This page tells you about further tests you may have to find out whether the mesothelioma has spread. This is called staging. The stage of your cancer is important because it helps to decide on the best treatment. But it may not be possible to be sure of the stage without having surgery. There is information on
Bronchoscopy
This is a test that looks at the inside of the airways. A flexible tube called a bronchoscope is put into the airway. The tube has an eyepiece so that the doctor can see into your airways. Biopsies (samples of tissue and cells) can also be taken during a bronchoscopy. These are sent to a laboratory for testing to see if there are any cancer cells present.
The test is usually done as an outpatient under local anaesthetic. This means you are awake for the test, but your throat has been numbed. Sometimes it is done with a general anaesthetic. If you have an anaesthetic, you may have to stay in hospital overnight. This depends on the time of day the test is carried out and your general health.
MRI scan
This is a scan that uses magnetism to build up a picture of the inside of the body. You may be asked to have a chest MRI or an abdominal MRI, depending on which type of mesothelioma you are being investigated for. But MRI isn't a routine test for mesothelioma, so you may not have one at all.
MRI scans can be very noisy and some people who don't like small spaces find them difficult to cope with. Tell your doctor beforehand if you have any of these worries or fears. If you have any metal in your body, you cannot have an MRI scan. There is more about having an MRI scan in the About Cancer Tests section of CancerHelp UK.
Mediastinoscopy
This is a test that examines the mediastinum (the centre of your chest) to see if the mesothelioma has spread there. This area contains
- The heart
- The main blood vessels
- Lymph nodes
- The oesophagus (foodpipe)
Sometimes in pleural mesothelioma, the lymph nodes in the chest are enlarged.
You need to have a general anaesthetic for this test and so have to stay in hospital for at least one night. The surgeon makes a small cut at the base of the neck. A small tube is put through the cut and into the mediastinum. The surgeon can look through this tube to examine the area. The tube may contain a small video camera, so the surgeon can look at the area on a screen. Tissue samples can also be taken, which will be examined under a microscope to see if there are any cancer cells.
When you wake up, you will have a small dressing over the cut where the tube was put in. Don't be afraid to say if you are feeling sore. The nurses will be happy to give you a painkiller. Once you have got over the anaesthetic, you will be able to go home. This will probably be the day after the test.
PET scan
Your doctor may suggest a PET scan if your mesothelioma is likely to be treatable with surgery. Unfortunately, surgery is only possible for a small number of people with mesothelioma. PET stands for 'positron emission tomography'. It is a fairly new type of scan that can show how body tissues are working, and not just what they look like. A PET scan may show whether the cancer has spread to lymph nodes or another part of the body. Your surgeon may need to rule this out before finally deciding that surgery is possible. There is more about having a PET scan in the CancerHelp UK section about cancer tests .
CT-PET scan
A combined CT and PET scan can give the doctor more information than either test on its own, and is more helpful in deciding which patients are likely to benefit from surgery.
Laparoscopy
This is a small operation that may be used to diagnose peritoneal mesothelioma. A tube with a camera and a light is put into your abdomen through a small cut. Your doctor can look inside to see whether there is any sign of cancer. The doctor will take samples (biopsies) of any abnormal looking areas. These will be sent to the laboratory for examination under a microscope. Laparoscopy is done under general anaesthetic. You will have a small wound with a couple of stitches. Sometimes, the camera is put in through more than one cut, so you may have more than one wound.
After the tests
You will be asked to come back to the hospital when your test results have come through. This is bound to take a little time, even if only a day or two. You may feel very anxious during this time.
Suggestion While you are waiting for results it may help to talk to a close friend
or relative about how you are feeling. Or you may
want to contact a cancer support group to talk to someone
who has been through a similar experience. Look
in help and support for an organisation
that can give you information about
support groups or counselling services near you.
http://www.cancerhelp.org.uk
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