The first step to diagnosing mesothelioma is a complete evaluation of a patient’s medical history to determine symptoms and any past asbestos exposure, as well as a complete physical. In addition, physicians may request an MRI scan or X-ray of the abdomen or chest region to help determine the location and size of the tumor.

With pleural and peritoneal mesothelioma, tell-tale fluid (effusion) may collect in the chest or abdominal region. Physicians may use a procedure known as fine needle aspiration to obtain a sample of this fluid for further testing. This procedure can be used to drain the effusion to temporarily relieve chest pain or other symptoms.

Common procedures in diagnosing the disease include:

Thoracoscopy — In diagnosing pleural mesothelioma, a doctor may use a special instrument called a thoracoscope to examine the patient’s chest cavity. This test involves an incision in the chest wall and insertion of the scope between the patient’s ribs. If the doctor finds fluid collected in the patient’s chest, it will be drained out of the chest cavity through a needle.

Peritoneoscopy — In suspected peritoneal mesothelioma, the doctor will insert a peritoneoscope into an opening made in the patient’s abdomen. If fluid is found in the abdomen it will be drained with a needle through a process called paracentesis.

Biopsy — A tissue sample is surgically extracted, during one of the above procedures or in a separate operation. If cancer is found in the patient’s lungs or abdomen, the sample will be examined by the doctor to determine appropriate treatment.

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