Mesothelioma Stages

To diagnose and to determine how far cancerous cells have spread, doctors employ many different staging methods, including the Butchart system, the TNM system, and the Brigham system. These systems determine the most effective course of treatment for the asbestos cancer.

Although there are three types of mesothelioma (pleural, peritoneal, and pericardial), staging has been established for pleural mesothelioma, which is the most commonly occurring form of this cancer.

The Butchart System is based on the degree of major tumor mass. There are four stages in the Butchart system, and it is the oldest and most commonly used system of cancer staging.

Stage I: Mesothelioma is present in the thin, transparent membrane which covers the lungs and lines the inside of the chest walls. The cancer may also be in the diaphragm, or the muscle separating the chest from the abdomen.

Stage II: Mesothelioma has either invaded the chest wall or involves the esophagus, heart, or pleura on both sides. Lymph nodes in the chest may also be infected.

Stage III: The diaphragm into the lining of the abdominal cavity or peritoneum has been penetrated by the mesothelioma. Lymph nodes in the chest are almost always infected, and lymph nodes beyond those in the chest may also be infected.

Stage IV: Mesothelioma has spread through the bloodstream to other organs in the body by a process known as metastasis.

The TNM, or Tumor (T), Lymph Nodes (N) and Metastasis (M) System looks at these three components. Like the Butchart System, it is also divided into four stages.

Stage I: Mesothlioma has infected one of the pleura with a primary tumor, and may have spread to the lung, pericardium or diaphragm on the same side as the infected pleura. Lymph nodes are not yet involved.

Stage II: Mesothelioma has begun to infect nearby lymph nodes on the same side as the primary tumor. It may also have spread into the lung, pericardium or diaphragm on the same side as the infected pleura.

Stage III: Mesothelioma has invaded the chest wall, ribs, heart, esophagus, muscle and other organs in the chest on the same side as the primary tumor. It may have spread to the lymph nodes.

Stage IV: Mesothelioma has spread to the lymph nodes or has infected the pleura or lung on the opposite side of the primary tumor. It may extend into organs in the abdominal region. Metastasis is included in this stage, as the infection is being carried in the blood to other regions of the body.

The most recent system developed for staging mesothelioma is known as the Brigham System. Unlike the other two systems described, the Brigham System stages the disease by how likely surgery would be able to remove the primary tumor. This system also involves the lymph nodes and is also categorized into four stages.

Stage I: Mesothelioma is easily removable and there is no lymph node involvement.

Stage II: Mesothelioma is still removable, yet lymph node infection has begun to occur.

Stage III: Mesothelioma infection is extending into the chest wall, heart, or through the diaphragm or peritoneum, and is not removable. There may or may not be lymph node involvement throughout the body.

Stage IV: Mesothelioma has spread throughout the body through metastasis, and is not removable.

Last modified: April 29, 2009