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Mesothelioma Stages: The Brigham System

The symptoms of mesothelioma are similar to many other conditions, making diagnosis complicated. Yet, it is these complications that lead physicians to discover the unique features of a given disease, that, once isolated, make it possible to identify the specific disease and make a diagnosis.

    BALTIMORE, MD, October 19, 2008 /Cancer PR News/ -- The symptoms of mesothelioma are similar to many other conditions, making diagnosis complicated. Yet, it is these complications that lead physicians to discover the unique features of a given disease, that, once isolated, make it possible to identify the specific disease and make a diagnosis.

Diagnosis

And, so it is with mesothelioma. Diagnosis starts with a medical history review, examination, and diagnostic testing. During your medical history review and examination you will learn facts that he will use as clues to direct him. Your symptoms, your work history, and likelihood of exposure to asbestos and other facts, combined, will give him an idea what to look for, and thus, a list of diagnostic tests to run that will give him the foundation for a his diagnosis. If he suspects mesothelioma, you can expect the following list of tests to be done:
• X-rays of chest, abdomen or both
• Pulmonary function tests (to measure breathing capacity)
• CAT scan or MRI
• Biopsy (if a mass is present it is needed to confirm a mesothelioma diagnosis)

Once mesothelioma is diagnosed, its progression is measured by classifying symptoms into four stages, called staging. Staging systems measure the extent that the primary mass has spread within the body. It does not account for secondary tumors or complications caused by the cancer. All staging systems describe the stages that originate from the pleura, since over 80% of mesothelioma cases manifest in the pleura. Only two are used for peritoneal mesothelioma.

Of the three main staging systems for mesothelioma, the Brigham System is the newest system, and has a unique purpose among the three. It is used primarily to determine whether the tumor is operable and the degree of lymph node involvement. The Brigham System is not used as often as the TNM System because most cases of mesothelioma are inoperable by the time it is diagnosed.

Stage 1
There is no lymph node involvement and the tumor can be surgically removed.

Stage 2
Cancer cells have been found in the lymph nodes, but the tumor(s) in the mesothelia and chest cavity can be removed with surgery.

Stage 3
The cancer has spread to other organs and is inoperable. There may or may not be cancer in the lymph nodes.

Stage 4
The cancer has spread through the blood stream to other body sites, and is inoperable. Recurrence is highly probably even if the primary tumor is removed.
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