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Tests before surgery

You have tests to make sure you are fit enough to have surgery. Here's what to expect.

You might already have had some of the tests below while your cancer was being diagnosed or staged. If so, you may not need to have them again.

Mediastinoscopy

A mediastinoscopy is a test to look inside the centre of the chest (the mediastinum). You might have it to see if pleural mesothelioma has spread into the lymph nodes or elsewhere in the centre of the chest.

Pericardioscopy

A pericardioscopy is a test to look at the covering layers of the heart (pericardium) and take tissue samples (biopsies). It can show the doctor whether pleural mesothelioma has spread into your pericardium.

PET-CT scan

A PET-CT scan can help to clearly show the size and position of the mesothelioma. It can also show whether it has spread anywhere else in the body. PET-CT scans are not available in every hospital.

Lung function tests

Lung function tests measure how well your lungs take in oxygen. Your specialist needs to be sure that your lungs are working well enough for you to recover well from your surgery.

There are different types of lung function test. The simplest involves you breathing out as hard as you can into a tube attached to a machine. This measures how much air your lungs can take in.

Lung ventilation and perfusion scan

For another type of lung function test, you have two tests to check

  • the circulation of air in your lungs (called ventilation)
  • the blood supply to your lungs (called perfusion)

You can have these two tests together. They take about 20 minutes.

In the lung ventilation test you may have to breathe in a very small and harmless amount of radioactive gas. This shows up your airways on a scan. The radioactivity involved is very small and goes away within a couple of hours.

In the lung perfusion test you have an injection of a small amount of a harmless radioactive substance. This shows up the blood flowing to your lungs on a scan. It also shows how important each lung is to your overall breathing capacity.

Echocardiogram

An echocardiogram is a painless test of your heart using sound waves. It shows how strong your heart is, and how well it will cope when you have a lung removed. This test takes about 30 minutes.

Heart and lung exercise test

You might have a test that checks how well your heart and lungs work when you are resting and exercising. This is called cardiopulmonary exercise testing (CPET or CPEX).

You wear a mask that measures the levels of particular gases in your breath. Your blood pressure and heart rate are also monitored.

First you rest. Then you walk on a treadmill or cycle on an exercise bike for as long as you can. A computer monitors your breath gases and how well your heart is working.

For two hours before the test you shouldn't eat, smoke, drink caffeine drinks or have other stimulants. You should also avoid physical exercise and breathing cold air.

Last reviewed: 
25 Nov 2015
  • Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma 
    A Scherpereel and others
    European Respiratory Journal, 2010; 35 (3): pages 479-495

  • Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    P Baas and others
    Annals of Oncology, 2015. 26 (supplement 5), v31-v39

  • Statement on malignant mesothelioma (MM) in the United Kingdom
    British Thoracic Society Standards of Care Committee, 2007

  • Mesothelioma
    W Weder
    Annals of Oncology, 2010. 21 (supplement 7), vii 326-vii333

  • Malignant mesothelioma
    R Rudd
    British Medical Bulletin. 2010. 93: pages 105-123

  • Malignant pleural mesothelioma: The standard of care and challenges for future management
    J van Meerbeeck and others
    Critical Reviews in Oncology/Hematology. 2010. May 11

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