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Mesothelioma Treatment - Surgery - Biopsy

Mesothelioma is a very rare form of asbestos cancer that is most effectively treated when detected early. Unfortunately, the nature of the disease and the fact that it remains latent for decades usually results in detection after the cancer has spread to other parts of the body, making it extremely difficult to treat. Since the only proven cause of mesothelioma is exposure to asbestos, ongoing check-ups and testing after exposure make early detection a greater possibility.

One method used in the detection of mesothelioma is a surgical biopsy. There are a few different types of biopsies available for those who have developed mesothelioma.

First, a cancer doctor may surgically remove the tissue in question. With an incisional biopsy or a core biopsy, just a small part of the tissue is removed. This is common if the sample is in a location that makes it easy to collect.

However, in the case of mesothelioma, the cancerous cells develop in places that do not lend themselves to core biopsy, particularly the pleura, peritoneum, and pericardium. Rather than operating and removing just a small piece of the tissue in question, doctors are more likely to remove the entire effected area of a patient with mesothelioma. This is known as excisional biopsy.

Excisional biopsy naturally comes with greater risks. Surgery will be longer and more complicated and doctors may need to remove a significant portion of the sensitive linings surrounding major organs. However, it is much less risky to perform just one surgery than to operate twice if the cells prove to be cancerous.

The third type of diagnostic biopsy is called needle aspiration biopsy. In many cases, this is the technique most preferred by surgeons because it is a safe, quick procedure. Although most often used for tumors that are close to the skin's surface, needle aspiration biopsy (also called fine needle aspiration cytology or fine needle aspiration) can also be used to diagnose mesothelioma. Essentially, this technique uses a long, hollow needle to remove a sample of cells from the body to be tested and properly diagnosed.

After the cells are removed from the body in one of the three aforementioned procedures, experts analyze the cells to determine if mesothelioma is present. This work is done by a pathologist, a doctor that specializes in diagnosing diseases. The pathologist examines the cells under a microscope to determine the diagnosis. There are a number of techniques that can be used to diagnose the cells after biopsy, but in most cases the pathologist removes a very thin layer of tissue from the sample, places it on a microscope slide, adds dye to make cells more visible, and seals the slide so it can be examined under a microscope. A pathologist is trained to analyze abnormal cell growth, which can indicate mesothelioma as well as other diseases.

Biopsy also allows the oncologist to examine the possible spread of cancer to other parts of the body. When the tumors in the body are removed, the pathologist carefully examines the margins to see if cancer is present. "Negative margins" means the cancer has probably not spread; the appearance of "positive margins" means there is a good chance that doctors have not completely removed the cancer. Mesothelioma travels quickly, so if doctors are concerned about metastases, they will run additional tests that may include biopsies and x-rays on parts of the body that are commonly affected, such as the lymph nodes.

Sources:

1. MedLine Plus, http://www.nlm.nih.gov/medlineplus/ency/article/003416.htm
2. Net Doctor, http://www.netdoctor.co.uk/health_advice/examinations/biopsy.htm
3. Cancer Guide, http://cancerguide.org/pathology.html

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