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Further tests for mesothelioma

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This page tells you about further tests you may have if you are diagnosed with mesothelioma. There is information about

 

A quick guide to what's on this page

Further tests for mesothelioma

You may have further tests to find out whether the mesothelioma has spread. This is called staging. The stage is important because it helps your doctor to decide on the best treatment. But it may not be possible to be sure of the stage of mesothelioma without having surgery. The tests you may have include

Your doctor will ask you to come back to the hospital when your test results are available. This is bound to take a little time, even if only a day or two. You may feel very anxious during this time. While you are waiting for results, it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a support group to talk to someone who has been through similar experiences.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Diagnosing mesothelioma section.

 

Why you need further tests

Once mesothelioma is diagnosed, you need to have further tests to find out how big the tumour is and whether it has spread. This is called staging. The stage of your cancer is important because it helps to decide on the best treatment. But it may not be possible to be sure of the stage without having surgery.

 

PET-CT scan

This is a combination of a PET scan and a CT scan. A PET-CT scan takes CT pictures of the structures of your body. At the same time, a mildly radioactive drug shows up areas of your body where the cells are more active than normal. The scanner combines both of these types of information. This allows your doctor to see any changes in the activity of cells and know exactly where the changes are happening.

The scan can show the area where the mesothelioma is and may also show whether it has spread into nearby lymph nodes. There is detailed information about PET-CT scans in the cancer tests section. PET-CT scans are not available in every hospital so you may need to travel to have one.

 

Endobronchial ultrasound scan

Doctors call endobronchial ultrasound scans an EBUS. You may have it if scans show that the lymph nodes around your lung are enlarged. You may have an EBUS under a general anaesthetic or you may have medicine to make you drowsy (sedation). The doctor gently passes a small tube called a bronchoscope into your mouth and down into the windpipe (trachea). It can pass into the smaller airway passages and create ultrasound pictures of the lung and pleura and also the nearby lymph glands. So it can help to show the size of the tumour and whether the mesothelioma has spread into any lymph nodes.

The doctor can pass a hollow needle down the tube to take an ultrasound guided biopsy of any enlarged lymph nodes. This test usually takes less than half an hour.

 

Endoscopic ultrasound scan

An endoscopic ultrasound scan can check for mesothelioma cells in the lymph nodes close to the food pipe (oesophagus) and the centre of the chest. Doctors call this test an EUS. You may have it under a general anaesthetic or you may have medicine to make you drowsy. The doctor gently puts a long, flexible tube (a bronchoscope) with an ultrasound probe down your throat and food pipe. This creates ultrasound pictures of the area around the heart and lungs.

The doctor can pass a hollow needle down the tube to take an ultrasound guided biopsy of any enlarged lymph nodes or any pleural tissue at the centre of the chest that looks abnormal. This test usually takes less than half an hour.

 

Mediastinoscopy

This is a test that examines the mediastinum (the centre of your chest) to see if pleural mesothelioma has spread there. This area contains

  • The heart
  • The main blood vessels
  • Lymph nodes
  • The oesophagus (food pipe)

You usually need to have a general anaesthetic for this test and so you have to stay in hospital for at least one night. The surgeon makes a small cut at the base of the neck. A small tube is put through the cut and into the mediastinum. The surgeon can look through this tube to examine the area. The tube may contain a small video camera, so the surgeon can look at the area on a screen. They can take some tissue samples, which will be examined under a microscope to see if there are any cancer cells.

When you wake up, you will have a small dressing over the cut where the tube was put in. Don't be afraid to say if you are feeling sore. The nurses will be happy to give you a painkiller. Once you have got over the anaesthetic, you will be able to go home. This will probably be the day after the test.

 

Pericardioscopy

A pericardioscopy allows the doctor to see whether the mesothelioma has spread into the covering layers of the heart (the pericardium). It is not a common test. You may have this test if your doctor feels that surgery may be a treatment option for you.

You usually need to have a general anaesthetic for this test and so you have to stay in hospital for at least one night. Some people have the test with a local anaesthetic and a medicine to make them drowsy.

The surgeon makes a small cut in the skin over the heart and they put a small tube with a camera and light attached through the cut. Fluid or air is inserted through the tube so that the doctor can see the covering layer of the heart clearly. The tube may contain a small video camera, so that the surgeon can look at the area on a screen. The surgeon can also take tissue biopsy samples, which will be examined under a microscope to see if there are any mesothelioma cells.

When you wake up, you will have a small dressing over the cut where the tube was put in. Do say if you are feeling sore. The nurses will give you painkillers. Once you have got over the anaesthetic, you will be able to go home. This will probably be the day after the test.

 

After the tests

Your doctor will ask you to come back to the hospital when your test results have come through. But this is bound to take a little time, even if only a few days. You may feel very anxious during this time. While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through the same experiences.

Our mesothelioma organisations page gives details of people who can help and support you. You can also find details of counselling organisations. Our mesothelioma reading list has information about books and leaflets on mesothelioma and its treatment.

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Updated: 12 November 2015