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23

NCCN Guidelines for Patients

®

:

Malignant Pleural Mesothelioma, Version 1.2016

EBUS-FNA

EBUS-FNA (

e

ndo

b

ronchial

u

ltra

s

ound–guided

f

ine-

n

eedle

a

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.

PFTs

PFTS

(

p

ulmonary

f

unction

t

ests)

show how well

your lungs work. This test also includes measuring

the DLCO (

d

iffusing capacity of the

l

ungs for carbon

monoxide [

CO

]). 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

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

(

e

lectro

c

ardio

g

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.

Next steps

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.

4

Treatment guide

Stage I–III epithelioid or mixed mesothelioma