Doctors weigh uncertainty of finding, treating mesothelioma early

Very few cases of malignant pleural mesothelioma (MPM) are found in their initial stages, to the point that the American Cancer Society (ACS) suggests the extreme unlikelihood of early diagnosis. However, a team of researchers recently examined the idea of discovering and treating MPM before it spreads throughout the chest cavity.

The results appeared in the International Journal of Clinical Oncology. In brief, scientists found that it is difficult to detect the earliest stage of mesothelioma, so much so that it is largely happened upon by accident. However, once found, localized MPM might be surgically removed using a parietal pleurectomy (PP), they argued.

In its earliest stage, known as T0, mesothelioma has not yet formed a visible tumor or even begun causing noticeable symptoms, the ACS states. The authors noted that in these cases, a cellular examination of the pleural fluid is very imprecise - often yielding a 40 percent false-negative rate.

However, this is the stage in which MPM would be theoretically at its most treatable. To this end, the team described using PP among a select group of patients whose pleural fluid examinations were ambiguous and whose lung health was "characterized with strong clinical suspicion."

The results were mixed, particularly since uncertain pleural health hardly makes an airtight case for or against a radical treatment. Still, more work remains to be done to see if it is ever warranted to perform, as they put it, a "highly invasive diagnostic surgery for pathologically unproven disease."