Stages of Mesothelioma

How Do Doctors Determine Stages of Mesothelioma Cancer?

At the time of a mesothelioma diagnosis, your physician may assess your cancer in a process called staging. This assessment is used to gain more insight into the location(s) and severity of your mesothelioma diagnosis. It may also be used as a tool for determining the appropriate treatment courses available to you depending on the stage of your mesothelioma and your overall health.

The most common staging system used by hospitals and health systems is the TNM (tumor, nodes, metastasis). This system was created by the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer (UICC), and is comprised of 3 key pieces of information:

• The extent (size) of the main tumor (T)
• The spread to nearby lymph nodes (N)
• The spread (metastasis) to distant sites (M)

After this categorization is completed, your physician will assign it an overall stage that is determined by a combination of the tumor’s T, N, and M values.

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).”

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.