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Pleural Mesothelioma: Stage 1

As is the case with all forms of cancer, pleural mesothelioma goes through distinct stages. Mesothelioma stage 1 is the earliest phase of the disease, when it is at its most treatable.

About Staging

Oncologists use different systems for various kinds of cancer; when it comes to pleural mesothelioma, there are three different systems:

• Butchart System
• TNM
• Brigham System

The Butchart System uses Roman numerals to classify pleural mesothelioma patients according to how far the disease has progressed. The Butchart System is used only for pleural mesothelioma (cancer of the visceral lining of the lungs).

TNM stands for tumor, node and metastasis. This system has the advantage of greater precision when describing the progression of the disease in a patient; within the two of the three broad categories (T and N) are five subcategories, numbered 0-4, that identify the extent of the tumor. Unlike the Butchart System, it is equally applicable for all forms of mesothelioma. For this reason, oncologists increasingly favor the TNM classification method.

The Brigham System is also new, and describes whether or not the lymph nodes are involved and if the tumor can be removed surgically.

Pleural Mesothelioma Stage 1 - The Butchart System

The Butchart Stage I describes a patient whose tumor is confined to either one side of the chest or the other. The tumor may be present on the surface of the lung, the visceral lining (mesothelium) surrounding the heart or the diaphragm, but has not yet affected the inner chest wall. The disease is relatively treatable at this stage, but symptoms are not always apparent or may be mistaken for a different disease.

Pleural Mesothelioma Stage 1 - TNM

The earliest stage of pleural  mesothelioma under the TNM classification system would be T0N0M0. Broken down, this tells the oncologist that the tumor is confined to one location, has not affected the lymph nodes and has not metastasized. If the classification was T1N0M0, it would mean the tumor has grown in size, but has still not affected the lymph nodes nor metastasized to other areas of the body.  A T2 identification would indicate a larger tumor, and so on.

The T0N0M0 stage is a "best case scenario," if the tumor is still relatively small and localized, it is easily removed. There is always a chance that the cancer may return, however.

Pleural Mesothelioma Stage 1 - the Brigham System

In Brigham Stage 1, pleural mesothelioma has not spread to the lymph nodes and can be removed surgically. This does not preclude return of the malignancy, however.

Sources

1. http://www.cancerguide.org/basic.html
2. Dodson, R. and Hammar, S. Asbestos: Risk Assessment, Epidemiology, and Health Effects. Taylor & Francis: Boca Raton. 2006.
3. Galateau-Salle, Francoise. Pathology of Malignant Mesothelioma. Springer-Verlag London Limited: London. 2006.
4. http://www.mc.vanderbilt.edu/root/vumc.php?site=thoracic&doc=3594