Stages of Mesothelioma
Once a conclusive diagnosis of malignant mesothelioma has been reached, the process of determining the best course of treatment shifts into high gear. Immediate attention is focused on determining exactly what the patient’s cancer status is, and that is determined through a process known as staging. Staging is used in treating all types of cancer. By assessing the degree of the cancer’s progress on an objective, predetermined scale, medical professionals can ensure that everybody understands exactly what the patient’s condition is and can more effectively collaborate on essential decision making. Mesothelioma staging is broken down into four stages, some of which have sub-stages. A mesothelioma patient who is diagnosed as being in Stage I is at the least advanced stage of progression, while patients diagnosed in the later stages are at the most advanced, and have the shortest expected survival.
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There are a number of different methodologies and staging systems used in determining how far a cancer patient’s disease has progressed, but most physicians that work with mesothelioma patients employ the TNM Classification of Malignant Tumors (TNM) staging system. This system, which categorizes patient conditions into four separate stages, has been used for almost two decades in the evaluation of tumor and cancer cell progression.
Stage I – Localized
Stage I is the earliest possible stage at which mesothelioma can be diagnosed, and represents the highest likelihood of long term survival, as it means that cancer cells that are present in a localized area and have not spread. A patient can be identified as being in either Stage Ia or Ib. A patient whose mesothelioma is located in either the lining of one side of the chest wall or in the chest cavity lining that is situated between the two lungs is identified as having Stage Ia mesothelioma. By contrast, if the cancer is found in both areas but has not spread beyond that localized region, the patient is identified as being in Stage Ib.
Stage II is the first advanced stage of mesothelioma, in which the mesothelioma is moved beyond the chest wall and cavity area and infiltrated the lining of either the diaphragm, one or both lungs, or all of them.
This is an advanced stage of mesothelioma cancer. Mesothelioma patients who are diagnosed as being in Stage III have cancer in their lymph nodes, as well as all of the areas previously identified in Stage I and Stage II.
When a mesothelioma patient has been classified as having Stage IV cancer it means that the malignant cells have been found beyond the lining of the chest, lungs and diaphragm and beyond the lymph nodes, and have moved on to also impacting chest tissue lining or the chest walls themselves, the peritoneum, other organs such as the brain, prostate or thyroid, and the heart muscle and its sac. Stage IV mesothelioma is considered inoperable.
Resectable or Unresectable Mesothelioma
The primary reason for identifying the stage of a patient’s mesothelioma is to help physicians arrive at the best understanding of a patient’s condition. The clearer the picture of how far a patient’s disease has spread, the more easily surgeons and oncologists can collaborate in determining the best course of treatment. One of the most important decisions that must be reached when dealing with mesothelioma is whether to subject a patient to surgery and what the benefits of doing so would be.
Generally speaking, patients who are identified as being in any of the first three stages of mesothelioma may be candidates for surgery if their tumors are resectable. Resectable means that they can be operated on and removed. Stage IV patients are generally judged to be unresectable because their cancer has spread to so many different areas and has so severely infiltrated so much of their body. Each patient’s case is different, and physicians will weigh not only whether a mesothelioma is resectable or not, but also the mesothelioma cell type that the patient has, their overall health condition and ability to withstand the physical trauma of surgery, and the patients’ overall goals and stated wishes to reach the best decision.
Other Staging Methodologies
Though the TNM staging methodology is the system that is most frequently used in classifying mesothelioma patients, there are other systems that have also proven to be helpful. These include:
The Brigham System, which was developed by renowned mesothelioma physician Dr. David Sugarbaker while he was on staff at Brigham and Women’s Hospital at Harvard. This system goes beyond the generalized information provided by the TNM system and refines it through the use of diagnostic imaging and specifics of mesothelioma to arrive at a different four stage classification. The four stages under the Brigham System are as follows:
Stage I – no lymph node involvement, localized in pleural area
Stage II – lymph node involvement, still localized in pleural area
Stage III – mesothelioma has metastasized to the diaphragm, as well as other structures including the thorax
Stage IV – mesothelioma has metastasized into other organs and parts of the body and is no longer resectable
The Butchart Staging System, which is one of the earliest staging systems created specifically for use in classifying patients diagnosed with malignant mesothelioma. The system was first introduced in the late 1970s by Dr. Eric Butchart of the University Hospital in Wales, United Kingdom. Butchart was a renowned cardiothoracic surgeon who devised his four stage system to classify mesothelioma patients in order to determine the appropriate treatment for them based upon the progression of their disease.
Stage I – mesothelioma is restricted to one side of the lungs or lining of the heart
Stage II – mesothelioma is on both sides of the lung lining as well as one or the other side of the chest wall, heart or esophagus. Mesothelioma has also spread into the lymph nodes. A patient diagnosed in stage II was considered to be a candidate for radiation therapy if they were strong enough to withstand the protocol.
Stage III – mesothelioma has progressed into the diaphragm or the lining of the stomach as well as outside of the chest from the lymph nodes. A patient diagnosed in stage III was considered to be a candidate for chemotherapeutic drugs.
Stage IV – mesothelioma is not found within the patient’s bloodstream as well as in other organs. A patient diagnosed in stage IV was considered to be beyond surgery and only a candidate for palliative treatments designed to ease pain and provide comfort.
Legal Help for Mesothelioma Patients
People who have been diagnosed with mesothelioma may be eligible for compensation from the $30 billion asbestos trust funds, or to file a mesothelioma lawsuit against the asbestos companies that negligently exposed them to asbestos. If you or someone you love has an asbestos-related condition like mesothelioma, asbestosis, or asbestos lung cancer, contact our office today at 1-800-706-5606. We will put you in touch with one of our experienced mesothelioma attorneys or send you a free Financial Compensation Packet that will provide you with helpful information about the compensation that you may be eligible to receive.