After a mesothelioma diagnosis is confirmed, physicians will determine the extent of the disease by performing additional medical studies such as x-rays, MRI scans, PET scans and CT scans. These staging tests allow the doctors to place patients in categories, which in turn help the team of specialists establish the best course of treatment for each individual patient in an effort to improve their prognosis.
There are several different mesothelioma staging systems that physicians currently use to help predict a patient’s prognosis and determine appropriate treatment based on the stage of the disease. These systems particularly apply to patients diagnosed with pleural mesothelioma, as the other types of mesothelioma are much less common.
Staging System for Mesothelioma
The Butchart System: Dr. Eric G. Butchart developed this system in 1976 on the basis of looking at the size, location and degree of metastasis or spreading.
- Stage I: The cancer is in its earliest stage and affects only one side of the body, the pleura or pericardium. There is no metastasis to the lymph nodes.
- Stage II: The cancer has extended to both sides of the pleura or pericardium and spread into the wall of the chest and/or the esophagus. Cancer cells may also be detected in the lymph nodes of the chest.
- Stage III: The cancer has spread through the diaphragm, the muscle that separates the chest from the abdomen, into the abdominal cavity called the peritoneum. The cancer has also spread to lymph nodes beyond the chest.
- Stage IV: The cancer is in its most advanced stage, spreading to other organs in the body such as the bones, brain or liver. Palliative care is recommended.
The Brigham System: This staging system was developed in 1993 by Dr. David Sugarbaker and later revised in 1998. The four stages were broken down on the basis of whether the mesothelioma cancer could be removed with a surgical procedure and whether there are lymph nodes involved.
- Stage I: The cancer is limited to the pleura, lung, pericardium, diaphragm or chest wall. None of the lymph nodes are affected. Surgery is a viable treatment.
- Stage II: The cancer remains localized to the pleura, lung, pericardium, diaphragm or chest wall. The lymph nodes are now affected. Surgery is still an option.
- Stage III: The cancer has spread into the chest wall, heart or through the diaphragm into the peritoneum. Cancer may or may not be detected in the lymph nodes. Surgery is not an option.
- Stage IV: The cancer has spread extensively through the bloodstream to other parts of the body.
The TNM Staging System: This is the most recently developed system and most widely accepted system, also known as the International Mesothelioma Interest Group (IMIG) Staging System and created in the 1990s by the American Joint Committee on Cancer. This system looks at the extent the primary tumor has spread, if cancer cells are present in the lymph nodes and whether there is any metastasis or spreading to other organs in the body. Number scores are given in the following areas: T for Tumor, N for Nodes and M for Metastasis. The scores are then correlated to a specific stage.
- Stage I: This is the earliest stages of the disease and involves only the left or right pleura lining of the chest. It may also have grown into the lung’s outer layer, pericardium or the diaphragm on the affected side. The cancer is localized and has not spread to the lymph nodes. Stage I is sometimes broken down into two separate groups, Stage IA and Stage IB.
- Stage II: Cancer has spread to both layers of either the right or left pleura, into the lungs and/or the diaphragm. Nearby lymph nodes on the same side may be affected. The disease remains localized to one side of the body.
- Stage III: Cancer has spread to the chest wall, esophagus, ribs, heart or other organs on the same side of the primary tumor location. Lymph nodes on the same side of the chest may be affected.
- Stage IV: This is the most advanced stage and there is distant metastatic disease present in various parts of the body. Surgery is not an option for this stage.
Brookman, Rosenberg, Brown & Sandler: Experienced Mesothelioma Lawyers in Philadelphia Dedicated to Protecting the Rights of Mesothelioma Victims
If you or someone you love has been diagnosed with mesothelioma as a result of asbestos exposure, contact the law firm of Brookman, Rosenberg, Brown & Sandler in Philadelphia. Regardless of what stage of mesothelioma you have been diagnosed with, you may be entitled to obtain financial compensation. Call us today at 215-569-4000 to schedule a free consultation or submit an online inquiry.