It is a way by which first doctors identifies the seriousness of the disease, and how far is has spread, and they also want to know the depth in roots. How much strong are the roots? And after examining, the malignant mesothelioma is ranked, from stage 1 up till stage 4. Stage is the starting of the disease while stage four is the most critical stage.
After examining the body, it is marked with a stage, that doesn’t change. Such as if in the first stage mesothelioma tumor expands to other parts of the body; it will still remain stage 1 with metastasis; and accordingly, if in the after stages, the size of mesothelioma tumor shrinks in capacity or takes a u-turn to remission, the stage will still not change. But treatment will vary according to the patient’s internal circumstances. Due to the uniqueness in the disease of mesothelioma, a proper staging section is only for the pleural mesothelioma, which is most known type of this malignant mesothelioma and threats the lining of chest cavity and lungs. The initial staging can be named after the imaging scans, which gives caner expert with a pictorial aid of the stage of the tumor in the patient’s body. But it the experts are not able to determine what is in the imaging scans or the disease isn’t localized then a physician’s help can he taken to undergo biopsy to state, are the malignant cells have metastasized to the blood or lymph nodes through lab tests.
There are four stages of mesothelioma which have minute difference within each system but they are normally categorized
The TNM category
This category is mostly used to tell us the spread and growth rate of pleural mesothelioma is the American Joint Committee on cancer (AJCC), TNM staging system. This system is structured on 3 main categories.
- Tis used for the tumor. It tells us about how much area has it covered
- N tells us about the expanding of cancer to the neighboring lymph These are tiny bean shaped nodes, reserve of immune system cells to which cancer attacks first.
- M is used to inform us whether cancer has attack (metastasized) to the organs of the body.
TX: this tumor can’t be looked into for some reason.
T0: There is no proof for the root tumor but the cancer exists somewhere else
T1: On one side of the chest, mesothelioma is in the pleura lining of the chest wall. There are un-certain chances that it can or can’t disturb the pleural lining of the diaphragm (the weak breathing muscle under the lungs) or the mediastinum (the area between the lungs). This can also have reached till pleuron that is protecting the lungs.
T2: On one side of the chest, mesothelioma is in the pleura lining of the chest wall. Mesothelioma is also in the pleura, covering the diaphragm, the lungs and mediastinum. Mesothelioma can also transform into minimum one from the two
- The lung itself
- The diaphragm
T3: Mesothelioma may have increase in the size but it is still possible to extract it with the help of surgery. The tumor lies in the pleura lining the chest wall on one side of the chest; pleura will be covering the lungs, the mediastinum and the diaphragm as well. Mesothelioma can also transform into one of the mentioned.
- The fatty tissue in the mediastinum
- The initial layer of the chest wall which is known as endothoracic fascia.
- The surface of the pericardium
- The only 1 place in the deeper layers of the chest wall.
T4: The mesothelioma has so strong roots that to evict it from the help of surgery will be a difficult thing. The tumor is now transformed into the pleura lining the chest wall on one side of the chest; pleura will also be covering the diaphragm, lung, mediastinum on the same side as well. This cancer will also grow into at-least one of the mentioned.
- The spine
- Any organ in the mediastinum
- Across to the pleura on the other side of the chest
- Through the diaphragm and into the peritoneum
- Into the heart itself or through the heart lining
- More than one place in the deeper layer of the best wall, Including the ribs or muscles
NX: The closest lymph nodes that can’t be assessed
N0: No increase to the closest lymph nodes.
N1: Increase to lymph nodes within or/and surrounding the place where the bronchus go to the lung is known as the bronchial lymph node or hilar.
N2: Increase to the remaining lymph node on the same side as the primary tumor for example the mediastinal lymph node and subcarinal. Also count increase to the lymph nodes in the area just back the breastbone and also those close to the diaphragm.
N3: Increase to lymph nodes near the collarbone on ay side or/and increase to the hilar or the mediastinal lymph nodes on the side against the primary tumor.
M0: No increase to the far areas or organs
M1: The cancer has increase to the far away sites. This can be a far to other organs or lymph nodes
Category grouping for pleural mesothelioma
When this information is process together, the T, N and M groups are then combined to form a stage I, II, III and IV. The patients with the initial stages have more chances to survive from this cancer
M0, N0 and T1. Mesothelioma has expanded into the pleura lining the chest wall on one side of the chest. It may or may not inflect damage to the pleura lining the diaphragm or the mediastinum. It can also have increased to the pleura coating the lung (T1). It has not increased to the lymph nodes (N0) or to far way places (M0).
T2, N0, M0. Mesothelioma has expanded into the pleura lining the chest wall on one side of the chest. Now it is present in the pleura covering the diaphragm, the lungs and mediastinum. The caner has also expanded into the lung itself (T2) or into the diaphragm. It has not been exported to the far away area (M0) or to the lymph nodes (N0).
Among two, it can be one.
T1 or T2, N1 or N2, M0: Mesothelioma gas grown into the pleura lining the chest on one side, it may or may not has expanded into the pleura lining the diaphragm, the mediastinum or the lung. It can also expand into the muscles of the lung itself or diaphragm (T2 or T1). It has increased to the lymph nodes in the chest on the same side as the primary tumor (N1 or N2). It has not gone to the faraway places (M0).
T3, N0 to N2, M0: Mesothelioma resides in the pleura lining the chest on one side and has expanded into the initial layer of the chest wall, a single place in the deeper layer of the chest wall, the fatty tissue in the mediastinum or the outside coating layer of the heart (T3). It may or may not have gone to lymph node in the chest on the same side as the tumor but it has not gone till lymph nodes close to the collarbone or on the against side of the chest (N0, N1 or N2). It has not gone till the faraway sides (M0).
Can be any one from the mentioned
Any T, any N, and M1: The mesothelioma may or may not have expanded into the close tissues (any T). It also may or may not have gone to the lymph nodes (any N). But it has gone to the faraway place (M1).
Any T, N3, M0. The cancer may or may not have expanded into the close tissues (any T). It has gone to the lymph nodes close to the collarbone on any side or/and to hilar or mediastinal lymph nodes on the side against the primary tumor (N3). It has not gone to the faraway place (M0)
Any N, M0 and T4: The mesothelioma has expanded into the pleura lining the chest on one place and has expanded into more than one side in the deeper layer of the chest wall, into the peritoneum via the diaphragm into any organ in the mediastinum, into the spine, crossing the pleura on the other side of the chest, and/or into the heart itself or via the heart lining (T4). It may or may not have gone to lymph nodes (any N). It also has not gone to the faraway places (M0).