Staging Systems for Mesothelioma

Since mesothelioma is such a rare form of cancer, it can be difficult to stage correctly. There are a few different methods used in staging mesothelioma, but the TNM system is the one used most often. As we continue to learn about mesothelioma and how it behaves in the body, we’ll be able to make more accurate stage diagnoses. 

Staging Systems

It’s important to know what stage of mesothelioma a patient is at diagnosis because the stage determines the type of treatment necessary.

Along with treatment specifications, setting parameters for different stages allows doctors to track mesothelioma progression in the patient. 

There are three main types of staging systems that have been used for mesothelioma. It’s beneficial to have a universal staging system, which is why TNM is most widely used. 

TNM stands for Tumor Node Metastasis. The staging system is used the most, especially for pleural mesothelioma. It provides the greatest amount of information to doctors by taking into account the number and size of tumors in the body. 

The Butchart staging method is the oldest but is not widely used anymore. This staging method is based on the location of the first tumor. This method doesn’t give much information on tumors in other areas of the body, or their size. 

The Brigham method looks at how feasible surgery is at any point during the process. The more difficult the surgery would be, the higher, and more serious, the stage of mesothelioma. 

Some types of mesothelioma still do not have accepted staging systems. 

TNM Staging

Tumor Node Metastasis staging is where three different observations combined to form a stage diagnosis. 

  • T stands for tumor and is measured by the size and location of the tumor(s). 
  • N represents node, and is documented by any cancer cells present in the nearby lymph nodes. 
  • M is for metastasis which measures whether or how far tumors have spread in the body. 

With TNM staging, there are currently three stages of mesothelioma. 

  • Stage 1 – minimal presence of tumors and they are all located within the abdominal lining 
  • Stage 2 – a moderate number of tumors, but they are all still contained within the abdominal lining
  • Stage 3 – an extensive number of tumors being present and have potentially spread outside the abdominal lining or to the lymph nodes

There is not yet an official fourth stage of mesothelioma. Unofficially, stage four mesothelioma is when the cancer has spread extensively, to parts of the body distant from the initial tumor. With more research, an official definition of stage four mesothelioma is likely to be defined. 

Updating the Staging Systems

Since staging mesothelioma research is still in its infancy, these staging systems are not set-in stone and can be subject to change or editing at any point, with emerging research. As new medical equipment develops, doctors will have more information and models to go by, making the stages of mesothelioma much clearer and more consistent across the board. 

With more defined diagnosis stages in the future, doctors will be able to treat patients more effectively and hopefully offer a higher chance of remission.