Getting your mesothelioma diagnosis is just the beginning of your journey, but there’s a lot to learn before you hear the official word from your doctor. To be absolutely sure that you have been exposed and affected by asbestos, you need to have a battery of tests that will help you and your doctor feel certain about your mesothelioma diagnosis.

Here are some of the most common ways of testing for mesothelioma in your body, starting from the least invasive test to the most invasive:

Chest X-Ray A chest x-ray is simply a way to take a picture of your lungs without having to do anything invasive. From this x-ray film, a doctor will be able to diagnose if there is any thickening of the lung tissue, which is often a sign of mesothelioma. If you’ve been recently exposed to asbestos, this may not show up immediately, but these kinds of results do signify that something dangerous is happening to the lung tissue.

CT Scan If the initial chest x-ray looks suspicious, the next usual step is a CT scan. If a CT is not available, a doctor may also order an MRI. What this does is point out the fluids that are present in the body. If there is a lot of fluid in the lungs, it may be a sign of a mesothelioma diagnosis and asbestos exposure.

Pleural and Peritoneal Aspiration

When the CT or the MRI shows a lot of fluid in these parts of the body, you can also aspirate, or draw out the fluid with a needle to see if it contains any cancerous cells. This sample is sent to pathology for examination, but if there are no cancerous cells, that doesn’t mean that you’re necessarily in the clear either. It can mean that you have some other diagnosis than mesothelioma.

Biopsy If you have an obvious mass in your lungs or in your abdominal cavity, the doctor might want to take a part of it to examine for cancerous cells, called a biopsy. This allows the doctor to see if the cancer has spread to this part of the body.

With these various tests and procedures, a doctor will be gathering the evidence needed to make a conclusive mesothelioma diagnosis. There may actually be something else going on that’s simply similar to the symptoms you may be having, so you want to rule out mesothelioma cancer as a possibility.

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In spite of the rapid growth of technology and the bright discoveries of the medical fraternity, the treatment of mesothelioma has been far from successful. Conventional therapies have somewhat flopped, and patients survive twelve months, at an average, after being found out having the disease. The following are the options available for a person with mesothelioma:

One is surgery, either by itself, or in conjunction with pre-operative or post-operative therapies. However, this has only a 5-year survival rate of less than 10% of those affected by the disease.

The tumor is extremely resistant to chemotherapy and radiotherapy; yet these methods are sometimes deployed to alleviate symptoms caused by tumor metastases, like obstruction of a blood vessel.

Treatment methods that involve immunotherapy have brought about inconsistent results. For instance, “intra-pleural immunization” of Bacillus Calmette-Guerin (BCG) to enhance the immune response was found to be of no advantage to the mesothelioma patient. However, those suffering from bladder cancer have benefited from this treatment. Patients undertaking this specific therapy felt major side effects, like fever and cachexia. Nevertheless, other methods using “interferon alpha” have proven to be more effective, with a fifth of all tested mesothelioma patients experiencing more than half the reduction in tumor mass, with few side effects.

Then there is another procedure called “heated intraoperative intraperitoneal chemotherapy”. It was discovered by a surgeon named Paul Sugarbaker, of the Washington Cancer Institute. In this method, the surgeon takes out as much of the tumor mass as possible. This is subsequently followed by using a chemotherapy agent (at about 40 to 48°C) in the abdomen. The agent (a fluid) is inserted for an hour to two hours before being drained. This method allows for the usage of high concentrations of specific drugs into the pelvic surfaces. It also facilitates greater penetration of the medicines into the cancer tissues. Also, heating adversely affects malignant cells more than normal cells.

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Any disease eventually shows symptoms. Most disorders of the internal system are clearly visible and this rings a bell. Mesothelioma has its own symptoms, but they tend to appear after much damage is done, and the disease does not have many specific symptoms. Mesothelioma is a cancerous tumor occurring in the lining of the lungs and chest cavity, often associated with exposure to asbestos dust.

An individual with mesothelioma cancer usually develops symptoms such as exertion dyspnea (difficulty with breathing) and decreased physical exercise tolerance. The insidious onset and difficulty in breathing are considered as the most usual presenting symptoms. The cancer, which slowly encases the lung tissue and invades the chest wall, produces pleural effusion (pleural fluid - or fluid in the pleural or lung cavity) in about seventy five percent of victims.

When the volume of fluid increases few changes like shortness of breath and sometimes pain ranging from mild to stabbing can occur. In few cases, the person may experience dry cough. Normally, when the doctor listens to the patient’s chest with a stethoscope, normal breath sounds are muted and tapping on the chest will reveal dull rather than hollow sounds.

Symptoms or signs of airway disease include coughing, phlegm, and wheezing and are not common, but can occur in heavy smokers who have associated habitual bronchial inflammation. The chest x-ray depicts diffusely distributed, tiny irregular or linear opaqueness (non-transparencies), usually most noticeable in the lower lung zones.

