Mesothelioma Stage 3

Summary

Stage 3 mesothelioma is the second latest stage of this disease. Tumors that formed in the mesothelium (organ linings) have now spread to distant organs and tissues, and to nearby lymph nodes. Most stage 3 mesothelioma patients are no longer eligible for curative surgeries, but can still undergo treatments to help slow disease spread and manage symptoms.

Overview of Stage 3 Mesothelioma

  • Second most advanced stage of the 4 mesothelioma stages
  • Pleural mesothelioma is the only disease form that doctors stage, but they apply similar staging criteria to peritoneal and pericardial mesotheliomas
  • Most mesothelioma cases are diagnosed at stage 3
  • In stage 3, patients experience significant metastasis making it unlikely that the mesothelioma can be resected (removed)
  • Stage 3 symptoms are typically quite uncomfortable and have noticeably worsened
  • Stage 3 mesothelioma has a poor prognosis for long-term survival but can be improved with the right treatments
  • Doctors treat stage 3 mesothelioma with a combination of palliative surgery, chemotherapy and radiation therapy
  • Stage 3 mesothelioma patients are usually excellent candidates for clinical trials, which test new and promising therapies

What is Stage 3 Mesothelioma?

Stage 3 mesothelioma is the second most advanced stage of 4 mesothelioma stages. It refers to tumors having metastasized (spread) outside the primary location. In stage 3, metastasis can occur in the chest wall, the pericardium and nearby lymph nodes. However, the tumor is still contained to one side of the chest, making it easier to treat than stage 4 mesothelioma.

The place where the tumor first forms is referred to as the primary location. As mesothelioma cells multiply, they cause tumors to grow and spread. The process of tumors spreading is called metastasis, and it’s what doctors try to prevent or control through treatment. In stage 2, there is only slight metastasis beyond the primary location, but by stage 3 there is further metastasis. Different factors determine the rate of metastasis because some mesothelioma cell types spread more aggressively than others.

When diagnosing mesothelioma, doctors take images of the patient’s chest using tests like X-rays, CT scans, PET scans and MRIs. By seeing inside the patient’s chest and from multiple angles, doctors can tell how far the mesothelioma has spread. The level of metastasis found in imaging tests allows doctors to diagnose patients at stage 3. It also allows them to know the exact locations to target with treatments, such as radiation.

Stage 3 Mesothelioma Prognosis and Life Expectancy

Mesothelioma has a poor prognosis (disease outlook). The prognosis for stage 3 mesothelioma is worse than stage 2 but better than stage 4. The average mesothelioma patient’s life expectancy ranges from 12-21 months. Stage 3 life expectancy is at the mid to lower end of this range.

The average life expectancy for stage 3 mesothelioma 16 months. It’s possible for patients to improve their prognosis with palliative surgeries, chemotherapy, and radiation therapy.

MJN Brief

Many stage 3 patients are also eligible for clinical trials to test out new treatments not yet available to the public. Though these novel therapies are still undergoing testing, many of them are promising and may help to increase life expectancy.

 

Stage 3 Mesothelioma Symptoms

While early-stage mesothelioma is typically asymptomatic—meaning showing no signs or symptoms—stage 3 mesothelioma patients generally notice significant symptoms that they report to their doctors. Doctors may still initially confuse stage 3 mesothelioma symptoms for other conditions like viral pneumonia, which delays time in diagnosing stage 3 mesothelioma.

Common stage 3 symptoms include:

  • Difficulty breathing
  • Chest pain
  • Significant unexplained weight loss
  • Chronic fatigue
  • Fever and sweating
  • Thickening in the pleura (lung lining)

Stage 3 mesothelioma symptoms are severe and doctors will typically order a chest x-ray whenever patients report difficulty breathing. With weight loss, fatigue and fever, doctors may even suspect malignancy (cancer).

By reading the results of a chest x-ray, doctors can identify abnormalities such as tumors, fluid buildup, and pleural thickening. Because these symptoms are all strong indicators of mesothelioma, it’s critical for patients to tell their doctors about their history of asbestos exposure. Without this information, doctors may incorrectly suspect a different type of cancer, such as lung cancer, which is far more common.

Stage 3 Mesothelioma Treatment Options

Most stage 3 mesothelioma patients are not eligible for curative surgeries as these are typically only performed on stage 1 and 2 patients. However, some specialists will treat certain late-stage patients with aggressive surgeries. One study found that the average survival time for stage 3 patients treated with the extrapleural pneumonectomy surgery was nearly 19 months.

All treatment plans for stage 3 mesothelioma are individualized. Some of the standard mesothelioma treatments for stage 3 patients include:

Palliative Surgery

Palliative surgeries are different curative surgeries as they are not intended to remove the mesothelioma completely. Rather, palliative surgeries are intended to alleviate painful symptoms. While palliative surgeries are not necessarily going to increase life expectancy, they can extend life because the patient isn’t in as much pain. An improved quality of life is critically important for late-stage mesothelioma patients.

The standard palliative surgery options for stage 3 pleural mesothelioma are:

  • Pleurodesis: Surgeons drain fluid from the pleural cavity and administer an agent that will cause scarring to the pleura to seal it off and prevent further fluid buildup.
  • Thoracentesis: Surgeons use a needle to drain fluid that has accumulated in the pleural cavity, but do not seal the pleural space.

Alleviating fluid buildup in the pleural cavity can help reduce symptoms such as chest pain and pressure as well as shortness of breath and painful breathing.

Chemotherapy and Radiation Therapy

Radiation therapy and/or chemotherapy are also standard treatments for stage 3 patients. Both anti-cancer therapies can help slow down metastasis—another source of pain. Radiation therapy has fewer side effects and may be a better option for some patients. Chemotherapy has more side effects but may be more effective at slowing disease progression in some patients.

Clinical Trials

As mesothelioma research advances, doctors develop and test out new therapies and treatment approaches that can possibly increase life expectancy. Some new therapies are more promising than others, however, all patients are different. Some patients have had excellent, life-extending results from novel therapies. Talk to your doctor about participating in clinical trials for stage 3 mesothelioma.

Stage 3 Mesothelioma Specialists

All stage 3 mesothelioma patients should seek the second opinion of a doctor who specializes in late-stage mesothelioma treatment. Seeking a second opinion can open up new treatment options for you that you otherwise wouldn’t have had available. If you’ve been diagnosed with stage 3 pleural mesothelioma, then legal compensation may be available to you. Mesothelioma patients can file claims against negligent asbestos manufacturers. Successful claims can pay for treatments and cover other expenses associated with your diagnosis.

View Author and Sources
Sources
  1. American Cancer Society, “Malignant Mesothelioma Stages” Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/staging.html. Accessed on January 2, 2018.
  2. Medscape, “Surgery for Malignant Pleural Mesothelioma.” Retrieved from: https://www.medscape.com/viewarticle/724140. Accessed on January 2, 2018.

Last modified: July 17, 2018