The TNM Staging System

The TNM system for staging cancer is an essential component of a proper diagnosis of mesothelioma, and greatly affects the treatment process. Staging systems such as this one are instrumental in determining which treatment methods will be the most effective.

The letters in the title of the TNM staging system represent tumor, lymph node and metastasis respectively. This is because doctors use this system to determine how big and how close to organs the patient’s tumor is, whether or not the malignancy has spread to the lymph nodes, and if the cancer has traveled to organs other than the mesothelium. The American Joint Committee on Cancer developed the TNM Staging System, and it is currently the main system used to determine the stages of mesothelioma.

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TNM Stage I

Localized mesothelioma is known as stage I. In this stage, the cancer has not traveled outside of the mesothelium, or the membrane covering the wall of the chest. It also may be found on the lung when a patient has the disease’s pleural form. At times, the cancer also might be localized on the sac around the heart or the diaphragm. In stage I, mesothelioma may be treated effectively by surgical removal of the affected cells, plus some of the surrounding tissue. If the cancer is localized but is present in more than one area, then surgeons may perform a pleurectomy, or the removal of the lung’s surrounding membrane. In addition to surgery, chemotherapy may be used to further fight the stage I mesothelioma.

TNM Stage II

Mesothelioma in stage II has traveled to the lungs and/or the diaphragm, but the lymph nodes have not been affected.

TNM Stage III

Stage III mesothelioma occurs when the cancer either moves into the lymph nodes or the abdomen lining or mediastinum.

TNM Stage IV

A diagnosis of stage IV mesothelioma means that the cancer has spread to organs outside the point of origin, such as the brain. The cancer could also be present in essential areas like the heart, spine, or esophagus.

Testing for Mesothelioma and Treatment Options

The procedures and tests used for staging include MRI, chest X-ray, CAT scan, and endoscopic ultrasound, which is also used to biopsy organs suspected of having cancer. After assignation of staging, the severity of disease and the overall health and age of the patient are considered in order to determine the best treatment options. Traditional treatment involves chemotherapy, radiation therapy, and surgery. These methods are generally used together to first remove the malignant tumor and later prevent it from returning or spreading. This type of combination treatment is the most common for treating patients with mesothelioma.

New forms of treatment include photodynamic therapy, gene therapy, intensity modulated radiation therapy, and immunotherapy can also be used in conjunction with traditional methods. Doctors and patients are also constantly looking into alternative therapies for palliative care.

Reference:

National Cancer Institute

American Cancer Society