asbestos is questionable as well; one study found it helpful at identifying persons at risk of mesothelioma and another study did not.
The SOMAmer test can detect more than 1,000 proteins in blood serum, and these proteins may have diagnostic value in identifying mesothelioma. A 2012 study analyzed blood serum samples from 117 malignant mesothelioma cases and 142 people exposed to asbestos. These samples detected 13 protein biomarkers that helped to accurately identify malignant mesothelioma.
The test accurately detected malignant mesothelioma in 90 percent of cases and ruled out the cancer in 95 percent of people without the cancer. The biomarker levels correlated with cancer stage, indicating the test may have value in monitoring the progress of mesothelioma. Continued analysis of more cases of mesothelioma is needed to validate the worth of the SOMAmer test.
The Human MPF test measures a protein called megakaryocyte potentiation factor (MPF), which is produced by a mesothelin precursor protein. MPF levels increase as mesothelioma tumors grow and are detected in about 91 percent of late-stage patients. The test can rule out mesothelioma in 95 percent of people who don’t have the cancer, but it accurately identifies the cancer in only 64 percent of people with mesothelioma. The test isn’t sensitive enough to help with diagnosis, but it could help doctors monitor the cancer’s progression and response to treatment.
Diagnostic Capabilities of Mesothelioma Blood Tests
| Test: | Sensitivity1 | Specificity2 |
|---|---|---|
| MESOMARK | 68% | 92% |
| SOMAmer | 90% | 95% |
| Human MPF | 64% | 95% |
- The percentage of mesothelioma patients correctly diagnosed by the test.
- The percentage of healthy people in which the test correctly ruled out a mesothelioma diagnosis.
Staging Mesothelioma
The diagnostic tools used prior to surgery help doctors to estimate
the cancer’s stage of progression, which is called clinical staging.
These tools are advanced, but directly examining the body through
surgery is the most accurate way to determine a cancer’s stage.
Imaging tests are the most noninvasive tools doctors have for estimating the growth and spread, or stage, of mesothelioma cancer. The images created by the scans give an inside view of the body that shows where tumors are growing. Radiologists use these images to identify how far the cancer has spread and then assign a stage based on what they see.
For example, if the images show little tumor growth in a small area on one lung, the cancer could be in stage I or II. If the image shows extensive tumor spread throughout the lungs, diaphragm and possibly into the abdomen, the cancer is likely in stage IV.
Some minimally invasive diagnostic techniques are used to estimate stage, such as the thoracoscopy or mediastinoscopy, which can help determine if the cancer has spread beyond the pleural lining.
However, surgery is the most accurate way to diagnose mesothelioma. Unfortunately, surgery is an invasive procedure and can’t be performed on patients who are in poor health or have late-stage mesothelioma. Imaging scans work well enough to identify late-stage tumor spread, which precludes patients from surgery because the cancer has grown to the point that surgical removal becomes life-threatening.
A 2012 study that analyzed more than 3,000 pleural mesothelioma cases reported on the discrepancy of staging based on clinical versus surgical staging. It showed clinical staging is most accurate for stage III and IV cases. Around 80 percent of patients with clinical stage I cancer were found to have more advanced disease upon surgery, known as upstaging. About 65 percent of patients with clinical stage II disease were upstaged, but only 20 percent with stage III and none with stage IV were upstaged.
Imaging tests are the most noninvasive tools doctors have for estimating the growth and spread, or stage, of mesothelioma cancer. The images created by the scans give an inside view of the body that shows where tumors are growing. Radiologists use these images to identify how far the cancer has spread and then assign a stage based on what they see.
For example, if the images show little tumor growth in a small area on one lung, the cancer could be in stage I or II. If the image shows extensive tumor spread throughout the lungs, diaphragm and possibly into the abdomen, the cancer is likely in stage IV.
Some minimally invasive diagnostic techniques are used to estimate stage, such as the thoracoscopy or mediastinoscopy, which can help determine if the cancer has spread beyond the pleural lining.
However, surgery is the most accurate way to diagnose mesothelioma. Unfortunately, surgery is an invasive procedure and can’t be performed on patients who are in poor health or have late-stage mesothelioma. Imaging scans work well enough to identify late-stage tumor spread, which precludes patients from surgery because the cancer has grown to the point that surgical removal becomes life-threatening.
A 2012 study that analyzed more than 3,000 pleural mesothelioma cases reported on the discrepancy of staging based on clinical versus surgical staging. It showed clinical staging is most accurate for stage III and IV cases. Around 80 percent of patients with clinical stage I cancer were found to have more advanced disease upon surgery, known as upstaging. About 65 percent of patients with clinical stage II disease were upstaged, but only 20 percent with stage III and none with stage IV were upstaged.
Misdiagnosis
Sometimes mesothelioma is misdiagnosed
as a less serious disease or another cancer. The initial symptoms of
mesothelioma can resemble other conditions like pneumonia or irritable
bowel syndrome, making it common for the cancer to be misdiagnosed as a
nonterminal condition.
An initial misdiagnosis is common for people who have mesothelioma. As the cancer progresses and more serious symptoms develop, increasingly advanced testing becomes warranted, which leads to an accurate diagnosis.
However, mesothelioma can also be misdiagnosed as other forms of cancer, most commonly a form of lung cancer that develops in mucus-secreting glands called adenocarcinoma. Pathologists are the professionals who analyze tumor biopsy samples, and if they aren’t experienced with differentiating mesothelioma from other cancers a misdiagnosis can occur.
Working with a cancer center that specializes in mesothelioma can confirm or deny the diagnosis. The professionals working at such cancer centers have the experience that’s necessary to accurately diagnose the disease.
An initial misdiagnosis is common for people who have mesothelioma. As the cancer progresses and more serious symptoms develop, increasingly advanced testing becomes warranted, which leads to an accurate diagnosis.
However, mesothelioma can also be misdiagnosed as other forms of cancer, most commonly a form of lung cancer that develops in mucus-secreting glands called adenocarcinoma. Pathologists are the professionals who analyze tumor biopsy samples, and if they aren’t experienced with differentiating mesothelioma from other cancers a misdiagnosis can occur.
Working with a cancer center that specializes in mesothelioma can confirm or deny the diagnosis. The professionals working at such cancer centers have the experience that’s necessary to accurately diagnose the disease.
After a Mesothelioma Diagnosis
The next step after a mesothelioma diagnosis for many people is that
of seeking a second opinion. Opting for a cancer center that specializes
in mesothelioma can confirm the diagnosis and get you access to
innovative therapies and clinical trials.
Other steps to take after a mesothelioma diagnosis:
Other steps to take after a mesothelioma diagnosis:
- Learn about your type of mesothelioma and the therapies that may
help you live longer. The more you know, the better prepared you’ll
feel.
- Discuss your treatment plan in great detail with your health care team. Thorough communication will help you feel more comfortable and secure with the plan.
- Ask about complementary therapies that may help with side effects, such as acupressure for chemotherapy-induced nausea. Divulge any medications or supplements you are taking because they could interfere with treatment.
- Ask your health care team or a patient advocate about financial assistance options, such as travel grants.
- Reach out to family, friends and health professionals for support. Building a support network will help you and your loved ones cope with mesothelioma.
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