Mesothelioma Staging

There is no cure for mesothelioma but long-term survivors prove there are no boundaries for hope. Using a combination of traditional medicine, alternative treatments and groundbreaking clinical trials, many patients have proven living with the disease, and a possible cure, is a reality.

There are three primary staging systems used to determine the growth of mesothelioma, but a formal staging system only exists for pleural mesothelioma, the most common type of the disease. Because all types of mesothelioma are so rare, specialists have not focused on staging systems for peritoneal and pericardial disease.

Staging systems look at the site of the primary tumor, size of the tumor, amount of lymph node involvement and tumor grade, or how closely the cancer cells and surrounding tissue resemble other types of cells and tissue. Knowing where the disease is located and how much it has spread sets the stage for specialists to create an effective plan for treatment.

Staging Systems

  • Brigham – This system, created by mesothelioma treatment innovator Dr. David Sugarbaker, focuses on the location of tumors and extent of lymph node involvement to determine whether a patient can withstand radical surgery as a primary treatment.
  • TNM – Most commonly used for pleural mesothelioma patients, this system identifies the tumor (T), lymph node (N) and metastasis (M). A number associated with the letter indicates how much the cancer has spread.
  • Butchart – The oldest method used to stage pleural mesothelioma, the Butchart system identifies patients who are eligible for curative treatments (typically in stages I and II) and those who can undergo palliative treatments (stages III and IV).
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Treatment Options

  • Surgery – Some patients may benefit from surgical procedures that can offer some relief from tumor growth. This could allow patients to breathe easier, reduce chest pressure and decrease pain. Surgery is usually recommended for patients with stage 1, stage 2, and stage 3 mesothelioma.
  • Chemotherapy – Chemotherapy is often used for stage IV patients because the drug slows the growth of, and sometimes shrinks, tumors. This helps patients live more comfortably and may extend survival.
  • Radiation – Targeted beams of high energy used to shrink cancerous cells and tumors. This form of treatment focuses on destroying the DNA of the cancerous cells and tumors.
  • Multimodal Therapy – The combination of surgery, radiation, and chemotherapy. Researchers have found that no single treatment or therapy can produce the same positive results as multimodal treatment in mesothelioma patients.
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Early and Later Stages

  • Stage 1 Mesothelioma – tumors are localized, no lymph node involvement and the cancer has not metastasized (spread) to any other organs. Patients who are diagnosed with mesothelioma in the earliest stage of the disease have the best chance at long-term survival and a possible cure.
  • Stage 2 Mesothelioma – tumors have grown in size and spread into the lung or diaphragm with some lymph node involvement and mild symptoms. Considered an early stage cancer, stage II mesothelioma is marked by tumors and cancerous cells that have not spread far from the origin.
  • Stage 3 Mesothelioma – the cancer has spread to several locations on the same side of the body, including in lymph nodes, muscles, the chest wall and the heart, and symptoms are more pronounced. In some cases, stage III can be treated surgically. Often, patients are treated with treatments that focus on relieving pain.
  • Stage 4 Mesothelioma – tumors have spread throughout the body through the bloodstream, including into the liver and brain, with severe symptoms. In stage 4 tumors have spread throughout the chest cavity, spread to distant organs and possibly the brain. Treatment options are focused on palliative care.
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Why is an Early Diagnosis Important?

When mesothelioma is caught in the early stages, there is a greater chance for long-term survival because physicians have greater flexibility for treatment options. The average one-year survival rate for stage 1 patients is about 40 percent and for stage II patients is about 28 percent, with the five-year survival rate at 15 percent.

Since all patients respond differently to treatment, it is important to use a specialist who is open to trying a variety of therapies. Patients can access asbestos trusts for funds that will help finance the best medical care possible.

Final Stages of Mesothelioma

The median life expectancy for stage III mesothelioma patients is 16 months. Generally, patients who are eligible for surgery have a more positive prognosis than those whose disease has advanced beyond curative means. Patients who receive palliative treatments are kept comfortable and pain free.

At stage IV, the cancer will continue to spread but a positive response to treatment could extend survival beyond the typical prognosis of 12 months. Since every patient responds to treatment differently, survival statistics only show a small picture of the overall patient prognosis. Factors that could lead to a positive outcome include cell type, good overall health and younger age.


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