What are Some of the Preoperative Tests for Mesothelioma Patients?

• Nancy Meredith
• Patients

Many mesothelioma patients have surgery to remove tumors, parts of tumors, or parts of organs that have been affected by the disease. Before any surgery, however, there are necessary tests to determine if the disease has spread, whether it has advanced to another stage, and the size of the tumor being targeted.

Accurate staging is important for deciding on mesothelioma treatment.

Advanced Diagnostic Tools Let Physicians See Organ Damage from Mesothelioma

Pleural mesothelioma, which invades the linings around the lungs, is the most common form of mesothelioma. Pericardial mesothelioma, which is rarer, invades the linings around the heart.

Surgeons will often perform mediastinoscopy on patients with these kinds of mesothelioma. This is a minimally invasive procedure where a small incision is made in the chest so that a scope can be inserted to look in the area around the lungs or heart. A needle can be used to remove tissue and fluids for testing to help determine the disease stage.

Pericardioscopy is another minimally invasive surgery used to determine the extent that the heart linings have been damaged. A surgeon makes a small cut in the skin over the heart and places a small tube with a camera inside. Cell samples are often removed during pericardioscopy.

Endobronchial ultrasound (EBUS) is a newer treatment that doesn’t require an incision. Instead, a physician places a bronchoscope, with a special endoscope attached to it that is outfitted with an ultrasound processor and fine-gauge aspiration needle, down the patient’s throat and through the trachea. EBUS lets physicians see more of the airways, lungs, and smaller lymph nodes than they would through mediastinoscopy. Views are clearer and illuminate areas missed in the mediastinoscopy.

Endoscopic ultrasound (EUS) might be used on patients with peritoneal mesothelioma, which affects the linings of abdominal organs. During EUS, a tube with an endoscope is placed down the throat or through the rectum to view the digestive tract. A transducer on the tip of the endoscope provides higher-quality images than those obtained through traditional ultrasound. It can also get closer to the affected organs and provide more detail on lymph node activity.

What Do These Tests Show?

Physicians order these tests to get closer views and details about organ damage and changes in lymph nodes.

Lymph nodes are small glands found throughout the body that are a key part of the immune system. The largest lymph nodes are located in the neck, around the groin, and in the armpits. Smaller ones are found throughout the body.They send lymph fluids around the body to trap bacteria, viruses, and other threats and send lymphocytes—special white blood cells—to destroy them. They also carry nutrients to different parts of the body and help remove waste.

When lymph nodes are overwhelmed by disease, infection, or an injury, they become swollen in the affected area. This swelling is an important sign that a disease may have taken hold or spread.

Mesothelioma attacks the linings that protect organs, specifically, mesothelial cells on the inside of these linings. These cells provide lubricating fluids that let these organs move and function smoothly. Asbestos fibers that are inhaled or swallowed attach to these linings and damage the mesothelial cells.