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Mesothelioma Staging Systems - Stage 2

In general terms, Stage 2 mesothelioma is referred to as 'advanced' mesothelioma. This means the cancer is located not only at its point of origin, but has spread to at least one nearby organ. In pleural mesothelioma Stage 2, for example, the cancer has spread from the pleural membrane to the lungs or diaphragm.

Stage 2 and the Butchart System

The oldest system used to stage cancers, the Butchart System is the system used for staging pleural mesothelioma. Other types of mesothelioma are rarely staged according to 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 the Butchart system, Stage 2 pleural mesothelioma has spread from its point of origin in the pleural membrane of one lung to the pleural membrane in the other lung, or to the esophagus or the pericardial membrane (which surrounds the heart). Lymph nodes may also be affected.

Stage 2 and the TNM System

A newer cancer staging system that categorizes cancer based on the size of a tumor, its presence in the lymph nodes, and whether the cancer has metastasized, the TNM system is sometimes used to stage pleural mesothelioma. In addition, it is the system used to stage peritoneal cancer if required. The TNM system uses four stages.

When using the TNM system, Stage 2 indicates that pleural mesothelioma has spread from its point of origin to nearby lymph nodes on the same side of the body. Mesothelioma may have also spread to the lung, to the diaphragm, or to the pericardial membrane of the heart.

The Brigham System

The Brigham system is the newest of the three systems that may be used to stage mesothelioma. The Brigham system focuses on categorizing mesothelioma according to two criteria: whether or not tumors can be removed via surgery, and whether the cancer has spread to nearby lymph nodes. There are four stages in the Brigham system.

In Stage 2 of the Brigham system, mesothelioma is resectable, meaning it is still able to be surgically removed. In this stage, the asbestos cancer has spread to at least one grouping of lymph nodes.

Treatment Options for Stage 2 Mesothelioma

Treatment options for Stage 2 mesothelioma may be more limited than in Stage 1, and the prognosis for patients is not as good as Stage 1. This is because Stage 2 involves the spread of mesothelioma from its point of origin to nearby organs (for example, from the pleural membrane to the lung), and because lymph node involvement means there is the possibility of metastasis to other locations - even if the primary tumor and the affected lymph nodes are surgically removed.

In Stage 2, patients may receive surgery to remove primary tumors and affected lymph nodes, depending on the size and location of tumors and the extent of the disease in nearby organs. Surgery is generally followed by chemotherapy or radiation therapy to kill 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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Select... Mesothelioma Lung Cancer Asbestosis Severe Asbestosis Unknown

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