Mesothelioma Diagnosis can be complicated as the symptoms are similar to those of a number of other conditions and because of its relative rarity, many cases are unfortunately misdiagnosed or take a considerable time to confirm the diagnosis. This then delays the start of any treatment.
Most people begin the diagnostic process by seeing their GP complaining of a dry cough or pain in the chest or abdomen.
Initially the mesothelioma diagnosis begins with a review of the patient’s medical and working history particularly focusing on any possible asbestos exposure during their life.
A thorough physical examination may be undertaken, followed by X-Rays of the chest or abdomen, lung function tests and a CT / MRI scan. A biopsy may also be required.
There are a lot of tests which need to be done to establish a diagnosis of mesothelioma and it may take some time to achieve this. The GP will then refer the patient to a specialist doctor or oncologist at a local hospital.
If mesothelioma is diagnosed, the oncologist will want to establish the extent of the disease - this is known as the stage of the disease, which will require further tests to find out if and where the cancer has spread. Understanding the stage of the disease helps the consultant to plan the required treatment.
Types of Diagnostic and Staging Tests for Mesothelioma
Results indicate the general level of health of the patient. Research work is ongoing to establish if there is a blood test that will diagnose mesothelioma (see the news section).
X-Ray images may be used to show up fluid collecting around the lungs, heart or in the abdomen.
Non-invasive test using sound waves to show up any abnormal areas in the abdomen.
A computed tomography scan – it uses X-rays to produce computer images of the inside of the body so the doctor can see any abnormal areas of internal anatomy. A contrast agent may be injected into the body to show up the area in more detail.
A tube carrying a light and a camera is placed through a small incision in the chest. The procedure is carried out under local or general anaesthetic in pleural mesothelioma cases. A biopsy may be taken at the same time.
Similar to a thoracoscopy but this time in the abdomen for peritoneal mesothelioma. Again a biopsy may be taken.
Fluid Drainage – Pleural or Peritoneal Aspiration
A common symptom of mesothelioma is a build-up of fluid either in the pleural cavity, around the heart or the abdominal organs depending on disease site. To alleviate discomfort this fluid may be drained out by inserting a small catheter (via a needle) into the chest or abdomen. The fluid can then be tested for cancer cells.
A needle is placed into the tumour and cells are removed and sent the laboratory to be analysed. This may be done at the same time as a Thoracoscopy or Laparoscopy.
When all of the test results have been analysed, the oncologist will be able to judge the full extent of the disease and decide on the best treatment option for the individual depending on the stage of the disease and general health of the patient. There are various ways of describing staging for mesothelioma which may be found following the link below. The prognosis of the disease will also be discussed.
Kathy Cooke MA. BSc(Hons)
Cancer consultant and advisor
Kathy has worked in the cancer field for over 30 years. She was course leader for the MSc in Radiotherapy and Oncology at University of Hertfordshire. Then radiotherapy manager at the Cromwell Hospital in London and Partnership Quality Lead for Macmillan Cancer Support.. Read more >