Stages of Mesothelioma

The treatment and outlook for patients with mesothelioma largely depends on the stage of their cancer, in other words how far it has progressed.

The staging systems most often used for mesothelioma are known as the Butchart system, which was designed specifically for mesothelioma, and the TNM system (which focuses on three elements: Tumor, Lymph Nodes, Metastasis that also applies to other types of cancer). A third system, the Brigham staging system, assesses cases of mesothelioma based primarily on the prospects for surgical treatment.

All three systems divide mesotheliomas into four stages depending mainly on the extent of the primary tumor mass and the extent to which the disease has spread. The higher the stage number, the more advanced the mesothelioma; patients in Stage I of the disease have a significantly better prognosis than those with a more advanced stage.

SURVIVAL RATES DEPEND ON MANY FACTORS INCLUDING THE STAGE, BUT ONE FACT IS ABSOLUTE: THE SOONER A PATIENT IS DIAGNOSED AND TREATMENT HAS BEGUN, THE BETTER THE CHANCES OF SURVIVAL.

If you have been diagnosed with mesothelioma or are experiencing symptoms of the disease, the Mesothelioma Options Help Center offers a comprehensive menu of services to ensure the best medical and legal care and improve your quality of life – find out more now.

Since pleural mesothelioma occurs most frequently and has been the most studied, it is the only type of mesothelioma for which a staging classification exists. In all diagnosed mesothelioma cases, however, doctors first attempt to determine the extent of the disease before determining which treatment options to pursue.

Once mesothelioma is diagnosed, more medical tests are usually performed to find out if cancer cells have spread to other parts of the body. These tests include such imaging studies as x-rays, CT scans, and magnetic resonance imaging (MRI). Laboratory tests that look at blood, urine, fluid and tissue can also provide key information about the stage of mesothelioma, as can a tissue biopsy.


Stage 1

Stage I mesothelioma is the easiest to treat, as the disease remains localized in the pleura and has not yet spread elsewhere. Such mesothelioma treatments as surgery are more likely to be used in Stage I cancers than in more advanced stages that involve multiple tumors in different locations.

The three staging systems that doctors use to assess mesothelioma are the ButchartTNM and Brigham systems. Though all three overlap to some degree as indicated below, each system has its particular utility and applications.

Stage I, Butchart system: Mesothelioma is located in the pleura on either the right or left side, not both. It may also be found in the lining of the chest cavity between the lungs and/or the lining that covers the diaphragm. The lymph nodes remain unaffected.

Stage I, TNM system: Cancer is found in either the right or left pleura and has only spread to the outer lining of the lung in, at most, a few small spots. The lymph nodes remain unaffected.

Stage I, Brigham system: Mesothelioma is operable and the tumor(s) can be removed. The lymph nodes remain unaffected.


Stage 2

Stage II mesothelioma has begun to spread beyond the pleura, though it remains confined to the chest cavity. Most medical treatments for Stage I mesothelioma are also available to patients with Stage II of the disease, but as with any cancer, the likelihood of a successful outcome decreases proportionally as it invades other organs and tissues.

The three staging systems that doctors use to assess mesothelioma are the ButchartTNM and Brigham systems. Though all three overlap to some degree as indicated below, each system has its particular utility and applications.

Stage II, Butchart system: Mesothelioma may be located on both sides of the chest and can involve other organs including the esophagus or heart. Cancerous cells may also have spread to nearby lymph nodes.

Stage II, TNM system: Cancer is found on either the right or left pleura and has spread further into the lung or the diaphragm.

Stage II, Brigham system: Cancer in the pleura or lungs can be removed. Cancerous cells have spread to nearby lymph nodes.


Stage 3

Stage III mesothelioma is considered advanced and has spread beyond the initial site into other organs of the body. As with all types of metastatic cancer, treating Stage III mesothelioma is a difficult proposition because multiple tumor sites are involved.

The three staging systems that doctors use to assess mesothelioma are the ButchartTNM and Brigham systems. Though all three overlap to some degree as indicated below, each system has its particular utility and applications.

Stage III, Butchart system: Cancer has spread through the diaphragm and into the mesothelium of the abdomen (peritoneum), and/or has spread to lymph nodes beyond those near the pleura.

Stage III, TNM system: Cancer is found on either the right or left pleura and has spread further into the lung, diaphragm or other vital organs in the chest. Cancer cells may also be found in the lymph nodes.

Stage III, Brigham system: Cancer has spread beyond the pleura and is considered inoperable. Lymph nodes are likely to be affected.


Stage 4

Stage IV mesothelioma is the most advanced of all stages; about 30 percent of all patients diagnosed with mesothelioma have Stage IV disease.

While Stage IV offers the poorest prognosis and treatment options are more limited than with other stages, different types of care are available that can limit pain and suffering and may slow the cancer’s progress. For more information on these options as well as how the Mesothelioma Help Center can assist Stage IV mesothelioma patients with financial and legal aid, contact us now.

The three staging systems that doctors use to assess mesothelioma are the ButchartTNM and Brigham systems. All three overlap to some degree – this is especially true in Stage IV, as indicated below.

Stage IV, Butchart system: The mesothelioma has spread to other organs of the body and entered the blood stream.

Stage IV, TNM system: Tumors may be found in both the right or left pleura. Cancer has spread into the chest wall, diaphragm, pericardium (lining of the heart), lymph nodes outside the chest and/or other organs.

Stage IV, Brigham system: Cancer has metastasized beyond the pleura into other vital organs and is considered inoperable.


The Mesothelioma Options Help Center can connect you with a physician experienced in the diagnosis and treatment of mesothelioma as well as provide you with legal help and financial assistance.

Robert SteinbergStages of Mesothelioma