Diagnosing peritoneal mesothelioma

Monday 1 August, 2016

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Your doctor (usually GP) will examine you and ask about your general health, family history and symptoms. If you believe you have been exposed to asbestos, mention this during your appointment. You will probably be asked to have tests and you may be referred to a specialist, such as a gastroenterologist. A gastroenterologist is a doctor who specialises in the diagnosis and treatment of diseases of the digestive system.

Peritoneal mesothelioma can be difficult to diagnose. You are likely to have quite a few tests and there will be different health professionals involved. Each person’s pathway to diagnosis is unique.

Blood test

A blood test will not detect mesothelioma, but it can let your doctors know how your blood cells, liver and kidneys are working.

X-ray

This scan will look for any abnormalities in the abdomen, such as fluid and thickening in the peritoneum. If changes are found, you will need more tests to find the cause, as it can also be due to other conditions. A lung x-ray may also be done to check if the lungs are also affected.

CT scan

This scan uses x-ray beams to create a detailed 3D picture of the inside of the body. It provides accurate information about the location and thickness of the tumour(s) in the abdomen. It can show if the mesothelioma has spread to other organs.

The CT scan is also used to help determine the best way of obtaining tissue for examination (biopsy).

MRI scan

An MRI scan uses magnetic waves to create detailed cross-sectional pictures of the soft tissues in your body. These show the exact location and extent of the tumour.

You should let your medical team know if you have a pacemaker, as the magnetic waves can interfere with some pacemakers.

PET scan

A PET scan is a specialised imaging test available at most major hospitals. It is used to find cancer cells that may not have been detected from other tests, and it can show if the mesothelioma has spread to lymph nodes or other parts of the body.

Biopsy

During a biopsy, a small sample of thickened tissue is removed from the abdomen. The cells are examined under a microscope to determine if the tumour is mesothelioma and, if so, what type of cells are present, i.e. epithelioid, sarcomatoid or biphasic.

A biopsy can be taken in two ways:

  • CT-guided core biopsy
    A CT scan is used to guide the needle into the tissue. This is done under local anaesthetic (the skin is numbed).
  • Laparoscopy
    A thin tube called a laparoscope is inserted into your body. Through this tube, the doctor removes tissue samples for biopsy. A small camera is also used to look for signs of tumours and to see if they have spread. You will be admitted to hospital and given a general anaesthetic for this procedure.
Paracentesis (fluid drainage/tap)

You may have a build-up of peritoneal fluid in your abdomen; this is called ascites or peritoneal effusion. This may happen because the mesothelioma cells irritate the area. The extra fluid can cause abdominal swelling, tightness and pain.

A specialist can drain the fluid from your abdomen by using a local anaesthetic, inserting a needle through the skin and drawing fluid into the syringe. A sample can be tested for mesothelioma. Removing the fluid can also improve your symptoms.


Reviewed: Prof Paul Moroz, Professor of Surgery, University of Western Australia and Director of the Western Australian Peritonectomy Service, Joondalup Health Campus, WA; Carole Arbuckle, 13 11 20 nurse, Cancer Council Victoria, VIC; Sharyn Fenech, consumer; Dr Vinod Ganju, Head of Translational Research, Monash Cancer Centre, VIC; Vicki Hamilton, CEO, Asbestos Council of Victoria-GARDS, VIC; Dr Tom John, Medical Oncologist, Austin Hospital, VIC; Victoria Keena, Executive Officer, Asbestos Diseases Research Institute, NSW; Prof David Morris, University of New South Wales, Department of Surgery, St George Hospital, NSW; Evelyn Ramirez, consumer; Rod Smith, Bernie Banton Foundation; Elaine Spellman, Peritonectomy, Clinical Nurse Specialist, Joondalup Health Campus, WA; Prof Nico van Zandwijk, Director of the Asbestos Diseases Research Institute and Professor of Medicine, University of Sydney, NSW and A/Prof Winston Liauw, Cancer Services Stream Director, South Eastern Sydney Local Health District, NSW. Note to reader Always consult your doctor about matters that affect your

Updated: 01 Aug, 2016