Mesothelioma Updates : New Technology To Detect Asbestos-Related Lung Disease

Michael Harbut, M.D., MPH, co-director of the National Center for Vermiculite and Asbestos-Related Cancers (NCVAC) at the Barbara Ann Karmanos Cancer Institute in Detroit, MI, and chief of the Center for Occupational and Environmental Medicine Wayne State University, announced the use of a new technology to aid in the diagnosis of asbestos-related lung disease. The announcement was made at the Asbestos Disease Awareness Organizations annual conference, Saturday, March 28, in Manhattan Beach, CA.

"Radiographic approaches developed by Carmen Endress, M.D., FACR, Associate Professor of Radiology, Wayne State University School of Medicine and radiologist at the NCVAC, allow us to visualize lesions caused by asbestos exposure in three dimensional detail and often at a much earlier stage than that of the current standard radiographic techniques," said Harbut.

This new approach involves taking images obtained on the 64-slice high resolution CT scan and enhancing them using the Vitrea imaging software program developed by Vital Images, Inc.

Harbut explained, "The benefits of this new approach include the possibility of earlier detection; better differentiation between patients with scarring on the lungs and other diseases; assistance in determining why some people who have thickening on the covering of the lungs have uncontrolled, unrelenting pain; and potentially increased success in the overall diagnosis and treatment of asbestos-related disease.

According to Harbut, this approach could also have a significant public-health impact.

If we can identify the sentinel or first cases of asbestosis or lung cancer at an early stage, then we can help identify asbestos exposures in places where it might not have previously been suspected. Such identification of early detection could help to reduce the death rate from asbestos-related diseases."

Harbut added that this new technology approach to chest radiography could also help reduce cases of fraud which have been reported in asbestos litigation, due to the clarity and sophistication of the images that can help identify which cases are asbestos-related and which are not.

Dr. Endress added, "Its my sincere hope that with this new approach and enhanced technology we will help reduce the death rate caused by asbestos-related diseases, reduce the suffering by patients and their loved ones, and make a significant contribution to medicine."

The use of this technology in the diagnosis and treatment of asbestos-related cancers and high-malignancy potential asbestos-related diseases represents another first for Karmanos Cancer Institute scientists and physicians. Previously, NCVAC researchers were among the first to discover the value of osteopontin a tumor marker of mesothelioma and published this finding in the New England Journal of Medicine. Karmanos workers have also reported the potential value of soluble mesothelin-related peptide, another tumor marker, in screening for mesothelioma.

Michael Harbut, M.D., MPH, Chief of the Center for Occupational and Environmental Medicine, is co-director of the National Center for Vermiculite and Asbestos-Related Cancers at the Barbara Ann Karmanos Cancer Institute, in Detroit, MI. In response to the United States Environmental Protection Agency's (EPA) identification of major sources of public asbestos exposure in Michigan, and to address the need for early diagnosis and aggressive treatment of asbestos-related diseases, the Barbara Ann Karmanos Cancer Institute and the Center for Occupational and Environmental Medicine (COEM) affiliated with Wayne State University, joined forces to establish The National Center for Vermiculite and Asbestos-Related Cancers (NCVAC). COEM has had a long interest in asbestos-related diseases and the Karmanos Cancer Institute is heavily involved in both clinical and basic research on asbestos-related cancers enabling the two centers to rapidly bring together the expertise and resources necessary to study the problem immediately.

Source: Karmanos Cancer Institute

What Are The Diagnosis Of Mesothelioma?

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.

A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.