Stages of Mesothelioma

Mesothelioma is treated as unique to each individual patient. Often, the stage of malignant mesothelioma diagnosis determines treatment options. Staging of a particular disease also helps the medical team, not only in treatment planning but also in the estimation of prognosis, and the identification of current clinical trials that the patient may be eligible. Three staging systems currently in use for pleural mesothelioma. None is being used for peritoneal mesothelioma.

Knowledge of how cancer develops is relevant to the staging process. Some staging systems cover only a specific cancer, while others may be used to cover a variety of types. Some common elements found in most test systems, namely, primary tumor location, tumor size, number of tumors, lymph nodes, histologic type, tumor grade and metastasis.

To accurately determine the status of any type of cancer, doctors usually rely on a variety of techniques. These include physical examination, imaging techniques like X-rays, CT scans, MRIs and PET scans. An examination of the patient's blood, urine, serum and tissue biopsy can also provide useful clues. Tumor markers can also be used. Pathology reports are very helpful in providing information on the exact size of tumor, tumor extension to adjacent structures, and tumor histology and grade. Surgical reports also assist staging.

The staging system most common cancer that is used for mesothelioma is the TNM (primary tumor, lymph nodes, distant metastases). Stage I mesothelioma is assigned when only involves the pleura, ipsilateral lung, pericardium of the same hand and the ipsilateral diaphragm. Lymph nodes are not affected. Stage II is assigned when mesothelioma has already involved hilar lymph nodes near the contralateral side. The lung, pericardium, or diaphragm on the contralateral side may also be involved. Stage III is assigned when the mesothelioma has spread involving the chest wall, soft tissue, ribs, heart, esophagus and / or other organs in the chest cavity on the ipsilateral side. Lymph nodes may or may not have spread to lymph nodes on the same side as the primary tumor. Stage IV is assigned when the disease has spread either in the lymph nodes in the chest on the opposite side of the primary tumor, spread to the contralateral pleura, or have spread to organs in the abdominal cavity or neck. The presence of distant metastasis is considered Stage IV.

The Butchart System is the oldest system of classification for cancer. It is also the most widely used system of staging for all cancers. The extent of the primary tumor mass is the primary basis for this system. Stage I is assigned when the mesothelioma is found in any of the pleura, or the ipsilateral diaphragm. Stage II is assigned when the mesothelioma has spread to the chest wall, esophagus, heart, or pleura on both sides. Lymph nodes in the chest may also be affected. Stage III is assigned when mesothelioma has invaded the diaphragm and has attained the peritoneum. The lymph nodes outside the chest may also be involved. Stage IV is assigned when there is evidence of distant metastases.

The Brigham System is the latest to develop. Resectability and lymph node status is the basis of this system. Stage I is assigned when Mesothelioma is still resectable, without involvement of the lymph nodes. Stage II is assigned when the mesothelioma is resectable, but the lymph nodes are affected. Stage III is assigned when the mesothelioma is not resectable, has spread to structures in the breast of neighbors, and may or may not have extrathoracic involvement of lymph nodes. Stage IV is assigned when there are distant metastases.

Information obtained from these systems of classification must be disclosed to patients. Patients reserves the right to know the exact state of his illness and all parties will benefit greatly when the information becomes.