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Pleural Mesothelioma: Stage 3

Surrounding the internal organs is a layer of fatty tissue called the visceral lining, or mesothelium. This is a lubricative and protective layer between the surface of the inner torso and the internal organs. When cancer develops in this layer, it is called mesothelioma and when it affects the lungs it is known as pleural mesothelioma.

Oncologists have developed three different staging systems for describing the progression of the disease. Two of these, the Butchartand Brigham systems describe these stages in general terms, but are of limited utility in planning a course of treatment for a given patient for this very reason. TNM (Tumor, Nodes, Metastasis) is more precise. Increasingly, TNM is the preferred classification method among oncologists.

Generally, by the time pleural mesothelioma has reached stage 3, it is inoperable – though some treatments that can prolong the patient's survival may be possible. The disease is usually beyond surgery however and usually requires chemotherapy or radiation treatments. Unfortunately, due to the nature of pleural mesothelioma – including latency period and symptoms that may masquerade as different respiratory diseases – this kind of cancer is not usually diagnosed until stage 3 or 4.

Butchart Stage III

Under Butchart, pleural mesothelioma stage III has spread from its origin affecting other regions in the body. Involvement of the lymph nodes is almost certain at this point.

Brigham Stage 3

Pleural mesothelioma stage 3 under Brigham is usually considered inoperable. By this point, the cancer has spread to the entire chest cavity; malignant cells have taken root in locations in which surgeons cannot safely operate, and too many tissues have been affected. In addition, the cancer has spread to the lymph nodes.

TNM

Under two of the three main categories, TNM has 10 subcategories. These are T0-4, which describes the size of the tumor, and N0-4, which tells the oncologist whether or not the lymph nodes are involved. The M category, or metastasis, has only two sub-categories, which describes whether or not the cancer has spread to other areas (0 or 1).

Pleural mesothelioma stage 3 under TNM would be T1-4, N1-4, M0, since the cancer definitely affects the lymph nodes but has not yet spread to other areas or organs of the body. It is however inoperable and any treatment options would likely involve chemotherapy and radiation treatments.

Sources

1. http://www.mc.vanderbilt.edu/root/vumc.php?site=thoracic&doc=3594
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.