Stages of Mesothelioma - The stage of mesothelioma affects the diagnosis, prognosis, and treatment options
E-Mail Article
Share ArticleOnce a patient has been diagnosed with mesothelioma, the next step for the oncologist (cancer specialist) is to determine how far the disease has progressed. The point to which the cancer has spread is called the stage; the process used in determining the extent of the disease is known as staging.
Determining the stage of a patient's mesothelioma is important in planning an effective course of mesothelioma treatment. If the mesothelioma is localized, it is confined to its point of origin, the membrane surfaces of the mesothelium. When the cancer spreads to the lungs, chest or abdomen wall, lymphatic system or other parts of the body, it is considered advanced.
The course of treatment will depend on the location of the malignancy, how far it has spread and to which organs and/or tissues, and the age and general health of the patient. Based on this information, the oncologist will recommend surgery to remove the malignancy, radiation therapy or chemotherapy to kill off the affected tissues, or a combination of any two or possibly all three of these procedures.
As with any disease, the prognosis for survival is significantly improved when the condition is diagnosed in its earliest stages. Although cancer will affect 25 percent of the U.S. population at some point, mesothelioma is relatively rare; there is limited information on survival rates at various stages of the disease.
What Are The Stages?
Currently, oncologists use a four-stage classification system in staging cases of mesothelioma. The first stage is localized; the other three are considered advanced stages.
In Stage I, the disease has not spread beyond the confines of the mesothelium (membrane covering) of the chest wall; it may also be found on the lung, diaphragm and/or the sac surrounding the heart. At this point, mesothelioma is relatively easy to treat by surgical removal. In addition to the diseased tissue, the oncologist will remove some of the surrounding healthy tissues as well.
If the disease is still localized, but found in more than one location, the oncologist may perform a pleurectomy, which is the removal of the outer membrane surrounding the lung. In addition, radiation therapy may be used to relieve symptoms of the disease.
Other treatment options in the early stage may include direct injection of anti-cancer medications following surgical removal of cancerous tissue.
By Stage II, the malignancy has spread beyond the mesothelium of the chest wall, and has moved into the lung tissue and/or diaphram, but not into the lymph nodes.
Stage III mesothelioma is characterized by spread into the fatty part of the mediastinum and/or into the lymph nodes within the thorax. Malignancy may also have spread beyond the diaphragm and into the lining of the abdominal wall, which is known as the peritoneum.
By the time mesothelioma has reached Stage IV, it has spread to organs and tissues far from the respiratory system and/or invades critical structures such as the heart, spine and esophagus.
What Are The Treatment Options?
In these advanced stages, treatment of mesothelioma must necessarily be more aggressive. In addition to the treatments used in Stage I, pleurodesis may be performed in order to stop the accumulation of fluids in the chest. Pleurodesis is a painful process that involves the deliberate irritation of certain membranes in and around the lung by administering certain chemical substances; patients are typically sedated before pleurodesis is performed.
If necessary, the oncologist may surgically remove part of the lung and diaphragm in addition to part of the membrane surrounding the heart. This procedure is called extrapleural pneumonectomy.
Radiation and chemotherapy are also used in treating advanced mesothelioma, either separately or in combination. With chemotherapy, drugs are applied directly to the cancerous areas in order to shrink and ultimately destroy them as they prevent the buildup of fluids within the chest and/or abdominal cavity.
If after successful treatment a cancer returns, it is considered recurrent. Recurrent malignant mesothelioma can occur in any part of the body, but most commonly, it recurs in the chest or abdomen.
What About Experimental Treatments?
Those with malignant mesothelioma may be candidates for experimental treatments, more accurately known as clinical trials. New types of chemotherapy and surgical techniques are researched on an ongoing basis; radiation techniques are constantly refined and updated.
One promising new area of research involves the use of biologic treatments. Biologics include medications that are developed at the cellular and even genetic level.
Medical researchers have long been seeking a way to use the body's own defenses in fighting cancer. The problem lies in the way those defenses - known collectively as the immune system - operate. Antibodies, which are the body's last line of defense, are specific to a certain pathogen, or invader. Antibodies recognize a virus such as malaria as a foreign body - a cell that has invaded from outside the body.
Since cancer cells are simply the body's own cells that have begun to grow and multiply in an uncontrolled manner, antibodies do not recognize them as "foreign cells." What researchers are seeking is a way to trick antibodies into attacking cancerous cells without destroying healthy tissue as well.
Currently, this research is focusing on the alteration of certain elements of the immune system at the cellular, genetic and molecular level. One line of research that shows promise involves the use of vectors, which are genetically modified viruses and bacteria that are used as delivery systems of pathogens that will stimulate the body's immune system and "trick" it into attacking cancer cells.
'Stages of Mesothelioma - The stage of mesothelioma affects the diagnosis, prognosis, and treatment options' Resources:
- National Cancer Institute. "Malignant Mesothelioma (PDQ®): Treatment". Cancer.gov. June 22, 2005.
- National Cancer Institute. "Malignant Mesothelioma (PDQ®): Treatment- Patient Version". Cancer.gov. August 22, 2006.
- Mesotheliomaweb.org. "The Immune System and Immunotherapy.", http://www.mesotheliomaweb.org/immuno.htm
Accessed: 25 May 2007. - National Cancer Institute. "Malignant Mesothelioma (PDQ®): Treatment- Patient Version". Cancer.gov. August 22, 2006.
Free case consultation
If you or a loved one has been diagnosed with mesothelioma or another asbestos-related disease, contact us using the form below to speak with a mesothelioma consultant, free of charge.