In these cases, only minimal x-ray changes are visible and are easily mistaken for other conditions. Parenchyma is the tissue characteristic of a body organ and it can be seen by using diffusing method or localized pleural thickening. The illness advances around 1 to 5 years in about 5% to 12% of patients whose exposure has ended. As a result, a marked deterioration in oxygenation happens in lungs along with respiratory failure.

Many of these symptoms occur only at the advanced stages of the disease. The symptoms that are visible are very common ailments, like colds, cough, and difficulty in breathing. The onset of these minimal symptoms also hampers the treatment options, and in turn the affected one’s lifetime.

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To address my post-prostatectomy impotence, I used the vacuum system to gain an erection. My engorged penis turned blue and cold. According to the equipment instructions, it can be used for up to thirty minutes. I could, however, answer the question of my urologist, Dr. Ram Rao: “Did you have penetration?” Yes. Not great, but a step forward.

Next came Caverject. There we were in Dr. Rao’s pristine office with wall charts and drawings depicting all things urological in living color. Dr. Rao, a trim, handsome man of about 55, a native of India, stood on my left, orchestrating this show. My wife, Lorraine was on my right, her face asking the question “What am I doing here?” On center stage I stood with my limp penis, extended by my left hand, as I awaited the first act.

Dr. Rao described the Caverject system, a clever product from Sweden, consisting of a relative of Cialis, a diluent, and a thin injection needle. He armed the system by mixing the fluid with the drug, dialed in the dose, and handed it to me.

“You want me to inject this where?” I asked. He pointed to the target areas on both sides of my penis, noting that I should avoid the midline where key structures such as veins, an artery, the urethra, and nerves reside.

“Lorraine, you do it,” I beg her in quiet desperation.

“No, Bernie it’s your job, after all, you are a doctor, and it’s your penis.”

I did it. Peer pressure at the age of 66. It worked. I had an erection. Not a complete one, but certainly adequate for penetration. And it was pink and warm. Unfortunately, Lorraine had an appointment for a flu shot and we had not made arrangements for a nearby room to put my reawakened tool to the test.

Over the next month we increased the dose slowly until one sunny morning in Islamorada in the Florida Keys, I “shot up” and we enjoyed great sex as I cried, tears streaming off my face and on to Lorraine. Elated, I telephoned my mentor, confidant, fellow physician, and a twelve-year survivor of prostate cancer.

“John, I just used Caverject and we enjoyed fifty-five minutes of penetration.”
Lorraine shouted from the background, “Not so, John, there was fifty minutes of penetration and five minutes of Bernie walking around the room admiring his erection.”

I met and married Lorraine, my second wife, twenty-eight years ago. We were both going through divorce. We often drove to Bar Harbor on Mt. Desert Island, slowly savoring the crisp taste of chilled Chardonnay and awaiting its effect. We would talk, cry, share stories, and cry again. Then we laughed, stopped the car to hug and disrobe as much as we dared. Soon we ran off into a favorite woodland glen, ideal for a hobbit house, where we enjoyed passionate love on a flannel blanket over a bed of soft and aromatic spruce and pine needles. During that year there were a number of startled tourists who will probably never forget that trip to Bah Habba.

Lorraine stayed with me over the decades, long enough to teach me how to take the risks involved in truly loving another. She led me by the hand through the trackless land of love. We became proficient with Tantric sex, maximizing the senses, finding new erogenous zones. I enjoyed multiple orgasms without ejaculation, savoring the climactic experience with its primal scream. Fortunately we lived in a rural area

I became addicted to sex. Sex became my demon.

The ancient Greek philosopher Aristotle noted that the ultimate goal of humankind was for happiness, in Greek,”eudimonia”, which means “good demons”. Was my demon good or bad or both?

For twelve years I had been on a research study, wherein my lack of “free” PSA (prostatic specific antigen) suggested that I would eventually get prostate cancer. In the interim I changed my diet and added a wide range of vitamins, minerals, and other “nutraceuticals” to stave off or minimize cancer, while I chased my demon.

About two years ago my second prostate biopsy showed definite cancer. As a pathologist I had seen the worst cases, the failures, so I opted for aggressive therapy– androgen depravation therapy, prostatectomy, chemotherapy, and radiation therapy. The treatment plan is almost over and I have no detectable PSA. A possible cure? Only time will tell.

Our new sexuality may lack spontaneity, for it requires me to arm and inject Caverject, but our sessions together last for well over an hour. Close friends ask us what do we do with so much time for loving? We get out our tattered copy of Kama Sutra from college days and try all the positions.

Bernhoff A. Dahl, M.D., pathologist, author, keynote speaker, consultant, humorist and veteran mountaineer, shares his experience with prostate cancer and his efforts to maintain his masculinity and sexuality during and after his 28-month period of maximal therapy. He is currently writing a book about this experience entitled Sex and Prostate Cancer
Dr. Dahl is the author of the International Bestseller Optimize Your Life!
Visit TrionicsUSA.com TrionicsUSA.com for details.
Contact: Bernhoff Dahl, M.D. DrBDahl.com DrBDahl.com

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Winterport, ME 04496

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Phone : 207-223-9998

Cell phone: 207-745-7272

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