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Mesothelioma Misdiagnosis & the Importance of a Second Opinion

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A mesothelioma misdiagnosis can be common due to the rarity of the cancer. For example, pleural mesothelioma symptoms can be misdiagnosed as pneumonia or COPD. In order to avoid a misdiagnosis, those with known asbestos exposure and symptoms should get a second opinion from a mesothelioma specialist.

Renowned mesothelioma thoracic surgeon Dr. David Sugarbaker explains why a mesothelioma misdiagnosis occurs so frequently.
Renowned mesothelioma thoracic surgeon Dr. David Sugarbaker explains why a mesothelioma misdiagnosis occurs so frequently.
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Why Is Mesothelioma Misdiagnosed?

Malignant mesothelioma is a rare and complex cancer. Most physicians and many oncologists rarely see it and don’t fully understand how it works. It takes a team of doctors familiar with the cancer to accurately diagnose mesothelioma.

Mesothelioma is commonly misdiagnosed as other cancers or less serious conditions depending on where the tumors form in the body. When tumors begin to grow and spread, they cause symptoms that mirror those of other conditions.

For example, early symptoms of pleural mesothelioma, such as shortness of breath and coughing, resemble symptoms of emphysema or pneumonia.

Common Misdiagnoses of Mesothelioma by Type

Pleural Mesothelioma Peritoneal Mesothelioma Pericardial Mesothelioma

Influenza (flu)

Irritable bowel syndrome (IBS)

Heart disease



Coronary artery disease



Congestive heart failure

Chronic obstructive pulmonary disease (COPD)

Ovarian cancer

Metastatic lung cancer

Lung cancer

Other abdominal cancers


Other respiratory conditions

If you have a history of asbestos exposure and are experiencing common mesothelioma symptoms, it is important to find a specialist who can diagnose or confirm your condition quickly. These doctors can tailor an effective treatment regimen to fit your personal needs.

“Not many doctors have knowledge treating mesothelioma beyond standard chemotherapy. Getting a second opinion is what everyone should do. That was my case. In 2014, doctors gave me months to a year. If not for a second opinion from doctors in Calgary who research the disease, I wouldn’t be alive today.”

Raeleen Minchuk, Peritoneal Mesothelioma Survivor
Raeleen Minchuk
Peritoneal Mesothelioma Survivor

What to Do if You Suspect You Were Misdiagnosed

If you get symptoms in the chest or abdomen and are not convinced of your diagnosis after your initial visit with your regular doctor or another doctor who is not familiar with asbestos-related diseases, seek a second opinion from a mesothelioma specialist.

A second opinion from a mesothelioma doctor gets you access to pathologists who specialize in mesothelioma. Pathologists are the doctors who look at your biopsy samples in the lab. They’re the ones who ultimately confirm whether you have mesothelioma or a different cancer.

Dr. Fontaine explains why choosing a mesothelioma specialist is so important.

Second Opinions After a Mesothelioma Diagnosis

People already diagnosed with mesothelioma should get a second opinion from an expert. The average oncologist won’t have the right experience to accurately diagnose and treat your cancer.

Many unspecialized oncologists will get the cancer right, but they misgauge the stage. Mesothelioma specialists know the right tests to get an accurate stage. This makes all the difference to getting the most effective treatment.

If you have mesothelioma, a second opinion is crucial to getting the right treatment.

Dr. Abraham Lebenthal Thoracic surgeon and mesothelioma specialist

“This is not a knock on anyone, but many doctors only see one or two cases a year, and you don’t want to be on someone’s learning curve. Find the best. Find someone who sees this a lot.”

Where to Find a Specialist

It may be easy to ask a family member or friend for a good referral when looking for a family doctor but finding a mesothelioma specialist is not so simple.

Only 2,000 to 3,000 patients are diagnosed with mesothelioma in the U.S. each year. There are few specialists and cancer centers with the resources and experience to give mesothelioma patients a fighting chance.

