Mesothelioma Diagnosis

Quick Summary

Doctors use many tests to make a mesothelioma diagnosis. They will first look at your medical history and symptoms, then perform imaging scans (like X-rays) and blood tests. Finally, doctors must perform a biopsy (study of possibly cancerous fluid/tissue) to confirm a diagnosis. An accurate mesothelioma diagnosis is critical to receive the best treatment.

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How Is Mesothelioma Diagnosed?

Doctors diagnose mesothelioma by examining the patient’s history of asbestos exposure (the only known cause of this cancer) and using a series of tests to look at possibly cancerous growths in the body.

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Video Summary: Registered Nurse Amy Fair discusses the team of doctors that are involved when getting a mesothelioma diagnosis. View Transcript

Who should be on my medical team for treatment?

The health care professionals that are involved in the diagnosis of mesothelioma many times start with your primary doctor because of the symptoms of a cough or shortness of breath.

Many times they are referred then on to a pulmonologist if the symptoms don’t resolve. After the pulmonologist does a CT scan or a chest X-ray and notes a mass in the pleura or the abdomen, they will refer them on to a thoracic surgeon to have that biopsy to confirm the disease.

The surgeon, after getting the diagnosis, will then refer them on to either a radiation oncologist or oncologist for treatment.

Steps to make a mesothelioma diagnosis include:

  1. Physical Exam: A diagnosis usually starts with your medical history and symptoms, according to the American Cancer Society (ACS). Most patients see their doctors for a physical exam shortly after symptoms of mesothelioma (chest pain, shortness of breath, weight loss) appear.
  2. Imaging Tests: If diseases like flu and pneumonia have been ruled out, you may need to see an oncologist (cancer doctor). Oncologists can order imaging tests to look for tumors in your body. Commonly used tests are X-rays, computed tomography (CT) scans, and positron emission tomography (PET) scans.
  3. Blood Tests: Blood tests look for certain signs within the blood that may show cancer might be present. For example, high levels of proteins like osteopontin or fibulin-3 could mean you have mesothelioma.
  4. Biopsy: If mesothelioma is still suspected after these tests, a biopsy will be ordered to extract a sample of tissue or fluid. The sample is then studied under a microscope to see if cancer cells are present. A biopsy is the only way to confirm if you have mesothelioma.

See a doctor right away if you might have mesothelioma. Getting diagnosed before the cancer spreads is key to helping you live longer as more treatments will likely be available.

U.S. veterans that served between the 1930s and 1980s have a higher risk of mesothelioma due to military asbestos exposure. Thankfully, veterans can get diagnosed and treated with help from the U.S. Department of Veterans Affairs (VA). Learn more with a free veterans packet.

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Imaging Tests for Mesothelioma

Imaging scans are usually the first tests mesothelioma doctors will use if cancer is suspected. These tests cannot confirm a mesothelioma diagnosis, but they can help doctors see if tumors may be present in the body.

One or more of the following imaging tests may be used to help diagnose mesothelioma.

X-Rays

An X-ray uses a low dose of radiation to take a detailed image of bones, muscles, and internal tissues.

X-rays can show fluid buildup in the chest wall or abdomen and thickening of the lung lining (pleura).

According to the ACS, a chest X-ray is often the first scan doctors perform if a patient may have malignant pleural mesothelioma (which forms in the lung lining).

Computed Tomography (CT) Scans

CT scans use computer-guided X-rays to create a 3D picture of the body’s insides.

A CT scan takes longer than an X-ray, but doctors can see tumors and other abnormalities more easily. Doctors may order CT scans of the chest and/or the abdomen.

Magnetic Resonance Imaging (MRI)

MRI scans use strong magnets and radio waves to see bones, soft tissue, and organs in the chest and abdomen. Like a CT scan, it takes pictures of the organs inside the body.

The ACS notes that MRIs provide a very detailed view of the body’s soft tissues and can help locate exactly where a mesothelioma tumor may be located.

Positron Emission Tomography (PET) Scans

PET scans use radioactive drugs called tracers to find possible cancerous cells in the body. The radioactive drug is painless and has little to no side effects.

Before a PET scan, patients are injected with a radioactive tracer. Cancer cells absorb more of the tracer than healthy ones. Doctors then scan to see which cells absorbed the most radiation, if any.

PET scans may be combined with CT scans to get an even more detailed view of your body.

Find a mesothelioma specialist who can help diagnose you with our doctor match tool.

