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How to establish accurate diagnosis of asbestos-related diseases

By Treven Pyles

Posted on April 21st, 2017

The symptoms of asbestos diseases, chest pain and coughing, are also symptoms of other common diseases. This makes diagnosis hard to pinpoint. A misdiagnosis may not only prevent you from getting effective treatment but also hinder you from recovering the financial compensation you deserve.

The low prevalence of asbestos-related diseases has led to a very concerning issue over the years - a high rate of misdiagnosis. According to the National Cancer Institute, up to 20% of people who have been heavily exposed to asbestos in the past will develop a disease. Nevertheless, frequently, asbestos victims are initially misdiagnosed. In addition to the rare nature of asbestos-related diseases, there are other factors that contribute to the alarming rate of misdiagnosis. The similarity between asbestos-related diseases and less severe conditions such as pneumonia or bronchitis in terms of symptoms, as well as their complexity, can also mislead medical professionals.

A variety of diagnostic tests might be needed to help identify diagnosis

Although mesothelioma, lung cancer, and asbestosis are quite common among people with a history of asbestos exposure, these diseases are not very well-known by most medical professionals. There are over 200,000 new lung cancer cases every year in the U.S., out of which only 4,800 occur as a consequence of asbestos exposure. Mesothelioma is also a rare disease, representing approximately 0.3% of all cancer diagnoses. Thus, it is probably not surprising that the majority of oncologists do not have the chance to examine patients suffering from these illnesses very often.

To make sure your health will be properly evaluated, we highly advise you to choose a specialist in asbestos-related diseases, preferably with relevant practical experience. Because they focus exclusively on the diagnostic and treatment of these illnesses, your chances of being misdiagnosed will be very slim.

Generally, physicians will first ask you about your work history. It is recommended to share everything you can remember about your asbestos exposure with them, as this will give them an idea about how severe your condition might be. Subsequently, after a standard physical examination, your doctor will refer you to a series of other specialists, such as:

  • Pulmonologists
  • Radiologists
  • Surgical oncologists
  • B-readers
  • Thoracic surgeons
  • Pathologists

Because asbestos-related diseases are complex and resemble other pulmonary disorders, multiple tests are employed to ensure you will receive an accurate diagnosis, hence the number of additional specialists who are going to be involved in your examination. The following diagnostic procedures are typically used to evaluate patients with a history of asbestos exposure. We strongly encourage you to visit a specialist as soon as possible, regardless of whether you experience symptoms or not, as failing to receive a correct diagnosis can have devastating consequences for your health.

Chest X-rays

While a chest X-ray cannot be used to determine whether you have asbestos fibers in your lungs, it will provide basic information about the condition of your organs. Pleural plaques and pleural effusion, which often accompany mesothelioma and asbestos-related lung cancer, can easily be seen on X-rays. This diagnostic method can also detect asbestosis, as the affected portion of your lungs will appear white on a chest X-ray. After you undergo this test, the images will be analyzed by a radiologist or by a B-reader. For asbestos-related diseases, the expertise of a B-reader might be more valuable, as they specialize in examining the radiographs of people who suffer from occupational pulmonary diseases.

Computed tomography (CT) scans

Computed tomography is an extremely useful diagnostic tool for people with a history of asbestos exposure. Unlike X-rays, a CT scan will provide very complex and detailed images of your lungs and can detect asbestos-related diseases in their incipient phases. Moreover, a CT scan might prove to be life-saving for patients whose chest X-rays are vague or do not show any abnormalities, as computed tomography can reveal the early onset of mesothelioma, lung cancer or asbestosis. Although asbestos fibers are not visible on the images, a CT scan will help your doctor timely detect the signs of disease.

