Staging
Extent of Tumor Development for Mesothelioma Lung Cancer & A
Look into Staging Systems
(July 28th, 2008)
 Staging
Mesothelioma cancer is finding out the extent of a patient's Cancer
and how far the primary tumor has spread in the body. Staging is
conducted to help identify any clinical trials the patient can participate
in, as well as estimate prognosis & plan treatment options.
There are 3 main staging systems, detailed below. They are the Brigham
System, Butchart System and the TNM system. All 3 of these systems
have the following in common:
- They detect the primary location of the tumor
- They determine the size & number of tumors that have developed
- They determine whether cancer has spread to nearby lymph nodes
- They determine the type of cells involved & grade of the tumor
- They look for development of Metastatic cancer
Here is an indepth look at each Cancer staging system.
a) Brigham System - Mesothelioma Staging
Systems
The Brigham system is used to determine the stage of development
of malignant tumors in the lungs. The Brigham system is powerful
in that not only does it measure the extent of tumor growth, it
also indicates whether reductive surgery is a treatment option for
the patient. The Brigham system is the least used mesothelioma cancer
staging system because by the time mesothelioma is diagnosed, the
tumor has advanced into very high stages and is usually not curable.
 The
Brigham system is made up of 4 distinguished stages each of which
consider 2 variables; 1) capability of surgery to remove mass tumor
from the lungs and 2) presence of cancer in the lymph nodes. The
4 stages of Brigham system are detailed as follows:
i) Stage 1 - Any malignant tumors can be extracted
or removed using surgery and there is no transfer or growth of tumors
in the nearby lymph nodes. Tumors are confined within capsule of
the parietal pleura, lungs, pericardium, diaphragm and chest walls.
ii) Stage 2 - Tumor masses that have developed
in the pleura or the lungs can be removed with surgery, but cancer
has spread to nearby lymph nodes.
iii) Stage 3 - Tumor masses can no longer
be removed using surgery because Cancer has spread to nearby organs
such as diaphragm into the lining of the abdomen, heart and chest
wall.
iv) Stage 4 - Tumor masses have metastasized
(spread everywhere) and are carried into the nearby organs through
the bloodstream. Areas where they can center include the brain,
bones and other important organs of the body.
 b)
Butchart System - Mesothelioma Staging Systems
The Butchart system is the oldest & most commonly used Cancer
staging system put in place to diagnose malignant mesothelioma.
The Butchart system measures the proximity and size of tumor masses
residing in the lungs and is divided into 4 stages.
i) Stage 1 - Malignant tumors have penetrated into the right or
left side of the Pleural lining (chest cavity) and can be seen in
the diaphragm.
ii) Stage 2 - Malignant tumors are present in the Pleura on both
sides of the lungs and could possibly have been transported to the
heart, stomach & the esophagus. Furthermore, tumor masses may
have moved to the lymph nodes through the bloodstream.
iii) Stage 3 - Malignant mesothelioma has located in the Peritoneum
(abdominal cavity) and lymph nodes around the chest.
iv) Stage 4 - Malignant mesothelioma has reached other organs of
the body and is flowing through the bloodstream.
c) TNM System - Mesothelioma Staging Systems
The TNM is the newest Cancer staging system in place and stands
for Tumor, Lymph Nodes & metastasis. It takes into account how
far the cancer has spread (metastasis) and whether it has affected
the Lymph nodes. It is also divided into 4 stages.
i) Stage 1 - Malignant tumors are present in the right or left
Pleura, and might have spread to the lungs, the pericardium (double
walled sac enclosing the heart) or the diaphragm on the side. Malignant
tumors have usually not spread to the lymph nodes in Stage 1.
ii) Stage 2 - Malignant tumors have translocated from one side
of the chest cavity to lymph nodes near the lungs on the same side
where the malignant tumors reside. Cancer has also spread to the
diaphragm, pericardium and the the side of the lungs where the primary
tumor lives.
iii) Stage 3 - Malignant tumors have moved into the chest linings,
the heart, muscles, ribs & the esophagus as well as other important
organs within the body. The cancer may or may not have spread to
the lymph nodes.
iv) Stage 4 - Malignant mesothelioma has spread to the pleura and
lymph nodes on the opposite sides of where the cancer is located.
It may have also reached the chest cavities & lungs on both
sides.
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