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Mesothelioma Diagnosis

A biopsy is the only definitive way to diagnose mesothelioma. However, doctors may also use imaging tests, blood tests, and physical exams to rule out other conditions and get a complete picture of your overall health. The team at Mesothelioma Hope can help you prepare for diagnostic tests and figure out what to do next if you’re diagnosed.

Medically reviewed by: Mark Levin, MD

Last updated:

Key Facts: Mesothelioma Diagnosis

  • Mesothelioma can be misdiagnosed — it’s a rare cancer and symptoms can be mistaken for other illnesses.
  • Getting a second opinion from a mesothelioma specialist can help ensure you’re properly diagnosed and know what treatment options are available to you.
  • Diagnostic testing costs depend on your insurance and other factors. If you’re concerned about paying for testing, we can help you evaluate your financial options.
  • If you’ve been diagnosed with mesothelioma, the next step is to find a mesothelioma doctor (if you don’t have one already).
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How Is Mesothelioma Diagnosed?

To get an accurate mesothelioma diagnosis, you’ll likely need to see a specialist. Your primary care doctor may not have the expertise to recognize the signs of mesothelioma cancer, so it’s crucial to find a specialist to help you.

The basic steps for a mesothelioma diagnosis include:

  1. Symptom evaluation. During your initial exam, the mesothelioma doctor will ask about your symptoms to get a full picture of your health. It’s important that you share everything you’ve noticed, such as fatigue, weight changes, pain, and any respiratory changes.
  2. Medical and personal history. Your doctor will also want to know about your medical history, including any existing health conditions and whether you might have been exposed to asbestos (the only known cause of mesothelioma).
  3. Testing. Depending on your symptoms, your doctor may order blood tests and imaging scans to get an internal look at your lungs and abdomen. These tests will help your doctor rule out other conditions and better understand your health situation.
  4. Biopsy. The only way to confirm a mesothelioma diagnosis is through a biopsy. During a biopsy, a pathologist examines fluid or tissue samples for cancerous cells.

Patients are also sometimes diagnosed with mesothelioma during surgery or treatment for another condition.

If you have questions about the diagnosis process, our Patient Advocates can help. Call us now at (866) 608-8933 to learn how to prepare for your appointment, what you should ask your specialist, and what to expect during each test.

Mesothelioma Testing by Symptoms & Cancer Type

Doctors use specific techniques and equipment to make a mesothelioma diagnosis depending on the patient’s symptoms and where in the body their cancer may be located.

Learn about the common tests used to diagnose each type of mesothelioma below.

Pleural Mesothelioma

This type of mesothelioma is located in the lining of the lungs, also known as the pleura.

Common symptoms of pleural mesothelioma include chest pain, coughing, shortness of breath, and fatigue. Doctors use different tests to determine if cancer is present in the pleura, whether it has spread, and whether the lungs have been weakened.

Common tests for pleural mesothelioma include:

  • CT scans
  • MRIs
  • PET scans
  • Pulmonary function tests (lung function tests)
  • X-rays

Peritoneal Mesothelioma

This type of mesothelioma is located in the peritoneum, or lining of the abdomen.

Common symptoms of peritoneal mesothelioma include abdominal pain, bloating, constipation, loss of appetite, nausea, and vomiting. Doctors use several tests to determine if cancer is present in the peritoneum and whether it has spread.

Common tests for pleural mesothelioma include:

  • Biopsies
  • Blood tests
  • CT scans

Patient Diagnosis Stories

Each person’s medical journey is unique. But hearing how other mesothelioma patients were diagnosed can help you see the different paths to treatment.

Below, learn what symptoms led three mesothelioma patients to seek medical care, the tests they underwent, and their final diagnosis.

pleural mesothelioma survivor John Stahl with his wife

John Stahl

  • Initial symptoms: Fatigue, shortness of breath, feeling off
  • Appointments: Urgent care center, primary care visit, and then referred to an oncologist
  • Tests: X-ray of lungs followed by CT scan

John was diagnosed with stage 4 pleural mesothelioma. Read John’s full story here

peritoneal mesothelioma survivor Alexis Kidd with her husband

Alexis Kidd

  • Initial symptoms: Abdominal pain
  • Appointments: Unrelated gallbladder surgery
  • Tests: Tissue biopsy from diaphragm

Alexis was diagnosed with peritoneal mesothelioma. Read Alexis’s full story here

pleural mesothelioma survivor John Panza

John Panza

  • Initial symptoms: Flu-like symptoms
  • Appointments: Doctor visit for “flu” and two thoracentesis procedures to remove fluid around John’s lungs that kept returning
  • Tests: Chest X-ray, which found pleural effusions (fluid collection), followed by VATS (video-assisted thoracoscopic surgery)

John was diagnosed with stage 3 pleural mesothelioma. Read John’s full story here

Get more insights and information on diagnosis, treatment, and more in our Free Mesothelioma Guide.