Pulmonary function tests

These tests are used to determine whether the function of your lungs is impaired and if it is, to what extent. When you have an asbestos-related disease, the function of your lungs will inevitably be affected and the results of pulmonary function tests will help your physician assess the severity of your condition. There are numerous pulmonary function tests, each evaluating a certain aspect of how well your lungs are working. Some of the most common are:

  • Pulse oximetry, which determines the oxygen levels in your blood
  • Lung volume tests employed to measure how much air you can hold in your lungs
  • Spirometry, which estimates the size of your lungs and evaluates the rate of airflow
  • Lung diffusion capacity, a test used to measure how much oxygen your blood receives from the air you breathe
  • Arterial blood gas tests, which evaluate the concentration of various gases in your blood, including oxygen and carbon dioxide

Biopsies

There are two types of biopsies: nonsurgical and surgical. A non-surgical approach might be recommended to patients with pleural effusion, as it involves collecting a sample of fluid from the lungs, which will subsequently be examined by a cytologist for the presence of cancer cells. However, this is not a very reliable method of detecting mesothelioma or asbestos-related lung cancer.

On the other hand, surgical biopsies are the most accurate diagnostic methods which can also confirm the presence of asbestos fibers in the lungs. During a surgical biopsy, one or multiple small samples of tissue will be collected from your lungs and will then be thoroughly examined by a pathologist. Additionally, if malignant cells are discovered, the pathologist will be able to properly identify them and you will be assigned a precise diagnosis. Surgical biopsies are of many types, depending on how they are performed.

When performing an endoscopic procedure, a doctor inserts a tube-like device into the patient's body so they can examine the organs. The endoscope is a tube that has a light and camera attached to its end. The most common endoscopies include:

  • Thoracoscopy - a minimally invasive procedure during which a thin, flexible tube will be inserted into your chest cavity to allow the surgeon to collect tissue samples
  • Bronchoscopy - a thin, flexible tube will be inserted through your nose or mouth to reach your lungs
  • Mediastinoscopy - this is another minimally invasive type of biopsy which involves the insertion of the tube through a small incision in your neck or in the left side of your chest

An ectomy, for example, a thoracotomy, is a procedure more invasive than the endoscopy and it involves the collection of tissue samples and the direct examination of lungs through a wide incision across the chest.

The most accurate methods used by medical professionals to diagnose asbestos lung disease are:

  • A biopsy. Biopsies involve extracting tissue and fluid samples directly from the patient's lungs and analyzing them.
  • Sputum cytology. This generally non-invasive test is performed only when doctors suspect lung cancer. The patient coughs up a sample of thick mucus from their lungs and the medical professionals examine the sample to determine the presence of abnormal cells.

An asbestos lung cancer diagnosis can be difficult due to cancer's similarities with other diseases and respiratory infections and the patient or the primary care physician may not be initially alerted of the gravity of the situation.

Initial symptoms - such as a cough or a sensation of tightness and pain in the chest area - are similar to asthma and pneumonia, while later symptoms are similar to mesothelioma and asbestosis. That is why, to guide all efforts in the right direction, pulmonary issues of any kind should be immediately presented to the doctor if the patient has a work history in industries that were at high-risk for asbestos exposure.

Furthermore, it can be a matter of decades - even up to 50 years - before the inhaled asbestos fibers develop into diseases. Thus, it becomes especially important to include a thorough and attentive look at the occupational and medical history of a patient in case there is a reason to suspect exposure to asbestos.

If you believe you have an asbestos disease, contact us today to receive a free case evaluation.

There are several methods for diagnosing bronchial cancer:

  • A chest x-ray. If this test shows an abnormality it can prompt further evaluation with other imaging methods, such as a chest CT scan.
  • A PET scan. This is the most sensitive way of accurately staging bronchial cancer and finding the spread of the disease.
  • A lung biopsy. This can be done to confirm the diagnosis and to learn about cancer's molecular profile. The gold standard is currently a test called next-generation sequencing as it detects the greatest number of treatable mutations and is faster and cost-effective.
  • A liquid biopsy. If medical professionals are looking for mutations, they can also do this simple blood test. Tests like PD-L1 testing and tumor mutation burden testing can estimate who will best respond to the immunotherapy drugs now available for bronchial cancer.

Each person that was exposed to asbestos has a unique experience with the event, meaning that many factors need to be considered to assess their particular case. These range from their overall health to how much time they spent in mediums contaminated by the toxic mineral to the density of the asbestos concentration in a given space and time interval.

In the United States, asbestos was heavily used until regulations started being implemented in the late 1970s. In the period before the general ban on asbestos, however, all the leading industries acquired large quantities of the mineral, thus exposing millions of workers to its damaging effects.

