Thoracentesis for Mesothelioma Diagnosis

When tumors develop in the linings of the lungs (pleura), it’s known as mesothelioma. A disease that is caused by prolonged asbestos exposure; more uncommon, mesothelioma can also metastasize in the lining of the abdomen (peritoneum) or the heart (pericardium). Asbestos is a known carcinogen (cancer-causing) that was once heavily used in several industrial and construction capacities. Because of this, construction workers, veterans, and service members are at high risk of exposure, and consequently, the development of disease over time.

Due to the rarity of mesothelioma, diagnosing it can be difficult. A less experienced doctor may even mistake the disease for lung cancer or another illness. A biopsy is a diagnostic method that’s the most definite way to determine this type of illness. Thoracentesis is a kind of biopsy that a doctor may perform, based on the location of the tumors. If you ever have concerns about your mesothelioma diagnosis, don’t hesitate to question your doctor thoroughly. Get a second opinion if you continue to have doubts.

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Other Biopsy Types

If a patient is experiencing symptoms that suggest they have mesothelioma, a doctor may perform some standard tests. If these additional tests continue to point to cancer, they may choose to administer a biopsy. This process involves a medical professional removing cells from the abnormal areas and further examining them under a microscope. There are several different types of biopsies. The three main types are:

Needle Biopsies – This involves the health professional removing a small piece of the mesothelioma tumor or excess fluid from either the lung tissue, chest, abdomen, or other areas. After mildly numbing the site, the doctor will inject a long, hollow needle through the skin of the affected spot, sometimes with the help of imaging tests. From here, they’ll extract the tiny samples directly from the tumor to be further examined. There are several different types of needle biopsies based on procedure and location. Thoracentesis is a type of needle biopsy.

Endoscopic Biopsies – The most common method for diagnosing mesothelioma, it’s also known as a camera or video biopsy. The procedure encompasses a medical professional making a small incision and then inserting a tube-like tool into the affected location. The tube will have a light and lens or even a small video camera for observing the damaged sites, sampling tissues, and extracting excess fluid within the body. There are three different types of endoscopic biopsies based on the location of the tumors or suspect locations needing to be examined.

Open Surgical Biopsies – The most invasive type of biopsy, a surgeon will make larger incisions and remove larger samples from the patient. Open surgical biopsies are only performed if the endoscopic biopsy isn’t clear enough. There are two different open surgical biopsy methods that are dependent on whether the tumor is in the chest or abdominal cavity.

Thoracentesis Procedure

Typically, there are 4 teaspoons of fluid between the lung and chest cavities, also known as the “pleural space.” The amount of fluid in this space typically remains unchanged, unless there’s a present illness that can cause that amount to go up. When this happens, pleural effusion occurs, making it much more laborious to breathe. Pleural effusion can be a condition all on its own or a complication of mesothelioma. Your doctor will perform thoracentesis to find out the exact cause and determine the best treatment plan moving forward.

Thoracentesis involves the health professional mildly numbing the incision area, then inserting a hollow needle between the ribs to measure or remove excess fluid from the pleural space. This procedure is a diagnostic technique but also used for palliative care, as removal of excess fluid can relieve chest pain, ease shortness of breath, and loosen up the pressure in the lungs. This procedure is used for mesothelioma as well as to detect other illnesses, such as COPD, blood clots, or even congestive heart failure.

Thoracentesis Side-Effects and Risks

As with many medical procedures, there’s always some risk involved. The level of risk is based on the patient’s overall health, stage of the disease, and other factors that a doctor can relay. The thoracentesis procedure also comes with a chance of side effects. Call your doctor if you experience any of the below side effects:

  • Breathing trouble
  • Chest pain
  • Fever over 100.4F
  • Redness, swelling, blood, or other fluid leaking from the needle site

Rare complications and risks from thoracentesis can include:

  • More fluid in the lungs, otherwise known as pulmonary edema
  • Pneumothorax, or collapsed lung
  • Infection at the needle site
  • Liver or spleen injury (even more rare)

Your doctor can recommend best practices for preparing for the procedure that can further protect you from the above risks and side effects.

Preparing for Thoracentesis

Besides your doctor’s recommendations, there are a few steps you can take to make sure you are well prepared for the procedure. Some ways you can prepare:

  1. Making a list of all medications and supplements you may be taking. Take note of all your allergies, including any you may have to anesthesia.
  2. Alerting your doctor if you think you may be pregnant
  3. Scheduling someone to drive you home after the procedure in case you’re groggy from the numbing medicine you are given.

Contact Your Doctor

If you are experiencing any mesothelioma symptoms, visit your doctor immediately. They will examine you and determine the best method for diagnosis or even palliative care if needed. Ask your doctor to explain anything you may find confusing or irregular, and don’t be afraid to seek a second opinion if you continue to have doubts.

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