NCCN Guidelines for Patients® | Malignant Pleural Mesothelioma - page 32

NCCN Guidelines for Patients
Malignant Pleural Mesothelioma, Version 1.2014
Treatment guide
Stage I–III epithelioid or mixed mesothelioma
EBUS-FNA 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.
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
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
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
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
Next steps
After completing the pre-surgery tests,
read the next page for surgical treatment
recommendations. If your doctor decided
that surgery isn’t possible, see page 34 to
read about treatment options other than
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