The cancer caused by exposure to harmful asbestos fibres known as mesothelioma can be tricky to diagnose since it often appears to have little difference to other types of cancer. However once the diagnosis has been confirmed (the ‘Guide to Diagnosing Mesothelioma’ explains this process), further tests will be needed so that your doctor can ascertain how big the tumour is and whether it has spread to other parts of your body. This is called ‘staging’.
Although surgery is often the only way to pinpoint the stage of mesothelioma, staging is an important process because it will provide the right steer for your doctor to formulate the best course of treatment – while the condition is currently incurable, there are treatments available to slow its development and improve your quality of life.
This guide will explore some of the staging test options – 3 types of scans depending on the type of mesothelioma you have been diagnosed with.
PET-CT Scan
As the title infers, this procedure is a combination of a PET (Positron Emission Tomography) scan and a CT (Computerised Tomography) scan.
PET scans involve a small amount of radioactive (no more than an X-ray) drug being injected to highlight through the scan how the body’s tissues are working, these machines are highly expensive and there are only a few in the UK so you might have to travel for the test. CT (or CAT) scans meanwhile involve a readily available machine that takes a series of X-rays and renders them for display on a computer.
A PET-CT scan is performed to take CT pictures of the body’s structures, while at the same time the PET scan drug highlights areas of the body where cells are more active than normal. In this way, your doctor will be able to view the changes happening in your body’s cells.
The scan will serve to pinpoint the area where the mesothelioma is occurring and may also show whether it has spread into nearby lymph nodes.
EBUS Scan
The EBUS (Endobronchial Ultrasound Scan) may be prescribed by your doctor if previous scans reveal that the lymph nodes around your lung are enlarged. Generally, it takes under half an hour.
This type of scan involves the patient being given a general anaesthetic or sedation. The doctor will gently pass a small, long, flexible tube (bronchoscope) into your mouth and down the windpipe (trachea). This tube can pass into your smaller airway passages and provide ultrasound images of your lung, pleura (membrane covering the lungs) and lymph glands to reveal the size of the mesothelioma tumour and whether it has spread to the lymph nodes.
Additionally, a hollow needle can be passed down the tube to take an ultrasound-guided biopsy (extraction of a small amount of tissue for testing purposes) of any enlarged lymph nodes.
EUS Scan
The EUS (Endoscopic Ultrasound Scan) may be used to check for mesothelioma cells in the lymph nodes located close to the oesophagus (food pipe) and the centre of the chest. It usually takes less than half an hour.
It is performed under general anesthetic or sedation. The doctor will gently insert a bronchoscope tube with an ultrasound probe attached down your throat and into the oesophagus to produce ultrasound pictures of the area around your heart and lungs.
As with the EBUS test, the doctor may pass a hollow needle down the tube to take an ultrasound-guided biopsy of any enlarged lymph nodes or pleural tissue at the centre of the chest that looks abnormal.
Conclusion
While the EBUS and EUS tests might seem rather invasive, bear in mind they are effective at helping your doctor get to grips with the size and progression of the cancer. As mentioned, it is vital to pinpoint the stage of mesothelioma in order to best treat it.
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