Furthermore, manufacturers would pour asbestos fibers into equipment and protective clothing to increase the safety of their employees, as the mineral has impressive resistance to fire and is non-corrosive and easy to mix in with other compounds. Asbestos would also be present at the workplace in the form of insulation, covering wirings and pipes or turbines, but it would just as much be in the flooring or the paint covering the walls.

Diagnosing mesothelioma can be very difficult since similar symptoms may be caused by several conditions. That is why, before performing a physical exam, medical professionals will take a careful history, including questions about employment history.

To establish the diagnosis, doctors often do imaging studies that may include X-rays of your chest and abdomen, CT scans, MRI scans, or PET scans.

If the X-ray shows the accumulation of fluid in the chest, otherwise known as pleural effusion, you may be suffering from an asbestos-related disease. Only detected by an X-ray but often announced by a feeling of pain in the chest, pleural effusion occurs a lot earlier than other illnesses caused by asbestos. At the same time, however, the condition can be the warning sign of the more serious mesothelioma. A background of asbestos exposure might prompt your doctor to follow up with more tests to identify the exact reason that has led to the build-up of the fluid.

It is generally the case that a disease like mesothelioma will first show up in the form of nodules but pleural effusion can often accompany them. Any masses that are round in shape and reach up to three centimeters in size are commonly referred to as lung nodules and they can suggest the early stages of cancerous tumors. More opaque shapes on the X-ray typically point to a form of scarring of the lung and it could represent the early development of a condition like asbestosis. Already far advanced asbestosis would appear like a honeycomb on the scan clearing all doubts for the pulmonologist.

If doctors suspect mesothelioma, they will schedule a biopsy. They may recommend a thoracoscopy or video-assisted thoracoscopy (VAT) or a peritoneoscopy. If the biopsy reveals mesothelioma, further studies are then done to determine how advanced the cancer is.

The tests used to diagnose esophageal cancer are often ordered for people who have difficulty swallowing, a persistent cough, or risk factors for the disease and may include:

  • A barium swallow
  • Endoscopy
  • Endoscopic ultrasound

Other procedures and imaging tests such as CT, PET, and bronchoscopy can help determine the stage of the disease which is important for choosing the best treatment options. The lab tests used for diagnosing esophageal cancer are fairly non-specific but are used along with imaging tests, a health history review, and a physical exam.

It's helpful to be aware of your history of exposure to asbestos so that you can make an appointment to see your doctor and get professionally tested. It's important to pay attention to a history of working in occupations that involved repairing, renovations or maintenance of asbestos-containing products. When encased in a compound, asbestos does not pose a threat to anyone's health, however, when it becomes airborne, as it would usually happen in a workspace in which materials would be constantly disturbed as part of the daily activities, the tiny fibers are easily inhaled and can cement themselves in the lungs. The human organism has no natural defense against asbestos and cannot expel it, meaning that irritation of the lungs begins as soon as the first exposure occurs.

To qualify for an asbestos trust fund claim when you have a history of asbestos exposure and receive a diagnosis of esophageal cancer, you have to have pathology reports from a biopsy or surgery. You also must have an underlying disease to go with that, such as asbestosis or pleural disease.

Throat cancer is most often diagnosed when a person seeks medical care for one or more of the following symptoms: persistent cough, difficulty swallowing, or persistent sore throat.

First, the doctor will review your health history to determine whether you may be at risk for throat cancer. Then, the physician will perform a physical exam, during which he or she will feel the throat area for any abnormalities, such as lumps.

If he or she believes that you may have cancer or another disease, you may be referred to an otolaryngologist, also called an ENT specialist who specializes in conditions that are related to the ears, nose, and throat. Any sort of abnormalities or distorted shapes or masses should legitimately be considered as the consequences of asbestos exposure if you have a history of working with the material.

To get a better view of the inside of the throat, an ENT doctor may recommend having a laryngoscopy during which a sample of tissue may be taken if any suspicious areas are discovered. This is called a biopsy and its purpose is to either confirm or rule out cancer. If cancer is found, it is then necessary to determine its extent. This process is called staging. The stage of cancer will affect which treatment method is best suited for you.

