Mesothelioma is a rare and aggressive form of cancer caused by exposure to asbestos. Like other cancers, a comprehensive mesothelioma diagnosis will include determining what stage the disease is in. Staging is an important tool, and understanding what the different stages mean can help patients know what to expect.
Malignant pleural mesothelioma is the most common form of mesothelioma and infects the lining of the lungs and chest cavity, also known as the pleura. When asbestos fibers are inhaled or ingested, they become lodged in the pleura and spend decades damaging the surrounding tissue. Over time, mesothelioma tumors begin to form on the scar tissue and eventually spread to other areas of the body. Early diagnosis is key, as it can determine the aggressiveness of the disease, but getting a diagnosis in early stages can be difficult.
Characteristics of Each Stage
Patients in stage 1 are in the earliest phase of the disease, when tumors are still localized to the pleura. Many patients do not experience any symptoms at this stage, so they may not be aware that something is wrong. When tumors begin to metastasize to the surrounding tissue, which can include one of the lungs or a lymph node, the patient moves into stage 2.
Symptoms in stage 2 are usually still fairly mild and might include persistent cough, chest pain, difficulty swallowing, or shortness of breath, which can be mistaken for other conditions. Patients diagnosed in stages 1 or 2 are typically still eligible for more aggressive treatment options, including surgery.
Most patients begin to experience more severe symptoms, such as fatigue, muscle weakness, loss of appetite, fluid buildup in the chest or abdomen, and sudden weight loss, when they reach stage 3. At this stage, the tumors have spread further, infecting the lungs, chest wall, and into the abdomen. Surgery is no longer an option at stage 3, as the tumors are too widely spread to be successfully removed.
Patients reach stage 4, the final stage of the disease’s progression, when the tumors have reached distant areas, such as the neck, liver, brain, and bones.
Mesothelioma Staging Systems
There are three different staging systems for pleural mesothelioma, all of which follow the same general pattern but with some unique qualifiers. The Butchart System is the original mesothelioma staging system; it is not widely used anymore, but provided a useful base for other staging systems. It does not take into account the size of the tumor or amount of cancer in the body, rather focusing exclusively on tumor location.
Similarly, a staging system developed at Brigham and Women’s Hospital in the 1990s checks for the viability of surgery by establishing tumor location. Lymph node involvement is a key indicator between stages 1 and 2 in the Brigham system.
The most widely accepted staging system for mesothelioma is the tumor, nodes, and metastases (TNM) system, which was first developed in the 1940s for other cancer types and was adapted for pleural mesothelioma in the 1980s. In addition to tumor location and lymph node involvement, the TNM system measures tumor size and extent to determine the stage of the disease. The TNM system was recently updated to divide stages 1 and 3 into two subsets. Having six stages instead of four allows oncologists to make more specific treatment decisions.
Peritoneal mesothelioma, which infects the lining of the abdomen rather than the chest, has its own staging system. The peritoneal cancer index (PCI) classifies patients based on their tumor size, with a higher score indicating more progression.
Pericardial mesothelioma and testicular mesothelioma, which infect the linings of the heart and testes, respectively, are exceedingly rare and do not have their own staging systems.
Philadelphia Mesothelioma Lawyers at Shein Law Find Justice for Mesothelioma Patients
If you have been diagnosed with mesothelioma, one of our Philadelphia mesothelioma lawyers at Shein Law can offer legal assistance. Our knowledgeable, experienced lawyers will work tirelessly to hold those responsible for your asbestos exposure. Located in Philadelphia and Pennsauken, New Jersey, we serve clients in Pennsylvania and New Jersey. Call 877-743-4652 or contact us online to schedule an initial consultation.