As with most cancers, often the prognosis for this disease depends on how early it is diagnosed and how aggressively treated. Unfortunately, mesothelioma is often found at the stage where cure is unattainable. Many will succumb to the disease within a year of diagnosis.
Mesothelioma treatment options (traditional and new therapies being studied)
Treatment options are determined by the stage of mesothelioma (the extent to which the tumor has metastasized). There are three intermediate stations currently in use, and each one measures something different variables.
The oldest staging and the most frequently used is the Butchart system, based mainly on the size of the primary tumor mass and divides mesotheliomas into four stages.
Butchart system of primary tumor mass level
Stage I: Mesothelioma is present in the right or left breast and may also involve the diaphragm on the same page.
Stage II: Mesothelioma attacks 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 than those of the breast may also be involved.
Stage IV: There is evidence of metastasis or spread through the bloodstream to other organs.
Newer TNM system considers variables of tumor in mass and spread, lymph node involvement, and metastasis.
TNM system: the variable T (tumor), N (lymph nodes) and M (metastasis)
Stage I: Mesothelioma involves right or left breast and may also have spread to the lungs, pericardium, or diaphragm on the same page. Lymph nodes are not involved.
Stage II: Mesothelioma has spread from the pleura on one side to nearby lymph nodes next to the lung on the same page. It also may have spread to the lungs, pericardium, or diaphragm on the same page.
Stage III: Mesothelioma is now in the chest wall muscles, ribs, heart, esophagus or other organs in the chest on the same page with or without spread to lymph nodes on the same side as the primary tumor.
Stage IV: Mesothelioma has spread to lymph nodes in the chest on the opposite side of the primary tumor, spread to the pleura or lung on the opposite side, or directly extended to the organs in the abdominal cavity or neck. Any distant metastases is included in this phase.
Brigham System is the latest system and stages mesothelioma after resectability (the ability to eliminate tumor surgery) and lymph node involvement.
Brigham System: the variables of tumor resectability and nodal status
Stage I: Mesothelioma surgery and no lymph node involvement
Phase II: mesothelioma surgery, but with involvement of lymph nodes
Stage III: Mesothelioma surgery extending into chest wall, heart, or through diaphragm, peritoneum, with or without glandular involvement extrathoracic
Stage IV: distant metastatic disease
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