When a patient is diagnosed with mesothelioma, a disease stage is also assigned. The stage determines the treatment plan for the patient. These standards for stage evaluation have been updated through a project led by Dr. Valerie Rusch, renowned mesothelioma specialist from Memorial Sloan Kettering Cancer Center in New York. This re-categorization will lead to additional options for some patients diagnosed with stage 3 or stage 4 mesothelioma.
At this time, stage 3 mesothelioma means:
• The cancer is located on one side of the body
• The tumor has spread to other organs
• The tumor has spread to the lymph nodes
A stage 4 mesothelioma diagnosis means:
• The cancer has spread to both sides of the body
• The tumor has spread to multiple different organs
• The cancer has progressed through both the lymph node system and the blood vessels
The new system changes how stage 4 is diagnosed and how stage 3 is categorized. Instead of identifying patients with large tumors as stage 4, they will now be “3b”, opening up more therapeutic and surgical options to them, while also giving more hope.
Generally, staging for mesothelioma is based on the TNM Staging System. The size the spread of the cancer is represented by letters.
• T = size of tumor and its spread to nearby tissues
• N = cancer spread to lymph nodes
• M = cancer spread to other parts of the body
Numbers are attached to these letters which categorizes them further. These go from “0” meaning no cancer found to “4” meaning metastatic cancer.
“For instance, right now, anything that’s stage T4 is considered stage 4 disease, and stage 4 disease for any patient automatically means ‘the end of the road.’ That’s now been moved to stage 3b, and only metastatic disease is stage 4,” Dr. Rusch commented while speaking at the 2016 International Mesothelioma Interest Group conference.
This new categorization begins in 2017. Until that time, many clinicians are using the new system in advance of its formal adoption. This is great news for some patients who are now eligible for treatments that can prolong their lives.
