Mesothelioma Diagnosis Process
Diagnostic tests
Your consultant will review your medical history and imaging, assess your current symptoms and if required may recommend additional diagnostic procedures, which will take place at Clinique de Genolier in Switzerland.
The range of diagnostic tests and other services offered in the Mesothelioma Clinic include:
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Chest X-ray
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Bronchoscopy and biopsy (direct examination of the airway with a fibreoptic instrument and a camera - this is performed under sedation)
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EBUS (Endobronchial Ultrasound Transbronchial Needle aspiration)
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Chest Computed Tomography (CT) and CT-guided biopsy
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Chest MRI
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PET-CT
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Echocardiogram and Coronary Angiography (Echocardiogram, this is an ultrasound of the heart. Coronary Angiography, involves an injection of contrast placed into the heart arteries to diagnose or rule out coronary artery disease)
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Pulmonary function test (spirometry) and full cardiopulmonary exercise test (MVO2 max)
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Ultrasound scanning
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Medical thoracoscopy (sedation and local anaesthetics) and Videothoracoscopy (under general anaesthesia).
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Blood tests
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Genomic testing (analysis of the patient’s DNA and tumor DNA looking for gene mutations or alterations).
Second opinion
You may already have a diagnosis of mesothelioma and may be looking for a second opinion, wish to have diagnosis confirmed or seek further expert advice.
Our consultants’ team are very experienced with the management of complex cases. We receive referrals from all over the world for second opinions or complex treatment.
We often see patients who have been turned down for surgery or systemic therapy elsewhere due to poor lung function, co-morbidities or advanced-stage tumour. We often operate on patients who would not be offered surgery at other centres, with good outcomes.
Our team is familiar with minimally-invasive procedures or extended resections for advanced-stage mesothelioma and operations following induction therapy with chemotherapy, immunotherapy or radiotherapy.
We do accept patients presenting with complications following previous surgery. We also welcome patients presenting with mesothelioma relapse of or any other thoracic tumor following previous treatment.
Our consultants will be glad to give their views on your medical condition and help you make the best possible choice of treatment.
Video visits
As he cares for patients in Europe and all over the world, Prof. Lang-Lazdunski offers online visits for both preoperative and postoperative appointments. He started the process with patients living in Asia and Australasia more than 5 years ago and adopted the technique widely during the COVID-19 pandemic. During your visit, he will review your medical history and discuss your imaging, laboratory and blood tests and examine you. He will discuss with you -and if you wish so with your family- your treatment plan.
Nothing can replace a face to face meeting and a shake of hands, but video appointments have proved very useful for patients living overseas who wish to obtain a super specialised opinion. Those meetings are also useful to avoid unnecessary travelling for patients who are too frail or those with inoperable tumours. Often, plans can be made with local medical teams to optimize the patient before an in-person visit and an operation.
Multi-disciplinary Approach to Mesothelioma Diagnosis
Difficult decisions and treatment are discussed by leading consultants in:
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Anaesthesiology
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Clinical Oncology (radiation therapy)
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Critical Care Medicine
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Haematology
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Histopathology
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Medical Oncology
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Microbiology
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Nuclear Medicine
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Palliative Care
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Radiology and Interventional Radiology
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Thoracic Medicine and Interventional Bronchoscopy
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Thoracic Surgery
Occasionally, we may obtain opinions from colleagues who are specialists in:
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General, Hepato-biliary and Laparoscopic Surgery
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Neurosurgery
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Urology
Physiotherapy and Nutrition
We believe that active and passive physiotherapy is an essential part of treatment before and following thoracic surgery. We rely on an experienced team of Thoracic Physiotherapists who will discuss your operation and establish a rehabilitation program with you, prior to your operation. Our physiotherapists will visit you several times a day after your operation.
Optimising your nutritional status is essential before and after a thoracic operation. It is widely demonstrated that adequate nutritional status is key to improving effectiveness of your treatment, long term survival, quality of life and limit complications after surgery. A poor nutritional status can affect your healing following surgery and increase the risk of complications (i.e. infection). Our team of experienced dieticians are able to assess your needs and implement an individualised nutrition plan before and after your operation. They can also provide you with support should you require chemotherapy and/or immunotherapy before or after your operation.
Pain control
If you are scheduled for surgery, one of our Consultant Anaesthetists will come and discuss with you the type of anaesthetics required and the postoperative analgesia. For most complex cases, an epidural catheter or a paravertebral catheter are used to give you the best possible pain relief following your operation.
These are usually placed by the Anaesthetist or the Surgeon in theatre, before or during your operation. Local anaesthetics are continuously infused near your spinal cord through a small catheter placed in your back and left in place for two to four days. Alternatively, the Surgeon may inject local anaesthetics directly into the chest wall at the end of your procedure and the anaesthetist will set up a patient-controlled analgesia system called PCA by connecting a small venous cannula to a pump and a patient-activated button while you are in the recovery area. This will allow you to inject small boluses of morphine intravenously every time you press the button. Once the chest drains have been removed and the pain is mild to moderate, pain will usually be controlled by pain killers given orally.
