Your doctor will ask about your symptoms and other medical conditions you have had. He or she will then examine you.
Because mesothelioma symptoms can be caused by other medical conditions, your doctor will probably run a few tests. These tests include an electrocardiogram (ECG), to check your heart, and a chest or abdominal x-ray.
If these tests show abnormalities in the lungs or pleura, you will need a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan. These imaging studies help your doctor determine the size and location of any tumors in the chest or abdomen.
If you have fluid in your chest or abdomen, your doctor may use a needle or thin tube to remove a small sample of it for examination. (Fluid may also be drained to relieve chest pain and shortness of breath.) Occasionally, mesothelioma can be diagnosed from this fluid sample alone. But in most cases, your doctor will take a tissue sample (biopsy), too.
Depending on the tumor's location, your doctor will make a small cut through the chest wall or into the abdomen. He or she will then insert a lighted tube through the incision to see the tumor and remove a tiny piece of it. Your doctor may also look for masses in your airways or remove lymph nodes.
Investigational blood tests that check levels of two chemicals—osteopontin and mesothelin—may help diagnose mesothelioma. (They may also assess a patient's response to treatment.) Tests for these biomarkers are available as part of some clinical trials.
If your doctor diagnoses pleural mesothelioma, the next step is to determine the cancer's stage. This is a measure of how far the tumor has spread. These are the stages of pleural mesothelioma:
Stage I also is called localized disease. Stages II, III, and IV are called advanced disease. If the disease returns after treatment, it is called recurrent mesothelioma.
Doctors don't have a staging system for mesothelioma in the abdomen.
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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.
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