Mesothelioma Stages
The treatment protocol for mesothelioma differs based on the stage that a patient has progressed to at the time of diagnosis. Provided below is an example of the types of treatment that a pleural mesothelioma patient will undergo at various stages of the disease. We have identified the stages using the Butchart staging system.
Butchart System – extent of primary tumor mass
- Stage I: Mesothelioma is present in the right or left pleura and may also involve the diaphragm on the same side.
- Stage II: Mesothelioma invades the chest wall or involves the esophagus, heart, or pleura on both sides. Lymph nodes in the chest may also be involved.
- Stage III: Mesothelioma has penetrated through the diaphragm into the lining of the abdominal cavity or peritoneum. Lymph nodes beyond those in the chest may also be involved.
- Stage IV: There is evidence of metastasis or spread through the bloodstream to other organs.
Brigham System: (variables of tumor respectability and nodal status)
- Stage I: Respectable mesothelioma and no lymph node involvement
- Stage II: Respectable mesothelioma but with lymph node involvement
- Stage III: Unrespectable mesothelioma extending into chest wall, heart, or through diaphragm, peritoneum; with or without extra thoracic lymph node involvement
- Stage IV: Distant metastasis disease
TNMA more advanced staging system has been developed by the International Mesothelioma Interest Group and endorsed by the American Joint Committee on Cancer (AJCC). This is a TNM system, very similar to staging systems used for other cancers. T stands for tumor, its size and how much it has spread, N stands for spread to lymph nodes, and M stands for metastasis. TNM combines information about the tumor, lymph nodes, and metastasis four stages:
- Stage I: Mesothelioma is found in chest pleura on one side only and may also have spread to the outer lining of the lung, pericardium, or diaphragm on the same side. It has not affected the Lymph nodes.
- Stage II: Mesothelioma is found in the pleura on one side only, the nearby lymph nodes next to the lung on the same side. It may also have affected the lung, pericardium, or diaphragm on the same side.
- Stage III: Mesothelioma is found in the chest wall, muscle, ribs, heart, esophagus, or other organs in the chest on side only. It may have affected the lymph nodes on the same side.
- Stage IV: Mesothelioma is found in the lymph nodes in the chest on the opposite side, may extend to the pleura or lung on the opposite side, or extends into organs in the abdominal cavity or neck. Any metastases is a part this stage.
Once staging is completed, doctors can choose the appropriate method of malignant mesothelioma treatment.
The stage of the cancer will determine treatment options and helps determine the prognosis of the disease. Pleural mesothelioma is the only mesothelioma that has a staging system. But the clinical staging systems are considered inadequate due to the way the disease spreads.
