Mesothelioma Diagnosis

Quick Summary

Doctors use a variety of tests when diagnosing mesothelioma. They will examine your symptoms, then perform imaging scans (such as X-rays) or blood tests. A mesothelioma diagnosis is officially made through a biopsy. An accurate diagnosis of mesothelioma is critical to receive the best treatment.

Get a Free Veterans Packet

How is Mesothelioma Diagnosed?

A mesothelioma cancer diagnosis usually starts with monitoring your symptoms, according to the American Cancer Society (ACS). Most patients see their doctors to get a physical exam a few months after the first symptoms of mesothelioma (chest pain, shortness of breath, and/or weight loss) begin.

Mesothelioma Doctors Video Thumbnail

View 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.

At first, some mesothelioma symptoms may be mistaken for more common illnesses like the flu or pneumonia. If diseases like these have been ruled out, you may need to see a pulmonologist (respiratory system doctor) or oncologist (cancer doctor).

These specialized doctors will likely order imaging tests to look for cancerous tumors in your body. Commonly used tests include CT scans, X-rays, and PET scans. They may also take samples of your blood and analyze it to look for signs of cancer.

If mesothelioma is still suspected at this stage, a biopsy will be ordered. Through a biopsy, doctors extract a sample of tissue or fluid. A lab analyzes the sample under a microscope to see if cancer cells are present. Doctors can then formally diagnose a patient based on the results of this test.

It’s crucial to see a doctor right away if mesothelioma is suspected. The sooner you are diagnosed, the sooner you can access treatments to help you live longer or manage your symptoms.

Learn how mesothelioma is diagnosed and treated with our free veterans packet.

Mesothelioma Diagnosis & Asbestos Exposure

Asbestos is the biggest risk factor and only known cause of mesothelioma. As a result, your doctor may ask if you were ever exposed to asbestos if they think you might have mesothelioma.

“A suspicion of mesothelioma should always arise when a patient with a case history of reasonable asbestos exposure is examined for pleural effusion or pleural masses of unknown [origin].”

– European Respiratory Journal

U.S. veterans have an increased risk of mesothelioma due to asbestos exposure in the military. Veterans who worked in shipbuilding, naval shipyards, or construction have the highest rates of asbestos exposure.

Non-veterans can also be exposed through blue-collar work or secondhand exposure if someone they loved worked around asbestos.

Our team can help determine if you have ever been exposed to asbestos. Contact us right now for more information.

Imaging Tests for Mesothelioma

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

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

X-Rays

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

  • How Doctors Use X-Rays

    X-rays can show a fluid buildup in the chest wall or abdomen, and thickening in the lining of the lungs.

A chest X-ray is often the first scan doctors perform if malignant pleural mesothelioma is suspected, according to the ACS.

Computed Tomography (CT) Scans

CT scans use computer-guided X-rays to create a three-dimensional picture of the body’s internal structure.

CT scans take longer than X-rays, but doctors can see the size and location of tumors and other abnormalities more easily with these scans. 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 can help locate exactly where a mesothelioma tumor may be located, as this test provides a very detailed view of the body’s soft tissues.

Positron Emission Tomography (PET) Scans

PET scans use radioactive proteins to identify potentially cancerous cells within the body.

  • How PET Scans Work

    Before a PET scan, patients are injected with radio-labeled sugar that is better absorbed by cancer cells than healthy ones. The PET scan then finds the cells that absorbed the sugars.

Combined PET-CT scans may also be used to get an even more detailed view of your body.

Blood Tests & Biomarkers

Outside of imaging scans, doctors may also use blood samples to look for abnormalities within a patient. 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.

Commonly used 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 elevated levels of a protein known as osteopontin in some mesothelioma patients, though these levels also rise with other conditions. Researchers are still testing how reliable osteopontin is to diagnose mesothelioma.
  • Tests for Fibulin-3: Fibulin-3 is another protein that may be increased when a patient has mesothelioma. Researchers are still studying how accurate this blood test is. Very high levels of fibulin-3 may also be linked to a poorer prognosis, according to a study from Current Opinion in Pulmonary Medicine.

Doctors are developing other mesothelioma blood tests with the goal of quickly and accurately diagnosing this cancer.

While blood tests may help narrow down the cause of symptoms, 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 potentially cancerous area found on an imaging test.

Types of biopsies include:

  • Laparoscopy: This test is used to diagnose peritoneal mesothelioma. A camera attached to the end of a tube is inserted into part of the abdomen through an abdominal incision (laparotomy).
  • Mediastinoscopy: A tube is inserted near the neck. There is a camera that can show areas that look cancerous. Doctors can then take a sample from the area.
  • Needle biopsy: A thin, hollow needle is inserted through the skin. Fluid and/or tissue can then be collected through a syringe.
  • Thoracoscopy: Similar to a mediastinoscopy, a camera is attached to the end of a tube and is inserted through a chest incision (thoracotomy) into the lung cavity. The cancerous areas can be seen with the camera and the biopsy is taken using small tools attached to the thoracoscope.

