As noted in the previous article on mesothelioma staging; staging is of importance. It looks at how serious the cancer is in respect of how far it has spread in the body and is of great relevance to the treatment options availed to the patient. This article focuses on the Brigham staging mesothelioma system.
The Brigham staging mesothelioma system was created by Dr. David Sugarbaker while at the Brigham and Women Hospital in Boston. It was developed based on 52 patients in 1993 but further updated the system in 1998. The Brigham staging mesothelioma system emphasizes on the viability of surgery as a treatment option. Generally, Stages I and II allow for the surgical removal of tumors while Stages III and IV do not consider surgery as a viable treatment option. It is one of the most used system by mesothelioma specialists. However, some doctors believe that no one staging system is accurate enough thus a combination of staging systems are used. The Brigham staging mesothelioma system is similar to the TNM staging system.
There are four stages in the Brigham staging system. The stages assess and define the following factors:
- Location of cancer
- Nodal responses and metastasis or size of cancer
- The possibility and effectiveness of surgical intervention at each stage
Brigham staging mesothelioma system
BRIGHAM STAGE I
Tumors are confined to lung lining and cancer has not spread to the lymph nodes. Cancer is limited to initial or original tumor. Surgery is a viable option at this stage.
BRIGHAM STAGE II
Tumors are confined to lung lining and lymph nodes in the area between the lungs containing the heart, aorta, trachea, esophagus and thymus are cancerous. At this stage surgery is still a viable option.
BRIGHAM STAGE III
Aggressive and unresectable tumors in the lung lining have spread into the chest wall, diaphragm and/or opposite side of the chest lymph nodes. Surgery at this stage is no longer an option.
BRIGHAM STAGE IV
At this stage cancer has spread to other parts of the body and is unresectable. Therefore, surgery is not a viable option at this stage.