More About Mesothelioma

Mesothelioma uses a four-stage system to determine how far the disease has progressed. Being diagnosed at an early stage of the cancer provides the best hope for patients, but those who are diagnosed in later stages typically have fewer mesothelioma treatment options.

Note that only pleural mesothelioma, which is the most common type, has an official staging system. Other types of mesothelioma (peritoneal and pericardial) are rarer, and therefore do not have defined staging systems.

The Stages of Pleural Mesothelioma

The most common staging system for mesothelioma is known as the TNM, which stands for Tumor, (Lymph) Nodes, and Metastasis. Developed by the American Joint Committee on Cancer, the TNM staging system has identifies where the tumor originated, whether it has affected the lymph nodes, and how far the disease has spread.

Mesothelioma Stages
Stage 1Stage 2Stage 3Stage 4
The cancer is limited to the area where it first developed. The lymph nodes have not yet become involved, and the tumors have not started to spread beyond their initial location.

Surgical removal of tumors is the best option at Stage 1.

The cancer has spread locally, but is still contained in the area where it originated. For example, it may have spread to the nearby lung or diaphragm.

Surgery may still be possible at this point, but will require a more aggressive, such as removal of the lung and possibly nearby tissue.

By this stage, the cancer has started to spread to the lymph nodes and areas beyond where it originated. Tumors have grown into nearby areas, such as the chest wall, the area surrounding the heart, or other places in the thoracic cavity.

While surgery may still be possible at this point, its effectiveness may be limited.

The disease has spread through the lymph nodes and now is present in distant parts of the body from where it originated.
Surgery is no longer an option. Chemotherapy may kill some of the cancer, but will likely be used only as a palliative option at this point.

Other Mesothelioma Staging Systems

While the TNM system is the most frequently used staging system for pleural mesothelioma, two other systems have been developed.

  • Brigham Staging System: Developed at Brigham and Women’s Hospital by Dr. David Sugarbaker, this system differs in that in both Stages 3 and 4, the tumors are no longer operable.
  • Butchart Staging System: The first mesothelioma staging system developed, this version was developed before modern diagnostic methods were in use. It is no longer considered a viable staging systems, having been replaced by the Brigham and TNM systems.

Mesothelioma Staging and Survival

The stage of mesothelioma at diagnosis is one of the most important factors in determining prognosis of the patient. The earlier stages offer the best opportunity for improved life expectancy, while long-term survival often is not viable with later stages.

For this reason, it is extremely important to get checked out if you begin to experience any mesothelioma symptoms and have a known history of asbestos exposure. While the substance is a known carcinogen, there are many products that still contain asbestos, and exposure should be limited as much as possible. The sooner you are diagnosed, the better opportunity you have to beat this terrible disease.