Mesothelioma diagnosis and staging 

Doctors use staging to describe the size and growth of a cancer. This information is crucial for determining the best mesothelioma treatment and clinical trials for you.  

Unlike other cancers, mesothelioma is staged into broad categories depending on where the cancer is and whether it can be surgically removed. The categories include: 

• Local and resectable: The cancer has not spread outside the area where it started and can be surgically removed. 
• Local and not resectable: The mesothelioma has not spread outside its area of origin, but it cannot be surgically removed. 
• Metastasized and not resectable: The cancer has spread to other areas of the body and cannot be surgically removed. 

Once a patient is diagnosed with mesothelioma the question of prognosis will naturally arise. Like most cancers, the prognosis for this disease often depends on how early it is diagnosed and how aggressively it is treated.

It is often very difficult for oncologists to provide definitive answers regarding the likely course of the disease. Although in general the prognosis of mesothelioma is poor, many factors come into play and long-term mesothelioma survivors do exist. 

Patients who come to Penn Medicine for mesothelioma treatment are in good hands. The physicians and teams at Penn Medicine have a level of experience and training that is unparalleled in the region. 

A number of variables determine a mesothelioma patient's prognosis. These include: 

• Type: Malignant mesothelioma is generally divided into three cell type categories depending on the tissues involved. The three types are epithelial, sarcomatoid, and biphasic, also known as mixed type. The most common type is epithelial mesothelioma which accounts for approximately 50 percent of all cases. Epithelial mesothelioma has a better survival rate than the other two types. 
• Location: Mesothelioma is also classified by location. Pleural mesothelioma occurs in the lining of the lung and accounts for approximately 75 percent of all cases. Those with this type of cancer have the best rate of survival. The less common, peritoneal mesothelioma, is found in the lining of the abdomen and is generally harder to treat. Less common types are very difficult to treat, including pericardial and testicular mesothelioma. 
• Stage of the disease: Early diagnosis and treatment of mesothelioma results in a better prognosis. Unfortunately, many symptoms of mesothelioma are very similar to less serious diseases resulting in misdiagnosis. Mesothelioma is often not diagnosed until it has already reached the later stages of the disease. 
• Metastasis: Once the diagnosis of mesothelioma is finally made, oncologists will often find that the cancer has spread—or metastasized—from the location of the primary tumor. The extent of the metastases and the location where it has occurred will determine what type of treatment is recommended, as well as the prognosis. 
• General health of the patient: Like most other illnesses and diseases, younger and stronger patients with mesothelioma live longer than those of advanced age who may already be dealing with multiple health issues. Patients with pre-existing health issues such as heart disease, diabetes, and high blood pressure may face an increased risk of mesothelioma surgery and other traditional cancer treatments such as chemotherapy and radiation. Additionally, non-smokers often have a better prognosis than patients who smoke. 

Over 2,000 cases of mesothelioma are diagnosed in the United States each year. Although there is no cure for mesothelioma, treatment options are improving as the disease becomes better understood. 

Early detection greatly increases the prognosis of mesothelioma. For this reason, research dollars have been dedicated to studying ways to diagnose the disease at an earlier stage. For example, the MESOMARK® assay is a simple blood test that measures a biomarker that is released by mesothelioma cells into the bloodstream. This biomarker, called soluble mesothelin-related peptides (SMRP), can be elevated for many years before symptoms appear and an actual diagnosis of the disease is made. This potential for early diagnosis could save many lives. 

Scientists have also focused on new drugs and treatments to provide hope of a better prognosis for mesothelioma. 

If you have been diagnosed with mesothelioma and have questions about the many mesothelioma treatment options available at Penn Medicine, contact a mesothelioma an oncology nurse navigator at Penn today. 

People travel from across the country to seek the expert care of our mesothelioma specialists. We provide: 

• Vast experience and skill: Our team has years of experience diagnosing and treating this complex condition. We are skilled at using the latest tests, including endoscopic techniques, to accurately biopsy and diagnose mesothelioma. We take the time to explain what diagnostic and staging tests show and work with you to create the right treatment plan. 
• Research-backed techniques and tools: Our physicians are also active researchers who participate in studies and clinical trials designed to advance the understanding of and treatment for mesothelioma. Our team helped develop TumorGlow® technology. This technique illuminates cancer cells during surgery to help surgeons identify and remove mesothelioma tumors with more accuracy. We offer TumorGlow and other innovative treatments like CAR T cell therapy to select patients through clinical trials. 
• Second opinion: Having an accurate diagnosis is the most important step towards the best possible treatment. Getting a second opinion will give you confidence that you are pursuing the right treatment for your specific cancer and circumstances.