If your doctor tells you that you have mesothelioma, shock and disbelief will quickly set in. Cancer is always a difficult diagnosis to accept, but mesothelioma is such a rare type of cancer that it may be even more difficult to grasp. But because it's so unusual, mesothelioma can also be more difficult to diagnose — particularly by someone who isn't a mesothelioma expert. You want to be certain of exactly what you're dealing with before you undergo major surgery to treat mesothelioma. So before you start treatment, consider getting a second opinion from an expert. Mesothelioma: Why a Second Opinion Is Important A second opinion about your mesothelioma diagnosis will make you feel more certain about your course of treatment. You may even find that one doctor offers more hope, or a treatment plan that sounds better to you. "Mesothelioma is such a rare disease — only about 2,500 to 3,000 cases are diagnosed annually," says David Rice, MD, an associate professor and director of the mesothelioma program at the University of Texas M.D. Anderson Cancer Center. "Most physicians only see one to two cases in their career. If a patient is diagnosed by a physician who doesn't see a lot of mesothelioma, a second opinion is a great idea." And if you're going for a second opinion, make sure it's with an expert at a high-volume cancer center with experience in treating mesothelioma. "In my opinion, a patient should always want to be seen at a center that has a lot of experience with this disease," continues Dr. Rice. Mesothelioma: Repeat Tests When getting a second opinion for a mesothelioma diagnosis, the new doctors may want to perform additional diagnostic tests. They may repeat tests you've already had done, or run a whole new set of tests. "They may repeat CT scans or biopsies — because the information at hand is not sufficient," says Rice. The old tests may not be able to pinpoint the location or type of mesothelioma, so it's safer to run new tests. Tests that may be performed to diagnose mesothelioma include: CT (computed tomography) scan X-rays of the chest or abdomen MRI (magnetic resonance imaging) scan PET (positron emission tomography) scan Blood tests (to confirm a suspected diagnosis) Biopsies of fluids or tissue More invasive tests may also be done. Laparoscopy. This test allows the doctor to look inside your abdomen. A small incision is made and a tube with a camera attached to the end is inserted. Your doctor can biopsy abnormal mesothelial tissue or organs (such as your liver) to confirm a diagnosis or spread of mesothelioma to other organs. Thoracoscopy/Mediastinoscopy. This is a like a laparoscopy, but the cuts are made in the lungs or middle section of the chest. Your doctor can take a biopsy to confirm a diagnosis. Mesothelioma Second Opinion: Are There Risks? While repeated scanning tests will increase your exposure to potentially harmful radiation, it's most important to focus on getting the right diagnosis. Any potential risks of additional testing — or cost of additional testing if your insurance won't pay for another diagnostic visit and additional tests — are well worth the peace of mind of knowing you have the right diagnosis. "The worst thing to do is to start treating the cancer without knowing," says Rice, who adds that people are not often treated for a condition they don't have. Mesothelioma: The First Step to a Second Diagnosis Don't be nervous about asking your doctor to refer you to an expert, or telling him that you'd like another opinion. You won't hurt his feelings or offend him — getting a second opinion for a diagnosis like mesothelioma is not only a smart thing to do, but it's often encouraged. Ask your doctor if he can recommend a mesothelioma expert, or review Web sites like the National Cancer Institute or the American Cancer Society. Those organizations can point you toward a specialized cancer center, with the experts you need to appropriately diagnose and treat your condition — for the best outcome possible.