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 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 1 to 4 discussions.
Staging systems are used for explaining 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 the primary tumor mass. The TNM (which stands for Tumor, Lymph Nodes, Metastasis) system is the most recent form of staging. This method considers a tumor in mass and if it has spread to lymph node involvement and metastasis. The last system, the Brigham system, categorizes 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 also have grown into the heart and diaphragm cover. Stage 2 affects the lymph nodes already. At this stage, cancer may have started to spread to the lungs, pericardium or diaphragm. Mesothelioma has already spread to the chest wall, food pipe (esophagus) or even the lymph nodes during Stage 3. The most advanced stage, Stage 4, happens when mesothelioma has already gone into 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 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 still 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 into the bloodstream, the heart, the brain, the bones and the liver.
Symptoms in Various Stages of Mesothelioma
Once diagnosed, a doctor would inform the patient about the stage of cancer. With stage 1, it means localized cancer, while 2,3, and 4th stages indicate the extent or spread of the disease. The higher the stage, the more severe would be the symptoms and the poorer the prognosis. It should also be noted that cancer specialists may use another kind of classification for describing the mesothelioma, so they would use a so-called TNM classification. This is where T is the size of the tumor, N would say if cancer has spread to the lymph nodes or not, and M would tell about the spread of cancer to distant sites. However, for the ease of understanding the specialist would inform the patient using the simpler system, which is the average of TNM. Following are the symptoms in the various stages of mesothelioma:
Stage 1- early stage Mesothelioma
Cancer is still confined to the single location, symptoms at this stage may be either absent or mild and can easily be confused with common illnesses. Although very few patients are diagnosed at this stage, however, there are high chances of a cure at this stage. Even if a person is not cured, the prognosis is good with most expected to survive 2-3 years after the diagnosis.
Most people at this stage would have vague kind of symptoms like general malaise, low fever, weakness, and some other local symptoms depending on the location of the tumor, like chest pain, abdominal pain, and shortness of breath.
Stage 2 Mesothelioma
It means that cancer has started to spread to the surrounding areas and symptoms would become more intense. In a small number of cases, curative treatment is still a possibility while one-fourth can expect to be a long-term survivor.
At this stage, the symptom may become noticeable in the majority of cases like a persistent cough, shortness of breath, chest or abdominal pain, weight loss, and fever.
Stage 3 Mesothelioma
Unfortunately, most patients are diagnosed with 3rd stage mesothelioma; it is a stage when cancer has already spread to the lymph nodes and surrounding organs. Though curative therapy is still an option, the success rate is really low, and the focus is on symptomatic relief.
At this stage most would have severe symptoms affecting the normal quality of life, since cancer has started to evade the surrounding organs. There may be severe pain and tightness in the chest, shortness of breath, fever, fatigue, and weight loss. In some patients, symptoms may be similar to those with severe pneumonia.
Stage 4 – The final stage of Mesothelioma
It indicates that disease has spread to other parts of the body. Symptoms are most severe, and treatment is mainly palliative. On average the survival rate is around 12 months. At this stage, the symptoms may occur not only due to disease of local organs but also due to metastasis of other organs as cancer may travel to various organs of the abdominal cavity or even to the brain.
Some of the symptoms of the last and final stage are fever and night sweats, tightness in chest, difficulty in breathing, abdominal pain, fluid accumulation in chest or abdomen, difficulty in swallowing, and coughing with blood.