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Mesothelioma !!

Also called: Malignant mesothelioma

The tissue that lines your lungs, stomach, heart and other organs is called mesothelium. Mesothelioma is cancer of that tissue. It is a rare but serious type of cancer. It usually starts in the lungs, but can also start in the abdomen or other organs. Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles. It can take a long time - 30 to 50 years - between being around asbestos and getting the disease. Treatment includes surgery, radiation, chemotherapy or all three.

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How Is Malignant Mesothelioma Staged?

Staging is the process of finding out how far the cancer has spread. Staging of mesothelioma is based on imaging studies such as x-rays, CT scans, and MRI scans. The treatment and outlook for patients with mesothelioma largely depends on the stage (extent of spread) of their cancer. Since pleural mesothelioma occurs most frequently and has been studied the most, it is the only mesothelioma for which a staging classification exists.

The major staging system has recently been developed by the International Mesothelioma Interest Group and adopted by the American Joint Committee on Cancer (AJCC). This is a TNM system, similar to staging systems used for most other cancers. T stands for tumor (its size and how far it has spread to nearby organs), N stands for spread to lymph nodes, and M is for metastasis (spread to distant organs). In TNM staging, information about the tumor, lymph nodes, and metastasis is combined in a process called stage grouping to assign a stage described by Roman numerals from I to IV.

T Stages

T1: Mesothelioma involves either the right or left pleura lining the chest. It has only spread to the pleura covering the lung, with the exception of possibly a few other small spots.

T2: Mesothelioma involves either the right or left pleura lining the chest and has spread from the lining of the chest into 1) the outer lining of the lung, 2) the diaphragm, or 3) into the lung itself.

T3: Mesothelioma involves either the right or left pleura lining the chest and has spread into 1) the first layer of the chest wall, 2) the fatty part of the mediastinum, 3) a single place in the chest wall, or 4) the outer covering layer of the heart.

T4: Mesothelioma involves either the right or left pleura lining the chest and has spread 1) into the chest wall, either muscle or ribs, 2) through the diaphragm, 3) into any organ contained in the mediastinum (esophagus, trachea, thymus, blood vessels), 4) into the spine, 5) across to the pleura on the other side of the chest, 6) through the heart lining or into the heart itself, or 7) into the brachial plexus (nerves leading to the arm).

N Stages

N0: No spread to lymph nodes.

N1: Spread to lymph nodes on the same side of the chest as the mesothelioma.

N2: Spread to lymph nodes around the point where the windpipe branches into the left and right bronchi or to lymph nodes in the space behind the chest bone and in front of the heart (mediastinum). Affected lymph nodes are on the same side of the cancerous lung.

N3: Spread to lymph nodes near the collarbone on either side, to hilar or mediastinal lymph nodes on the side opposite the cancerous lung.

M Stages

M0: No spread to distant organs or areas.

M1: The cancer has spread distantly.

Stage Grouping for Pleural Mesothelioma

Once the T, N, and M categories have been assigned, this information is combined (stage grouping) to assign an overall stage of I, II, III, or IV. Patients with lower stage numbers have a better prognosis.

Stage I (T1, N0, M0): Mesothelioma involves either the right or left pleura lining the chest. It has only spread to the outer lining of the lung in, at most, a few small spots. It has not spread to the lymph nodes or distant sites.

Stage II (T2, N0, M0): Mesothelioma involves either the right or left pleura lining the chest and has spread from the lining of the chest into 1) the outer lining of the lung, 2) the diaphragm, or 3) into the lung itself. It has not spread to the lymph nodes or distant sites.

Stage III (T1 or 2, N1 or 2, M0; OR T3, N0-2, M0): Mesothelioma involves either the right or left pleura lining the chest and may or may not have spread from the lining of the chest into 1) the outer lining of the lung, 2) the diaphragm, 3) into the lung itself and has spread to lymph nodes anywhere in the chest on the same side as the tumor, but has not spread to distant sites; OR Mesothelioma involves either the right or left pleura lining the chest and has spread into 1) the first layer of the chest wall, or 2) the fatty part of the mediastinum, or 3) a single place in the chest wall or 4) the outer covering layer of the heart and may or may not have spread to lymph nodes but not as far as to lymph nodes near the collarbone or on the opposite side of the chest. It has not spread to distant sites.

Stage IV (T4, any N, M0; OR any T, N3, M0; OR any T, any N, M1): Mesothelioma involves either the right or left pleura lining the chest and has spread 1) into the chest wall, either muscle or ribs, 2) through the diaphragm, 3) into any organ contained in the mediastinum (esophagus, trachea, thymus, blood vessels), 4) into the spine, 5) across to the pleura on the other side of the chest, 6) through the heart lining or into the heart itself, or 7) into the brachial plexus (nerves leading to the arm), and may or may not have spread to lymph nodes anywhere, but has not spread to distant sites; OR the tumor is of any size, but has spread to lymph nodes near the collarbone on either side, to hilar or mediastinal lymph nodes on the side opposite the cancerous lung but not to distant sites; OR the mesothelioma has spread to distant sites.

Other Prognostic Factors

Although stage is an important factor that determines a patient�s prognosis, other factors should also be considered. Some of these are poor performance status (for example being too sick to perform normal tasks of daily life), chest pain, shortness of breath, weight loss, high levels of a substance in the blood called LDH, low red blood cell count, high white blood cell count and others. These are considered serious factors and most people with all of these factors usually die within 6 months. Few live 2 years. Most people with none of these serious factors will live at least one year and have a 40% chance of living 2 years.

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Cancer treatments

This page has links to the main radiotherapy and main chemotherapy sections, and to information about specific cancer drugs.

There is also a link to brief, general treatment pages from our About Cancer section. Below that, there is a list of links to the treatment sections for all specific cancers covered on CancerHelp UK. There is also information on treating symptoms and side effects is in its own section elsewhere on the site.


Chemotherapy
Radiotherapy
Hormone therapy
Biological therapy
Bisphosphonates
Individual cancer drugs
Ways of taking drugs

This link below will take you to a section of brief, general treatment information pages from our About Cancer section.
About cancer treatments

Treating specific cancers.


There are links below to the treatment sections for all the specific cancers covered on CancerHelp UK.

Treating acute leukaemia
Treating bladder cancer
Treating bone cancer
Treating bowel cancer
(colorectal cancer)
Treating brain tumours
Treating breast cancer
Treating cervical cancer
Treating chronic leukaemia
Treating gallbladder cancer
Treating Hodgkin's disease
Treating kidney cancer
Treating larynx cancer
Treating liver cancer
Treating lung cancer
Treating melanoma
Treating mesothelioma
Treating mouth and oropharyngeal cancer
Treating multiple myeloma
Treating nasal and sinus cancers
Treating nasopharyngeal cancer
Treating non-Hodgkin's lymphoma
Treating oesophageal cancer
Treating ovarian cancer
Treating pancreatic cancer
Treating prostate cancer
Treating skin cancer
(not melanoma)
Treating soft tissue sarcoma
Treating stomach cancer
Treating testicular cancer
Treating thyroid cancer
Treating vaginal cancer
Treating vulval cancer
Treating unknown primary cancer
Treating womb cancer

Information about other cancer treatments will be added over time




*more infoForward to Chemotherapy

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Last updated 29 January 2007

CancerHelp UK is not designed to provide medical advice or professional services and is intended to be for educational use only. The information provided through CancerHelp UK is not a substitute for professional care and should not be used for diagnosing or treating a health problem or a disease. If you have, or suspect you may have, a health problem you should consult your doctor.

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