> Pleural Mesothelioma > Mesothelioma Metastasis > Mesothelioma Staging > Stage 4

Pleural Mesothelioma: Stage 4

By stage 4, any kind of cancer is commonly terminal. This is particularly true of pleural mesothelioma stage 4, by which point the disease has progressed far beyond the visceral lining and has spread into the lymph nodes and metastasized to distant parts of the body, such as the neck and brain. By this point, any life-saving or life-extending treatment is usually ineffective; all that can be offered is palliative treatments, including surgical resection (removal) of the affected tissues and drug therapy that can ease the pain of the disease and make the patient's remaining weeks more comfortable.

There are three different staging systems currently in use by oncologists. The oldest system, Butchart, is useful for cancer in general, but is less precise than the TNM system, which give oncologists a much more detailed picture of the disease in a given patient. Brigham was developed for use in diagnosing mesothelioma, but may in fact be the least useful of the three, since it primarily describes mesothelioma in its later stages, when most treatment is ineffective.

Butchart Stage IV

Pleural mesothelioma stage IV under Butchart has metastasized throughout the patient's body. Outlaw cells have broken away from the primary tumor and traveled to distant organs via the bloodstream and lymphatic system.

Brigham Stage 4

Pleural mesothelioma stage 4 under Brigham is usually completely inoperable. At this point, the tumor is simply too large and has spread too far. Malignant cells may be found almost everywhere in the body, and tumors have penetrated far into various organs where surgery would be ineffective.

TNM

Stage 4 pleural mesothelioma under the TNM system may be found on one side of the body or both. In either case however, the lymph nodes are completely involved and the cancer has spread to distant regions of the body, including the neck. This is where the "M" is involved. TNM stands for "Tumor," "Nodes" and "Metastasis."

The first two categories each have five sub-categories, numbered from 0-4 and describing the size of the tumor and the extent to which the lymph nodes are involved. The "M" category has only two however, since a cancer has either metastasized or it hasn't. Therefore, pleural mesothelioma stage 4 under TNM would be T3-4, N1-4, M1.

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.