Mesothelioma patients are frequently introduced to new concepts and technologies that may seem complex or difficult to understand. Most people—and therefore, most mesothelioma patients—do not have a background in clinical oncology, which means that it can be difficult to make heads or tails of all of this new, often highly technical information.
However, it’s essential to stay as up to date as possible. New discoveries and applications for those discoveries are being made all the time. This means that, for example, a testing method that may have been less important or may not have even been around a few years ago could be an essential diagnostic tool for mesothelioma patients today, or in the very near future.
One of the most recent examples of this type of evolving technology is a new blood-based testing method to diagnose mesothelioma—often far earlier than mesothelioma has traditionally been diagnosed.
A recent study on blood serum testing for mesothelioma was conducted by a Turkish research team. The team examined the use of blood serum testing in tackling one of the biggest issues with mesothelioma diagnosis and prognosis: timing.
As those familiar with mesothelioma may already know, one of the biggest barriers to effective treatment and positive prognosis for mesothelioma patients is mesothelioma’s very long latency period.
Specifically, mesothelioma is usually only diagnosed once symptoms start to appear, which is often at least 20 years and sometimes 30 years—or more—after exposure to inhaled asbestos. This is why mesothelioma is usually diagnosed later in life, with an average diagnosis age of 74.
In patients with asbestos exposure history, presenting with symptoms like shortness of breath, difficulty swallowing, dry cough, muscle soreness/weakness, unexplained weight loss, and fatigue will usually signal a doctor to start the testing process for a variety of conditions including mesothelioma.
Mesothelioma testing usually involves an array of imaging of the chest/abdomen and lungs (from basic chest x-rays to CT scans, PET scans, and MRIs) after which clinicians usually move on to more invasive tissue/fluid procurement and imaging procedures.
These include thoracentesis (removing and examining fluid from the pleural space around the lungs by puncturing the chest wall with a needle) and thoracoscopy (inserting a thorascope, a thin tube with a camera on the end, into the chest cavity via a small incision near the lower part of the shoulder blade). Once a sufficient sample of tissue or fluid is obtained, it is examined under a microscope; if the abnormal cells present indicate mesothelioma, diagnosis is usually confirmed.
However, by this point, the patient’s mesothelioma is usually quite advanced, and often has already metastasized and spread to the lymph nodes and other parts of the body. This makes it much more difficult to treat mesothelioma effectively: by the time they are diagnosed, decades after their asbestos exposure, most pleural mesothelioma patients cannot pursue multimodal treatment (i.e., surgery in addition to chemo and potentially also radiation), since their cancer has already advanced to a stage where aggressive treatment is no longer effective or even possible.
This leaves the vast majority of pleural mesothelioma patients with very limited treatment options—usually just standard chemotherapy—and a rather narrow prognosis window. This is one of the main reasons, if not the main reason, why the median survival rate of mesothelioma is only around 12 months. The issue of diagnostic timing poses a serious challenge to those who are working to improve the prognosis of mesothelioma patients.
That’s where blood serum testing comes into play. The new study, which was conducted using a large sample group of patients in standard hospitals, medical centers, and university-affiliated research and teaching hospitals in Ankara and Istanbul, Turkey, revealed exciting findings about the promise of blood serum testing in providing earlier diagnosis of mesothelioma in patients, thereby broadening their treatment options and improving their prognoses.
Dr. Feride Severcan of Altinbas University, one of the co-authors of the study, noted that “timing is the worst aspect” of mesothelioma, and that “an early diagnosis from easily collected blood serum is a very valuable approach”, which may “increase the chance of successful treatment and survival”. Dr. Severcan further explained that blood serum testing has other benefits, including being more accurate, quicker, less expensive, and less invasive than standard mesothelioma testing. He believes that blood serum testing will help facilitate “early and accurate” mesothelioma diagnoses, an essential piece of the puzzle when it comes to “decreasing the morbidity rate” and improving the odds for mesothelioma patients.
How does it work?
The newly developed blood serum testing method involves the use of a hyper-specialized tool called ATR-FTIR (short for “attenuated total reflectance-Fourier transform infrared spectroscopy”). While this sounds like quite a mouthful, the tool essentially enables clinicians and scientists to analyze small amounts of blood serum for specific biomarkers—“molecular fingerprints” in the form of “structural and compositional changes” in the components of the blood serum that serve as “early signs” of mesothelioma— far earlier than any other diagnostic tool commonly utilized to identify mesothelioma.
“Based on FTIR measurements, the molecular fingerprints of serum samples can be obtained and the structural and compositional changes in the components of that fluid can serve as biomarkers for early signs of the disease,” Severcan said.
The study utilized samples from patients with three different lung diseases—malignant mesothelioma, lung cancer, and non-malignant pleural effusions—as well as a control group of samples from healthy people. Researchers sought to differentiate between the samples and identify which is which using only the blood serum biomarkers as viewed through ATR-FTIR.
The results were very promising, both for the study’s authors and for mesothelioma patients worldwide: Dr. Severcan and his colleagues were able to reliably identify malignant mesothelioma from blood serum alone with an accuracy rate of 87.5%.
The process of ATR-FTIR-assisted blood serum testing for mesothelioma is still being fine-tuned by the research team behind this study, as well as by others around the world. The ultimate goal, which is excitingly close to becoming realized, is to identify earlier-stage mesothelioma quicker and more accurately, improving prognoses for mesothelioma patients and enabling them to access a broader range of more aggressive and effective treatments.
The study, titled “Rapid diagnosis of malignant pleural mesothelioma and its discrimination from lung cancer and benign exudative effusions using blood serum”, will be published in October 2022 in the journal Biochimica et Biophysica Acta—Molecular Basis of Disease. It is currently available online via Science Direct.