Stage 1 Mesothelioma

Stage 1 mesothelioma is the earliest stage of the disease, in which the tumor is confined to a specific area and has not yet spread to other parts of the body. Very few mesothelioma cases are caught at Stage 1, but those which are typically live for about 21 months or longer.

As with other cancers, mesothelioma is categorized using a four-tiered staging system that indicates the severity and development of the disease. At Stage 1, mesothelioma has begun to develop, and usually the individual has very few noticeable symptoms.

The three staging systems used to classify mesothelioma have similar, but slightly different, definitions of Stage 1 mesothelioma:

  • Butchart System

    Butchart Staging System for Pleural Mesothelioma

    The Butchart system is the oldest method of determining someone’s pleural mesothelioma stage. Eric Butchart proposed this system in 1976 in an article for Thorax medical journal.

    The Butchart system classifies tumors as stage 1 through 4 using the same basic parameters as the TNM and Brigham systems.

    Stage 1

    The cancer affects the pleura on only one side of the chest, and may have spread to the pericardium and diaphragm. Curative surgery is considered a first-line treatment.

    Stage 2

    Cancer has spread to the chest wall and may affect both sides of the pleura. It may have spread to the esophagus, heart or lymph nodes of the chest. Butchart primarily recommends high-dose radiation therapy to most patients with stage 2 mesothelioma.

    Stage 3

    Cancer has spread to the diaphragm or peritoneum. Mesothelioma cells have also traveled through the lymphatic system to lymph nodes outside the chest. These tumors are generally unresponsive to curative therapies, so patients are introduced to their palliative options. Butchart suggests tube drainage for pleural effusions and delivery of chemotherapy drugs directly to the chest.

    Stage 4

    The cancer has spread through the bloodstream to distant parts of the body. Tumors may now be present on the liver, brain or bones, among other organs. Patients with stage 4 mesothelioma are considered terminal and Butchart recommends solely palliative treatments.

  • The TNM staging system

    The TNM staging system

    The system most often used to describe the growth and spread of pleural mesothelioma is the American Joint Committee on Cancer (AJCC) TNM staging system. The TNM system is based on 3 key pieces of information:

    • T sums up the extent of spread of the main (primary) tumor.
    • N describes the spread of cancer to nearby (regional) lymph nodes. Lymph nodes are small bean-shaped collections of immune system cells to which cancers often spread first.
    • M indicates whether the cancer has spread (metastasized) to other organs of the body. (The most common sites are the pleura on the other side of the body, the lungs, and the peritoneum.)

    Numbers or letters appear after T, N, and M to provide more details about each of these factors. Higher numbers mean the cancer is more advanced.

  • Brigham Staging System

    Brigham Staging System

    The Brigham staging system was created by Dr. David Sugarbaker at the Brigham and Women’s Hospital in Boston. With this system, doctors examine organs, tissues and other structures to learn how far the cancer has advanced.

    Stage 1

    Tumors are confined to the lining of the lungs and cancer has not spread to the lymph nodes.

    Stage 2

    Tumors are confined to the lining of the lungs. Either the intraparenchymal or mediastinal lymph nodes are cancerous.

    Stage 3

    Aggressive and unresectable tumors in the lining of the lungs have spread into the mediastinum or invaded the chest wall, diaphragm or contralateral lymph nodes.

    Stage 4

    Cancer has spread to other parts of the body and is unresectable.