Understanding your diagnosis
Your specialist gets a lot of information about the mesothelioma from your test results.
This may include:
- the cells it started in (cancer type)
- whether it has spread from where it started (cancer stage)
Your specialist uses this information to explain how the cancer could affect you in the future (your prognosis), and what your treatment options are.
What you need to know
Types of mesothelioma
Mesothelioma starts in mesothelial tissues that line the inside of the chest and abdomen and cover the body’s internal organs.
There are two main types of mesothelioma:
- Pleural mesothelioma starts in the pleura which line the chest cavity and cover the lungs.
- Peritoneal mesothelioma starts in the peritoneum which lines the abdominal cavity and covers most of the organs in the abdomen.
Mesothelioma can also start in the covering of the heart (pericardium) or the covering of the testicles, but these types are very rare.
Mesotheliomas are also described by how the cancer cells look under the microscope:
- epithelioid – the cells look similar to normal mesothelial cells
- sarcomatoid (fibrous) – the cells are spindle shaped and look like fibrous cells
- biphasic (mixed) – has a mix of epithelioid and sarcomatoid cells.
Epithelioid is the most common type, which typically grows slowly. Sarcomatoid is less common and tends to progress faster. The way biphasic mesotheliomas behave depends on the proportion of epithelioid and sarcomatoid cells they contain.
The stage of a cancer describes how far it has grown and spread when it is first diagnosed. The cancer stage is usually worked out from the results of biopsies, scans and other tests.
With mesothelioma, it can be difficult to be sure of the stage from test results. For people who are suitable for surgery, the lymph nodes and tissues removed during surgery provide more details about the stage.
Knowing the stage or extent of a mesothelioma helps doctors to work out the best treatment options. It also means the person with mesothelioma can fully understand their situation and discuss any concerns they have.
Staging for pleural mesothelioma
Pleural mesotheliomas are usually staged using the TNM system. This assesses three categories:
- T (tumour) – how much the tumour (cancer) has grown or spread from where it started
- N (lymph node) – whether it has spread into any nearby lymph nodes
- M (metastasis) – whether it has spread to other parts of the body.
Based on the TNM results, mesotheliomas may then be grouped into numbered stages.
Staging for peritoneal mesothelioma
There is no standard staging system for peritoneal mesotheliomas. Staging systems that may be used include the TNM system and the peritoneal cancer index (PCI).
What to ask or talk about
Talking about prognosis
Prognosis means what is likely to happen to you in the future because of your cancer. You may find it hard to talk about prognosis but it can help you make decisions about the treatment and care you want.
Everyone’s cancer is different, and everyone responds differently to treatment. Because of this, doctors can’t tell you exactly what will happen to you. Instead, they can give you the best information they have about what to expect.
Doctors work out prognosis based on statistics. These show what happens in large groups of people with cancer. They cannot predict what will happen to you or any other individual person.
Your specialist will share information about you and your cancer with a multidisciplinary team (MDT) to decide the best treatment options for you.
You may need more than one type of treatment or have a choice of treatments. You may also need to see other specialists during treatment planning.
Dealing with your diagnosis
Getting a cancer diagnosis is very distressing for the person with cancer, and their carers, family and friends. Different people react in different ways. They can be upset and angry or just in shock. Many people find it difficult to take in all the information and understand what it will mean for them.
The situation can be especially difficult for people who get a diagnosis of advanced cancer.
If you need to speak to someone about your diagnosis, you can call the Cancer Council on 13 11 20.
People who develop mesothelioma due to asbestos exposure may be able to claim compensation.
Organisations that can help with this include:
- Cancer Council
- Asbestos Diseases Foundation of Australia.