Stages of Mesothelioma

A diagnosis of mesothelioma is accompanied by a series of tests given by your doctor. These tests will help your doctor understand your overall health relative to the progression of the disease and what methods are available for your treatment. Your doctor may use one of several staging systems to classify the severity and spread of mesothelioma.

Mesothelioma Diagnosis

Your mesothelioma stage is determined during your diagnosis. Your doctor may give you a blood test and may take tissue or fluid samples for lab analysis. Your diagnosis may also involve one or more imaging scans that will be performed by your doctor. Imaging scans provide your doctors with a visual display of the interior of your body to help them determine the size of the tumors and if the mesothelioma has spread to other areas of your body.

Mesothelioma Staging Systems

Mesothelioma is staged according to one or more of the three staging systems that are currently used in the United States. The specific definition of each stage is slightly different in each staging system, but all are sufficient in providing your doctors with the information required for your treatment.

Butchart Mesothelioma Staging System

Of the three staging systems for mesothelioma, the Butchart system has been in place the longest. It was introduced by Dr. Eric Butchart in 1976 and remains the most widely accepted system for mesothelioma staging in the United States. The basis of the Butchart system is the particular location of the tumors within the body.

The Butchart staging system is comprised of four stages:

  • Stage I – Cancerous cells exist in one of the three types of mesothelium: the pleura (lung lining), pericardium (heart lining) or peritoneum (lining of abdomen and other organs). In the pleura, only one side of the lung lining is affected, but the disease may be also be present in the diaphragm or the lung on the afflicted side.
  • Stage II – In pleural mesothelioma, the tumor has progressed to the wall of the thoracic (chest) cavity. It may also affect the esophagus, heart or the opposite side of the pleura from where it began. The lymph nodes near the thoracic cavity may also be affected.
  • Stage III – In the third stage, the tumor has penetrated through the diaphragm to the mesothelium on the other side: whether it’s the pleura or the peritoneum. The disease may also have spread to lymph nodes outside the immediate area.
  • Stage IV – Distant metastasis is present in stage four. This means that cancerous cells have traveled through your bloodstream to other parts of your body. At stage four, surgery can no longer be performed to control the disease, and treatment focuses on patient comfort.

TNM Mesothelioma Staging System

The TNM staging system was introduced by the American Joint Committee on Cancer (AJCC) and is preferred by some specialists for being more specific than the Butchart system. According to the TNM staging system, mesothelioma is categorized according to three criteria: tumor size and spread (T), the spread to the lymph nodes (N) and the spread to other organs in the body (M).

After the TNM criteria have been classified, the results are combined in a process called stage grouping. The final stage groupings are very similar to those of the Butchart system and are listed as follows:

  • Stage I – In the first stage, only one side of the pleura or peritoneum is affected by mesothelioma, but the cancerous cells may also appear in nearby organs on the same side. Lymph nodes have yet to be affected.
  • Stage II – At this stage, the tumor may have spread to the lung or bronchial passages on the same side of the pleura that was originally affected. The pericardium and the diaphragm may also have been affected on the same side. Cancerous cells may be present on the lymph nodes in the immediate area.
  • Stage III – The third stage is characterized by the spread of mesothelioma to the wall of the thoracic cavity, the heart or other organs on the same side as was originally affected. Additional lymph nodes may also be affected.
  • Stage IV – Stage IV mesothelioma occurs when cancerous cells have spread to the opposite side of the pleura or peritoneum. It may also have spread into the mesothelium on the opposite side of the diaphragm. Organs in the abdomen or the neck may be affected at this stage, which also includes metastasis to distant organs.

Brigham Mesothelioma Staging System

The Brigham staging system is based on the viability of surgery as a treatment for your particular case of mesothelioma. However, it also takes into consideration other treatments, including radiation therapy and chemotherapy. In addition, the spread of the cancer to the lymph nodes plays a role as to the stage in which your mesothelioma is categorized.

The stages in the Brigham system are similar to those of the TNM system and the Butchart system. The details of the stages are as follows:

  • Stage I – Surgery is a strong option for treatment because the tumor is localized to a specific area of the mesothelium and has not spread to any other areas or lymph nodes.
  • Stage II – The mesothelioma is still contained to the same local area as in stage I, but it may have spread to nearby lymph nodes. Surgery is still possible in treating the disease.
  • Stage III – Cancerous cells have broken free of the local area where the disease began. The cancer may have spread to the chest wall or to the mesothelium on the opposite side of the diaphragm. Lymph nodes may also be affected, but this is not a requirement in categorizing mesothelioma into this stage. Surgery can no longer be performed.
  • Stage IV – The mesothelioma has become metastatic and spread to distant organs of the body. Surgery is not viable at stage IV.

It is imperative that you contact an experienced mesothelioma attorney as soon as possible to assess your situation and prospective claim for compensation, and we encourage you to contact the offices of Goldberg & Osborne today. Simply call 1-800-THE-EAGLE (1-800-843-3245) or fill out our online case form for your free, no obligation evaluation. We work at no cost until we win your case!


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