Stages of Mesothelioma

When a patient is diagnosed with any form of Mesothelioma, they go through a “staging” process, which basically is where the doctor finds out how far the cancer has spread out. A lot of the staging process involves CT scans, multiple x-rays, and even MRI’s of the patient’s body. The doctor needs to go through this critical stage in order to form an effective treatment plan for the patient. Pleural Mesothelioma is the most common type, so therefore it is studied the most, and is the only form in which staging classifications exist. Not only are there different types of Mesothelioma, but there are also different staging types that a doctor may reference in the staging process. The most common and most often used is the Butchart Staging System. This system focuses on the extent of the primary mass (tumor), and it divides the Mesothelioma into 4 stages.

• Stage 1: There is Mesothelioma found in the right or left pleura, and it may also involve the diaphragm, lung, or pericardium on the same side.
• Stage 2: Mesothelioma has invaded the chest wall, or it has affected the esophagus, pleura, or heart on both sides. It also may involve the chest lymph nodes.
• Stage 3: Mesothelioma has penetrated into the lining of the abdominal cavity (the peritoneum). Lymph nodes other than the chest may now be involved.
• Stage 4: Evidence of distant metastases exists (meaning it has spread through the bloodstream to other vital organs). TNM (Tumor, Lymph Node, Metastasis)

Staging System

Recently, the AJCC (American Joint Committee on Cancer) developed the TNM staging system. The TNM system is similar to staging systems commonly used for other forms of cancer. With this system, the information about the tumor, lymph nodes, and metastasis is combined in a process known as “stage grouping” to assign a stage level of 1-4. This is very similar to the Butchart system, and is being used more and more, as it seems to be a bit more specific than the Butchart System, although both staging systems are equally important, and up to the doctor to use. Although TNM is more detailed and specific, the Butchart system is still the most common when it comes to describing and staging the spread of pleural Mesothelioma.

Prognostic Factors Pleural Mesothelioma has been studied more often than the other two types, and researchers and doctors know more about the factors associated with prognosis for pleural Mesothelioma. Mesothelioma typically comes in three different cell types:

1. Epithelial – This usually has the most favorable prognosis
2. Fibrosarcomatous – This one usually has the worst prognosis
3. Mixed cell type – Intermediate prognosis.

With current advances in medicine, and more emerging cases of Mesothelioma, research foundations are being given more money and priority in figuring out more about this mysterious cancer. The staging process will surely develop as more is revealed about Mesothelioma.