Being diagnosed with peritoneal mesothelioma

You will usually see your family doctor (GP) first. They will examine you and arrange for tests. Depending on the results they may refer you to hospital to be assessed.

If the doctors suspect you have mesothelioma they will ask you if you could have been exposed to asbestos in the past. This may have been through your work or through someone in your family who worked with asbestos.

A number of tests are used to diagnose a peritoneal mesothelioma. The peritoneum is a tissue that lines all the organs in your tummy (abdomen), so you will have x-rays and scans taken of your abdomen. If you have a swollen tummy, caused by a build-up of fluid between the two layers of the peritoneum, a doctor may drain the fluid. The fluid will then be checked for cancer cells. You will usually also have samples (biopsies) taken from your peritoneum to check for cancer cells. This can be done under a local anaesthetic while you are awake or under a general anaesthetic while you are asleep.

How peritoneal mesothelioma is diagnosed

Usually, you begin by seeing your family doctor (GP). They will examine you and may arrange for you to have some blood tests and x-rays.

Depending on the results of any tests and x-rays, your GP may refer you to hospital for further tests and specialist advice and treatment.

At the hospital, the specialist will ask you about your general health and any previous medical problems before they examine you.

You may be asked questions about any possible exposure to asbestos in your past, such as during jobs you’ve had or at places you’ve worked. This is called your occupational history. You may also be asked if someone in your family, a parent for example, worked with asbestos. Don’t worry if you can’t remember all of the details at first. You can let your doctor know later about anything you remember.


Tests for peritoneal mesothelioma

You may have a number of tests to help diagnose a peritoneal mesothelioma. These may include:

Abdominal x-ray

This checks for any abnormalities in your tummy.

CT (computerised tomography) scan

A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. The scan takes 10–30 minutes and is painless. It uses a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.

CT scan
CT scan

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You may be given a drink or injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It’s important to let your doctor know if you are allergic to iodine or have asthma, because you could have a more serious reaction to the injection.

You’ll probably be able to go home as soon as the scan is over.

MRI scan

This test uses magnetism to build up a detailed picture of areas of your body. The scanner is a powerful magnet so you may be asked to complete and sign a checklist to make sure it's safe for you. The checklist asks about any metal implants you may have, such as a pacemaker, surgical clips, bone pins, etc. You should also tell your doctor if you've ever worked with metal or in the metal industry as very tiny fragments of metal can sometimes lodge in the body. If you do have any metal in your body it's likely that you won't be able to have an MRI scan. In this situation another type of scan can be used.

Before the scan, you'll be asked to remove any metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm, which doesn't usually cause discomfort. This is called a contrast medium and can help the images from the scan to show up more clearly. During the test you'll lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It's painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It's also noisy, but you'll be given earplugs or headphones. You can hear, and speak to, the person operating the scanner.

Drainage of fluid from the abdomen (peritoneal aspiration)

Mesothelioma cells can cause fluid to collect in the abdomen. This is called ascites. Your doctor may take a sample of this fluid to send to the laboratory as mesothelioma cells are sometimes present. Your doctor will give you a local anaesthetic to numb the area. A needle will then be inserted through the skin into the fluid and some fluid is removed. Sometimes the sample of fluid is taken while you’re having an ultrasound scan. The scan helps the doctor guide the needle to the fluid.

Peritoneal biopsy

A biopsy of the peritoneum is usually needed to help the doctors diagnose peritoneal mesothelioma. It can be carried out by:

  • Laparoscopy This procedure allows the doctor to look at other structures in your abdomen and take further biopsies if required. You’ll either be given a general anaesthetic or a local anaesthetic with a sedative to make you drowsy. Your doctor will make a small cut in the tummy wall. They will then put a thin tube with a light and camera at the end (laparoscope) into your tummy. Your doctor can then take a small biopsy of the peritoneum.
  • CT or ultrasound guided biopsy You will have a local anaesthetic to numb the area. Your doctor will then pass a special type of needle through the tummy into the area they want to biopsy. They will use an ultrasound or a CT scanner to help them guide the needle into the right place. The needle has a tip that can cut out a sample of tissue.

Biopsy

Having a biopsy can be uncomfortable but shouldn’t be painful. If you have any pain during or after the procedure, let your doctor or nurse know.

Once a biopsy has been taken, it’s sent to the laboratory and examined by a pathologist (a doctor who advises on the type and spread of cancer).

Sometimes, even after taking a biopsy, the doctors may still not be sure of the diagnosis. This is because peritoneal mesothelioma can be very difficult to tell apart from some other illnesses. In this situation, the biopsy samples may be sent to other laboratories to confirm the diagnosis. Some of your tests may need to be repeated or you may be referred to another hospital for a second opinion.


Waiting for test results

Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready. You may find it helpful to talk with your partner, family or a close friend. Your specialist nurse or one of the organisations listed on our database, can also provide support. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.

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