When doctors diagnose patients as having mesothelioma, they must determine the severity of the disease in order to proceed with the best treatment options. To do this, they must divide the disease into stages. The stages of mesothelioma also help doctors to determine the disease’s progression, and it aids them in determining the patient’s prognosis. Medical professionals currently use three different mesothelioma-staging systems to diagnose and treat pleural mesothelioma.
Each system measures different variables including the extent of the cancer, lymph node involvement, metastasis, and more. When reviewing mesothelioma stages, the lower the stage, the less severe the disease. People who have more severe mesothelioma will be placed in the higher stages, like Stage III or Stage IV, for example. The later stages are also when mesothelioma metastasis typically occurs.
1. The Butchart System
The Butchart System is the oldest and most commonly used mesothelioma cancer staging system. Its measurement of the mesothelioma stages is primarily based on the extent of the tumor mass. Butchart System divides mesothelioma into four stages:
- Stage I – Mesothelioma cancer is seen in the right or left side of the chest area, or pleura cavity, and may also be found in the diaphragm.
- Stage II – Mesothelioma cancer has invaded the chest lining and reaches the esophagus, heart, or pleura on both sides. Lymph nodes may also be affected.
- Stage III – Mesothelioma cancer has passed the diaphragm and entered the abdominal cavity or peritoneum. Lymph nodes beyond the chest may also be affected.
- Stage IV – Mesothelioma cancer has spread through the bloodstream to other organs. At this stage, it is metastatic mesothelioma.
2. TNM System
TNM System is a more recent system used to stage mesothelioma by considering variables such as the tumor size and spread, lymph node involvement, and metastasis. In the TNM system, the disease is divided into four stages:
- Stage I – Mesothelioma cancer is located in the right or left chest cavity and may have spread to the pericardium, diaphragm, or lung on the same side. Lymph nodes are not affected.
- Stage II – Mesothelioma cancer has spread from one side of the chest to a lymph node near the lung on the same side. The disease may have also spread to the lung, diaphragm, or pericardium on the same side, but generally the cancer remains in the primary location at this stage.
- Stage III – Mesothelioma cancer has entered the chest wall, muscle, heart, esophagus, ribs, and vital organs in the pleural cavity on the same side. Lymph nodes may or may not be affected on the side of the tumor. True mesothelioma metastasis will have begun in this stage.
- Stage IV – In this stage, the mesothelioma cancer has spread to the lymph nodes in the chest area on the other side of the tumor, to the pleural cavity or lung on the other side; or it has reached organs in the abdominal area or neck.
3. The Brigham System
The Brigham System is the latest mesothelioma cancer staging system and is based on tumor resectability, and lymph node status. The Brigham system is divided into four stages. The four stages of mesothelioma measured by this system are:
- Stage I – Mesothelioma cancer is resectable and lymph nodes are not involved.
- Stage II – Mesothelioma cancer is resectable, but lymph nodes are involved.
- Stage III – Mesothelioma cancer is unresectable and has spread to the chest wall, diaphragm, heart, or abdominal area. Lymph nodes may or may not be involved.
- Stage IV – Distant metastatic mesothelioma cancer.
Regardless of whether you have early stage or metastatic mesothelioma, you should understand what your rights are as a victim of asbestos exposure. Contact us here at Mesothelioma Treatment Centers to set up a consultation with an attorney experienced with asbestos and mesothelioma. A lawyer can help you and your family explore the legal options that are available to you. See our excellent guide to the different stages of cancer.
More About Mesothelioma Stages
It is important to keep in mind that the different stages of mesothelioma can provide the patient with guidance about what the general course of the disease may be, as well as the prognosis. However, it is important to remember that the above staging systems are simply guides. At all of the above stages whatever the system used, mesothelioma can be fatal. And there can be some amount of hope as well, regardless of the stage you are in.
Every patient’s treatment plan will vary depending upon the stage, but also the types of cancer cells, the location in the body, and also specifics about the patient. These include age, gender, and overall health. Men get mesothelioma more than women, and the older you are, the more likely that mesothelioma will be fatal more quickly. People who are in better physical condition are usually able to better withstand the aggressive treatments needed to fight the cancer.
