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Stages of mesothelioma
Once you receive a diagnosis of malignant
mesothelioma, more tests will be done to determine whether cancer
cells have spread to other parts of the body. This is called "staging".
Your doctor will need to know the stage of the cancer in order to
plan treatment.
Staging is the process by which doctors judge how dangerous a cancer
is in a patient. When staging a cancer, doctors investigate where
the cancer is located, the size of the cancerous tumor, whether
the cancer has spread to other body parts, and if the cancer is
affecting other bodily functions. By running a series of diagnostic
tests, including tomography
and radiographic
imaging, doctors ascertain the information they need to plan
an effective treatment and judge the patient’s prognosis.
It is important that doctors have a common system for staging
cancer so they can easily exchange information about patients. Although
there are many different kinds of cancer, the TNM system, developed
by the American Joint Committee on Cancer (AJCC) is the system used
for most varieties of cancer. (Cancers of the spinal cord or brain,
as well as lymphoma, do not warrant use of the TNM system). When
using the TNM system, doctors assign a numeric value to a “T”,
“N”, and “M” category.
The “T” category is used to classify the original
tumor. Doctors assign a numerical value between 0 and 4 to the tumor,
with 4 indicating a large tumor that has grown deep into adjacent
structures. The “T” value of the tumor can also be an
“Tx” meaning the tumor can’t be measured, or a
“Tis,” which indicates the tumor is in situ (the tumor
has not grown into nearby tissues).
The “N” category measures if, and to what extent,
the cancer has spread to neighboring lymph nodes. Like the “T”
category, the “N” category is assigned a value of 0-4,
with the higher “N” values indicating a larger area
of affected lymph nodes. A “Nx” value means the nearby
lymph nodes cannot be evaluated.
The “M” category is used to tell whether the cancer
has generated any distant metastases. Distant metastases are areas
far from the site of the tumor that show signs of cancerous cells.
Usually, the presence of distant metastasis indicates the cancer
has entered the bloodstream. The “M” category only has
three possible values: “Mx” (metastasis can’t
be evaluated), “0” (no distant metastases) and “1”
(metastasis has occurred).
When all three TNM values have been found, doctors then assign
the cancer a stage value of 0-IV. (Some stages are subdivided into
categories like IIIa or IIIb as well.) Once the stage is determined,
a doctor can give a prognosis and decide on the most effective treatment.
The standard for staging mesothelioma is as follows:
Localized malignant mesothelioma
Stage I: The cancer is located in the lining of the chest cavity
near the lung and heart, or in the diaphragm or the lung.
Advanced malignant mesothelioma
Stage II: The cancer has spread beyond the lining of the chest
to lymph nodes in the chest.
Stage III: The cancer has spread into the chest wall, center of
the chest, heart, through the diaphragm, or abdominal lining, and
in some cases, into nearby lymph nodes.
Stage IV: The cancer has spread to distant organs or tissues.
Recurrent malignant mesothelioma
Recurrent disease means that the cancer has come back after it
has been treated. It may come back in the lining of the chest or
abdomen or in another part of the body.
The difference between metastatic cancer
and advanced cancer.
Three types
of mesothelioma – epithelioid, sarcomatoid and biphasic
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