The Four Mesothelioma Stages – How Far Has the Cancer Spread?

Physicians and cancer researchers have always relied on understanding mesothelioma stages in order to properly treat this invasive cancer. As with many other forms of cancer, the body goes through various stages as the illness progresses, with each one influencing whether or not treatment of the mesothelioma cancer will be effective.

The various mesothelioma stages generally indicate how far the disease has progressed in relation to its point of origin. Localized mesothelioma is diagnosed when the cancer has not spread beyond the membrane (most often the lining of the lungs) in which it originated. If the cancer cells have spread beyond this lining to invade the lungs, chest wall cavity or other body organs it is considered an advanced mesothelioma stage, which is much more difficult to treat.

Beyond the informal localized vs. advanced, four distinct stages are recognized by each of the two most widely used mesothelioma staging systems. One system, the TNM staging system, is used most often in progressive cancer treatment centers and is recognized by the American Cancer Society as the most accurate mesothelioma staging system. The other, the Butchart Staging System, is the most common system for staging cancer in general.

Butchart Mesothelioma Stages

The Butchart system divides mesothelioma cancer into four different stages depending on the stage of the main tumor mass.

Mesothelioma Stages - Lung Xray

  • Stage I – Cancer is only seen in one side of the chest lining, or pleura
  • Stage II – The mesothelioma has spread to any one of the chest wall, esophagus or heart or the lymph nodes of the chest
  • Stage III - The cancer has invaded the diaphragm and the lining of the abdominal cavity (peritoneal cancer) or has spread to additional lymph nodes in the body
  • Stage IV - Mesothelioma has spread to several major organs

Although still very commonly used, the Butchart staging system is slowly being replaced by the TNM system for identifying mesothelioma cancer stages.

100 Questions & Answers About Mesothelioma

TNM Staging System

TNM stands for Tumor, Nodes and Metastasis; three keys to determining how advanced mesothelioma cancer is using this system. The extent of the tumor, how advanced the disease is in the lymph nodes and whether the cancer has spread to other organs are the criteria for TNM staging.

  • Stage I - Mesothelioma is restricted to the pleura of the chest and has not spread to other areas.
  • Stage II - The cancer has spread to the pleural lining and to the outer lining of the lung or into the lung itself.
  • Stage III - In addition to the pleura, mesothelioma spreads to part of the chest cavity behind the breast bone or within the chest wall. This stage also usually includes cancer of the lymph nodes.
  • Stage IV - The most advanced of the mesothelioma stages, when cancer has spread to major organs or the bones or brain. Metastasis refers to the generalized spreading of the cancer.

Each individual case of mesothelioma is different and these stages are only guidelines for physicians and other treatment specialists. Their determination of what kind of treatment a patient will go through and how advanced their cancer is depends on a great many other factors as well, such as age of the patient and relative health outside of the cancer. These mesothelioma stages are a short-hand for doctors, patients and loved ones to get a general idea of where the patient stands.

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