Mesothelioma is a form of cancer that almost always is a result of exposure to asbestos dust. While this form of cancer is fairly rare appearing in roughly 2000 to 3000 cases each year in people over the age of 65, it is a deadly form of cancer with a poor survival rate.
Diagnosis for this form of cancer is often difficult as early symptoms can mimic other illnesses and the time between contact with the asbestos and the onset of the cancer can be decades apart. However, early detection can lengthen the survival time for people with Mesothelioma.
Diagnosis of Mesothelioma
Diagnosis of this cancer often begins when a patient visits his medical professional complaining of shortness of breast or perhaps even chest pains. A complete review of the patients medical history and a physical exam then takes place. This is often followed by a chest Xray, Lung function tests, either a CAT scan or an MRI and finally after other illnesses such as congestive heart failure are ruled out a biopsy.
At this point the doctor then needs to determine what stage the cancer is at before beginning treatment. There are two systems the doctor may use to determine what stage the cancer is in, One is the TNM system which stands for Tumor, Nodes and Metastasis and the other is known as the Buchart System. Though the Buchart system is still often used, the TNM system is recommended as it gives clearer definitions to each stage. Both systems place the progress of the cancer into 4 stages.
There is another staging system for Mesothelioma known as the Brigham staging which is based completely on whether or not surgery can and should be performed on the cancer.
TMN System stages of Mesothelioma
Stage One
In using the TMN system for determining the progression of the disease stage one signifies the onset of the cancer. It is the stage where the Mesothelioma is found either on the left or right side of the chest lining or the pleura (the outside lining of the lung) and consists of only a few small spots.
Treatment at this stage is easier and offers a better chance of success as the cancer has not yet spread to other areas of the body and does not involve the lymph nodes. However, detection at this stage is rare as patients often do not experience symptoms until the disease is further advanced.
At this stage treatments consists of removal of the tumors and surrounding area and then either radiation or chemotherapy to kill the remaining cancer cells.
Stage two
In stage two the cancer has metastasized to the lung itself, the lining surrounding the heart or the diaphragm. It may also have penetrated the lymph nodes on the same side of the chest as the original tumor.
Treatment at this stage may or may not include surgery depending on the size and location of the tumors. Chemotherapy and radiation is again used but the prognosis at this stage is not good as the cancer has already begun to spread to other systems of the body.
Stage three
In stage three the malignancy has penetrated the chest wall, outer covering of the heart and perhaps the heart itself, and the muscles, ribs and other vital organs within the chest wall. The lymph nodes may or may not be affected at this stage.
By stage 3 treatment to stop cancer growth is no longer effective. Most treatment from this stage on is done to relieve the symptoms of the cancer rather than real treatment. This may consist of removal of large tumors to relieve pain and discomfort, fluids are removed from around the lungs and abdomen and other measures are taken to make the patient as comfortable as possible.
Stage 4
The last stage of the disease has spread to the lymph nodes and other side of the chest from where the cancer began. It may have reached the chest cavities on each side, or affected the abdomen and may have spread to the blood stream.
By stage 4 the patient is too weak for any kind of surgery and the tumors have penetrated too deeply into the vital organs. Most treatment at this stage consists of pain killers and whatever else will help relieve the discomfort for the time the patient has remaining.
Medicine’s aim at this point is to find ways to diagnosis this cancer in its earliest stage in order to provide a better prognosis for those patients with this disease.