Tests and diagnosis

If you have signs and symptoms that might indicate mesothelioma, your doctor will perform a physical examination to check for lumps or other unusual signs. Your doctor may prescribe imaging tests, such as chest radiography and computed tomography (CT) scan of your chest or abdomen to look for abnormalities. Based on the results, you can receive additional testing to determine whether mesothelioma or another disease is causing your symptoms.

Biopsy

Biopsy, a procedure to remove a small portion of tissue for laboratory examination, is the only way to determine whether you have mesothelioma. Depending on what area of ​​your body is affected, your doctor selects the right biopsy procedure for you. Options include:

Fine needle aspiration. The doctor removes fluid or a piece of tissue with a small needle inserted into the chest or abdomen.

Thoracoscopy. Thoracoscopy allows the surgeon to see inside your chest. In this procedure, the surgeon makes one or more small incisions between your ribs. A tube with a tiny video camera is then inserted into your chest cavity - a procedure sometimes called video-thoracoscopy surgery (VATS). Special surgical tools allow your surgeon to cut small pieces of tissue for testing.

Laparoscopy. Laparoscopy allows the surgeon to see inside your abdomen. Using one or more small incisions in the abdomen, the surgeon inserts a tiny camera and special surgical tools to obtain for examination a small piece of tissue.

Thoracotomy. Thoracotomy is surgery to open your chest, between the ribs to allow the surgeon to check for signs of disease. A tissue sample can be removed for test.

Laparotomy. Laparotomy is surgery to open your abdomen to allow a surgeon to check for signs of disease. A tissue sample can be removed for test.

The tissue sample is analyzed under a microscope to see if the abnormal tissue is mesothelioma and what types of cells are involved. The type of mesothelioma you have determines your treatment plan.

Directed by

Once mesothelioma is diagnosed, your doctor other tests to determine the extent or stage of cancer. Imaging tests that can help determine the stage of your cancer may include:

The chest radiograph

Computed tomography of the thorax and abdomen

Magnetic resonance imaging (MRI)

Positron emission tomography (PET)

Your doctor will determine which tests are most appropriate for you. Not every person needs each test.

Once the extent of pleural mesothelioma is determined, a stage is assigned.

Phase I mesothelioma is considered localized cancer, meaning that it is limited to a portion of the wall of the chest.

Phase II mesothelioma may spread beyond the wall of the chest to a membrane or lung.

Phase III mesothelioma can spread to other structures in the chest and may involve nearby lymph nodes.

Stage IV mesothelioma is an advanced cancer that has spread more widely across the chest. Stage IV can also indicate that mesothelioma has spread to distant parts of the body such as the brain, liver and lymph nodes around the chest.

Formal steps are not available for other types of mesothelioma because these types are rare and are not well studied.