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Stage IV Mesothelioma

When determining the extent and nature of any kind of cancer - which in turn, plays a large part in designing an appropriate course of treatment - oncologists use a rubric or "staging" system. 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:

In Stage IV, the cancer has spread throughout the body and is invariably terminal.

Butchart System

This is the oldest system used by oncologists, and is used only for patients diagnosed with the pleural variety of mesothelioma. In Stage IV under the Butchart System, the cancer has spread via the blood stream and can be found throughout parts of the body remote from the tumor's point of origin.

TMN System

TNM stands for Tumor, Lymph Nodes, and Metastasis. This is a newer method which is usually employed for staging malignant pleural mesothelioma, although it is also used for the peritoneal type as well.

Under this system, the cancer has spread well beyond the original site and into the neck as well as the lymphatic system.

Brigham System

This is the newest staging system, which was developed especially for use in cases of mesothelioma.

In Stage IV of the Brigham System, the cancer is inoperable. Tumors are either be too large to remove surgically or have penetrated deep into vital organs. The cancer has metastasized to that point that malignant cells can be found throughout the patient's body, so that even if some of it can be removed, the cancer will almost certainly recur elsewhere.

Prognosis

By Stage IV, the patient is terminal, and has less than a year to live in most cases. At this point, doctors focus on quality of life issues, offering palliative treatments that can at the very least reduce patient discomfort and pain.

Sources

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.)

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