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What to Do After a Mesothelioma Diagnosis

If you or a loved one were diagnosed with mesothelioma, it’s important to take a moment to process this news and your feelings — you won’t solve everything right away. It’s important to take the time to understand your diagnosis and determine what steps you need to take to get the treatment you need.

A few things to consider after a mesothelioma diagnosis include:

  1. Getting a second opinion
  2. Finding a mesothelioma specialist who can develop a custom treatment plan for you
  3. Asking about alternative treatment options and clinical trials

Additionally, it can be helpful to join a support group or peer mentor program and find a licensed therapist or mental health counselor to help you navigate the mental, emotional, and social aspects of diagnosis and treatment.

A Mesothelioma Diagnosis Video Thumbnail

Nurse Amy Fair discusses what to expect after getting a diagnosis of mesothelioma. This holistic disease affects not only the victim but the family and the caretaker too. View Transcript.

Duration: 1 min 43 sec

The most important thing folks that have been diagnosed with mesothelioma need to do is to take one minute and one day at a time. To get a diagnosis and try to fast forward about the when’s and the what’s and the how’s of what’s going to happen next month, or in six months or a year, can be very overwhelming.

When talking with families of someone that’s been diagnosed with mesothelioma, I encourage them to first let that particular person go through the stages of the feelings that they’re going to go through with this disease.

It’s important that the caregivers stay healthy too. They need to still be able to get away. They still need to be able to surround themselves with support through their family and through their church and through their friends.

Many times, when caregivers are struggling with the change of life that they are going through with this disease, I encourage them to reach out to; if they have local support groups there some of the oncologists can refer them to some local support groups. If they do not have those resources, then I do refer them directly to a mesothelioma support group.

The clients I have work with that have made the most profound impression with me are the clients that, they just needed someone to talk to and sometimes it’s not about medical, it’s not about the side effects of chemotherapy, it’s just sharing a memory of their loved one.

I get cards from them for different occasions, and there’s always a note that says that we made a difference.

Our team of medical professionals and patient advocates is here to assist you. From helping you find a mesothelioma specialist to arming you with information about what questions to ask during your next appointment, we’re here for you. Call (866) 608-8933 to get support for your diagnosis now.

Biopsies for a Mesothelioma Diagnosis

The only way to confirm a mesothelioma diagnosis is to perform a biopsy. A mesothelioma biopsy involves collecting a tissue or fluid sample from a possibly cancerous growth.

The sample is then examined under a microscope for cancer cells. Fluid may be drawn from around the lungs or abdomen, but the American Cancer Society notes that doctors usually need a tissue sample to make a definitive mesothelioma diagnosis.

A microscope in a lab examining a fluid sample
Doctors look at the tissue or fluid sample under a microscope to make a definitive mesothelioma diagnosis.

Types of mesothelioma biopsies include:

  • Thoracoscopy. Doctors create a small incision in the chest and use VATS (video-assisted thoracoscopic surgery) to extract a biopsy sample. This type of biopsy is highly accurate and is one of the preferred methods of diagnosing pleural mesothelioma.
  • Fine needle biopsy. A fine needle biopsy collects sample cells using a long and skinny needle. This type of biopsy is valued for its ability to access hard-to-reach locations in the body, such as the lungs and the heart.

Although thoracoscopy and fine needle biopsies are the two most common types, other techniques may be used to diagnose mesothelioma in some cases.

Additional types of biopsies include:

  • Endobronchial ultrasound needle biopsy. Doctors insert a tube down the windpipe of a sedated patient to examine the airway and collect tissue samples from the lymph nodes.
  • Laparoscopy. Doctors use a small tube with a light and camera to look inside the abdomen to locate tumors.
  • Mediastinoscopy. Doctors take a sample of the area between the two lungs (the mediastinum) if they believe the cancer has spread to nearby lymph nodes.

A mesothelioma doctor can explain which type of biopsy will work best to confirm your diagnosis.

