When determining the extent and nature of any kind of cancer, oncologists use a rubric or “staging” system. This system plays a key role in determining the appropriate course of cancer treatment for a patient. This is only one of the criteria by which malignancies are classified; the first of which is determined by the location of the tumor and the third of which is determined by the cellular structure (or lack thereof).
Staging assists the oncologist in determining how far the cancer has advanced and how treatable the patient's malignancy really is.
Although there are three distinct staging systems currently in use, all three are based on four primary stages of mesothelioma:
Stage 1: The tumor is confined to one organ or region and is relatively small.
Stage 2: The tumor has grown in size, and has spread to one other tissue.
Stage 3: The tumor has spread to adjacent areas.
Stage 4: The tumor has spread to distant areas of the body, or “metastasized.”
In Stage 1, mesothelioma is localized and confined to one area of the body.
Stage 1 Mesothelioma Prognosis
The main problem for mesothelioma patients is that historically, their condition is not detected until it has reached Stage 3 mesothelioma or Stage 4 mesothelioma - by which time it is too late to offer anything other than palliative treatments.
One ray of hope lies in the new MESOMARK™ diagnostic test recently approved for use in the U.S. by the FDA. This test was developed by a Japanese biotech firm and is reportedly able to detect the early biological markers of mesothelioma when it is most treatable and has the best chances for a mesothelioma cure. When the disease is caught at Stage 1, the cancerous tissue can usually be removed with mesothelioma surgery; mesothelioma radiation and chemotherapy treatments are used to follow up in order to get rid of any traces of malignancy.
What are the Common Treatments for Stage 1 Mesothelioma?
The range of Mesothelioma treatment options available for Stage 1 patients is the broadest available because, at this stage, the cancer is still localized. Conventional treatments and / or participation in clinical trials are most often recommended for patients presenting with early stages of mesothelioma.
For Stage I Mesothelioma, surgery is the first treatment option explored, and in most cases, it is usually the best option. Surgery removes the affected lining around the lungs, heart or abdomen.
Typically used in conjunction with surgery and chemotherapy, radiation is a common treatment method for Stage 1 Mesothelioma. Radiation therapy targets and controls the metastases of cancerous cells. By destroying cancerous cells, radiation therapy inhibits the spread of mesothelioma. Though there are some side effects associated with the treatment, like fatigue and joint pain, radiation therapy usually yields positive results for Stage I Mesothelioma.
Another common treatment option for Stage 1 Mesothelioma is chemotherapy. By administering high doses of specific medications, chemotherapy targets the cancerous cells and destroys them. With chemotherapy, however, the side effects of the treatment can be worse than the symptoms of the cancer itself.
Hyperthermia and Chemotherapy
Recent studies have shown that cancerous cells are more responsive to chemotherapy in cases of hyperthermia due to the increase of body temperature. Currently this treatment modality shows only a minimal impact on overall life expectancy and is still in its infancy.
A breakthrough in carcinoma treatment, gene therapy involves implantation of healthy genes that target cancerous cells. Though not commonly used for Stage I Mesothelioma, gene therapy is a growing treatment for several types of cancer, and is under going further research.
By “enhancing” the immune system’s ability to fight off disease, immunotherapy is showing some promise for treating Stage I Mesothelioma. Through intravenous immune-enhancing drugs, the immune system is “jump-started” to attack invading cancerous cells. Research for this type of treatment is still ongoing and results, thus far, are inconclusive as to whether immunotherapy is a viable option for Stage I Mesothelioma.
For some mesothelioma patients, taking part in a clinical trial may be the best option. Clinical trials often test treatment and drug options on mesothelioma patients that have already undergone vigorous scientific testing. Many clinical trials use a placebo as a control, and mesothelioma patients should consult with their doctor to understand the risks involved before entering any trial.
Cancer Guide. "Understanding Cancer Types and Staging." Cancerguide.org, March 2009, http://cancerguide.org/basic.html
Dodson, R. and Hammar, S. Asbestos: Risk Assessment, Epidemiology, and Health Effects. (Boca Raton:Taylor & Francis, 2006.)
Galateau-Salle, Francoise. Pathology of Malignant Mesothelioma. (London: Springer-Verlag London Limited, 2006.)