Stage I Mesothelioma
Mesothelioma, like other types of cancer, is staged at the time of diagnosis. The stages include I, II, III, and IV, with I being the earliest and IV being the most progressed stage of the disease. Staging is important because it guides treatment and helps give patients a more accurate prognosis. Stage I is the earliest stage of mesothelioma, but diagnosing it this early is rare.
Because mesothelioma is difficult to diagnose, because it is rare, because it mimics more common illnesses, and because it has a long latency period, stage I diagnoses are not as common. This cancer, which attacks the mesothelium that lines most organs in the body, is aggressive and moves quickly. Most patients get a diagnosis at a later stage, but those that get a stage I diagnosis have more treatment options and a better overall prognosis and hope for a cure.
TNM Staging for Mesothelioma
There are multiple systems for staging cancer, but the TNM system is most common and most often used for mesothelioma. While diagnosing the cancer, doctors, pathologists, and specialists will also try to stage the disease accurately. This involves looking at the cells in the tumor, the extent of the tumor, and any metastasis or spreading of the original tumor to the lymph nodes or any other part of the body. Doctors use biopsy samples and imaging scans. In some cases they may need to do exploratory surgery, although this is invasive and avoided if possible.
The T in TNM describes the extent of the primary tumor, how big it is, how much it has grown into surrounding tissue. N describes any spread of the cancer to lymph nodes. These are cells in the immune system and often the first place cancer spreads. M describes the extent to which the cancer has metastasized or spread to other organs and tissues in the body.
Stage I Mesothelioma According to TNM
Stage I mesothelioma is diagnosed if the TNM assignments are T1, N0, and M0. T1 means that the original tumor has not spread very far from its original location. With pleural mesothelioma, the most common type of this cancer, T1 describes a tumor that exists in the pleura—the tissue that surrounds the lungs—on just one side of the chest. It may have penetrated the pleura around the diaphragm, which is the muscle underneath the lungs, or the pleura in between the two lungs. An assignment of N0 means that the cancer has not yet spread to any nearby lymph nodes and an assignment of M0 means that there has been no metastasis.
Treatment for Stage I Mesothelioma
Because there has been no spread of the cancer to lymph nodes or other organs, stage I mesothelioma has the most treatment options. Mesothelioma is almost always considered incurable, but for those at stage I there is hope and a possibility of going into remission. As long as a patient is healthy and able to withstand it, most doctors will recommend aggressive and multimodal treatment at this stage.
One of the most important distinctions between stage I and later stage mesothelioma is that it is most likely resectable. In other words, surgery to attempt to remove all or most of the cancerous tissue is a possibility. When the cancer has spread to other locations, surgery becomes a less viable option. For most stage I patients a combination of surgery, radiation, and chemotherapy gives the best hope of survival.
For surgical treatment there are a couple of options. A pleurectomy and decortication removes all of the pleura on the side of the chest with the tumor that surrounds the lungs, the diaphragm, and the space between the lungs. More radical is an extrapleural pneumonectomy, which removes the pleura, but also the lung and the diaphragm on the side where the tumor is found. This surgery is only recommended for health patients and is only performed by specialists. Surgery to remove as much of the tumor as possible is also an option for peritoneal mesothelioma. That surgery may remove the abdominal mesothelium as well as the omentum, a layer of fat that hangs over the abdominal organs.
Chemotherapy is medication that targets fast-growing cells in the body and radiation is a beam of high-energy waves that can be aimed at a tumor to kill cancer cells. Each of these are often used before or after surgery in patients with stage I mesothelioma. Chemotherapy may be used before surgery to shrink the tumor and either may be used after to kill any remaining cancer cells and to prevent a recurrence.
Stage I Prognosis
Patients getting a stage I diagnosis for mesothelioma are rare. This stage of the disease comes with the best prognosis and an average survival time of nearly two years. That is compared to a survival time of one year or less for stage IV patients. Some stage I patients have actually beaten mesothelioma and remained in remission for years and even decades. The average is only a guideline and the actual prognosis for a patient depends on many individual factors.
Aside from the stage of the cancer, other factors that improve the prognosis are a younger age, good overall health, positive lifestyle habits, like not smoking, and aggressive and early treatment. Getting treatment for mesothelioma almost always extends life expectancy, and in stage I it actually has a chance of curing the cancer. If you have been diagnosed at this stage, you may want to take an aggressive approach to give yourself the best prognosis possible.
Most people with mesothelioma were exposed to asbestos at work through materials they used on the job. Years of exposure has led to thousands of cases of this devastating cancer and too few receive a diagnosis early enough to have much hope of surviving it. Even if you are a stage I patient with hope of beating it, you still have legal rights to sue and seek compensation for your illness. Let a mesothelioma lawyer help you decide what to do next and what steps to take to get justice.
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