A mesothelioma diagnosis is a terrifying experience. It means you have an aggressive type of cancer caused by exposure to asbestos. Your approach should be three-pronged:
Emotional – Seek counseling for yourself and your family through your doctor’s office or your church to help you cope with your mesothelioma diagnosis.
Legal – Seek specialized legal assistance to help you identify those responsible for your asbestos exposure and to help you obtain both financial help for your medical treatment, and the justice you deserve.
Medical – Work with your doctor and medical care team to optimize your chances. To better help you understand and be part of the conversation, here’s an overview of specific mesothelioma stages that accompany a mesothelioma diagnosis.
Mesothelioma Diagnosis Includes a Cancer Staging Designation
Your mesothelioma diagnosis includes vital information known as cancer staging. This means your mesothelioma will be assigned one of a list of designations depending on how much and where it has spread. This helps your doctor determine your prognosis (outlook) and chart the best path for your treatment.
Your mesothelioma’s stage is determined by the results of physical exams, biopsies, and imaging tests and scans. Pleural mesothelioma, the most prevalent type, is the only mesothelioma that has a formal staging system.
Mesothelioma Diagnosis Using the TNM Staging System
One system used to assess the growth and spread of pleural mesothelioma is the American Joint Committee on Cancer (AJCC) TNM staging system. It is the one used by the American Cancer Society and it is based on three basic pieces of information:
T stands for tumor and the extent it has spread.
N stands for nodes as in lymph nodes and whether the tumor has spread to any of these.
M refers to metastasis, the cancer’s spread to other organs of the body. In mesothelioma, the most common sites are the pleura on the other side of the body, the lungs, and the peritoneum.
Numbers or letters after the T, N, and M provide more details. Higher numbers indicate the cancer is more advanced.
T Groups in a Mesothelioma Diagnosis
T1 – The tumor is found in the pleura lining the chest wall on one side of the chest. It may also affect the pleura lining the diaphragm or the space between the lungs. It could also have spread to the pleura covering the lung.
T2 – The tumor has spread beyond the pleura lining the chest wall on one side of the chest to the pleura of the diaphragm, the space between the lungs, and possibly into the lung.
T3 – In addition to all the above, this mesothelioma diagnosis indicates that it has spread to deeper layers of the chest wall and the surface of the pericardium – the heart’s outer layer. But surgery may still be an option.
T4 – The tumor has now also spread to spine, the pleura on the other side of the chest, other nearby organs such as the esophagus or trachea, and possibly to the heart. Surgery is usually not advisable.
N groups in a Mesothelioma Diagnosis
N0 – No spread to lymph nodes.
N1 – The tumor has spread to lymph nodes within the lung and/or around the bronchial lymph nodes on the same side as the tumor.
N2 – It has spread to the lymph nodes in the space behind the breastbone and those near the diaphragm.
N3 – Cancer is present in the lymph nodes near the collarbone on both sides, and in the lung lymph nodes on the opposite side opposite of the main tumor.
M groups in a Mesothelioma Diagnosis
M0 – No spread to other organs or areas.
M1 – The cancer has spread to distant lymph nodes and organs.
Numbered Staging as part of the TNM System of Mesothelioma Diagnosis
Once the T, N, and M categories are determined, they are combined in a designation called stage grouping to label the mesothelioma as overall stage of I, II, III, or IV. A lower stage number usually means a better prognosis.
T1, N0, M0 – Mesothelioma is present in the pleura lining the chest wall on one side of the chest. It might affect the pleura lining the diaphragm or the space between the lungs. It may also have spread to the pleura covering the lung. It hasn’t spread to the lymph nodes (N0) or distant organs (M0).
T2, N0, M0 – Mesothelioma has spread into the diaphragm or the lung itself (T2). It has not spread into the lymph nodes (N0) or distant organs (M0).
T1 or T2, N1 or N2, M0 – As above, mesothelioma is present in the pleura lining the chest on one side, possibly the pleura lining the lung, the diaphragm, or the space between the lungs. But it may have spread into the lung itself (T1 or T2). It has spread to lymph nodes in the chest on the same side as the main tumor (N1 or N2) but has not metastasized to other organs (M0).
T3, N0 to N2, M0 – Mesothelioma has also spread to the outer covering of the heart (T3). It might or might not have gone into lymph nodes in the chest on the same side as the tumor, but not to lymph nodes near the collarbone or on the opposite side of the chest (N0, N1, or N2) or distant organs (M0).
T4, any N, M0 – Mesothelioma has grown into the pleura lining the chest on one side and has grown into more than one place in the deeper layers of the chest wall (including the muscle or ribs), through the diaphragm and into the peritoneum, into the spine, across to the pleura on the other side of the chest, and possibly through the heart lining or into the heart itself (T4). It might or might not have spread to lymph nodes (any N). It has not spread to distant sites (M0).
Any T, N3, M0 – The tumor may or may not have grown into nearby tissues (any T). It has spread to lymph nodes near both sides of the collarbone and/or to lymph nodes on the side opposite the main tumor (N3). It has not metastasized to other organs (M0).
Any T, any N, M1 – The tumor might or might not have grown into nearby tissues (any T). It might or might not have spread to the lymph nodes (any N) but it has metastasized to distant organs (M1).
Why You Need to Understand Your Mesothelioma Diagnosis Through TNM Staging
The concept of stages of cancer is most likely a familiar one as it is used to describe someone’s condition for most types of cancer. But the TNM staging system is unique to mesothelioma. It may seem confusing, we know. But if you have received a mesothelioma diagnosis, it is important that you understand as much as you can so you can discuss your situation fully with your doctor and other medical practitioners if they are using the TNM staging to describe your mesothelioma. Feel free to print this article and take it with you when you go to your appointments.