Mesothelioma Diagnosis: Tests, Biopsies & What to Expect
When mesothelioma is suspected, confirming the diagnosis involves several steps. Imaging scans are typically the first tool doctors use, then blood tests, and ultimately a biopsy, which remains the only way to definitively confirm the disease.
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Mr. Wasserberg is proud to call himself a Trial Lawyer. He is often a featured speaker at industry summits and gatherings of the nation’s leading attorneys, from both sides of the bar. He is recognized by both his peers and his adversaries and is considered one of the nation’s premier mesothelioma and negligence attorneys
Content written by Dan Wasserberg
- Expertise
Mr. Wasserberg is proud to call himself a Trial Lawyer. He is often a featured speaker at industry summits and gatherings of the nation’s leading attorneys, from both sides of the bar. He is recognized by both his peers and his adversaries and is considered one of the nation’s premier mesothelioma and negligence attorneys
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Mesothelioma Diagnosis Steps
Getting a confirmed diagnosis for mesothelioma isn’t a single test, but a step-by-step process. Your doctors will use a series of tests to gather information. Each test gives them a different piece of the puzzle towards confirmation. Knowing the usual order of these steps can help you feel less anxious about what comes next.
How Doctors Diagnose Mesothelioma
- Medical history and physical exam: Your doctor will first ask about your work history and any possible exposure to asbestos in your lifetime. They’ll do a physical exam to check for signs of fluid buildup or lumps in the chest area that could point to mesothelioma.
- Imaging tests: You’ll be asked to get imaging scans such as X-rays, CT scans or PET scans. These tests let doctors visualize internal structures to find abnormal areas or tumors and their sizes.
- Lab tests: Your doctor will order blood work to check for certain substances that can be a sign of mesothelioma. If you have fluid buildup in the chest area, they might take a sample of that fluid to test for the presence of cancer cells.
- Biopsy: This is the final and most important step. A surgeon or specialist will take a small sample of any suspicious tissue from the area. A pathologist then looks at this tissue under a microscope to see if cancer cells are present.
Going through these steps can take some time, and waiting for results is often the toughest part for the patient. To settle your concern, you can and should ask your doctor questions at every step. Understanding the process can help you feel more supported.
Why Is a Biopsy Critical for a Mesothelioma Diagnosis?
Examining a tissue biopsy is the only way to get a confirmed answer to whether or not a patient has mesothelioma. Other tests can be strong clues telling your doctor something is wrong and even pointing strongly toward mesothelioma. But only a biopsy and pathology report can confirm the diagnosis.
During a biopsy procedure, a doctor removes a tiny piece of tissue from the suspected tumor in the chest. To obtain a biopsy sample, a long, thin needle may be used to draw out tissue or fluid. In other cases, they might need to make a small cut near the tumor to feed a tiny camera to visualize and take a sample. Your doctor will discuss the best method based on where the tumor is located.
A pathologist then examines this tissue under a microscope. They can observe the abnormal cells and confirm if there are mesothelioma cells present. This does more than just confirm you have cancer. It can also tell your doctors your specific mesothelioma cell type. This detail is crucial because it directly informs the treatment plan that will work best for you. Without a biopsy, your doctors can’t build a truly personalized treatment plan for you.
Benefits of an Early Mesothelioma Diagnosis
Mesothelioma is a cancer that grows and spreads over time. Because its early symptoms are easy to mistake for other common illnesses, it’s often found in later stages. For those who are diagnosed early, it can open up many more treatment possibilities. An early diagnosis can make a difference in your outcomes.
Why Early Diagnosis Matters
- Access to clinical trials: An early diagnosis may give you more time to find and qualify for mesothelioma clinical trials testing promising new treatments.
- Better surgical candidacy: In the early stages, the cancer is often still in one area. This may make you a better candidate for surgery to remove the tumor, which isn’t always an option in later stages.
- Improved prognosis: Generally, people diagnosed at an earlier stage have a better outlook and longer life expectancy than those diagnosed after the cancer has spread.
- Wider range of treatment options: When mesothelioma is less advanced, your medical team can consider more types of treatment, including a combination of surgery, chemotherapy and radiation.
