Mesothelioma Tests, Diagnosis, Prognosis and Stages

Being diagnosed with mesothelioma may change many elements of your life, including physical abilities, emotional wellbeing, and relationships. At Banner MD Anderson Cancer Center, we’re dedicated to providing information, support and resources to patients affected by mesothelioma. We believe that cancer treatment requires personalized care. Our integrative approach combines evidence-based treatments with side-effect management techniques, to treat not just the disease, but the whole person.

Are There Screening Tests for Mesothelioma?

There are no standard screening tests for mesothelioma. People who have been exposed to asbestos should tell their doctor and have periodic imaging tests to monitor the lungs.

What Tests Are Used to Diagnose Mesothelioma?

Mesothelioma can be hard to diagnose. If you have symptoms of mesothelioma, your doctor will ask you about your symptoms, obtain your medical history, including possible risk factors like exposure to asbestos, and conduct a physical exam assessing for swelling or other signs of the disease.

If your doctor suspects you might have mesothelioma, additional tests will  be needed to confirm a diagnosis. These tests could include imaging tests, blood tests and/or biopsies of the suspected site.

• Imaging tests: Imaging tests give doctors a picture of the inside of your body. These images allow a closer look at suspicious areas and determine if the cancer has spread. Common imaging tests used to diagnose mesothelioma include:
  • Chest x-ray
  • Computed tomography (CT) scan
  • Echocardiogram ultrasound of the heart
  • Positron emission tomography (PET) scan
  • Magnetic resonance imaging (MRI) scan
• Blood tests: Mesothelioma can’t be diagnosed with blood tests alone, but high levels of fibulin-3 or soluble mesothelin-related peptides (SMRPs) can assist with  confirming the diagnosis.
• Biopsy: Several different types of biopsies may be used to help diagnose mesothelioma. All biopsy and fluid samples are analyzed by a pathologist to find out if they have cancer cells and the type of the disease. It is often hard to diagnose mesothelioma because the cells look like other types of cancer and special lab tests often are needed.  Sometimes, a small surgery is needed to get a piece of tissue in the chest to obtain the diagnosis.
• Pulmonary function tests: Pulmonary function tests (PFTs) show how well your lungs are working and is important to evaluate if surgery is one of your treatment options.
• Genetic testing: If you’re diagnosed with mesothelioma, you should consider doing genetic testing to help guide your treatment, lead to a more accurate prognosis, and see if family members may be more susceptible to the cancer.

What Is the Prognosis for Mesothelioma?

Mesothelioma is an aggressive form of cancer. Treatments for mesothelioma are available, however currently there is no cure. The prognosis for mesothelioma varies and is based upon a number of factors.

Based on the type of cell affected and its stage of progression, outcomes for individuals with mesothelioma vary.

Types of Mesothelioma Cells

• Epithelioid cells: 60% to 70% of cases, usually has the best outcome
• Sarcomatoid cells: 10% to 15% of cases, more aggressive
• Biphasic or mixed cells: 10% to 15% of cases, extremely aggressive

Stages of Mesothelioma Cancer

The stages of mesothelioma are based on tumor size and how far it’s spread. Symptoms of mesothelioma are not strongly correlated to stages. Mesothelioma tends to be diagnosed later because early stages don’t cause symptoms.

Staging helps your doctor decide on the best treatment options. Surgery is often needed to stage mesothelioma.

• Stage I (Stage 1): Cancer is contained in the mesothelial lining – surgery is an option
• Stage II (Stage 2): Cancer enters the lymph nodes – surgery is an option
• Stage III (Stage 3): Cancer spreads to nearby organs and further away lymph nodes - surgery and/or chemotherapy are options
• Stage IV (Stage 4): Cancer has metastasized (spread) to further parts of the body - surgery is not an option, but chemotherapy may improve life expectancy and ease symptoms   Surgery or radiation can be used to help control your symptoms

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