Stages of Mesothelioma

Doctors stage tumors for a variety of reasons. Accurately staging a tumor allows the doctor to determine how involved the disease is, how rapidly it is spreading, and what type of prognosis he can give his patient. For any patient that is interested in entering a clinical trial, staging is a necessary part of the application process. There are a variety of methods used to stage a cancerous tumor. Some methods are used for all types of cancer while others where developed specifically for the staging of mesothelioma. The method used to stage the mesothelioma is determined by your physician as well as the type of treatment options that you are considering. If the patient wants to qualify for a clinical trial, it is likely that all participants will be required to have their mesothelioma staged using the same method. If your doctor is considering surgical removal of the tumor, he may use the Brigham method of staging, a newer method that is aimed at recognizing which tumors are good candidates for surgery.

The Different Methods of Staging Mesothelioma

There are a variety of methods that are used to stage mesothelioma. The method of staging used for mesothelioma is less important than the ability for the physician to accurately stage the tumor. The methods used to stage a cancer tumor are TNM, Summary staging, Butchart and Brigham. The purpose of staging a tumor is to determine if the tumor has spread, and if so, the extent of the area it has spread to.

While each method of staging is slightly different, they all include similar information. The goal of staging a tumor is to provide an accurate assessment of the progression of mesothelioma. While the speed that mesothelioma progresses cannot be determined, the progression is straightforward.

The earliest stage of mesothelioma, or any cancer, is when the tumor is located only in the area where it developed. It has not spread throughout the organ, or left the organ. Tumors found at this stage are the most easily treated. The cancer tumor then spreads to the organ. While this indicates that the cancer is spreading, it it still confined to the organ where it developed. The next stage of spreading is to adjacent organs or lymph nodes. Once this occurs, the cancer has left the area of origin. The final stage occurs when the tumor spreads to distant organs or lymph nodes. For the tumor to bypass adjacent organs and move on to distant ones, the tumor cells must travel through the body. They do this by breaking free of the tumor and entering the bloodstream or lymphatic system.

Metastasized Tumors

When mesothelioma reaches its final stage, having spread to distant parts of the body, it is termed metastasized. This means that the tumor cells have broken free and moved to a different portion of the body. The tumor cells settle into a different area and begin to grow. The term used for these tumors are metastasized tumors, as opposed to the term for the original tumor, which is primary. Metastasized tumors can settle anywhere, but are commonly located in the lungs, brain, liver or the bones. Regardless of where they settle, they are still mesothelioma.

Once a tumor metastasized the treatment options are grim. Particularly in an aggressive form of cancer such as mesothelioma, the chances of a successful outcome are greatly diminished when a patient's cancer metastasizes. For many patients, once they receive news that their cancer has metastasized, they begin to consider palliative care for their condition.

Lymph Node Involvement

Lymph node involvement in mesothelioma is an important part of the staging of the disease. When a cancerous tumor spreads onto an adjacent lymph node, it provides an open pathway for the spread of the tumor if the disease metastasizes. The lymph system moves throughout the body, and cancerous cells located in the lymph nodes can easily reach the opposite end of the body. Because of the important of the lymph system in the spreading of cancerous tumors, lymph node involvement is always part of the consideration when staging tumors.

Successful Staging of the Tumor

Your physician will use a variety of methods to successful stage the tumor. Tests such as x-rays, CT scans and MRIs are a part of the diagnostic process, but are not 100% reliable. Mesothelioma tumors are often illusive on imaging equipment, and may not be clearly visible until the disease has spread. The most effective way to stage the mesothelioma tumor is through an open biopsy. Although this is an invasive procedure that must be completed in a hospital, the diagnosis is much more effective than a needle biopsy or cytology (the examination of fluid removed from the chest cavity). By accurately staging the disease, your doctor can develop the most effective treatment protocol for your particular cancer.

For information about mesothelioma and treatment, please see “Mesothelioma Overview” and “Mesothelioma Treatment Overview.”