The first step a physician will take if a patient is diagnosed with malignant pleural mesothelioma (MPM) or with pericardial or peritoneal mesothelioma is to determine the stage of the illness. Determining the stage tells the extent to which the tumor has spread outside the pleura, peritoneum, or pericardium.
History of Cancer Staging
Before the 1940’s, systems for classifying stages of cancer did not exist. The first interest in creating a staging system originated soon after with the desire to find a way to assess different levels of breast cancer. Having such a system would allow doctors to make targeted treatment plans, have a better idea of survival times, and speak a common language when referring to cancers.
The first formal system to be used with mesothelioma was created by Butchart, et al., which divided cancer into four different stages. Modifications to criteria have since been made and continue to be made to this system; however the 4-stage approach remains the same.
Another system that is sometimes used to define stages is the tumor-node-metastasis (TNM) staging system. This measures the tumor size, node involvement, and degree to which the cancer has spread to other places in the body.
Current Mesothelioma Stages
Mesothelioma, as well as many other types of lung cancers, is divided into four different stages. The criteria measured are usually the size of the tumor and the degree to which the disease has spread throughout the body.
Both systems mentioned above divide mesothelioma into four stages. Stage I refers to tumors that are relatively small and localized. Stage II means the tumor has grown, and although it has not spread into surrounding tissue, may have entered into the lymph nodes. Stage III means the cancer is even larger, has spread to nearby lymph nodes, and is starting to spread into surrounding tissues. Stage IV is when the tumors have begun to spread to other body organs, commonly referred to as metastasized.
Metastasis refers to the degree to which the tumors have spread throughout the body. Generally speaking, if cancer has metastasized, the stage will be advanced with poorer prognosis and less treatment options.
Determining the Stage of Mesothelioma
Several common tests and procedures are used to determine the stage of mesothelioma: chest X-rays, MRI’s, CT scans, surgery, and endoscopic ultrasounds (EUS). Your treating doctor will be able to recommend which test is best for you depending on the details of your individual case.
How Stages Affect Treatment and Prognosis
Stage I mesothelioma has the best prognosis as the tumors are localized and are more apt to be able to be removed surgically. Once mesothelioma has spread to lymph nodes on the same side as the tumor, or to the lining of the chest or heart, it has progressed to Stage II. Therapeutic interventions and survival times are always better if mesothelioma is diagnosed at these earlier stages.
Stage III mesothelioma occurs when the cancer has spread beyond the lining of the chest wall and to lymph nodes on the other side of or outside the chest wall. Survival times and therapeutic intervention options drop with each advancement in stage, or as the number of the stage gets higher. Stage IV mesothelioma, the most advanced, means tumors have spread throughout the body to other organs, tissues and lymph nodes. At this stage, therapy tends to focus on symptom and pain management versus disease progression or prolonging survival times.
Mesothelioma is an Incurable Cancer
Currently, there does not exist a cure for mesothelioma. However, many clinical studies are dedicated to finding ways of catching mesothelioma at earlier stages and before it has progressed too far. Research such as this may one day help to not only lengthen survival times and increase treatment times, but also find a cure.
Sally Clapper is a publicist for Clapper, Patti, Schweizer & Mason, asbestos lawyers that have been representing people with mesothelioma for over 25 years. As experts in the field of mesothelioma, the firm’s attorneys are recognized as some of the leading plaintiffs’ mesothelioma lawyers in the nation.