Stages of Mesothelioma

There are many ways to stage mesothelioma. Staging is the method that physicians use to determine how advanced a cancerous tumor is and what the best method of treatment is for the cancer. When you are diagnosed with mesothelioma your doctor may use one of the methods listed below to stage your cancer. It is important to understand that each method of staging cancer is effective, and your doctor will make his choice based on his experience and other factors. Your doctor can let you know what method he used to stage your cancer as well as his reason for the choice. Not all forms of cancer are staged. Peritoneal and pericardial mesothelioma are rarely staged, while pleural mesothelioma is always staged.

TNM Method

The TNM method of staging cancer is used for a variety of types of cancer. The letters stand for (T)umor, Lymph (N)odes and (M)etastasis. To stage a tumor using the TNM method, the doctor takes into consideration variables in each of these areas. There are four stages of cancer using the TNM method.

  • Stage I: Tumor in one side of the mesothelium, may have spread to the pericardium, lungs or diaphragm along the same side. No involvement of the lymph nodes.
  • Stage II: Tumor has spread to lymph nodes along the same side of the lungs as the primary tumor. May have continued its spread into the pericardium, lungs and diaphragm, but remains on one side of the body.
  • Stage III: Has spread into the chest wall, may be in the esophagus, ribs or heart.
  • Stage IV: The tumor has spread into the lymph nodes on the opposite side of the chest as the primary mesothelioma developed. May continue to spread through the body.

Staging Summary

Summary staging used a variety of medical terms to pinpoint the location of tumors within the body.

  • In Situ: The tumor is located in the cells where it developed only.
  • Localized: The tumor cells have spread across the organ where they originally developed, but have not involved the lymph nodes.
  • Regional: Tumor cells have spread to organs and lymph nodes that are adjacent to the area where the mesothelioma developed.
  • Distant: Mesothelioma develops in areas that are not adjacent to the primary tumor. This indicated that the cancer has metastasized. The tumor can be located in either distant organs or lymph nodes.
  • Unknown: Sometimes the physician is not able to gather enough information to determine the stage of the cancer.

Butchart Method

The Butchart method of staging includes four stages, and judges progression by the primary tumor. It is similar to the TNM method.

  • Stage I: The primary tumor is contained to one side of the pleural cavity. The diaphragm , on the same side, may also be involved.
  • Stage II: The tumor has spread to the chest wall, or organs such as the esophagus or heart. It may have also extended into the other side of the pleura. Lymph nodes in the area may be affected as well.
  • Stage III: In stage III mesothelioma, the primary tumor extends into the diaphragm, as well as the abdominal or heart cavity. Lymph nodes in other parts of the body may be affected.
  • Stage IV: The tumor has spread through the bloodstream or lymph system into other organs of the body.

Brigham Method

The Brigham method of staging tumors is commonly used to determine if the tumor is a good candidate for surgical removal. It, like the TNM and Butchart method, includes four stages.

  • Stage I: No lymph node involvement. Likely candidate for surgical removal of tumor.
  • Stage II: Tumor is good candidate for surgical removal, but the lymph nodes are affected.
  • Stage III: In stage III, the tumor extends into the chest wall or vital organs in such a way that surgical removal of the tumor is impractical. Lymph nodes may or may not be involved.
  • Stage IV: Stage IV of the disease indicates that the mesothelioma has metastasized into other areas of the body. Surgical removal of the tumors is not possible.

The importance of accurate staging of mesothelioma cannot be stressed enough. The treatment options for cancers vary considerably depending on the size of the tumor, whether it has spread to a lymph node, or metastasized throughout the body. In the early stages of mesothelioma, the patient may be a candidate for surgical removal of the tumor, while a progression of the disease may mean tumor growth is controlled through chemotherapy or radiation. In the final stages of mesothelioma, once the disease has spread through the body, palliative care may be the patient's only option.

Using one of the methods of staging listed above allows the doctor to provide the patient with the most balanced and well thought out approach to treatment available. In addition, staging the cancer accurately may allow the patient to qualify for clinical trials.