Pleural mesothelioma is the only mesothelioma for which there is a formal staging system. The most commonly used system for this form of cancer is the TNM system , which is based on 3 key elements: the size (size) of the main tumor (T), the spread in the nearby lymph nodes (N) and the spread (metastasis) in the distant places. (M). Once a person’s T, N and M categories have been determined, this information is combined into a process called grouping to assign a stage or stage.
Stage IA – Mesothelioma is in the pleura of the thoracic wall on one side of the chest, it may also affect other regions such as the diaphragm, the mediastinum (space between the lungs) or the pleura covering the lung (T1), it has not spread in the lymph nodes (N0) or in places. removed (M0).
Stage IB – Mesothelioma is in the pleura of the chest wall on one side of the chest, has increased in the diaphragm or even in the lung (T2), has not spread in the lymph nodes (N0) or in distant places (M0) or has increased in the structures of approach, but may be eliminated with surgery (T3).
Stage II – Mesothelioma is in the pleura of the thoracic wall on one side of the chest (T1) and may have increased in the diaphragm or even in the lung (T2), it has spread to the nearby lymph nodes, on the same side of the body with the main tumor ( N1), but not in remote locations (M0).
Stage IIIA – Mesothelioma has increased in the nearby structures, but can be eliminated with surgery (T3), it is found in the pleura of the chest wall on one side of the chest, as well as in the pleura covering the lung, diaphragm and mediastinum, in others nearby regions, in nearby lymph nodes (N1), but did not spread to distant locations (M0).
Stage IIIB – Mesothelioma may have developed in nearby structures, in nearby lymph nodes on the other side of the body (N2), but it did not spread to distant locations (M0).
Stage IV – Can be grown in nearby structures (any T), in nearby lymph nodes (any N) and in distant organs such as bones, liver, lung etc (M1).
Treatment of malignant mesothelioma
Surgery – Sometimes it is not possible to remove the entire cancer. In these cases, surgery can help reduce the signs and symptoms caused by the spread of mesothelioma in the body. Surgical options may include: surgery to reduce fluid buildup , surgery to remove tissue around the lungs or abdomen ( pleurectomy or peritonectomy ), surgery to remove as much cancer as possible, surgery to remove the lung and surrounding tissue.
Chemotherapy -Platinumbased chemotherapyremains the basis of treatment. Several classes of drugs are being tested, either in combination with cisplatin and pemetrexed, or as a unique agent for recurrent or progressive malignant pleural mesothelioma. Chemotherapy uses chemicals to destroy cancer cells. Systemic chemotherapy travels throughout the body and may reduce or slow the growth of a mesothelioma that cannot be removed by surgery. Chemotherapy can also be used before surgery (neoadjuvantchemotherapy) to ease the operation or after surgery (adjuvantchemotherapy) to reduce the chances of cancer recurrence.
Radiotherapy – For some patients, radiotherapy can be given after surgery to reduce the rate of recurrence. It can also help reduce the signs and symptoms of advanced cancer in situations where surgery is not an option.
Prevention of malignant mesothelioma
Reducing asbestos exposure can reduce the risk of mesothelioma. Ask your employer if you are at risk of exposure to asbestos at work. Observe the employer’s safety regulations, comply with all safety precautions at the workplace , such as protective equipment. Talk to your doctor about other precautions you can take to protect yourself from exposure to asbestos. Also, consult trained asbestos detection experts in your home.
Statistics and prognosis
The prognosis for people with mesothelioma varies with the stage (spread) of cancer – in general, survival rates are higher for people with early stage cancer. Many other factors can also affect a person’s prognosis, such as a person’s age and general health, where the cancer is located in the body, what type of mesothelioma is and how well the cancer responds to treatment.
The overall health of a patient is an important prognostic factor. Also, each body tolerates treatment in a different and unique way.
The prognosis of pleural mesothelioma with standard treatment is not usually high. Average overall survival is a little over a year, depending on the stage. The prognosis of peritoneal mesothelioma has become much better with the advent of surgery. The estimated overall overall survival is 24 months.
There is a better prognosis for patients who have small tumors and have had an efficient surgery (most of the tumor is removed). The survival of patients with malignant mesothelioma remains low and usually around one year, depending on the patient’s age, staging, histology and general health status, but is generally very poor.