Mesothelioma Stages

Posted by : indra budiman | | Published in

How treatment will be proceed generally determine by the stage of mesothelioma. There are three stages in which a pleural mesothelioma categorized, each one of these stages measures different variable. While peritoneal mesothelioma do not staged.

This stages generally describe the extent of a patients cancer, based on the primary tumor and how it is spread in the body. This staging system can help the medical team plan to treat their patients. Staging system is based on a knowledge of how much have the cancer developed in side the body, from the primary tumor to the attack on other internal organs and tissues, and to metastasis or distant spread. This system has evolved overtime, and will continue to change as scientist learn more and more new things about cancer. Some staging systems cover many different types of cancer while other staging focus on a more specific one. The most common staging system for mesothelioma is the TMN (primary tumor, regional lymph nodes, distant metastasis).

Common elements in staging system are :

  • The location of the primary tumor
  •  Numbers and size of the tumors
  • Involvement of Lymph node
  •  Metastasis
Before a treatment plan is formulated, several methods of testing may be used to help doctors determining cancer stages such as :
  • Physical examinations. The most common thing that a doctor do is examining the patient body by looking, listening, and feeling to anything suspicious in the patient condition.
  • Imaging techniques. (All of imaging techniques have been discussed in the last post)
  • Laboratory test. a test to perform an internal examination on cancer by doing Blood sample test, urine test, fluid and tissue test. Tumor markers, sometime can be found when cancer is present.
  • Pathology report. Is the results of the examination of tissues samples, include information about the size of the tumor, extension into adjacent structures, type of cells and grade of the tumor. Result of the examination cells in fluid, such as from mesothelioma pleural effusion may also provide information.

  • Surgical Reports. Reports about observation of the tumor ( size and appearances ), lymph nodes and nearby organs. 
The staging system that was used for mesothelioma in the past called the Butchart system. This system is based mainly on the extent of the primary tumor mass and divide the mesothelioma stages to four. The TNM system, the most common system that used for mesothelioma that consider tumor in its mass and how it spread, lymph node involvement, and metastasis. The newest system for staging mesothelioma called the Brigham system, this system stages mesothelioma according to resectability (the ability to surgically remove) and lymph node involvement.

 Butchart system stages :
  • Stage I   : Mesothelioma only present on oneside of the chest only (either on the left side or on the right side ) and it doesn't grow to the chest wall .
  • Stage II  : Mesothelioma attack the chest wall or esophagus (food passage connecting the throat to the stomach), heart, pleura on both side of the chest . Lymph node may be involved too.
  • Stage III : Mesothelioma has invade the diaphragm into the peritoneum (lining of the abdominal cavity) or has invade the lymph nodes that are in the chest .
  • Stage IV : Mesothelioma has invaded other organs through the bloodstream. 
TMN system stages :
  • Stage I   : Mesothelioma occur either in the right or left pleura lining the chest. The spread of this cancer only to the dept of outer lining of the lung and doesn't spread to the lymph nodes yet.
  • Stage II  : Mesothelioma invades from one side of the pleura lining the chest to the outer lining of the lung or the diaphragm or the lung itself.
  • Stage III : Mesothelioma has spread to the chest wall, ribs or muscle, diaphragm, any organ that is in the mediastinum ( esophagus, thymus, trachea, blood vessels), or a single place in the chest wall with or without invading the lymph nodes that is on the same size of the primary tumor.
  • Stage IV : Mesothelioma has invaded the lymph nodes on the side that is the opposite side of the primary tumor, or extends to the lung or the pleura on the other side, or directly invades organs in the abdominal cavity.
Brigham system stages :
  • Stage I   : Resectable mesothelioma with no lymph nodes involvement.
  • Stage II  : Resectable mesothelioma with lymph nodes involvement.
  • Stage III : Unresectable mesothelioma extending into chest wall, diaphragm, or into heart, peritoneum ; with or without extrathoracic lymph node involvement.
  • Stage IV : Distance metastatic disease. (