Cancer Information

Diagnosis of pleural mesothelioma

  • History of exposure to asbestos.

  • X-Ray chest - Chest radiographs reveal a variable amount of fluid, with pleural thickening or pleural nodules, often several centimeters in diameter, imposing a scalloped appearance. Mediastinum shift might be visible.

  • CT scan, MRI can detect the extent of the disease

  • Thoracocentasis reveals malignant cells in up to 30% cases and high content of hyaluronic acid.

  • Gallium scan

  • Echocardiography and ECG may reveal cardiac abnormality and pericardial involvement

  • Thoracoscopy or thoracotomy with biopsy is needed to confirm the diagnosis.

Diagnosis of peritoneal mesothelioma:

  • Direct biopsy by laparotomy or peritoneoscopy is the best diagnostic procedure.

  • CT scan and ultra sound can be used to follow the course of the disease.


Treatment of mesothelioma is often very difficult due to its diffuse mass. Treatment modalities include-

  • Surgical resection

  • A combination of Radiotherapy using Iodine-125 or Iridium-192 implants and surgery

  • Radiotherapy alone

  • Radiotherapy and Chemotherapy

  • Combination chemotherapy- Chemotherapy can be given either intravenously or intracavitary (chemotherapeutic agent put inside pleura or peritoneum). Doxorubicin , 5-azacytidine, cisplatin, mitomycin, 5-FU, methyl CCNU, and actinomycin  all have been used in different combinations.

  • Biological therapy - Human recombinant IFN-a was first shown to potentiate the effect of chemotherapy. Interleukine-2 has also some beneficial effect in patients with mesothelioma.

  • New developments - Adding pemetrexed (Alimta) to cisplatin improved survival for patients with malignant pleural mesothelioma, according to the results of a randomized phase III trial published in the July 15 2003, issue of the Journal of Clinical Oncology.