Mesothelioma Diagnosis

Being Diagnosed with Malignant Mesothelioma

When symptoms of mesothelioma start to appear, the next logical step for people to take is to visit a hospital or medical center for proper diagnosis. After discussing your symptoms and medical history, your doctor will likely begin with imaging tests, such as X-rays or CT scans, to detect any abnormal growths. If these tests reveal something unusual or the results are unclear, a biopsy will follow. This procedure involves taking a tissue sample to confirm the presence of mesothelioma, making it the most definitive way to diagnose the disease.

Once the biopsy results are in, your doctor will use the information to diagnose the type and stage of mesothelioma, helping guide the next steps for your treatment plan. This is the first stage of a long process when it comes to battling a mesothelioma diagnosis. If any of this sounds overwhelming, you are not alone in that feeling, which is why our contributors have created the following article about diagnosing mesothelioma and how it can shape your treatment options.

How is Mesothelioma Diagnosed

Mesothelioma is a rare and challenging cancer to diagnose, primarily caused by asbestos exposure. With its long latency period—sometimes taking decades to appear—mesothelioma often remains undetected until symptoms, such as chest or abdominal pain and persistent coughing, become noticeable. Given these factors, the diagnostic process can be complex and time-consuming, typically involving multiple tests such as imaging scans, bloodwork, and biopsies.

Because mesothelioma is so rare and takes years to develop, it can take a long time to accurately diagnose the disease, which is usually done with the help of a radiologist. It can be a stressful and time-consuming process. If you show symptoms of mesothelioma, such as chest or abdominal pain or a persistent cough, contact your primary care doctor immediately, especially if you know or suspect that you have encountered asbestos in the past. Due to its aggressive nature, early detection can significantly improve a mesothelioma prognosis.

What is the Best Diagnosis Method for Mesothelioma?

The most effective diagnosis for mesothelioma involves a combination of blood tests, imaging scans, and biopsies. These tests work together to pinpoint where asbestos exposure has caused damage—most commonly in the lungs, but it can also spread to the heart, abdomen, and testicles. Due to mesothelioma’s long latency period and rarity, it can be difficult to detect early. However, by using multiple diagnostic tools in tandem, doctors can offer a more accurate diagnosis, ensuring that patients receive the right treatment as soon as possible.

Imaging Tests for Mesothelioma Diagnosis

The process of diagnosing mesothelioma often begins with imaging tests, which help detect abnormalities in the body. Doctors typically start with basic scans like X-rays and may progress to more detailed imaging, such as CT scans or MRIs, if needed. These tests play a key role in identifying the location and extent of mesothelioma, allowing doctors to determine the best course of action for further diagnosis and treatment.

Does Mesothelioma Show on an X-Ray?

X-rays are low-resolution, low-radiation images that give doctors a two-dimensional glimpse into the body. Irregularities that may indicate the presence of mesotheliomas, such as fluid buildup, pleural thickening, pleural plaques, tumors, and irregularities in lung size, are usually visible with an X-ray. Abnormal scans may prompt doctors to move on to higher-resolution imaging tests. The average X-ray only takes around 15 minutes.

What does Mesothelioma look like on a CT Scan?

Computed tomography scans (also referred to as CT or CAT scans) combine rotating X-rays with computers to create multi-angled images of the body. They show if abnormalities are present and give doctors a deeper understanding of the extent and exact location of the abnormality, making them particularly helpful in diagnosing cancer. A CT scan lasts between 10 and 30 minutes, depending on the part of the body.

PET Scan for Mesothelioma Diagnosis

Positron emission tomography scans, or PET scans, use a small dosage of the radiotracer, a radioactive chemical, to produce three-dimensional images. PET scans can show changes in an organ or tissue at a cellular level, where most diseases begin. This technology allows doctors to determine the stage of mesothelioma based on how far it has spread throughout the patient’s body. Once patients are injected with the radiotracer, it takes about an hour to travel through the body and be absorbed by the affected organs or tissues. The actual scan takes an additional 30 to 60 minutes.

The Use of MRIs in Mesothelioma Staging

MRIs (magnetic resonance images) use powerful magnetic fields and a computer rather than radiation to create high-resolution, three-dimensional images of affected areas in a patient’s body. They identify areas requiring a biopsy and are often used for staging mesothelioma. MRI test times range from 15 minutes to nearly 60 minutes. Patients with claustrophobia (or a fear of enclosed spaces) may receive anti-anxiety medication, which requires a longer recovery.
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Blood Tests for Mesothelioma Diagnosis

Following imaging tests, blood tests are next in line when diagnosing mesothelioma. The most common blood tests doctors use to diagnose mesothelioma are listed below.