Mesothelioma Imaging Scans

Doctor reviewing a chest X-ray with a patient
X-rays can reveal the initial signs of pleural and peritoneal mesothelioma.

Doctors use mesothelioma imaging scans to see where possibly cancerous fluids, tumors, and/or masses have formed within the body. These tests are often used earlier in the diagnostic process to rule out other conditions.

Common types of imaging scans include:

  • X-rays. An X-ray uses electromagnetic radiation to create a picture of the inside of the body. According to the ACS, X-rays are typically the first test a doctor will order for pleural mesothelioma.
  • CT scans. Similar to X-rays, a computed tomography (CT) scan creates a comprehensive image of the body that can locate potentially cancerous growths.
  • MRI scans. A magnetic resonance imaging (MRI) scan is similar to a CT scan, but it uses radio and magnetic waves instead of light waves to see if cancerous tumors are present.
  • PET scans. A positron emission tomography (PET) scan uses a low dose of radioactive sugar to detect cancer cells. Your doctor may use this scan to see if the cancer has spread to lymph nodes or other parts of the body.

Mesothelioma Blood Tests and Biomarkers

Your oncology doctor may use mesothelioma blood tests to see if cancer cells are present within the body. Mesothelioma can’t be diagnosed with blood tests alone, so they are used less frequently than imaging tests and biopsies.

Mesothelioma increases the levels of certain substances within the blood, including fibulin-3, soluble mesothelin-related peptides (SMRPs), and other substances. These substances can be detected through various mesothelioma blood tests.

A lab tech analyzing a vial of blood
SMRP tests can measure blood levels to detect the presence of mesothelioma cells.

Learn more about the different types of mesothelioma blood tests below:

  • SMRP test. The most common mesothelioma blood test is the SMRP test, which goes by its trademarked name, MESOMARK®. This test looks for heightened levels of SMRPs, which are substances that develop in the blood if mesothelioma cells are present.
  • N-ERC test. Like MESOMARK®, this test determines if a substance called N-ERC (mesothelin) is present within the patient’s blood. While the N-ERC test is highly accurate in detecting cancer, it is not specialized to only mesothelioma.
  • Osteopontin test. Osteopontin is a naturally occurring protein that increases when a person has mesothelioma. An osteopontin mesothelioma blood test can determine whether a patient has cancer but does not indicate what type.
  • MPF test. The MPF test is a type of mesothelioma blood test used to detect the megakaryocyte potentiating factor (MPF), a protein found in the blood of mesothelioma patients.

Your doctor may also order blood tests to get an idea of your overall health, such as kidney and liver function. This will help them establish a treatment plan for your specific situation.

Challenges With Getting a Mesothelioma Diagnosis

Since mesothelioma takes decades to develop and is relatively rare, it can take longer to diagnose it accurately. In some cases, mesothelioma is diagnosed during treatment for other conditions, or not until other possibilities are ruled out.

Latency Period

It can take 10-50 years after asbestos exposure before noticeable symptoms of mesothelioma appear.

This long latency period (the time between asbestos exposure and a mesothelioma diagnosis) means that patients may not even remember being exposed to asbestos-containing products.

Patients may also not suspect that their relatively mild symptoms could be caused by mesothelioma.


Since mesothelioma symptoms can mimic those of more common diseases, it can sometimes be misdiagnosed.

For example, mesothelioma may be misdiagnosed as:

  • Bronchitis
  • Coronary artery disease
  • Chronic obstructive pulmonary disease (COPD)
  • Crohn’s disease
  • Emphysema
  • Irritable bowel syndrome (IBS)
  • Testicular infection
  • Other forms of cancer, like lung cancer

A mesothelioma misdiagnosis can occur when mesothelioma is inappropriately diagnosed as a different condition, or when the diagnosis is not the right stage or cell type.

Getting a second opinion from an experienced specialist can help ensure you have the correct diagnosis and are able to pursue an effective treatment plan. Use our Free Doctor Match service to find a specialist for a second opinion.

Mesothelioma doctor talking with an older couple
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Get Help With a Mesothelioma Diagnosis

Wherever you are in your mesothelioma journey, you are not alone. Mesothelioma Hope is here to help you every step of the way.

Some of the ways we can help include:

  • Connecting you with a mesothelioma specialist for a diagnosis or a second opinion
  • Empowering you with information and questions to ask your care team
  • Helping you navigate your insurance to understand what tests will be covered
  • Walking you through what to expect during the diagnosis process
  • And more

Call us any time at (866) 608-8933 or sign up for our Free Doctor Match service to get started.

