How Is Mesothelioma Found?

As a rule, a chest x-ray is not useful in finding mesothelioma early. One test being studied is a blood test. This test measures the levels in the blood of a certain protein that is higher in people who have lung damage due to asbestos. It is even higher if the person has mesothelioma.
Early symptoms of mesothelioma can be very general. Thus, they are often ignored. Most people with this type of cancer have symptoms for only 2 to 3 months before the cancer is found.
Symptoms of pleural mesothelioma (lining of the chest) can include:
pain in the lower back or at the side of the chest
shortness of breath
trouble swallowing
hoarseness
cough
fever
sweating
tiredness
weight loss
swelling of the face and arms
muscle weakness
Symptoms of peritoneal mesothelioma (lining of the abdominal cavity) include:
belly pain
weight loss
nausea
vomiting
fluid or a lump in the abdomen
Of course, these same symptoms can also be caused by other minor ailments. But if you have worked with asbestos and you have any of these symptoms, you should see your doctor right away.
If there is reason to suspect you might have mesothelioma, the doctor will ask you questions about your health and do a complete physical exam. The exam can help tell if you have fluid in the chest, abdomen, or heart. This fluid can be a sign of mesothelioma. Then one or more of the methods below can be used to find out whether you really have cancer.
Imaging Tests
These tests allow the doctor to see a picture of the inside of your body. These could include x-rays, CT scans (computed tomography), MRI (magnetic resonance imaging), or PET scans.
Chest x-ray: The x-rays might show thickening of the lining of the lungs or other signs of asbestos exposure leading to mesothelioma.
CT scans: A CT scan (also known as a CAT scan) is like an x-ray but it produces detailed cross-sectional images of your body. Instead of taking one picture, as does a regular x-ray, a CT scanner takes many pictures as it rotates around you. A computer then combines these pictures into an image of a slice of your body.
Often after the first set of pictures is taken, you will receive an intravenous injection of dye that helps better outline parts of your body. A second set of pictures is then taken. You will need an intravenous (IV) line through which the dye can be given. Some people are allergic to the dye and get hives, a flushed feeling, or, rarely, more serious reactions like trouble breathing and low blood pressure. Be sure to tell your doctor if you have ever had a reaction to any dye used for x-rays.
CT scans take longer than regular x-rays, and you need to lie still on a table while they are being done. But they are getting faster and your scan might be pleasantly short.
CT scans are often used to first find the mesothelioma, and they are helpful in finding out how far it has spread.
PET scan: A PET scan uses glucose (a form of sugar) that contains a radioactive substance. Cancer cells in the body absorb large amounts of the radioactive sugar and a special camera can detect the radioactivity. This test, which is still being studied, can help tell whether a thickening of the tissues is cancer or just scar tissue. It can also spot the spread of cancer.
MRI scans: This test uses radio waves and strong magnets instead of x-rays. The energy from the radio waves is absorbed and then released in a pattern formed by the type of tissue and by certain diseases. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of your body.
A contrast material might be injected just as with CT scans. MRI scans provide the same kind of information that CT scans do, but sometimes they can provide a different and more helpful picture.
MRI scans are useful in looking at the diaphragm (the thin muscle at the bottom of the lung cage that goes up and down during breathing). The mesothelioma may have spread to the diaphragm.
MRI scans take longer than CT scans – often up to an hour. Also, you are placed inside a narrow tube, which is confining and can upset people with a fear of enclosed spaces. The machine makes a thumping noise, and some places will provide headphones with music to block out the noise.
While there is a blood test to track the progress of the disease during and after treatment, it is not really useful in telling whether a person has this cancer. But a high level of a certain protein (osteopontin) is a cause for concern.
Fluid or tissue samples may be taken from the chest, stomach, or heart area with a needle and sent to the lab to see if cancer cells are present.
Other methods of looking inside the body involve making a small cut (incision) in the chest or stomach area and then using a small tube with a video camera to allow the doctor to look directly at the area in question and take a tissue sample.
In another approach, the doctor can insert a lighted tube through the mouth and into the chest. This is called a bronchoscopy (bron-kahs-kuh-pee). If the tube is placed under the chest bone and then moved down into the chest, it is called a mediastinoscopy (me-de-uh-stine-AHS-kuh-pee).
Surgery allows the doctor to remove a larger sample of tumor or, sometimes, the whole tumor.
It is often hard to identify mesothelioma by looking at the cells (or even tissue) from the fluid around the lungs, stomach, or heart. So your doctor may want to do other tests as well. Sometimes an electron microscope is used to look at cells in greater detail.