Mesothelioma Attorneys

Brigham System

Asbestos Cancer

The Brigham Staging System is the most recently developed mesothelioma staging system. Brigham stages are based on respectability, which is whether the tumor can be removed surgically, and lymph node involvement. The system was introduced after analyzing 52 patients treated with trimodality therapy at the Dana-Farber Cancer Institute/Brigham and Women’s Hospital Thoracic Oncology Program. Trimodality therapy is a combination of surgery, radiation, and chemotherapy.

Brigham Stages

Stage 1 – cancer can be removed surgically (resectable) and there is no lymph node involvement

Stage 2 – resectable, but lymph nodes have become involved

Stage 3 – not resectable, cancer has invaded the chest wall, mediastinum (space between the lungs), peritoneum through the diaphragm, or heart; lymph nodes may or may not be involved

Stage 4 – not resectable and the cancer has spread to distant parts of the body

Brigham Stage 3 combines Butchart Stage 2 and Stage 3.

Staging and Treatment

Staging is used to determine the best course of treatment for mesothelioma patients. The Brigham system is unique because the stages are defined, in part, by whether the cancer is operable. The stage of mesothelioma is not the only consideration when choosing treatment options. A patient’s age and overall health may rule out aggressive treatments. Mesothelioma is more common in older patients.

Staging is part of the diagnostic process. Tests used in staging can include:

  • X-ray
  • Computerized axial tomography (CAT scan)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET scan)
  • Endoscopic ultrasound (EUS)
  • Biopsy