Mesothelioma Diagnosis FAQs

How do I know if I have mesothelioma?

The only way to know for sure whether you have mesothelioma is to get diagnosed by a mesothelioma doctor.

Tests used to make a mesothelioma diagnosis may include imaging scans like X-rays and CT scans, biopsies, and blood tests.

If you’re experiencing mesothelioma symptoms or suspect that you were exposed to asbestos, you should reach out to a doctor right away for a physical examination.

How do they diagnose mesothelioma?

Doctors diagnose mesothelioma through a series of different tests. Specialists can make a diagnosis of mesothelioma through imaging tests, blood tests, and biopsies.

A biopsy is the only definitive way to diagnose mesothelioma and other cancers.

What tests are done to diagnose mesothelioma?

There are several different tests used to diagnose mesothelioma, including biopsies, imaging tests, and blood tests.

MESOMARK® is a blood test that is used to monitor elevated levels of soluble mesothelin-related peptides (SMRPs), which may indicate the presence of mesothelioma.

However, the only definitive test for mesothelioma diagnosis is a biopsy.

Does mesothelioma show up on an X-ray?

Chest X-rays may be one of the first tests used to diagnose pleural mesothelioma. Chest X-rays can show:

  • Calcium deposits in the pleura (pleural plaques)
  • Fluid buildup in the lungs (pleural effusion)
  • Thickening of the lining of the lungs or abdomen
  • Other abnormalities that may indicate mesothelioma

While an X-ray can help identify the need for further tests, a biopsy is the only definitive way to diagnose mesothelioma.

How difficult is it to diagnose mesothelioma?

There are some unique challenges to diagnosing mesothelioma, but a skilled specialist will know what tests to run to get you the answers you need.

Mesothelioma can sometimes be mistaken for other illnesses, so if you think you might have been misdiagnosed, you should get a second opinion from a specialist.

Why does it take so long to diagnose mesothelioma?

Mesothelioma takes a long time to diagnose because it can take 10-50 years for symptoms to appear after asbestos exposure (the only known cause of this cancer).

Due to this long time between asbestos exposure and symptoms (known as the latency period), many patients are not diagnosed until the later stages of the disease. This is why early detection and medical intervention are so important.

What should I do if I think I was misdiagnosed?

You should get a second opinion if you believe you were misdiagnosed. An accurate diagnosis is crucial to ensure you get the treatment you need to improve your life expectancy.

Use our Free Doctor Match to find a specialist near you who can evaluate your mesothelioma diagnosis.

Dr. Mark LevinReviewed by:Mark Levin, MD

Certified Oncologist and Hematologist

  • Fact-Checked
  • Editor

Mark Levin, MD, has over 30 years of experience in academic and community hematology and oncology. In addition to serving as Chief or Director at four different teaching institutions throughout his life, he is still a practicing clinician, has taught and designed formal education programs, and has authored numerous publications in various fields related to hematology and oncology.

Dr. Mark Levin is an independently paid medical reviewer.

  • Board Certified Oncologist
  • 30+ Years Experience
  • Published Medical Author
Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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  1. American Cancer Society. (2018, November 16). How is Malignant Mesothelioma Diagnosed? Retrieved February 2, 2024, from
  2. American Cancer Society. (2018, November 16). Malignant mesothelioma Stages. Retrieved February 2, 2024, from
  3. Cancer Council Victoria. (August 2021). Mesothelioma. Retrieved February 2, 2024, from
  4. Cancer Research UK. (2023, June 30). Tests to diagnose mesothelioma. Retrieved February 2, 2024, from
  5. El-Hadidy, T., & Rezk, N. (2015, November 12). Diagnostic accuracy and safety of rigid MEDICAL Thoracoscopy In undiagnosed pleural EFFUSION and ILD: Retrospective study of 100 patients. Retrieved February 2, 2024, from
  6. Mayo Clinic. (2020, October 20). Mesothelioma – Diagnosis. Retrieved February 2, 2024, from
  7. NHS. (2018, August 1). Laparoscopy (keyhole surgery). Retrieved February 2, 2024, from
  8. Scharf, J., Lees, G., & Sergi, C. (2015, September 8). Malignant pleural mesothelioma in a child. Retrieved February 2, 2024, from
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