The results from a biopsy are typically available in 4 to 5 days.

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

Mesothelioma Pathology Tests

After your doctor has performed a biopsy, the tissue sample needs to be reviewed under a microscope by a pathologist.

Pathologists will be able to determine a mesothelioma diagnosis if there are mutations among healthy cells. Then, the pathologist notes the characteristics of the cancerous cells.

  • Studying Mesothelioma Cells

    Mesothelioma cells have specific traits that can be revealed by immunohistochemistry, which shows special antibodies only found on these types of cells.

There are three different mesothelioma cell types:

  • Epithelioid: These cells are the most common and the easiest to treat due to their slower growth.
  • Sarcomatoid: These cells are highly aggressive and patients who have this cell type often have a very poor life expectancy.
  • Biphasic: Biphasic mesothelioma tumors contain both epithelioid and sarcomatoid cells. If more epithelioid cells are present, patients often have a better health outlook.

How Veterans Can Prepare for a Mesothelioma Diagnosis

Veterans who may have mesothelioma can get a proper diagnosis with the help of their doctor. See what you can do to make the process easier below.

How to Prepare for Diagnostic Tests

Doctors will likely tell you everything you need to do to prepare for an imaging scan, blood test, or biopsy. However, since every test is different, it can be helpful to ask questions if you aren’t totally sure how to prepare.

To prepare for diagnostic tests, ask your doctor:

  • What do I need to do ahead of time to prepare for the test?
  • Will I need to change my diet for this test? If so, how long will it need to be changed?
  • 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 no matter what your diagnosis is, it’s likely that treatments will be available to help you outlive your prognosis, manage your symptoms, or both.

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

Working With the VA

If you served in the U.S. military and later developed mesothelioma, it’s crucial to see if you can access medical care through the U.S. Department of Veterans Affairs (VA) health care system.

Past veterans who have been diagnosed with mesothelioma qualified for free or low-cost medical treatment and monthly financial payments from the VA.

It is important to keep your VA benefits in mind as you undergo diagnostic tests for mesothelioma. VA benefits can help you manage your health and stay financially sound if you are diagnosed with mesothelioma.

Eric Hall, a veteran and VA-accredited attorney, can help you file for VA benefits right now if you have mesothelioma. Don’t wait — you may qualify for free treatment and monthly compensation.

Why Mesothelioma Is Often Misdiagnosed

Mesothelioma is so rare that it is not the first thing doctors think of unless they know you have a history of asbestos exposure. As a result, mesothelioma can sometimes be mistaken for other types of cancer or even noncancerous illnesses.

Several factors can affect a mesothelioma diagnosis, including:

  • Difficulty getting an accurate biopsy: A pathologist might have trouble diagnosing mesothelioma because it can look like other kinds of cancer. For example, adenocarcinoma (a form of lung cancer) and mesothelioma cells have similar structures. More biopsies or further examination may be necessary to avoid a mesothelioma misdiagnosis.
  • Imaging scan issues: Small mesothelioma tumors may look like thickening of the pleura (the lining of the lungs), and they might not be visible on an X-ray. Many patients need additional CT or MRI scans of the chest to determine if cancer is present, which can add more time to the diagnostic process.
  • Latency period: In many cases, it takes 20 to 50 years after asbestos exposure before symptoms of mesothelioma appear. By this point, some patients may not suspect that their symptoms are related to asbestos. Others may simply forget that they were exposed.
  • Nonspecific symptoms: Mesothelioma symptoms are similar to those of many other diseases. As a result, your primary care provider may suspect a more common (and less deadly) condition like pneumonia or irritable bowel syndrome is causing your symptoms.

Next Steps After a Mesothelioma Diagnosis

Once your doctor has confirmed you have mesothelioma, they can provide a prognosis. A mesothelioma prognosis is the expected outcome of disease. Doctors will look at the mesothelioma type, stage, and your overall health to determine a prognosis.

While mesothelioma has a generally poor prognosis, medical treatments may be available to help you live for many years after your diagnosis. Thus, it’s key to 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.

Did you know

Surgeries, chemotherapy, and radiation therapy all may be used to treat this cancer. Specialists may also be a part of clinical trials testing new ways of treating mesothelioma.

You may also want to undergo follow-up tests to avoid a misdiagnosis. For example, electron microscopy can help doctors distinguish mesothelioma cells from adenocarcinoma. This type of imaging uses an electron microscope to get a much higher magnification of a biopsy or fluid sample.

Further testing also helps doctors create a tailored mesothelioma treatment plan based on your unique health factors.

