A Guide to the Stages of Mesothelioma.

Overview of Mesothelioma Stages

Mesothelioma treatment options depend on the stage of mesothelioma. Pleural mesothelioma uses three different staging systems, with each one measuring somewhat different variables. Peritoneal mesothelioma is not staged.

Staging describes the extent of the cancer, established by the primary tumor and its spread throughout the body. It helps medical professionals estimate prognosis, plan treatment, and discover clinical trials the patient can qualify for.

Staging is founded on a knowledge of the cancer's progression from the first tumor, to the spread into surrounding organs and tissues, to metastasis. Staging systems have developed over time and continually evolve as scientists discover more about cancer. The TNM (primary tumor, regional lymph nodes, distant metastasis) is the most commonly used staging system for mesothelioma.

Some factors of most staging systems include the location of the first tumor; size and amount of tumors; cell type and tumor grade; lymph node involvement; and metastasis.

Many cancer registries use summary staging, which is used for all kinds of cancer. This system groups cancer into five categories:

• In situ, where cancer is only present in the layer of cells in which it started
• Localized, where cancer is limited to the organ where it started, with no sign of spread
• Regional, where cancer has spread from the initial area to nearby organs or lymph nodes
• Distant, where cancer has spread from the initial area to distant organs or lymph nodes
• Unknown, where the stage cannot be indicated because of a lack of sufficient information

Several types of testing can help physicians determine the stage of mesothelioma and devise a plan for treatment. Physical exams allow the physician to examine the patient by feeling, listening and looking for abnormalities. Imaging techniques, such as CT scans, x-rays and MRIs, can reveal the size and location of the tumor and whether the cancer has reached other parts of the body. Laboratory tests of urine, blood, fluid and tissue can also offer information about the cancer. In addition, pathology reports of tissue samples can provide information about tumor size, expansion into nearby structures, cell type and grade of the tumor. Surgical reports can also provide information about the appearance and size of tumors, lymph nodes and adjacent organs.

A doctor should provide the patient with the staging information so possible treatment methods can be evaluated. The stage of the cancer, age, overall health and the patient's personal wishes can determine which treatments should be used.

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