NCCN Guidelines for Patients
Malignant Pleural Mesothelioma, Version 1.2016
spiration) is another way to perform a biopsy
of the lymph nodes in the mediastinum. However,
EBUS-FNA doesn’t require any surgical cuts. During
an EBUS-FNA, a bronchoscope attached to an
ultrasound device is guided down your throat into
your lungs. The ultrasound is used to find the lymph
nodes. Next, a very thin needle is passed through the
wall of a main airway of the lungs and into a lymph
node to get a tissue sample. This biopsy may be
done using general anesthesia or local anesthesia.
show how well
your lungs work. This test also includes measuring
the DLCO (
iffusing capacity of the
ungs for carbon
]). A DLCO checks how well your lungs
move important gases in (oxygen) and out of the
blood (carbon dioxide).
You may be asked not to eat much, not to smoke,
and not to take some medications before the tests.
Spirometry involves blowing into a tube to measure
how much air and how fast you breathe. A DLCO, or
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
PFTs 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
raphy) machine 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 and 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.
After completing the pre-surgery tests,
read the next page for surgical treatment
recommendations. If your doctor has
decided that surgery isn’t possible, see
page 27 to read about treatment options
other than surgery.
Stage I–III epithelioid or mixed mesothelioma