To file an asbestos trust fund claim when you're diagnosed with laryngeal cancer, you also must have pathology reports from a biopsy or surgery. You also have to have a diagnosis for an underlying asbestos-related disease, such as asbestosis or pleural disease.

To confirm and define the extent of colon cancer a diagnostic colonoscopy, biopsy, and imaging tests are needed.

  • Physical exam. After reviewing any symptoms that may be suggestive of colorectal cancer - blood in your stool or a change in bowel habits - as well as your risk factors for developing colon cancer, your doctor will perform a physical examination.
  • Lab tests. After a medical history and physical examination, your doctor may order labs - complete blood count, liver function test, tumor makers, especially if your symptoms and/or exam are suspicious for colorectal cancer.
  • Colonoscopy. If your exam and tests indicate colorectal cancer, your doctor will possibly recommend a diagnostic colonoscopy.
  • Biopsy. Also, if a suspicious mass is seen, the doctor can do a biopsy.
  • Imaging tests. Once the diagnosis of cancer is determined, the extent of the disease is determined with imaging tests and a treatment plan can then be devised. The imaging tests often used include chest X-ray, CT scan, MRI and PET scan.

If unexplained masses are appearing on an X-ray and yet the physician does not attribute them to asbestos in the case of a patient with a history of exposure, it would be best for the patient to get a second and even a third opinion just to make sure that the disease is or is not asbestos-related.

They could have their X-ray looked at again and have their medical and occupational history related to another doctor if they feel like their diagnosis was not right, especially since the chances of misdiagnosis are so high and the signs can be easily overlooked for years.

When you are diagnosed with colorectal cancer, you also must have a diagnosis for an underlying asbestos-related disease, such as asbestosis or pleural disease. Then, you may be eligible for compensation and to file a claim for a payout that will help you deal with the costs the asbestos condition will impose on your life and the lives of your loved ones.

The methods of diagnosing gastrointestinal cancer include:

  • Lab tests
  • Imaging tests
  • Biopsies
  • Endoscopy

Once the cancer is confirmed, its stage is then determined and a treatment plan is developed.

To file an asbestos trust fund claim, you must also receive a diagnosis for an underlying asbestos-related disease, such as pleural disease or asbestosis.

Regarding imaging tests, an X-ray cannot provide an image of asbestos fibers, it can only show abnormalities that could have a connection to asbestos exposure. Since asbestos-related diseases have symptoms that match the ones of many other possible conditions, reaching a diagnosis can be a slow process. That is why the occupational history of the patient is a valuable piece of information that could speed up the process.

An X-ray is usually the first type of scan that is recommended as a noninvasive way of investigation and so many patients that have admitted to having been exposed to asbestos are sent to have one for the doctor to have more ground to establish a diagnosis.

Medical specialists, however, explain the limitations of an X-ray, with its biggest impediment being that it is only able to present a two-dimensional image of the internal organs, meaning that there is always room for error, and consequently, for misdiagnosis. The information an X-ray can tell with certainty is the state of healthy organs for these should appear black on the scans; anything else would require interpretation on the part of the doctor based on the previous information offered by the patient.

Quality legal assistance for asbestos victims

If you were exposed to asbestos in the workplace, there is a considerable chance your health will be affected at some point in the future due to the asbestos fibers you have inhaled. Receiving a correct diagnosis is vital for your prognosis and for recovering the financial compensation you deserve. When you decide to take legal recourse, it's important to document your work and medical history. In the absence of a clear diagnosis, you may not be able to file a successful claim for compensation with asbestos trust funds.

If you have been diagnosed with asbestosis, mesothelioma or lung cancer, or another asbestos disease, you are eligible for financial compensation from asbestos trust funds. Filing a claim will help not only hold the wrongdoers responsible for their careless actions but also help you cover your medical expenses. Do not hesitate to contact Environmental Litigation Group, P.C. as soon as possible. Unfortunately, time is limited when it comes to asbestos claims. Due to the statute of limitations, you have between one and three years to file an asbestos claim if you decide to get compensation from asbestos trust funds.