Because early diagnosis offers such important benefits, it’s a good idea for anyone with a history of asbestos exposure to talk to their doctor about screening. This is true even before you notice any symptoms.
Why Is an Initial Misdiagnosis Common With Mesothelioma?
Mesothelioma is frequently misdiagnosed because its early symptoms are nearly identical to those of much more common illnesses. A persistent cough, chest pain and shortness of breath are the same signs you would see with pneumonia, the flu or COPD. Because these conditions are so common, they’re what doctors look for first. Standard medical practice is to rule out the most likely causes.
Adding to this challenge is the fact that mesothelioma is a rare cancer. Many general practitioners and even some cancer doctors may go their entire careers without personally seeing a case. They’ve learned about it from textbooks, but they don’t have the same practical experience they have with other diseases. So, when a patient’s symptoms don’t improve with treatment for something like pneumonia, it can take time for a doctor to consider symptoms of mesothelioma.
This is why your personal story and the choice to be your own advocate is so important. If you have a history of working around asbestos or exposure, tell your doctor. This is a critical clue that can guide them toward the right diagnosis. If your symptoms linger and you aren’t getting answers, don’t be afraid to ask for a referral to a specialist. A second opinion from a doctor who sees mesothelioma patients regularly can make all the difference in getting an accurate diagnosis.
What to Expect From the Mesothelioma Diagnosis Process
Every hospital and doctor’s office does things a little differently. The best way to know exactly what will happen during your tests is to ask your own care team. They can give you specific instructions based on where you are going for your procedure. Writing down questions and bringing them to your appointment can be very helpful.
Questions to Ask Your Care Team
- Do I need someone to drive me home? Some procedures, especially if they use sedation, can make it unsafe for you to drive.
- How long will the procedure take? This helps you plan your day and lets your family know when to expect you.
- How long will it take to get my results? Knowing the wait time can help ease your anxiety while you wait for the doctor to call.
- What should I bring to my appointment? This might include your ID, insurance card, a list of your medications and any relevant medical records.
- What side effects or discomfort should I expect? Ask how you might feel afterward and what you can do to manage any pain or soreness.
- Are there any activities or foods I should avoid before the procedure? You might need to stop eating or drinking for a certain number of hours beforehand.
Going through a diagnostic process can feel overwhelming. Remember that no question is too small or silly to ask. Your medical team is there to help you. An informed patient is always better prepared.
Mesothelioma Diagnosis FAQs
The whole process usually takes a few weeks. First, you need to schedule and complete the initial imaging tests. If those show something suspicious, you’ll need to schedule a biopsy. After the biopsy, it can take several days for a pathologist to prepare and study the tissue sample. While waiting can be stressful, it’s important for the doctors to be thorough and get the diagnosis correct.
You shouldn’t feel sharp pain during the biopsy. Doctors use local anesthesia to numb the area or sedation to make you sleepy and relaxed. After the procedure, once the numbness wears off, you’ll likely have some soreness or discomfort where the doctor took the sample. Your care team will give you instructions on how to manage this pain at home.
A CT scan is a very detailed 3D map of your insides. It shows the size, shape and location of tumors. A PET scan, on the other hand, shows the activity of your cells. Cancer cells are often very active, so they light up brightly on a PET scan. Doctors use these scans together to get a complete picture of where the cancer is located and if it’s active.
For most people, the tracer used in a PET scan is very safe. The radioactive material leaves your body quickly, usually within a few hours. Drinking plenty of water after the scan helps flush it out even faster. The amount of radiation is small and is considered worth the benefit of getting a clear and accurate diagnosis. Your doctor can answer any specific concerns you have.
A diagnosis can’t be confirmed without a biopsy. Blood tests and scans can suggest mesothelioma is likely, but they can’t say with accuracy. Only a pathologist looking at actual cancer cells from your body under a microscope can make a definitive diagnosis. This step is critical for planning the right treatment for the right cancer.
Most health insurance plans, including Medicare, do cover the medically necessary tests to diagnose cancer, such as biopsies, CT scans and lab work. However, coverage can vary based on your specific plan. It’s always a good idea to call your insurance company before your procedures. You can ask them what your out-of-pocket costs might be as a copay or deductible. The billing department at your doctor's office or hospital can also help you understand your coverage.
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