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Mesothelioma Staging Systems - Stage 1

In general terms, stage 1 mesothelioma (a form of asbestos cancer) means the cancer is localized and remains in one small area of the body, and has not spread to other locations. For example, in Stage 1 pleural mesothelioma the cancer is located in just one section of one lung.

Stage I and the Butchart System

The Butchart staging system is the oldest system in place and is commonly used for staging pleural mesothelioma. (However, other forms of mesothelioma do not use this staging system.) The Butchart system categorizes an individual case of mesothelioma based on the size of the primary tumor. The system uses four stages.

In Stage 1 of the Butchart system, either the left or right side of the lung is affected by cancer. Typically, this means that cancer is limited to just one section of the pleural membrane of either lung. Mesothelioma may also be located in the diaphragm as well as in one lung but will still be limited to just one side.

Stage 1 and the TNM System

The TNM staging system is a newer cancer staging system that categorizes cancer based on the size of a tumor, whether or not cancer has spread to lymph nodes, and whether the cancer has metastasized to other locations in the body. While in most cases peritoneal mesothelioma is not staged, if staging is desired this system will be used. The TNM system employs four stages.

In TNM Stage 1, mesothelioma is present in either the left or right pleura (in the case of pleural mesothelioma), and may have metastasized to the lung, the pericardium, or the diaphragm on the same side of the chest. In Stage 1, there is no lymph node involvement, and the cancer has not metastasized to distant body locations.

In the case of peritoneal mesothelioma, the cancer is localized on one side of the abdomen, and has not spread to lymph nodes or metastasized.

Stage 1 and the Brigham System

The Brigham staging system is the most recently-developed of the three systems used to stage malignant mesothelioma. The main focus of the Brigham system is categorizing mesothelioma based on whether the primary tumor can be successfully removed via surgery, and whether mesothelioma has spread to lymph nodes. As with other staging systems, there are four stages in the Brigham system.

In Stage 1 of the Brigham system, mesothelioma is able to be removed via surgery and the tumor is said to be resectable. At this stage, the cancer has not spread to any lymph nodes.

Stage 1 Treatment Options for Mesothelioma

Stage 1 mesothelioma patients have more treatment options and a better prognosis than patients at any other stage. However, in the past it has been rare for mesothelioma to be diagnosed at this stage because symptoms do not surface until the disease is already advanced.

Stage 1 patients typically undergo surgery to remove tumors and a small amount of surrounding tissue, followed by radiation therapy or chemotherapy to kill any remaining cancer cells.

Sources:

1. Dodson, R. and Hammar, S. Asbestos: Risk Assessment, Epidemiology, and Health Effects. Taylor & Francis: Boca Raton. 2006.
2. Galateau-Salle, Francoise. Pathology of Malignant Mesothelioma. Springer-Verlag London Limited: London. 2006.
3. http://www.cancer.gov/cancertopics/factsheet/Detection/staging
4. http://cancerguide.org/basic.html
5. http://www.cancer.gov/cancertopics/pdq/treatment/malignantmesothelioma/Patient/

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