NCCN Guidelines for Patients
Malignant Pleural Mesothelioma
Par t 1
Par t 2
Par t 3
Par t 4
Par t 5
Par t 6
Par t 7
Par t 8
Par t 9
Part 5: Treating mesothelioma
Surgery may be a treatment option. Your doctors will
use the tests described in Parts 3 and 4 to assess if
the tumor can be surgically removed. Also, your doctors
must assess the health of your heart and lungs.
Pulmonary function tests,
Possible perfusion scanning, and
Cardiac stress test
Pulmonary function tests
These are tests that show how well your lungs work. You
may be asked not to eat much, not to smoke, and not to
take some medications before testing. A common side
effect of these tests is shortness of breath.
Spirometry involves blowing into a tube to measure how
much air and how fast you breathe. A gas diffusion test
involves breathing in a harmless gas and measuring how
much you breathe out. It tells how much oxygen travels
from your lungs into your blood. A body plethysmograph
involves sitting in a small room and breathing into a tube.
This test measures how much air your lungs can hold
and how much air is in your lungs after you exhale.
Perfusion scanning shows the blood flow in and out
of your lungs. You may have this test if the pulmonary
function tests suggest your lungs aren’t working well.
First, a radiotracer will be injected into your arm. Next,
a camera that detects the radiotracer will take pictures
of your chest. In normal lungs, the radiotracer will be
evenly spread throughout the lungs. Areas without the
radiotracer may be caused by a blocked artery, tumor,
or other health problems.
Cardiac stress tests
Cardiac stress tests assess how well your heart works
while exercising. Some heart problems are easier to find
when your heart is working hard. Before the test, several
small patches will be placed on your chest. The patches
are connected to an ECG (
by long wires. The ECG machine measures the electrical
activity of your heart during the test. A blood pressure cuff
may be fitted on your arm too. Next, your heart activity
will be recorded while you rest then as you exercise. The
level of exercise will be increased until you are unable to
keep going. After the test, you will be watched until your
heart activity and blood pressure return to normal.
If surgery is still an option, read the next page for
treatment recommendations. If surgery isn’t possible,
you have two options. One option is to start observation
if you have no symptoms of the cancer. The second
option is to start treatment without delay. See page
to read about treatment options other than surgery.
Stage I – III epithelioid or mixed mesothelioma