Mesothelioma Blood Tests & Biomarkers

Besides imaging scans, doctors may also use blood samples to see if a patient may have cancer.

Mesothelioma may change the levels of certain substances (like proteins) within the blood. Doctors refer to these substances as biomarkers. If a biomarker is heightened on a blood test, a patient could have mesothelioma.

Common mesothelioma blood tests include:

  • MESOMARK: This test looks at proteins found in mesothelioma cells called soluble mesothelin-related peptides (SMRPs). Mesothelioma patients often have high levels of SMRPs in their blood. The MESOMARK test is approved for use by the Food and Drug Administration (FDA).
  • Osteopontin Test: There are high levels of a protein called osteopontin in some mesothelioma patients. Since these levels also rise with other conditions, researchers are still studying how reliable osteopontin tests are in diagnosing mesothelioma.
  • Tests for Fibulin-3: Fibulin-3 is another protein that may be increased when a patient has mesothelioma — it’s currently being studied. Very high levels of fibulin-3 may also be linked to lower survival, according to a study from the medical journal Scientific Reports.

While these blood tests and others may allow doctors to rule out other conditions, imaging scans and a biopsy are still needed to confirm a mesothelioma diagnosis.

Mesothelioma Biopsies

A biopsy is the only way to confirm if you have mesothelioma. Through a mesothelioma biopsy, a tissue or fluid sample is taken from a possibly cancerous tumor found on an imaging test.

Doctors then examine the sample under a microscope to see if cancer cells are present.

There are several types of biopsies that may be used to diagnose mesothelioma. Learn about the different types below.

Laparoscopy

This test is used to diagnose peritoneal mesothelioma (which first forms in the abdominal lining).

A camera attached to the end of a tube is inserted into part of the abdominal lining (peritoneum) with a small cut. Doctors can then look at possibly cancerous masses and extract a sample.

Mediastinoscopy

A tube with a camera is inserted through the neck and into the mediastinum (space between the lungs). Doctors can then take a sample from the area.

This test is helpful when trying to diagnose pleural mesothelioma, as the cancer often spreads to the lymph nodes found in the mediastinum.

Needle Biopsy

A thin, hollow needle is inserted through the skin. Fluid and/or tissue can then be collected through a syringe.

Thoracoscopy

A camera is attached to the end of a tube called a thoracoscope and inserted through a chest incision (thoracotomy) into the lung cavity. Cancerous areas can be seen with the camera and the biopsy is taken using small tools attached to the thoracoscope.

Thoracentesis

Doctors insert a needle into the pleura to drain fluid that has built up. They can then send the fluid to be studied in a lab and see if mesothelioma cells are present. If there is a lot of fluid in the pleura, doctors may insert a catheter to drain it so patients can breathe more easily.

Pathology Tests After Mesothelioma Biopsies

After your doctor has performed a biopsy, the tissue sample needs to be reviewed under a microscope by a pathologist. The results from a biopsy are typically available in 2 to 10 days.

Pathologists can see if there are mutated cancerous cells among healthy cells and note what type of cancerous cells are present.

Noting the cell type is very important — it tells doctors what form of cancer a patient has. Mesothelioma also has different cell subtypes that can affect a patient’s prognosis.

Preparing for a Mesothelioma Diagnosis

There are a few different steps you can take to prepare for a mesothelioma diagnosis.

See what you can do to make the process easier below.

A doctor checks an elderly male patient

Preparing for Diagnostic Tests

Doctors will explain what you must do to prepare for an imaging scan, blood test, or biopsy. However, since each test is different, it can be helpful to ask questions if you aren’t totally sure how to prepare.

Common questions to ask include:

  • Will I need to change my diet for this test? If so, how long will it need to be changed for?
  • What type of clothing is appropriate to wear for the test?
  • How long will the test take?
  • Will there be any side effects from the test?
  • When will we know the results of the test?
  • Will other diagnostic tests be needed after this one?

Awaiting a Mesothelioma Diagnosis

Even before a mesothelioma diagnosis is made, it can be scary to think that you might have cancer. Remember that mesothelioma treatments are available to help you possibly outlive your prognosis, manage your symptoms, or both.

Some patients have gone on to become long-term survivors thanks to a proper mesothelioma diagnosis and medical care from skilled doctors.

Working With the VA

If you served in the U.S. military and may have mesothelioma, it’s crucial to see if you can get diagnosed and treated through the VA Health Care System.

Many past veterans with mesothelioma qualified for free or low-cost medical care — and monthly financial payments — from the VA.