In some cases, you may want to request a second opinion to make sure your mesothelioma diagnosis is accurate.

Get a Mesothelioma Diagnosis from Top Doctors

If you may have mesothelioma, don’t wait – connect with a doctor immediately. Early detection of this cancer may help improve your life expectancy and expand treatment options.

Things to remember about a mesothelioma diagnosis:

  • Biopsy samples are the only conclusive way to diagnose mesothelioma
  • Talk to your doctor about a second opinion to avoid a misdiagnosis
  • The VA can help veterans get diagnosed and treated

Our team can help you learn more about getting a mesothelioma diagnosis and exploring your next steps. Get a free veterans packet today.

Common Questions About Mesothelioma Diagnosis

How does a doctor diagnose mesothelioma?

Doctors diagnose mesothelioma using a series of tests. They’ll typically start with imaging tests (like X-rays and CT scans) to look inside the body for possibly cancerous growths.

In some cases, doctors may also use blood tests to see if a patient has higher levels of certain proteins and other substances in their body. These heightened substances may mean that a patient has cancer.

If doctors believe a patient may have mesothelioma after these initial tests, they’ll order a fluid or tissue biopsy. They’ll send the biopsy to a pathologist to confirm the presence of mesothelioma in the body.

Is mesothelioma hard to diagnose?

While plenty of mesothelioma patients are correctly diagnosed, it is challenging to diagnose this cancer.

Doctors may have problems diagnosing mesothelioma since it is relatively rare, the symptoms are mild, and its cells may look like other types of cancer under a microscope. Fortunately, 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.

Generally speaking, mesothelioma patients live longer if they are diagnosed before the cancer has spread throughout the body.

Those with peritoneal mesothelioma (which forms in the lining of the abdomen) often live longer than those with other types. There are more treatment options available for peritoneal mesothelioma.

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.

View 14 Sources
  1. American Cancer Society. (n.d.). How Is Malignant Mesothelioma Diagnosed? Retrieved September 24, 2020, from https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/how-diagnosed.html
  2. American Cancer Society. “Can Malignant Mesothelioma Be Found Early?” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/found-early.html. Accessed on August 28th, 2017.
  3. American Society of Clinical Oncology. (Feb. 2019.) Mesothelioma: Diagnosis. Retrieved from https://www.cancer.net/cancer-types/mesothelioma/diagnosis.
  4. G. Martensson. European Respiratory Journal. “Diagnosing malignant Pleural Mesothelioma.” 1990. Retrieved from: https://pdfs.semanticscholar.org/9e3e/e3d16fecbea1f6ab95c39cd15c5c21654565.pdf. Accessed on August 28th, 2017.
  5. National Cancer Institute. (Mar. 2019.) Malignant Mesothelioma Symptoms, Tests, Prognosis, and Stages (PDQ®)–Patient Version. Retrieved from https://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq.
  6. American Cancer Society. (n.d.). How Is Malignant Mesothelioma Diagnosed? Retrieved July 26, 2021, from https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/how-diagnosed.html
  7. American Cancer Society. (n.d.). X-rays and other radiographic tests for cancer. Retrieved July 26, 2021, from https://www.cancer.org/treatment/understanding-your-diagnosis/tests/x-rays-and-other-radiographic-tests.html
  8. American Society of Clinical Oncology. (2020, March 06). Computed tomography (ct) scan. Retrieved July 26, 2021, from https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/computed-tomography-ct-scan
  9. Cancer Research UK. (2021, June 08). Laparoscopy and biopsy. Retrieved July 26, 2021, from https://www.cancerresearchuk.org/about-cancer/mesothelioma/getting-diagnosed/tests-diagnose/laparoscopy
  10. Creaney, J. (n.d.). Comparison of mesothelin and fibulin-3 in pleural fluid and serum as markers in malignant mesothelioma. Retrieved July 26, 2021, from https://journals.lww.com/co-pulmonarymedicine/Abstract/2015/07000/Comparison_of_mesothelin_and_fibulin_3_in_pleural.9.aspx
  11. Ferlosio, A., & Orlandi, A. (2016, November). The use of electron microscopy for the diagnosis of malignant pleural mesothelioma. Retrieved July 26, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5179440/
  12. Ledda, C. (n.d.). Biomarkers for Early Diagnosis and Prognosis of Malignant Pleural Mesothelioma: The Quest Goes on. Retrieved July 26, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025035/
  13. Pass, H. I., & Hesdorffer, M. (2014). 100 Questions & Answers About Mesothelioma. Burlington, MA: Jones & Bartlett Learning.
  14. UCSF. (2017, January 04). Pet/ct scan: How to prepare, what to expect & safety tips. Retrieved July 26, 2021, from https://radiology.ucsf.edu/patient-care/prepare/pet-ct
Back to Top