What tests should I get after a Mesothelioma diagnosis

Tests After a Mesothelioma Diagnosis

After being diagnosed with mesothelioma, your oncology team will order several important tests to understand your cancer better and plan your treatment. Here's what you should expect:

Staging Tests (To Determine How Far the Cancer Has Spread)

Imaging Studies:

• CT (Computed Tomography) scans - Usually of the chest and abdomen to see the size and location of tumors
• PET scan (Positron Emission Tomography) - Shows metabolic activity of cancer cells; helps identify areas of active disease
• MRI - Sometimes used for detailed imaging of specific areas

These imaging tests help your doctors determine the stage of your mesothelioma, which is critical for treatment planning.

Tissue and Fluid Analysis

• Pathology review - Your original biopsy sample will be carefully examined to confirm the mesothelioma type (epithelioid, sarcomatoid, or biphasic)
• Fluid samples - If fluid has accumulated around your lungs or abdomen, samples may be analyzed for cancer cells
• Immunohistochemistry (IHC) stains - Special staining techniques that help identify mesothelioma cells and rule out other cancers

Blood Tests

• Complete blood count (CBC) - Checks red blood cells, white blood cells, and platelets
• Metabolic panel - Evaluates kidney and liver function before treatment
• Tumor markers - Tests like mesothelin levels may be checked (though these aren't diagnostic on their own)

Pulmonary Function Tests

• Breathing tests - Measure how well your lungs work, important since mesothelioma affects the lungs and treatment may impact breathing

Cardiac Evaluation

• Heart function tests - May include an EKG or echocardiogram, especially if chemotherapy is being considered

Molecular/Genetic Testing (Emerging)

Some centers now offer:

• Gene panel testing - Looks for specific mutations that might guide treatment decisions
• Tumor microenvironment analysis - Tests like those described in the BostonGene Tumor Portrait Report can provide detailed immune profiling to help personalize treatment recommendations

Questions to Ask Your Oncology Team

1. Which staging system will you use for my mesothelioma? (TNM staging is standard)
2. Do you recommend molecular testing or tumor profiling for my case? This could help identify personalized treatment options
3. What is my stage, and what does that mean for treatment options?
4. Are there any clinical trials I might be eligible for based on my test results?
5. How often will these tests be repeated during treatment to monitor my response?

Important Context

According to current oncology practice, the combination of imaging, pathology, and functional tests gives your medical team the complete picture needed to:

• Confirm your diagnosis
• Determine your stage
• Assess your overall health status
• Identify the best treatment approach for YOUR specific situation
• Establish a baseline to measure treatment response

The specific tests your team recommends may vary based on your individual case, symptoms, and overall health. Some centers are increasingly using advanced profiling tools (like those mentioned in personalized medicine approaches) to identify novel treatment combinations, though these are still evolving in mesothelioma care.

Next Steps

Ask your oncology team for a clear summary of:

• Which tests have been completed
• Which tests are still needed
• When you'll get results
• How results will guide your treatment plan

This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.