Eric Hall, a veteran and VA-accredited attorney, can help you file for VA benefits now. Don’t wait: you may qualify for free medical care and financial payouts.

Challenges of Making a Mesothelioma Diagnosis

Mesothelioma is very hard to diagnose — it presents several unique challenges to doctors. Learn about the issues doctors face when making a mesothelioma diagnosis below.

Latency Period

In many cases, it takes 20 to 50 years after asbestos exposure before symptoms of mesothelioma appear.

By this point, patients may not suspect that their symptoms are related to asbestos. Others may have forgotten that they were exposed. These issues can delay a mesothelioma diagnosis, allowing the cancer to spread in the process.

Mesothelioma Stage

There are four mesothelioma stages. Stage 1 is the least advanced while in stage 4 the cancer has spread through the body. Doctors need to correctly diagnose the cancer’s stage as this impacts the treatments a patient receives.

Early-stage patients can receive life-extending treatments, while those in the later stages receive palliative care to ease symptoms. More imaging tests may be needed after an initial diagnosis to see how far the cancer has spread.

Misdiagnosis

Mesothelioma can be misdiagnosed for a number of reasons. For example, mesothelioma symptoms are shared by many other diseases. Your doctor may think a more common (and less deadly) condition is causing them at first.

Further, a pathologist might misdiagnose mesothelioma as the cells can look like other kinds of cancer. For example, adenocarcinoma (a form of lung cancer) and mesothelioma have similar cell structures.

More biopsies or scans may be needed to avoid a mesothelioma misdiagnosis.

Prognosis

Once your doctor has confirmed a mesothelioma diagnosis, they provide a prognosis. A mesothelioma prognosis is your expected health outlook. Most patients have a poor prognosis as they are diagnosed after the cancer has spread.

See a doctor immediately if you were exposed to asbestos and have mesothelioma symptoms (like a cough or shortness of breath). You may get diagnosed before the cancer spreads, meaning you’ll have a better prognosis.

Get a free veterans packet to learn about your medical and financial options after a mesothelioma diagnosis.

Mesothelioma Veterans GuideGet a FREE Veterans Packet

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Next Steps After a Mesothelioma Diagnosis

After getting a mesothelioma diagnosis, work with your doctor to develop a treatment plan that will best suit your needs. Some patients diagnosed with mesothelioma decades ago are still alive today thanks to treatments from skilled doctors.

Surgeries, chemotherapy, immunotherapy, radiation therapy, and new therapies available from clinical trials can be used to treat this cancer. You may also want to get follow-up tests or a second opinion to avoid a misdiagnosis.

Our team can help you navigate life after a mesothelioma diagnosis and protect your family’s future. Get a free veterans packet today.

Common Questions About Mesothelioma Diagnosis

How does a doctor diagnose mesothelioma?

Doctors typically start with imaging tests such as X-rays and CT scans to look inside the body for possibly cancerous growths. They may also use blood tests to see if a patient has higher levels of certain proteins that may mean cancer is present.

If doctors think a patient has mesothelioma after these tests, they’ll order a biopsy to confirm a diagnosis.

Call our team at (877) 450-8973 to learn about next steps after a diagnosis.

Is mesothelioma hard to diagnose?

Yes. Doctors may have problems confirming a mesothelioma diagnosis as it is relatively rare, the symptoms are mild, and its cells may look like other types of cancer under a microscope.

Thankfully, many cases are correctly diagnosed and you can seek a second opinion to make sure you were not misdiagnosed.

How long do you live after being diagnosed with mesothelioma?

This depends on several factors, including when you were diagnosed and what type of mesothelioma you have. Mesothelioma patients often live longer if they are diagnosed before the cancer has spread.

Your doctor can provide a prognosis and average life expectancy as part of your mesothelioma diagnosis.

Veterans Support Team
Todd Gersten, MD PhotoReviewed by:Todd Gersten, MD

Double Board-Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Todd Gersten, MD is a double board-certified medical oncologist and hematologist specializing in general adult oncology and hematologic disease. He is a physician partner with the Florida Cancer Specialists and practices in Wellington, Florida.

Dr. Todd Gersten is an independently paid medical reviewer.

Christopher Dryfoos PhotoWritten by:

Contributing Author

Christopher Dryfoos is a journalist and member of the American Medical Writers Association (AMWA). As the grandson of the U.S. Navy’s first forensic pathologist, he aims to help veterans with mesothelioma access needed care.

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