Patients experiencing potential mesothelioma symptoms such as coughing, shortness of breath, or chest pains should visit a doctor. After seeing a physician, the diagnostic process determines the causes of these symptoms and a treatment plan.
Blood tests
Blood tests can check your overall health and how your blood cells, liver and kidneys are working.
X-ray
X-rays can help identify any abnormalities in the lungs, thickening of the pleura or fluid in the space between the lungs and the chest wall. X-rays will also help identify fluid in the abdomen.
CT scan
CT scans produce three-dimensional pictures of several organs at the same time and can also scan chest lymph nodes. CT scans may also be used to see if the mesothelioma has spread to other locations.
Biopsy
A biopsy is when a sample of pleural or abdominal tissue is removed for examination under a microscope. It is the main procedure used to diagnose pleural mesothelioma, and can be taken in two ways: via VATS (Video-assisted thoracoscopic surgery), a type of keyhole surgery; or via CT-guided core biopsy, which is done under a local anaesthetic using a needle guided by a CT scan.
Draining fluid from the pleura
This can be done to relieve symptoms of breathlessness caused by pleura leaking into the pleural cavity (called pleural effusion), and in some instances, to diagnose pleural mesothelioma. People with peritoneal mesothelioma may have fluid in the abdomen (called peritoneal effusion), causing swelling and pain.
Using an ultrasound scan to guide the doctor, the fluid is drained via a needle inserted through the chest wall into the pleural cavity or into the abdomen. A sample of the fluid is then sent to a pathologist for testing.
Mesothelioma can be difficult to diagnose as the cells can look similar to other types of cancer cells. Combining results from fluid samples with information from an x-ray and CT scan can provide an acceptable level of certainty of a diagnosis.
If mesothelioma is diagnosed, further tests are usually done to find out if the disease has spread to other parts of the body, such as CT scans; FDG-positron emission tomorgraphy (FDG-PET); mediastinoscopy (used to examine and sample lymph nodes at the centre of the chest); or endobronchial ultrasound (EBUS).
