After malignant mesothelioma has been diagnosed,
tests are done to find out if cancer cells have spread
to other parts of the body.
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other
parts of the body.
The following stages are used for malignant
mesothelioma:
Stage I (Localized)
Stage II (Advanced)
Stage III (Advanced)
Stage IV (Advanced)
After malignant mesothelioma has been
diagnosed, tests are done to find out if
cancer cells have spread to other parts
of the body.
The process used to find out if cancer has spread outside
the pleura or peritoneum is called staging . The information
gathered from the staging process determines the stage of
the disease. It is important to know whether the cancer
has spread in order to plan treatment.
The following tests and procedures may be used in the
staging process:
CT scan (CAT scan) : A procedure that makes a series
of detailed pictures of the chest and abdomen , taken
from different angles. The pictures are made by a
computer linked to an x-ray machine. A dye may be
injected into a vein or swallowed to help the organs
or tissues show up more clearly. This procedure is
also called computed tomography, computerized
tomography, or computerized axial tomography.
PET scan (positron emission tomography scan) : A
procedure to find malignant tumor cells in the body. A
small amount of radioactive glucose (sugar) is
injected into a vein. The PET scanner rotates around
the body and makes a picture of where glucose is
being used in the body. Malignant tumor cells show
up brighter in the picture because they are more
active and take up more glucose than normal cells
do.
Endoscopic ultrasound (EUS) : A procedure in which
an endoscope is inserted into the body. An endoscope
is a thin, tube-like instrument with a light and a lens
for viewing. A probe at the end of the endoscope is
used to bounce high-energy sound waves
( ultrasound ) off internal tissues or organs and make
echoes. The echoes form a picture of body tissues
called a sonogram . This procedure is also called
endosonography. EUS may be used to guide fine-
needle aspiration (FNA) biopsy of the lung, lymph
nodes , or other areas.
Pulmonary function test (PFT) : A test to see how
well the lungs are working. It measures how much air
the lungs can hold and how quickly air moves into
and out of the lungs. It also measures how much
oxygen is used and how much carbon dioxide is
given off during breathing. This is also called lung
function test.
There are three ways that cancer
spreads in the body.
Cancer can spread through tissue , the lymph system, and
the blood:
Tissue. The cancer spreads from where it began by
growing into nearby areas.
Lymph system. The cancer spreads from where it
began by getting into the lymph system. The cancer
travels through the lymph vessels to other parts of
the body.
Blood. The cancer spreads from where it began by
getting into the blood. The cancer travels through the
blood vessels to other parts of the body.
Cancer may spread from where it began
to other parts of the body.
When cancer spreads to another part of the body, it is
called metastasis . Cancer cells break away from where
they began (the primary tumor ) and travel through the
lymph system or blood.
Lymph system. The cancer gets into the lymph
system, travels through the lymph vessels, and forms
a tumor ( metastatic tumor) in another part of the
body.
Blood. The cancer gets into the blood, travels through
the blood vessels, and forms a tumor (metastatic
tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the
primary tumor. For example, if malignant mesothelioma
spreads to the brain, the cancer cells in the brain are
actually malignant mesothelioma cells. The disease is
metastatic malignant mesothelioma, not brain cancer.
The following stages are used for
malignant mesothelioma:
Stage I (Localized)
Stage I is divided into stages IA and IB:
In stage IA , cancer is found in one side of the chest in
the lining of the chest wall and may also be found in
the lining of the chest cavity between the lungs and/
or the lining that covers the diaphragm . Cancer has
not spread to the lining that covers the lung.
In stage IB , cancer is found in one side of the chest in
the lining of the chest wall and the lining that covers
the lung. Cancer may also be found in the lining of
the chest cavity between the lungs and/or the lining
that covers the diaphragm .
Stage II (Advanced)
In stage II, cancer is found in one side of the chest in the
lining of the chest wall, the lining of the chest cavity
between the lungs, the lining that covers the diaphragm ,
and the lining that covers the lung. Also, cancer has
spread into one or both of the following:
Lung tissue .
Diaphragm.
Stage III (Advanced)
In stage III , either of the following is true:
Cancer is found in one side of the chest in the lining of the
chest wall . Cancer may have spread to:
the lining of the chest cavity between the lungs;
the lining that covers the diaphragm ;
the lining that covers the lung;
the lung tissue ;
the diaphragm.
Cancer has spread to lymph nodes where the lung joins
the bronchus , along the trachea and esophagus, between
the lung and diaphragm, or below the trachea.
or
Cancer is found in one side of the chest in the lining of the
chest wall, the lining of the chest cavity between the lungs,
the lining that covers the diaphragm, and the lining that
covers the lung. Cancer has spread into one or more of
the following:
Tissue between the ribs and the lining of the chest
wall.
Fat in the area between the lungs.
Soft tissues of the chest wall.
Sac around the heart.
Cancer may have spread to lymph nodes where the lung
joins the bronchus, along the trachea and esophagus,
between the lung and diaphragm, or below the trachea.
Stage IV (Advanced)
In stage IV , cancer cannot be removed by surgery and is
found in one or both sides of the body. Cancer may have
spread to lymph nodes anywhere in the chest or above the
collarbone. Cancer has spread in one or more of the
following ways:
Through the diaphragm into the peritoneum (the thin
layer of tissue that lines the abdomen and covers
most of the organs in the abdomen).
To the tissue lining the chest on the opposite side of
the body as the tumor .
To the chest wall and may be found in the rib.
Into the organs in the center of the chest cavity .
Into the spine .
Into the sac around the heart or into the heart
muscle.
To distant parts of the body such as the brain, spine,
thyroid , or prostate .
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