After diagnosis, it is important to determine what stage the cancer is already in. Mesothelioma is staged from I - IV, so the lower the number, the better the prognosis. Pleural Mesothelioma, or Malignant Pleural Mesothelioma (MPM) is the most common type, and is staged according to the following factors:
The American Joint Committee on Cancer (AJCC) also assigns a clinical stage to Pleural Mesothelioma. As of 2018, the following guidelines are utilized:
| AJCC Stage | Stage grouping | Stage description* |
| IA | T1 N0 M0 | Mesothelioma is in the pleura lining the chest wall on one side of the chest. It may or may not also affect the pleura lining the diaphragm (the thin breathing muscle below the lungs), the mediastinum (the space between the lungs), or the pleura covering the lung (T1). It has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
| IB | T2 N0 M0 | Mesothelioma is in the pleura lining the chest wall on one side of the chest, as well as in the pleura coating the diaphragm, the mediastinum, and the lung. It also has grown into the diaphragm or the lung itself (T2). It has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). |
| OR | ||
| T3 N0 M0 | Mesothelioma has grown into nearby structures but may still possibly be removed (resected) with surgery (T3). The tumor is in the pleura lining the chest wall on one side of the chest, as well as the pleura coating the lung, the diaphragm, and the mediastinum on the same side. It also has grown into at least 1 of the following:The first layer of the chest wall (called the endothoracic fascia)The fatty tissue in the mediastinumA single place in the deeper layers of the chest wallThe surface of the pericardium (outer covering layer of the heart)The cancer has not spread to nearby lymph nodes (N0) or to distant parts of the body (M0). | |
| II | T1 or T2 N1 M0 | Mesothelioma is in the pleura lining the chest wall on one side of the chest (T1), and it may have grown into the diaphragm or the lung itself (T2). The cancer has spread to nearby lymph nodes on the same side of the body as the main tumor (N1). It has not spread to distant parts of the body (M0). |
| IIIA | Â T3 N1 M0 | Mesothelioma has grown into nearby structures but may still possibly be removed (resected) with surgery (T3). The tumor is in the pleura lining the chest wall on one side of the chest, as well as the pleura coating the lung, the diaphragm, and the mediastinum on the same side. It also has grown into at least 1 of the following:The first layer of the chest wall (endothoracic fascia)The fatty tissue between the lungs (in the mediastinum)A single place in the deeper layers of the chest wallThe surface of the pericardium (outer covering of the heart)The cancer has spread to nearby lymph nodes on the same side of the body as the main tumor (N1). It has not spread to distant parts of the body (M0). |
| IIIB | T1-T3 N2 M0 | Mesothelioma may or may not have grown into nearby structures, and it may still possibly be removed (resected) with surgery (T1 to T3). The cancer has spread to nearby lymph nodes on the other side of the body, or to lymph nodes above the collarbone (supraclavicular lymph nodes) on either side (N2). It has not spread to distant parts of the body (M0). |
| OR | ||
| Â Â T4 Any N M0 | Mesothelioma has grown too far to be removed completely with surgery (T4). The tumor is in the pleura lining the chest wall on one side of the chest, as well as the pleura coating the lung, diaphragm, and mediastinum on the same side. The tumor also has grown into at least 1 of the following:More than 1 place in the deeper layers of the chest wall, including the muscle or ribsThrough the diaphragm and into the peritoneum (the lining around the abdomen)Any organ in the mediastinum (esophagus, trachea, thymus, or blood vessels)The spineAcross to the pleura on the other side of the chestThrough the heart lining (pericardium) or into the heart itselfThe cancer may or may not have spread to nearby lymph nodes (any N). It has not spread to distant parts of the body (M0). | |
| Â IV | Any T Any N M1 | Mesothelioma may or may not have grown into nearby structures (any T). It may or may not have spread to nearby lymph nodes (any N). It has spread to distant organs, like the bones, the liver, the lung or pleura on the other side of the body, or the peritoneum (the lining of the abdomen) (M1). |
*the following categories may also be used:
TX: Main tumor cannot be assessed due to insufficient information
T0: No evidence of a primary tumor
NX: Nearby Lymph nodes cannot be assessed due to lack of information
A resectable cancer is cancer that can be removed through surgical means. On the other hand, an unresectable cancer cannot be removed through surgery without risk of severe harm or death.
In general, mesothelioma from stage I up to stage II may be resectable. But this all depends on case to case factors, such as the size of tumor, the extent of the spread, the location, the patient’s overall health, and the specific tumor type.
When mesothelioma is deemed unresectable, other treatment options such as radiation or chemotherapy may be employed.
Were You Diagnosed With Mesothelioma?
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