Mesothelioma is a rare cancer that often mimics other illnesses in its early stages, making diagnosis difficult. Because it progresses quickly and is closely tied to asbestos exposure, understanding the diagnostic process is essential. An accurate diagnosis helps guide appropriate treatment options and may improve life expectancy.
Early Signs Prompting Diagnosis
Doctors begin the process by reviewing a patient’s medical history, including any known asbestos exposure. Common mesothelioma symptoms—such as chest pain, shortness of breath, abdominal symptoms, or fluid buildup—can trigger further testing.
Mesothelioma can occur in several forms:
- Pleural mesothelioma (lungs)
- Peritoneal mesothelioma (abdomen)
- Pericardial mesothelioma (heart)
- Testicular mesothelioma (tunica vaginalis testis)
Each presents differently, requiring different mesothelioma tests for confirmation.
Initial Exams and Imaging Tests
The first step in diagnosing mesothelioma typically involves a physical exam and basic chest X-ray to check for abnormalities, especially pleural effusion or pleural plaques. If signs are present, more detailed imaging tests follow:
Common Imaging Tools:
- Computed Tomography (CT scan or computed tomography CT)—Often the first advanced test to detect mesothelioma tumors or fluid.
- Magnetic Resonance Imaging (MRI or magnetic resonance imaging MRI)—Used to view soft tissues and assess whether the cancer has spread to the chest wall, diaphragm, or lymph nodes.
- Positron Emission Tomography (PET scan or positron emission tomography PET) – Highlights areas with high cancer cell activity.
- PET/CT scan—A combination used for better accuracy in detecting malignant mesothelioma.
Collecting Tissue Samples
Imaging alone cannot confirm a mesothelioma diagnosis. Doctors need to collect tissue samples to identify mesothelioma cells.
Biopsy Methods:
- Needle biopsy—A less invasive procedure that uses a fine needle to extract cells.
- Surgical biopsy—More invasive but provides larger samples. Especially helpful when precise results are needed.
- Endoscopic biopsy—Involves inserting a thin camera tube to examine internal areas and collect samples.
Each method may be guided by imaging tools to ensure proper sample collection.
Analyzing and Confirming the Diagnosis
Pathologists examine the tissue samples under a microscope to look for malignant pleural mesothelioma or other subtypes. Specialized staining techniques help distinguish mesothelioma cells from those of other cancers or lung diseases.
Doctors may also check for biomarkers—molecular signals unique to mesothelioma—which support an early diagnosis and reduce the chances of misdiagnosis.
Additional Tests for Staging and Planning
Once mesothelioma is diagnosed, the next step is staging mesothelioma to determine how far the cancer has spread. This guides physicians in choosing the best treatment options.
Additional tests may include:
- Pulmonary function tests—measure lung capacity and function.
- Blood tests—To assess organ health and potential tumor markers.
- Biopsies of nearby lymph nodes to check for metastasis.
The stage of cancer influences whether surgery, radiation therapy, targeted therapies, or palliative care will be used.
Importance of Early and Accurate Diagnosis
Early diagnosis is critical. It allows for the use of more aggressive or targeted therapies when the cancer affects a smaller area and hasn’t spread extensively. The complexity of diagnosing mesothelioma highlights the need for experienced mesothelioma specialists and access to clinical oncology resources.
Participating in Clinical Trials
Patients may be eligible for clinical trials through research institutions like the National Cancer Institute. These trials explore new drugs, therapies designed to kill cancer cells, or strategies to cure mesothelioma that may not yet be widely available.
Clinical trials can be a valuable option, especially in cases where standard treatment has been ineffective or the disease is in an advanced stage.
Next Steps After Diagnosis
After mesothelioma is diagnosed, specialists will design a personalized care plan. This may include:
- Surgery to remove tumors or fluid
- Chemotherapy
- Radiation therapy
- Immunotherapy
- Palliative care to relieve symptoms and improve comfort
A multidisciplinary team ensures that the patient receives the most comprehensive care possible.
Talk to a Mesothelioma Diagnosis Expert.
If you’re experiencing symptoms or are concerned about asbestos exposure, don’t delay. The Mesothelioma Asbestos Help Center offers information, guidance, and connections to top mesothelioma specialists who can help with diagnosis, treatment, and support.