Understand the Mesothelioma Stages


Staging is the process of exacting the extent of cancer spread based on primary tumor. Understand the Mesothelioma Stages wherea person’s cancer stage is based on results yielded by several tests including physical examinations,

imaging studies such as MRI and CT scans, laboratory tests (such of urine, blood, etc), and surgical and pathological or biopsy results. Staging allows a medical team to provide prognosis and treatment plans.

Staging has evolved over the time as new knowledge about cancer is discovered. Today, there are three staging systems used to determine the Mesothelioma Stages: the Butchart system, the TNM system, and the Brigham system.

Though each staging system measures different variables, there some factors that all staging systems consider. These are the location of tumor, size and number of tumors, affected lymph nodes, cell type, and metastasis. All forms of mesothelioma are staged except peritoneal mesothelomia or cancer of the abdominal lining.

Butchard System

The Butchart system is the oldest and, still, the most widely used staging system. Butchart staging is based primarily on extent of primary tumor mass.

Stage I: Cancer cells are found in one side of the pleura only Understand the Mesothelioma Stages

Stage II: Cancer cells have invaded the chest wall or involve the other side of the pleura, the esophagus, or the lymph nodes in the chest.

Stage III: Mesothelioma has invaded the peritoneum or abdominal cavity passing through the diaphragm, or involves lymph nodes beyond the chest.

Stage IV: Mesothelioma has metastasized or has spread to other organs through the bloodstream.


The more recent TNM system uses (T) tumor, (N) lymph nodes, and M (metastasis) as variables in staging. Many cancer facilities are starting to use this system as it is able to determine more accurately the extent of tumor than the older Butchart system.

Stage I: Mesothelomia involves one side of the pleura only. The outer lining of the lung is also invaded, characterized by a few spots.

Stage II: Either side of the pleura is involved. MEsothelioma has invaded either the outer lining of the lung, the lung, or the diaphragm through lining of the chest.

Stage III: Cancer cells are found in the chest wall, lungs, outer covering layer of the heart, and lymph nodes on the same side of the chest.

Stage IV: Lymph nodes, on the other side of the chest are invaded. Cancer cells have also spread to the pleura on the opposite side, abdominal organs, neck, nerves leading to the arm, spine, and other distant organs through the bloodstream (metastases).

Brigham system

This system considers whether the tumor can be surgically removed (resect) or not, and whether there are lymph nodes invaded or not.

Stage I: Tumor can be resected; no lymph nodes are affected.

Stage II: Mesothelioma can be resected. There are, however, invaded lymph nodes.

Stage III: Mesothelioma cannot be respected. Cancer cells have invaded the chest wall, heart, and abdominal lining.

Stage IV: Cancer cells have metastasized into other organs via the bloodstream.

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