Mesothelioma Misdiagnosis

Can Mesothelioma Be Misdiagnosed as Another Illness?

Each year, approximately 3,300 Americans are diagnosed with mesothelioma. Compared to other forms of cancer, asbestos-caused mesothelioma is fairly rare. Subsequently, many doctors (and even oncologists) are unfamiliar with diagnosing the disease and may mistake symptoms for something else at first. Non-small cell lung cancer, breast cancer, and pneumonia are among the commonly misdiagnosed illnesses due to early symptoms like pleural effusion and certain markers found in cancer cells.

To test for mesothelioma, a tissue biopsy is typically required. Imaging tests (such as PET scans) may not be definitive to make a staging diagnosis, while some fluid biopsies may be inconclusive. Furthermore, under a microscope, oncologists may have difficulty identifying the specific type of mesothelioma cell present (i.e., epithelioid, sarcomatoid, and biphasic/mixed). As such, specific tests have been designed to test for and stage mesothelioma.

For veterans who believe they may have an asbestos-related illness, travel to a comprehensive VA medical facility may be required to receive mesothelioma-specific testing.

Additional forms of mesothelioma testing include blood tests, tissue sample testing, and imaging tests. Lab results for these tests can take varying amounts of time to receive – meaning some patients may be waiting longer than others.

Asking questions of your cancer care team and staying informed about the testing and treatment processes may help ease some anxieties.

Common Mesothelioma Misdiagnoses

For most veterans and their families, a mesothelioma diagnosis begins with chest or abdominal pain followed by a doctor’s visit. To treat the patient’s symptoms, the doctor may prescribe an analgesic (i.e., painkiller) or minor procedure to alleviate pressure on other organs. Imaging scans (such as CT scans and MRIs) may later reveal cancerous tumors. However, a biopsy (an outpatient procedure that removes a small sample for analysis) is the only way to diagnose the presence of mesothelioma.

Since the rise of mesothelioma cases starting in the 1970s, several diagnostic techniques have been developed to detect the disease. Fluid removal procedures such as paracentesis, thoracentesis, and pericardiocentesis take cells from the abdomen, chest cavity, and heart cavity respectively for analysis. Certain immunohistochemical (IHC) markers have been found in mesothelioma that makes it easier to identify via tissue samples. Regardless, careful inspection by doctors with a history of diagnosing is important to avoiding mesothelioma misdiagnosis. Below are several common mesothelioma misdiagnoses based on the location of tumors.

Pleural Mesothelioma

• Breast cancer
• Chronic obstructive pulmonary disease (COPD)
• Emphysema
• Influenza (flu)
• Lung cancer
• Lymphoma
• Pneumonia
• Recurrent pleural effusion

Peritoneal Mesothelioma

• Gallstones
• Hernia
• Irritable bowel syndrome (IBS)
• Ovarian cancer

Pericardial Mesothelioma

• Coronary artery disease
• Heart disease

Getting a Second Opinion

If you have a history of asbestos exposure and you believe you may have mesothelioma, an official diagnosis is the only way to receive proper care and financial compensation for your injuries. Because initial diagnoses may be inaccurate, many patients seek a second opinion to either verify or correct the initial lab results. For veterans using VA health care services, getting a second opinion (and a second round of specialty tests) through TRICARE and/or the VA can be challenging to understand.

For TRICARE members, the patient, primary care manager (PCM), or regional contractor may request a second opinion. However, the list of services covered by TRICARE is not all-inclusive and some rules apply.

For other veterans, the Veterans Choice Program (VCP) can provide additional care and resources not available through the traditional VA health care framework. VCP allows veterans to receive care from a community provider (instead of traveling to a VA facility) and, in some cases, can help veterans get a second opinion on recent diagnoses. Veterans can reach the VCP customer service call center at 866-606-8198.

Using Medicare to Get a Second Opinion

Because mesothelioma affects the elderly more than other age groups, these patients are more likely to have additional health care resources that can help them get a second diagnostic opinion. Medicare is available to Americans turning 65 years-old and provides additional treatment options outside the VA network.

The VA supports patients enrolling for Medicare coverage. Medicare health insurance has no effect on VA health care.