- Four stages of progression.
- Treating Stage I
- Treating Stage II
- Treating Stage III
- Managing Stage IV
- Which System is in Wider Use?
Progression of Mesothelioma has 4 Stages
Traditionally, these stages measured only the tumor mass under the Butchart System. A second system, TNM system, looks at the growth of lymph nodes, which filter out harmful substances from the body, and metastasis, or the extent that the cancer has spread. Another system, called the Brigham System, focuses on surgical options and the extent that lymph nodes are affected. All staging systems relate to pleural (chest) mesothelioma, the most common form of the disease, and use four stages. There are no established staging systems for peritoneal or pericardial mesothelioma. The first two stages for Butchart and TNM are fairly similar.
Stage I: Cancer is limited to one side of the chest’s pleural lining.
The pleural lining is a wet, thin membrane between the lungs and the walls of the chest cavity. Its purpose is to protect the lungs from abrasion. There are two layers of this lining, or pleura: one that lines the lungs, and one that lines the chest wall. Under normal breathing, these linings easily slide over each other. When malignant mesothelioma develops in the lining (pleura), it thickens and can press on the lung. Fluid can accumulate between the pleura. At this point, there can be trouble breathing, chest pain, coughing, and hoarseness. The TNM staging system breaks down Stage I into two categories that describe where the cancer is located.
- Stage IA is when the cancer is found on one side of the chest in the chest wall lining. It also covers when it is found in the chest cavity lining between the lungs and/or the lining that covers the diaphragm. The cancer has not affected the lung.
- Stage IB is used when cancer is in the chest lining on one side of the chest and on the lining that covers the lung. It includes cancer in the linings of the chest cavity and/or diaphragm.
Stage II: The cancer has spread (metastasized).
However, the cancer remains in the chest or has reached above it to the esophagus.
The two systems have different definitions for Stages III and IV.
The tumor system, or Butchart System, defines Stage III as further spreading through the diaphragm to reach the lining around abdomen or lymph nodes outside the chest. Stage IV occurs when the cancer can be found in the bloodstream and has further spread to other organs.
- The TNM System defines Stage III as further spread within the same side of the chest. Stage IV is then the cancer has spread outside the one side of the chest to the other side and to other organs as well.
The Brigham System follows these stages:
- Stage I: The cancer has not spread to lymph nodes and can be surgically removed.
- Stage II: Surgery is still possible but the cancer has spread to lymph nodes.
- Stage III: Surgery is no longer possible and the cancer has spread to other parts of the chest, including the heart.
- Stage IV: Surgery is not possible and the cancer has spread to other parts of the body.