Diagnosis
If you have any symptoms of mesothelioma, your doctor will conduct a physical exam and ask you questions about your lifestyle, past exposures or work and general health to determine what might be causing them. Usually your doctor will order chest X-rays and other imaging tests including a CT scan to check for any abnormalities. If your doctor still suspects mesothelioma, he or she will conduct a biopsy to be certain. Here are some tests doctors commonly use to diagnose mesothelioma:
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Needle Biopsy
A specialized doctor (interventional radiology, interventional pulmonary. or thoracic surgeon) will use a CT scan to guide a hollow needle to your lungs and pleura, and use this needle to extract fluid from around your lungs. Your doctor will then have this fluid examined under a microscope to determine whether it is caused by cancer or another condition. Sometimes a needle biopsy does not provide a big enough tissue sample, and your doctor may need to perform a more invasive biopsy via thoracoscopy (surgeon).
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Thoracoscopy
Your doctor inserts a flexible, narrow camera with a light on the end into a small incision in your chest. Your doctor uses this device to examine the space between your lungs and chest wall, and then remove suspicious pleural tissue samples for a biopsy with a small biopsy forcep.
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Pulmonary Function Test (PFT)
Your doctor will perform a PFT after your lung cancer is diagnosed to get a sense of your respiratory health. This is not a diagnostic or staging test, but it is important to know how well your lungs are working and if you will be able to tolerate surgery to remove part of your lungs.
Chest X-Ray
A chest X-ray uses electromagnetic waves to create pictures of the inside of your body. Your doctor will order a chest X-ray to look for any abnormal areas in your lungs and pleura. If your chest X-ray looks suspicious in any way, your doctor will order additional tests.
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Computed tomography (CT) scan
A computed tomography (CT) scan uses X-rays to produce an image of your body. A special dye may be injected into your veins and you may be asked to drink a special fluid in order to make the internal organs stand out. A CT scan can show the location, size, and shape of a tumor in the pleura and lungs, and can also show cancer in the lymph nodes and other parts of the body.
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Magnetic resonance imaging (MRI) scan
Magnetic resonance imaging (MRI) uses radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show "slices" of the body. Doctors commonly use MRIs to check the brain and spinal cord for any signs of metastasis.
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Positron emission tomography (PET) scan
For a PET scan, the doctor injects a radioactive substance into the patient's bloodstream. This substance collects in malignant (cancerous) cells in the patient's body. The doctor then uses a PET scanner to detect these areas of radioactivity and to find the exact location of cancer in the patient's body.
