Center for Asbestos Safety in the Workplace

Mesothelioma Diagnosis and Treatment

How is mesothelioma diagnosed?

Mesothelioma is diagnosed by pathological examination. Tissue is removed, put under the microscope, and a pathologist makes a definitive diagnosis, and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid build-up or pleural effusions, shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an x-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:

Thoracoscopy

For pleural mesothelioma the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital with a local anesthetic or painkiller.

If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and use gentle suction to remove the fluid. This is called thoracentesis.

Read about endoscopy.

Peritoneoscopy

For peritoneal mesothelioma the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic. If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.

Biopsy

If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.

Read about bronchoscopy and laparoscopy.

What is the prognosis for mesothelioma?

Unlike benign mesothelioma, malignant mesothelioma is not so easily treated because the cancerous tumors can spread rapidly throughout the body. In the less severe benign form of the disease, the tumor may grow, but it does not spread. When a patient is diagnosed with this form of cancer, it is because a malignant tumor exists in the mesothelial tissues of the lungs and/or the abdomen. Although it occurs more frequently than its benign counterpart does, malignant mesothelioma is uncommon, and its rarity is one of the reasons why people are often unaware that they are infected with this terminal disease.

Like most cancers, the prognosis for this disease often depends on how early it is diagnosed and how aggressively it is treated. More on palliative care.