Stages of Mesothelioma

When referring to cancer, staging is the process used to determine how far the cancer has spread. Stages of mesothelioma were established by the Mesothelioma Interest Group and adopted by the American Joint Committee on Cancer (AJCC), and are similar to the staging system used by most other cancers. At this time, the staging system is only applied to mesothelioma around the lung, and uses Roman numerals from I to IV (1 to 4) to describe the severity of the asbestos cancer.
Mesothelioma stages are based upon the findings of imaging studies such as CT and MRI scans. The patient's prognosis and treatment is dependant upon the stages of their mesothelioma.
The first steps in determining a patients' mesothelioma stage is to determine the T, N, and M stages. Once the categories have been assigned, they are grouped to determine an overall stage represented by Roman numerals. The stages of mesothelioma are as follows:

T Stages

• T1 – Mesothelioma is in either the right or left pleura lining and has only spread to the pleura covering the lung and potentially a few other small spots.
• T2 – Mesothelioma is in either the right or left pleura lining and has spread to the out lining of the lung, the diaphragm or the lung itself.
• T3 – Mesothelioma is in either the right or left pleura lining and has spread to:
  • The first layer of the chest wall
  • The fatty part of the mediastinum
  • A single place in the chest wall
  • The outer covering of the heart
• T4 – Mesothelioma is in either the right or left pleura lining and has spread to:
  • The chest wall
  • Through the diaphragm
  • Into the esophagus, trachea, thymus or blood vessels
  • Into the spine
  • To the pleura on the opposite side of the chest
  • Into the heart lining or the heart itself
  • Into the nerves leading to the arm (brachial plexus)

N Stages

• N0 – No lymph nodes are affected
• N1 – The lymph nodes on the same side of the chest as the mesothelioma are affected
• N2 – The lymph nodes around the windpipe branching into the left and rich bronchi or the space behind the chest bone and in front of the heart on the same side of the chest as the mesothelioma are affected.
• N3 – The lymph nodes near the collarbone on either side, or lymph nodes on the opposite side of the mesothelioma are affected

M Stages

• M0 – No cancer has spread to distant organs or areas.
• M1 – Cancer has spread to distant organs or areas.

The categories above are combined into a stage grouping to assign the overall stage number. As expected, the patients with lower stage numbers have a better prognosis.

Combined Into a Mesothelioma Stage

• Stage I – categories are T1, N0, M0
• Stage II – categories are T2, N0, M0
• Stage III – categories are T1 or 2, N1 or 2, M0 OR T3, N0-2, M0
• Stage IV – categories are T4, any N, M0; OR any T, N3, M0; OR any T, any N, M1

Other Symptoms

While the stages are important to know, there are other symptoms of mesothelioma that determine the prognosis of a patient when dealing with mesothelioma. These include:

• Inability to perform daily tasks
• Chest pain
• Shortness of breath
• Weight loss,
• High white blood cell count

These are serious symptoms and must be factored in regardless of the stage.  A patient with all of these symptoms has less chance to survive as opposed to a patient with none of these symptoms.