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How Do Specialists Diagnose Mesothelioma?

The process of diagnosing mesothelioma often starts with X-rays and other imaging tests such as CT and MRI scans.

Fluid buildup around the lungs or in the abdomen can point to many diseases. But if it recurs after being drained, more tests should be done for a possible mesothelioma diagnosis.

x-ray of mesothelioma vs pneumonia
X-ray images of lungs with pleural mesothelioma (left) and pneumonia (right). Pneumonia is a common misdiagnosis of mesothelioma.

These factors help doctors identify mesothelioma:

  • Potential history of asbestos exposure (reviewing a patient’s work history)
  • Pathology tests looking for specific mesothelioma cell types in biopsy samples
  • Imaging tests such as X-rays and CT scans
  • Blood tests looking for mesothelioma biomarkers
  • Genetic tests looking for mutations associated with mesothelioma

The only way to confirm a mesothelioma diagnosis is through a biopsy of suspected cancer tissue. Pathology tests are performed on the biopsy sample to confirm or deny the presence of mesothelioma cancer cells. This step is important to avoid a misdiagnosis.

For example, a 2019 case report described a pleural mesothelioma patient who presented with cancer growth resembling lung cancer. Proper pathology testing revealed mesothelioma cancer cells instead of lung cancer cells.

Kasie Coleman Diagnosed with peritoneal mesothelioma in 2010

“Don’t take no for an answer. Pay attention to your body.”

An Accurate Diagnosis Leads to the Best Treatments

Treatment options are based on the diagnosis. In most cases, if a diagnosis is wrong, so is the treatment.

If you have a history of asbestos exposure, make sure you discuss it with your doctor. Be attentive to warning signs that may be early mesothelioma symptoms. If they persist after a short period, take action.

The sooner your diagnosis is confirmed, the sooner a specialist can develop a treatment plan. Patients diagnosed in an early stage usually qualify for more aggressive treatment options. Aggressive treatment has a higher chance of extending life expectancy.

How an Accurate Diagnosis Can Change Lives

An accurate diagnosis changed everything about peritoneal mesothelioma survivor Darlene Micciche’s treatment and prognosis.

She was originally misdiagnosed with pancreatic cancer. Seeking a second opinion changed her diagnosis to peritoneal mesothelioma. She got the right surgery and chemotherapy for her true cancer and now enjoys spending time with family and friends.

“For two weeks, I thought I had stage 4 pancreatic cancer,” Micciche said. “When they finally told me it was mesothelioma, I actually felt relieved. That was better than the diagnosis we originally thought I had.”

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Registered Nurse and Patient Advocate

Karen Selby joined in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the regional director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections. She is also a member of the Academy of Oncology Nurse & Patient Navigators.

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6 Cited Article Sources

The sources on all content featured in The Mesothelioma Center at include medical and scientific studies, peer-reviewed studies and other research documents from reputable organizations.

  1. Prisciandaro, E. et al. (2019). Not everything is what it seems: malignant pleural mesothelioma mimicking lung cancer.
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  2. American Cancer Society. (2018, November 16). Tests for Mesothelioma.
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  3. Hancock, K.L. et al. (2016). A case of mesothelioma masquerading pre-operatively as ovarian cancer and brief review of the literature. Gynecol Oncol Rep., 17, 26–28. doi: 10.1016/j.gore.2016.04.003
  4. Cleveland Clinic. (2014, November 18). Why You Should Consider a Second Medical Opinion.
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  5. Dana-Farber Cancer Institute. (2013, February 12). Getting a second opinion about your cancer care. :
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  6. Zandwijk, N. et al. (2013). Guidelines for the diagnosis and treatment of malignant pleural mesothelioma. J Thorac Dis., 5(6), E254–E307. doi: 10.3978/j.issn.2072-1439.2013.11.28

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Last Modified August 11, 2020

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