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Stages of Asbestos Mesothelioma

If your medical team determines that you have mesothelioma, they will then determine the stage, or progression, of your condition by performing one or more of the imaging tests described above. Three different mesothelioma staging systems are used, each of which are described below. (Note: these staging descriptions are those for pleural mesothelioma, as it is the predominant form of this asbestos cancer.)

Butchart System — the oldest and most commonly used system, it is based on tumor size.

  • Stage One: Mesothelioma has affected the right or left side of the chest cavity (pleural lining) and may be seen in the diaphragm.
  • Stage Two: Mesothelioma has been found in the pleura on both sides of the chest cavity and may have spread into the heart, stomach, or esophagus on both sides. Lymph nodes might be also be affected.
  • Stage Three: Mesothelioma has reached the abdominal cavity (peritoneum). Lymph nodes past the chest might be affected.
  • Stage Four: The cancer has spread to other organs and has entered the blood stream.

TNM System — this is a more modern system based on tumor size, metastasis and lymph node involvement.

  • Stage One: Cancer is present in the left or right chest cavity (pleura) and may have spread to the lung, the sac around the heart (pericardium) or the diaphragm on the same side. Lymph nodes are not involved.
  • Stage Two: Mesothelioma has reached from one side of the chest cavity to a lymph node near the lung area on the same side as the cancer. The cancer has metastasized to the diaphragm, pericardium or the lung on the same side as the primary tumor.
  • Stage Three: Mesothelioma has spread to the chest lining, heart, esophagus, muscle, ribs and vital organs within the chest cavity on the same side as the cancer. Lymph nodes may or may not be involved.
  • Stage Four: Mesothelioma has spread to the pleural area and lymph nodes on the opposite side of primary tumor. It may also have spread to the chest cavities or lungs on both sides, or the abdomen.

Brigham System — the most modern of the three staging systems, which considers lymph node involvement and ability to surgically remove the malignancy.

  • Stage One: Mesothelioma tumor is still resectable (able to be surgically removed) and the lymph nodes are not affected.
  • Stage Two: Tumor is still resectable, but the lymph nodes are now affected.
  • Stage Three: Tumor is not resectable and the cancer has spread to the heart, chest wall, abdominal cavity or diaphragm. Lymph nodes may or may not be affected.
  • Stage Four: Tumor is not resectable and has spread throughout the body.