Stage II Mesothelioma

Following a mesothelioma diagnosis, most doctors will inform the patient of the "stage" of the cancer. The stage refers to the level of development and how far the disease has progressed inside the body. This staging step is often a critical piece of information when determining a prognosis and treatment plan.

Three major systems exist to provide doctors with a rubric for staging malignant mesothelioma. Each divides the disease into four main stages characterized by a certain size of tumor, level of metastasis, and/or operability. In the various staging systems, the level of a disease's progression increases with each stage, with stage I indicating the lowest level of development. While mesothelioma has no known cure, stage I mesothelioma typically responds better to treatment than stage IV.

Stage II mesothelioma, which may also be called "advanced" mesothelioma, generally indicates the cancer has spread beyond its point of origin to at least one nearby tissue or organ. In pleural mesothelioma cases, this might mean that a cancer that originated in the pleural membrane is now present in the lungs themselves or perhaps the diaphragm. It is important to note that there are three major staging systems used by physicians. Each categorizes tumors in four different stages, but each uses slightly different criteria to determine staging information.

Stage II in the Butchart System

The Butchart System, the oldest staging system, is only used in cases of pleural mesothelioma. Under the Butchart System, the main criterion for categorization is the size of the primary tumor. According to the Butchart System, stage II mesothelioma is defined as pleural mesothelioma where the primary tumor has spread from its point of origin (the pleural membrane of one lung) to the pleural membrane of the other lung. In some cases, the stage II diagnosis may be applied to a cancer that has spread from one pleural membrane to the pericardial membrane of the heart, the esophagus, or, in some cases, the lymph nodes.

Stage II in the TNM System

The TNM System (Tumor, Lymph Nodes, and Metastasis) is sometimes used for malignant mesothelioma. Under the TNM System, malignant mesothelioma is categorized according to the size of the tumor, the level of metastasis and the degree of lymph node involvement. The TNM System is most likely to be used in cases of pleural mesothelioma (as this is the only variant of mesothelioma that has been formally staged), but it can also be useful in staging peritoneal mesothelioma.

Under the TNM System, stage II is used to describe a situation in which cancer has spread from the primary tumor (generally the pleura of one lung) to lymph nodes on the same side of the body. In some cases, the designation of stage II may also be used to describe a cancer that has spread to the diaphragm, pericardial membrane, or the lung itself. The key, however, is that stage II under the TNM System relies on lymph node involvement.

Stage II in the Brigham System

The Brigham System also uses four stages to classify disease development, but its variables include the extent to which lymph nodes are or are not involved and the likelihood that a given tumor can be surgically removed. In the specific case of mesothelioma, the Brigham System has limited utility due to the fact that many mesothelioma cases are not candidates for surgery.

Under the Brigham System, stage II is used to define a situation in which the mesothelioma can be surgically removed. The term used to define a tumor that can be surgically removed is "resectable." Additionally, stage II under the Brigham System indicates that at least one group of lymph nodes is involved.

Stage II Mesothelioma Diagnosis and Treatment

The first step in diagnosing mesothelioma generally involves an imaging test, such as an x-ray, MRI scan, CT scan, or PET scan. Imaging tests allow medical professionals to get a visual picture of what is happening inside the body. Physicians use these images to look for any abnormal areas and identify where cancer might be present. Imaging tests are then generally followed by biopsies of various tissues to chemically determine if the cells are cancerous. Because stage II Mesothelioma has typically spread beyond the point of origin, the diagnosis process will likely involve biopsies from more than one area of the body.

Stage II mesothelioma indicates a disease that has spread from its point of origin. When lymph nodes become involved in a cancer, the chance that cancerous cells will metastasize to another part of the body is very high. The primary tumor may be surgically removed - but there is a very good chance that cancerous cells have invaded other parts of the body.

In general, then, the treatment course for stage II mesothelioma may begin with surgery, followed by chemotherapy or radiation therapy. Due to the likelihood of metastasis, or spreading of the disease, this chemical or radiation follow-up is particularly important in the treatment of the disease.

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