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What Are The Four Stages of Mesothelioma Cancer?

One rare form of cancer is called Mesothelioma, a malignant tumor in the mesothelial tissues of the lungs and the abdomen, arising from the inhalation of asbestos. Its rarity is one of the reasons why a lot of people are not aware of this kind of fatal disease. In fact, many people die of Mesothelioma undiagnosed.

Although there is now a growing awareness of the hazards of asbestos to health, still many have not heard of Mesothelioma and thus, have not understood its nature, cause, signs and treatment. Even some physicians find it hard to detect Mesothelioma because its symptoms are akin to other diseases like lung cancer and pneumonia. Furthermore, it takes decades for a patient who was exposed to asbestos to show symptoms and develop Mesothelioma — fifty years, at most.

There are four main types of Mesothelioma, which include Pleural, Peritoneal, Pericardial, and Testicular cancer.

Being unaware of Mesothelioma poses higher risks since it deters diagnosis and treatment. A person undergoing treatment must know the different stages of the cancer or the extent of the disease. Chances of surviving Mesothelioma and the kind of treatment depend on the stage of the illness.

There are basically two staging systems used for Pleural Mesothelioma (lungs): TNM system and Brighan system. These staging systems are also used in other kinds of cancers; however, the first is commonly used. There is no established method in determining the stage of the Peritoneal Mesothelioma cancer (abdominal) so the TNM system is used.

How many Stages of Malignant Mesothelioma Cancer are there?

The Mesothelioma cancer stages are explained using three variables in the TNM system: tumor, lymph nodes and metastasis with progression going from Stage I to Stage IV.

TNM: Stage One (First Stage)

In the earliest stage of Mesothelioma, stage I, the malignant Mesothelioma cells start to grow and multiply only one layer of the pleura. The pleura is the membrane that encloses the lungs and lines the wall of the chest cavity. However, there are some instances wherein the pericardium (membrane that covers the heart) and diaphragm cover are already affected. In this case, the cancer patient is still in stage I Mesothelioma cancer.

TNM: Stage Two

In the second stage, the two layers of the pleura are already affected by Mesothelioma. Take note, however, that in this stage, only one side of the body is affected. Normally, the pleura produces only small amount of lubricating fluid that allows easy expanding and contracting of the lungs. The excess fluid is absorbed by the blood and the lymph vessels so there's a balance between the amount of fluid produced and removed.

During the second stage of Mesothelioma, fluid starts to build up between the membrane of the lungs and the membrane of the chest wall, resulting to pleural effusion. The increase in the volume of fluid produced causes shortness of breath and chest pain. Other Mesothelioma cancer patients experience dry and persistent cough. Diagnosis of the pleural effusion is achieved through a chest x-ray.

TNM: Stage Three

Stage III Mesothelioma means that the malignant cells have already spread to the chest wall, esophagus and the lymph nodes on one part of the chest. The patient may suffer severe pain near the parts affected. When not treated immediately or when the Mesothelioma patient doesn't respond well to medication, the cancer may advance to the fourth stage.

TNM: Stage Four (Last Stage)

The fourth and final stage Mesothelioma is formidable since at this stage the Mesothelioma cells have penetrated into the bloodstream and other organs in the body like the liver, the bones and the brain. The lymph nodes on the other side of the chest may also be affected by Mesothelioma in stage IV.

Brighan System

CT of chest in patient with left sided Mesothelioma

Photo: CT scan of the chest in a patient with left sided mesothelioma, courtesy of Dr Frank Gaillard.

Brighan staging system, on the other hand, determines whether the Mesothelioma can be surgically removed or not and whether the lymph nodes are affected or not.

Brighan: Stage One

In stage I Mesothelioma, the lymph nodes are not yet affected and the patient can still recover through surgery.

Brighan: Stage Two

In stage II, surgery can still be executed but some lymph nodes have already been infiltrated by the cancer cells.

Brighan: Stage Three

In stage III, the heart and chest wall are already affected; thus, surgery is no longer advisable. The lymph nodes in this stage, however, may or may not be affected.

Brighan: Stage Four

In the final stage, stage IV Mesothelioma, cancer cells have already gone to the bloodstream and other parts of the body like the heart, brain, bone and liver. In most cases, a patient who has reached stage IV Mesothelioma only has four to twenty-four months to live.

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About The Author

David Arnold Livingston is a believer in gaining knowledge around Health issues.