• Cancer Antigen (CA 125) Cancer antigen 125 is a protein biomarker found in large concentrations of cancer cells. The CA 125 test measures how much protein is present in a patient’s blood, but it is not specific to mesothelioma and can be elevated in other tumor types. When factored in with stage and tumor location, a change in CA 125 levels can help determine a person’s mesothelioma diagnosis and anticipate their response to systemic chemotherapy.
• MesoMark® Gaining FDA approval in 2007, MesoMark® was the first blood test to aid in mesothelioma diagnosis or monitoring. MesoMark® works by measuring levels of soluble mesothelin-related proteins released by diseased cells, allowing doctors to assess the severity of mesothelioma present in the body. However, because sarcomatoid mesothelioma does not release these proteins, MesoMark® is unable to assist in the diagnosis or monitoring of this mesothelioma cell type and should be used in concurrence with other tests to ensure an accurate diagnosis.

Needle Biopsies Role In Diagnosis

Needle biopsies, often referred to as closed biopsies, are the least invasive option for obtaining tissue samples in the diagnosis of mesothelioma. This outpatient procedure allows patients to undergo the biopsy and return home on the same day. During the process, a thin needle is used to extract small samples of tissue from the affected area, usually guided by imaging techniques such as ultrasound or CT scans. Needle biopsies provide valuable information about the presence of cancerous cells while minimizing recovery time and discomfort, making them a preferred choice for initial diagnostic evaluations in mesothelioma cases.

• Pleural Biopsy: The most common needle biopsy, doctors perform pleural biopsies on patients experiencing fluid buildup between their lungs and chest (pleural effusion). An anesthetic is first injected to numb the area. Then, the doctor inserts a needle to collect a sample of the pleural fluid and tissue to check for the presence and extent of mesothelioma. The procedure usually lasts about 30 minutes to an hour.
• Thoracentesis: Also similar to a pleural biopsy, thoracentesis involves the draining of fluid in the pleural cavity. It is done for diagnostic purposes and to reduce patient pain and discomfort. The procedure is fast, usually around 15 minutes in total, depending on the amount of fluid removed.
• Paracentesis: Similar to a pleural biopsy, during paracentesis, a doctor inserts a needle into the patient’s peritoneal cavity to retrieve a sample of the ascitic fluid buildup in the abdomen. This procedure allows doctors to test for the presence of mesothelioma, as well as relieve patient discomfort. Depending on the level of fluid buildup, this procedure usually takes about 30 minutes.
• Pericardiocentesis: For patients experiencing fluid buildup around the heart sac (pericardial effusion), a pericardiocentesis procedure may be done to drain the fluid and prevent future buildup. Like other needle biopsies, pericardiocentesis can be helpful in the diagnostic process as well as alleviating patient pain. The procedure usually takes between 20 minutes to an hour.

Camera-Assisted Biopsies

Camera- or video-assisted biopsies involve a small camera, a computer, and surgical instruments. Generally, a doctor will perform a camera-assisted biopsy after a needle biopsy and before a surgical biopsy.

• Thoracoscopy During this minimally invasive procedure, a surgeon makes a small incision to insert a viewing tube into the chest cavity. The doctor can capture a diagnostic sample and relieve the patient of some discomfort by draining excess fluid. The Thoracoscopy procedure ranges from 45 to 90 minutes.
• Laparoscopy (Sometimes Called Peritoneoscopy) Similar to thoracoscopy, laparoscopy involves making a small incision that allows doctors to insert a viewing tube and a camera into the abdomen. Doctors are able to examine the affected abdominal organs and take diagnostic samples. This procedure usually lasts around 75 minutes.
• Mediastinoscopy This camera-assisted biopsy procedure allows doctors to examine the lymph nodes and see if the mesothelioma has spread. It generally takes about 60 to 90 minutes.

Surgical Biopsies

A surgeon will perform a surgical biopsy when less invasive biopsies fail to provide definitive results. They are conducted under general anesthesia.

• Thoracotomy When a tumor is detected in the chest, a thoracotomy may be performed. During this surgical procedure, the surgeon makes an incision in the chest to take a tissue biopsy. When possible, the surgeon will also remove as much of the tumor as possible during this procedure.
• Laparotomy When a tumor is detected in the abdomen, a laparotomy may be performed. During this surgical procedure, the surgeon makes an incision in the abdomen to take a tissue biopsy. When possible, the surgeon will also remove as much of the tumor as possible during this procedure and consider what is called cytoreductive surgery with intraperitoneal heated chemotherapy. The latter is not for diagnosis but for treating peritoneal mesothelioma.

What to do After a Mesothelioma Diagnosis?

After receiving a mesothelioma diagnosis, it’s natural to feel overwhelmed and unsure of what to do next. The first step is finding a doctor with expertise in treating mesothelioma. Specialists in this field understand the complexities of the disease and can guide you through your options, including treatment plans and further testing. Seeking a second opinion is often a good idea, as it provides clarity and confidence in your diagnosis and care. At Mesothelioma Hub, we’re here to connect you with experienced professionals and support you through each step of this journey.