Staging represents a very important aspect of the diagnostic process, as it provides essential information regarding the extent of cancer and also determines the most effective and safe treatment for each patient. There are multiple cancer staging systems, each focusing on various particularities of the disease. However, pleural mesothelioma is generally evaluated using the TNM system, which reveals the location of the tumor (T), the number of lymph nodes affected (N) and whether cancer has metastasized (M), as well as additional details such as the cell type and whether the tumor can be removed surgically or not.
The TNM staging system has recently been reviewed by Dr. Valerie Rusch – a thoracic surgeon specializing in the diagnostic and treatment of pulmonary disease who has been conducting extensive research on mesothelioma throughout her 25-year career – and her medical team at the Memorial Sloan-Kettering Cancer Center in New York. Although the majority of changes and updates concern technical details, there is one which will certainly be of interest to pleural mesothelioma patients.
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Within the TNM Cancer Staging System, Stage 4 Will Become Stage 3B for Mesothelioma Patients
According to the previous TNM staging system, patients whose illness displayed the following characteristics would be assigned the diagnosis of stage 4 pleural mesothelioma:
- cancer has spread to multiple other organs
- both the lymphatic and the circulatory systems have been affected by malignant cells
- cancer is present on both sides of the body
However, not all people in the above category are terminally ill patients. Consequently, stage 4 will become stage 3B, while only people with metastatic mesothelioma will receive a stage 4 diagnosis. “For instance, right now, anything that’s stage T4 is considered stage 4 disease, and stage 4 disease for any patient automatically means ‘the end of the road.’ That’s now been moved to stage 3b, and only metastatic disease is stage 4”, Dr. Rusch explained.
The new TNM staging system will benefit mesothelioma patients considerably. By classifying patients who would have otherwise been diagnosed with stage 4 mesothelioma as stage 3B, they will gain access to more treatment options, including surgery. Consequently, the prognosis of numerous people struggling with pleural mesothelioma will be significantly improved and their life expectancy will also increase. Additionally, not thinking of themselves as terminally ill may ease some mesothelioma patients’ emotional suffering, as they will be less likely to perceive their diagnosis as a death sentence.
The changes are to take effect this year. By the end of 2017, most specialists will have begun employing it in the diagnostic of pleural mesothelioma. For the other types of mesothelioma, a clear, formal staging system is unfortunately not available due to the low prevalence of these diseases.