When the diagnosis is obtained by biopsy, the physician would then determine the mesothelioma stages and severity) of the disease. More specialized tests are required to conduct staging in cancer patients. It is important that the stage or severity of the cancer is determined to identify which treatment options are suitable for the patient.
Generally speaking, localized mesothelioma (Stage 1) is the first stage of the disease. This stage is characterized by the presence of cancer cells in one area of the body only, where the disease originated. Advanced mesothelioma (Stages 2, 3 4), on the other hand is a metastatic cancer. This means that the cancer cells have spread to other areas of the body from where it began. But stages are more detailed in the Stage 1 to 4 discussions.
Staging systems used for the different types of mesothelioma cancer. These three systems are called the Butchart System, TNM System and the Brigham System. The Butchart System is the oldest system of staging and it mainly considers the extent of primary tumor mass. The TNM (which stands for Tumor, Lymph Nodes, Metastasis) system is the most recent form of staging. This method considers tumor in mass and spread lymph node involvement and metastasis. The last system, the Brigham system, categorize the stages of mesothelioma according to resectability and lymph node involvement. Resectability means the ability of the doctor to remove the cancer cells.
The following is a discussion of the severity of cancer in the body, enumerating the areas where the cancer cells have spread.
Stage 1 of mesothelioma is characterized by one layer of the pleura affected by cancer cells. Though it may have grown into the heart and diaphragm cover. Stage 2 affects the lymph nodes already. At this stage the cancer may have started to spread to the lung, pericardium or diaphragm. Mesothelioma has already spread to the chest wall, food pipe (esophagus) or even the lymph nodes during Stage 3. The advanced stage, Stage 4, happens when mesothelioma has already gone to the bloodstream and other organs in the body including the liver, brain, bone or to the lymph nodes.
Based on the findings from systems of staging, the doctor can now determine whether mesothelioma can be removed by surgery and if lymph nodes are involved or not. In this stage, Stage 1, lymph nodes are not affected and mesothelioma can be removed with surgery. Lymph nodes are starting to contain cancer cells in Stage 2, but mesothelioma can be removed with surgery. Lymph nodes in stage 3 may or may not contain cancer cells and mesothelioma cannot be removed with surgery because the heart and chest wall have been affected. In Stage 4, surgery is not an option anymore because cancer cells have spread in the bloodstream, the heart, the brain, the bone and the liver.