Mesothelioma Treatment by Stages
For stage 1 of this disease, mesothelioma surgery is the most common treatment at first. It is generally the first line of defense for pleural mesothelioma in stage 1. The common procedures that are done are pleurectomy and decortication, and also extrapleural pneumonectomy.
After the surgery, the doctor may decide if you also need chemotherapy or radiation treatment. In some patients, those additional therapies may not be needed.
For stage 2, you still have plenty of treatment options available. Chemotherapy and radiation treatments may be the best options in your case. Surgery also could be a good option at this time as well. There are other experimental and alternative mesothelioma treatments that can slow the disease progression.
In stage 3, there are fewer treatment options for most types of mesothelioma. At this point, the cancer has spread outside of its origin area and is in other parts of the body. Treatments at this time usually center on providing patient comfort and improving quality of life.
At stage 4, you are, the prognosis is quite unfavorable, and treatment options are limited. The cancer normally has metastasized throughout the whole body, to organs, bones and other structures. At this point, most of the treatments are geared towards simply controlling pain and reducing symptoms.
Therapies such as chemotherapy and radiation normally are not used at this point. Usually, families will seek more support through a hospice program in their town. A cancer hospice team can provide detailed patient care and can help to reduce pain and to provide logistical support for the family. Patients who are in this stage may want to participate in clinical trials that may offer some chance of slowing the progression of the disease.
Mesothelioma and other cancers spread in three ways: by attacking surrounding tissue, through the blood and through the lymphatic system.
Metastasis is caused by the uncontrolled growth of cancer cells. It can lead to tumors in other parts of the body as well as other organs. This is called metastatic mesothelioma. Essentially, the cancerous cells do not get signals from healthy cells that tell them that they should stop growing.
Mesothelioma will become more advanced when cancer gets into the blood or the lymphatic system. At this point, it allows the cancer to spread to faraway organs and lymph nodes.
Metastasis in the lymph nodes is much more complex than in the tissues of the body or the blood and circulatory system. Lymph nodes are attached to each other through the lymphatic vessels and are a very important part of the immune system.
The lymphatic system interacts with the cardiovascular system. The cardiovascular system has countless blood vessels and capillaries, and the lymphatic system has thousands of lymph vessels and capillaries. Cancer can spread through the lymphatic system in just the same way as it does through the circulatory system. The only big difference is that the cardiovascular system does not feature nodes; the latter are very important when it comes to staging.
When the cancer gets to the lymph nodes, the nodes begin the production of white blood cells to combat it The production of white blood cells causes the lymph nodes to swell. Thus, monitoring the size of the lymph nodes is an effective way to monitor the progress of the cancer, as the cancer will cause the lymph nodes to swell if they have entered that system.
Life Expectancy and Cancer Stage
As noted earlier, one of the first things that cancer doctors do after they have diagnosed you with mesothelioma is to assign a stage to your cancer. It is very important to know how far the disease has progressed in the body. Staging is critical because it sets the foundation for your treatment plan.
In stages 1 and 2, without any treatment, pleural mesothelioma patients could live up to two years. Stage 1 patients who get an extrapleural pneumonectomy have a life expectancy of 40 months or so. Approximately 30 percent of stage 2 patients with pleural mesothelioma can live 40 months if they have the same surgery.
The five year survival percentage for stage 1 peritoneal mesothelioma patients who get surgery and heated chemotherapy is 88%. Approximately 53% of stage 2 patients who have this type of aggressive treatment have at least a five year life expectancy.
In stage 3, those who have aggressive surgery may be able to live 16 months or more. The five year life expectancy for those with stage 3 peritoneal mesothelioma who elect to have surgery and heated chemotherapy is 29%. Approximately 50% of stage 3 patients live 26 months or longer.
In stage 4, patients can expect to live approximately 12 months. But people who are younger and in good overall health may live more than a year.
Stage 4 peritoneal cancer cases do not qualify for most surgeries because the cancer involves too many other vital tissues that cannot be removed. Patients who elect to not have surgery can live approximately one year.
If you have mesothelioma cancer and have questions about your legal options, we recommend that you talk to an experienced mesothelioma cancer attorney today.