Diagnosis

If you have signs and symptoms that might indicate mesothelioma, your doctor will conduct a physical exam to check for any lumps or other unusual signs.

Your doctor may order imaging scans, such as a chest X-ray and a computerized tomography (CT) scan of your chest or abdomen, to look for abnormalities.

Based on the findings, you may undergo further testing to determine whether mesothelioma or another disease is causing your symptoms.

Biopsy

Biopsy, a procedure to remove a small portion of tissue for laboratory examination, is the only way to determine whether you have mesothelioma. Depending on what area of your body is affected, your doctor selects the right biopsy procedure for you.

Options include:

• Inserting a needle through the skin. The doctor might remove fluid or a piece of tissue with a thin needle inserted through the skin on your chest or abdomen.
• Collecting a sample of tissue during surgery. A fluid or tissue sample might be collected during an operation. The surgeon might make a small incision and insert a tube with a video camera to see inside your chest or abdomen. Special tools can be passed through the tube to collect a tissue sample.

The tissue sample is analyzed under a microscope to see whether the abnormal tissue is mesothelioma and what types of cells are involved. The type of mesothelioma you have determines your treatment plan.

Determining the extent of the cancer

Once your mesothelioma is confirmed, your doctor may recommend additional tests to understand whether your cancer has spread to your lymph nodes or to other areas of your body.

Tests may include:

• CT scans of the chest and abdomen
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)

Your doctor determines which tests are appropriate for you. Not every person needs every test.

Your doctor uses the information from these tests to assign your cancer a stage. The stages of pleural mesothelioma are indicated using Roman numerals ranging from I to IV. A lower numeral means the cancer is more likely to be localized to the area around the lungs and the highest numeral means the cancer has spread to other areas of the body.

The cancer staging system continues to evolve and is becoming more complex as doctors improve cancer diagnosis and treatment. Your doctor uses your cancer stage to select the treatments that are right for you.

Formal stages aren't available for other types of mesothelioma.