How Does My Doctor Know I Have Malignant Mesothelioma?
If you're having symptoms of malignant mesothelioma, your doctor will ask you about these things:
Your health history
Your family's history of cancer
Your other risk factors, such as working with asbestos
Your doctor will also do a 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. It can also be a sign of some other cancer, or could be related to a condition that is not cancer. Then the doctor may do tests to find out if you really have mesothelioma. The most important and definitive test is a biopsy.
Imaging tests help your doctor see what is happening in your body. You may have 1 or more of these imaging tests to help find out if you have malignant mesothelioma. Or, if a biopsy (removing a sample of cells and looking at them under a microscope) shows you have mesothelioma, these tests may be done to help figure out how far it has spread.
Chest X-rays are often the first test done when a patient has a complaint such as prolonged coughing or shortness of breath. X-rays of your chest can help your doctor see if you have fluid or other signs of cancer in the spaces between your lungs. X-rays of your abdomen can help the doctor see if the abdomen is affected with areas of cancer.
Abnormalities seen on chest or abdominal X-rays may trigger your doctor to order one of the tests that follow.
Computed tomography (CT) scan
This test takes X-rays from many angles. It can be used to find mesothelioma and it can also help in determining how far it has spread.
To have the test, you lie still on a table as it gradually slides through the center of the CT scanner. Then the scanner directs a continuous beam of X-rays at your chest. A computer uses the data from the X-rays to create many pictures of your abdomen, which can be used together to create detailed pictures.
A CT scan is painless and noninvasive. You may be asked to hold your breath 1 or more times during the scan. In some cases, you may be asked to drink a contrast dye 4 to 6 hours before the scan. You may be asked not to eat anything in the time between drinking the contrast dye and having the scan. The contrast dye will gradually pass through your system and exit through your bowel movements.
Magnetic resonance image (MRI)
MRIs can show more detail than X-rays and can help a doctor figure out the location, size, and stage of the cancer. MRIs use radio waves and magnets. The energy from the radio waves creates patterns formed by different types of tissue and diseases. This makes cross-sectional pictures that look like slices of the body.
For this test, you lie still on a table as it passes into a large tube that will scan your body. While inside the tube, radio waves called radiofrequency signals are sent through your body to your chest. These are not X-rays. They are painless and noninvasive, and will cause no harm. A computer uses the data from the radio waves to create detailed pictures of the inside of your body. You may need more than 1 set of images. Each 1 may take 2 to 15 minutes, so the whole scan may take an hour or more. There are loud, grating, and thumping noises created during the scan. You may be given earplugs, headphones, or both to wear. If you are claustrophobic, you may be given a sedative before having this test. A 2-way intercom will let you talk to the people controlling the scanner.
Positron emission tomography scan (PET scan)
A PET scan can help your doctor know if cancer has spread. For this test, you either swallow or get injected with a chemical — usually a form of sugar (glucose) that carries a mildly radioactive substance. Cancer cells are more active than normal cells, so they usually take up more glucose. A few hours to a day later, you lie still on a table that is pushed into the PET scanner. It rotates around you, taking pictures of where the glucose is being used in the body. A PET scan is painless and noninvasive. Some people are sensitive to the glucose and may have nausea, headache, or vomiting.
Some cancer centers have new technology that combines a PET scan with a CT scan. The result is a more precise image of where the cancer is located.