1. Pleural Biopsy: The definitive test to confirm the diagnosis of mesothelioma. Pleural biopsy provides tissue for histological examination, which is more accurate than cytology in diagnosing mesothelioma.
2. Imaging: Chest X-ray and CT scan of the chest to assess the extent of the disease.
Pulmonary Function Tests: To evaluate the impact on lung function.
Management:
Operable Disease:
. First Line: Surgery
. Plus: Pre- and/or postoperative chemotherapy
. Consider: Radiotherapy
Inoperable or Recurrent Disease:
i. First Line: Chemotherapy and/or immunotherapy
ii. Consider: Radiotherapy
iii. Consider: Palliative procedures and supportive care
iv. Long-term Indwelling Pleural Drain: For managing malignant pleural effusion and relieving symptoms.
v. Chemotherapy and Radiotherapy: As part of the treatment plan for malignant mesothelioma.
vi. Surgical Intervention: In select cases, surgery may be an option to remove the tumour.
vii. Palliative Care: To manage symptoms and improve quality of life.
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