4 Stages of Mesothelioma

How Do Doctors Determine Stages of Mesothelioma Cancer?

When diagnosed with mesothelioma, your doctor may talk to you about staging. Staging is a way for doctors to understand where the cancer is located and how advanced it is. This information will help your care team decide which treatment options may be best for you, based on the stage of your mesothelioma and your overall health.

Most doctors, hospitals, and health systems use a staging system called TNM, which looks at three main things:

• T (Tumor): How large the main tumor is and where it is located.
• N (Nodes): Whether the cancer has spread to nearby lymph nodes.
• M (Metastasis): Whether the cancer has spread to other parts of the body.

After reviewing these details, your doctor combines the T, N, and M information to determine the overall stage of your mesothelioma. The stage of mesothelioma helps guide treatment planning and next steps in your care.

What are the Stages of Pleural Mesothelioma?

Pleural mesothelioma (known also as malignant pleural mesothelioma or MPM), is the most common type of mesothelioma and is the only one a formal staging system. Peritoneal, Pericardial, and Testicular mesothelioma are so rare that there is not a generally accepted staging system in place. Instead, physicians will use similar guidelines and information regarding the unique location, size, and the metastatic rate of the patient's cancer to determine the best treatment plan and prognosis. Pleural mesothelioma starts in the pleura, which includes the lining of the lungs and the inner lining of the chest wall. Generally, each stage of pleural mesothelioma is defined as follows:

An example of a staging diagnosis for Pleural Mesothelioma, once all factors have been determined, could read “Stage 1- T1a N0 (IA).” 

• T1a: The tumor is small and limited. It is found on the lining of the lung (pleura) and has not grown into nearby lung tissue or deeper layers.
• N0: The cancer has not spread to any nearby lymph nodes.
• Stage IA: This confirms the cancer is very localized and has not spread.

What this means is that the patient would have Stage 1 mesothelioma cancer, which is an early stage. At this stage, the mesothelioma is confined to one area, which may allow for more treatment options and potentially better outcomes compared to later stages of mesothelioma.

Why Is Staging Mesothelioma Important?

Doctors use the cancer staging for mesothelioma to determine what treatment options may exist and how effective those options may be. If you’ve been diagnosed with early-stage mesothelioma, you are most likely eligible for traditional treatments.  These treatments include:

• Immunotherapy
• Chemotherapy
• Surgery
• HIPEC with CRS (Hyperthermic Intraperitoneal Chemotherapy with Cytoreductive Surgery)
• Radiation

These options may extend your life expectancy. However, if you have been diagnosed with advanced-stage mesothelioma, traditional treatments may not be an option although you can participate in clinical trials where researchers are testing newer treatments. It is important to discuss the options based upon your stage of mesothelioma and your overall health with your doctor.

 

What Tests Help Doctors Stage Mesothelioma Cancer?

Doctors use imaging tests and biopsies to visually confirm how far mesothelioma has spread. The results of your diagnosis help them decide which treatments fit your needs, and which will have the most positive impact on your prognosis. 

Each type of scan provides them with visual information on the growth and spread of a tumor; information they use to determine the cancer stage of the mesothelioma:

• CT Scan: A computed tomography (CT) scan generates several X-ray images doctors put together to make a single 3D image of the chest or stomach. Doctors use CT scans to determine if a tumor has spread to the chest wall or diaphragm.
• MRI Scan: Doctors use a magnetic resonance imaging (MRI) scan to find out if mesothelioma has spread from the lining of the lungs (the pleura) to the chest wall, lining of the heart, or nearby organs.
• Positron Emission Tomography (PET) Scan: A PET scan is often considered to be the best method to determine if mesothelioma has spread to other parts of the body. Doctors can even use it to find out if a tumor has spread to lymph nodes that are far from where the mesothelioma first appeared.