In Stage 3 mesothelioma, the cancer has spread to several areas beyond the point of the initial tumor.
Key Points about Stage 3 Mesothelioma
- More patients are diagnosed with Stage 3 mesothelioma than any other stage.
- Typically, at Stage 3 a significant amount of metastasis (spreading) has occurred, and lymph nodes are often involved.
- Symptoms for Stage 3 or usually severe and include pain in the chest, fatigue, weight loss, breathing difficulties.
- Curative therapy is an option; however, in many cases, Stage 3 treatment focuses on relieving pain and improving quality of life.
Stage 3 mesothelioma is classified as advanced disease given that, by this point, it has spread to areas beyond where it originated, though the cancer is still localized to some extent. The mesothelioma has spread throughout the lung lining and chest on one side of the body, and the cancer has invaded the lymph nodes.
There may also be tumors beyond the chest membranes affecting the chest wall itself, fatty tissue in the chest, or the heart lining (the pericardial membrane), regardless of whether local lymph node involvement is identified.
The majority of mesothelioma patients (roughly 70% according to one study) are diagnosed at Stage 3 or 4. In that same study, 57% of pleural mesothelioma patients were Stage 3 when diagnosed. Curative treatment becomes less likely, and prognosis is often poor.
Prognosis of Stage 3 Mesothelioma
Prognosis for Stage 3 patients depends on a number of factors, including the success of treatment. In general, most Stage 3 patients are not eligible for curative surgery, and the overall median survival for Stage 3 mesothelioma patients is between 12 and 24 month
Stage 3 Defined By Three Staging Systems
There are three systems used to stage mesothelioma known as the Butchart System, the Tumor, Node, Metastasis System (TNM), and the Brigham System. Each system defines the four stages of mesothelioma with slight differences.
The characteristics of Stage 3 mesothelioma according to the three systems are as follows:
|Butchart System||TNM System||Brigham System|
|The disease has spread from the primary area in the pleura to the lungs, abdominal cavity, and other parts of the body. Both nearby and distant lymph node groups may also be involved.||The cancer has spread from the lining of the lungs to other parts of the chest cavity including the esophagus, diaphragm, and other vital organs including the heart. The lymph nodes are also involved at this stage, including distant groups.||Surgery for tumor removal is no longer a possibility because the disease is now affecting other organs in the chest cavity as well as one or more groups of lymph nodes.|
Symptoms of Stage 3 Mesothelioma
In Stage 3, symptoms become much more severe and negatively impact a patient’s quality of life. Symptoms may result from tumors invading the lung tissue and chest cavity, but vary depending on how the cancer is advancing. In some mesothelioma patients, the symptoms are similar to the symptoms of lung infections like pneumonia and bronchitis.
- Chest pain or tightness
- Difficulty breathing
- Shortness of breath (dyspnea)
- Weight loss
Stage 3 Treatment Options
At this stage, treatment generally focuses on symptom relief (palliative) and improving prognosis, though curative surgery may still be an option in some eligible patients. For patients who aren’t candidates for curative surgery, palliative options include thoracentesis, paracentesis, or pericardiocentesis, depending on the type of mesothelioma.
Multimodal therapy is standard and recommended for overall healthy and eligible patients at this stage, and a combination of the following three standard treatment options has resulted in the most favorable survival rates:
|While many Stage 3 patients aren’t candidates for surgery, an extrapleural pneumonectomy may be recommended in order to remove tumors spreading to nearby organs and lymph nodes. In Stage 3 patients whose surgery was successful in removing all visible tumors, the median survival was 34 months.||Chemotherapy is used after surgery to eliminate any remaining mesothelioma cells.||Radiation may be administered before or after surgery, either to reduce the risk of recurrence or shrink tumors. A study of Stage 3 patients who underwent radical pleurectomy surgery followed by combined chemotherapy and radiation therapy resulted in a median survival of 21 months, with 28% still alive after 5 years.|