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Stages of Mesothelioma

Mesothelioma, a rare cancer that forms as a result of asbestos exposure, is assessed according to the severity of the disease and how much it has spread.

Like other cancers, mesothelioma is graded to allow doctors to better diagnose patients and determine the best course of treatment. The stages range from I (1), which is less severe, to IV (4), which is the most severe. Depending on the stage of the cancer, a variety of treatments are available, including surgery, chemotherapy, radiation and others. The staging system is also used as a way to standardize cancer diagnoses across the board.

Mesothelioma Staging Systems

Currently, one of three staging systems is used when diagnosing mesothelioma cancer. Each uses four steps, or stages, to describe the progression of the disease. A majority of doctors in the United States use the TNM system. Internationally, doctors use the Butchart Staging System. The Bringham Staging System is used exclusively for mesothelioma:

  • TNM – Developed by the American Joint Committee on Cancer (AJCC), this is the most commonly used staging system for pleural mesothelioma and other types of cancer overall. It describes the size and shape of tumors (T), the involvement of lymph nodes (N) and the spread, or metastasis, of the disease (M)
  • Butchart ( link to Butchart page) – As the oldest cancer staging system, this allows doctors to pinpoint a patient’s diagnosis. This was the first system to grade cancer based on the severity and progression.
  • Brigham – Similar to the TNM system, this grades cancer according to a multitude of factors, allowing for a more complete diagnosis. It also helps assess the possibility of surgical intervention at each stage.

Even though there are universally accepted standards for staging cancer, there may be some confusion among physicians who are not familiar with mesothelioma. Because the disease is so rare, many doctors are not equipped to understand the intricacies of such a diagnosis and the treatment options. Contact our patient advocates today for assistance in finding an expert in your area.

Stages of Mesothelioma

Overall, the four stages of mesothelioma are prevalent in all of the staging systems, with slight variations within each. Because mesothelioma is so rare, the formal staging system only applies to pleural mesothelioma, which damages the lungs and chest area:

Understanding Mesothelioma Stages
Stage 1
Stage 2
Stage 3
Stage 4
-Lungs
-Lining of the Diaphragm
Stage I – This stage is divided into stage IA and IB. In IA, the cancer is localized to one side of the chest wall and possibly between the lungs. In IB, the cancer is localized to one side of the chest wall, possibly between the lungs and in the lining that covers the lungs and diaphragm.
Stage 1
Stage 2
Stage 3
Stage 4
-Lungs
-Diaphragm
Stage II – In addition to the previously mentioned locations, the cancer has also spread to the diaphragm and a lung.
Stage 1
Stage 2
Stage 3
Stage 4
-Lungs
-Diaphragm
-Lymph Nodes
-Lining of the Heart
Stage III -- In addition to the previous locations, the cancer also may have spread to the lining between the chest cavity, the lungs and the lining that covers the diaphragm and the lungs. The cancer has also spread to the lymph nodes near the lung area or localized soft tissue.
Stage 1
Stage 2
Stage 3
Stage 4
-Lungs
-Diaphragm
-Lymph Nodes
-Chest cavity
Stage IV – This cancer is found on one or both sides of the body. It has spread to distant lymph nodes, organs and into the spine. This cannot be removed by surgery.
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