Stage 3 Mesothelioma

In stage 3 mesothelioma, the cancer has spread to nearby tissues and organs and possibly to distant lymph nodes. Stage 3 is the most commonly diagnosed stage of mesothelioma with an average life expectancy of approximately 16 months.

The severity of symptoms increases in patients with stage 3 malignant mesothelioma as the cancer progresses. Although there is no spread to distant organs and tissues, nearby spread and involvement of the lymph nodes generally limits the available treatments, aggressive surgery generally not being an option.

Mesothelioma stage 3 by type

During the diagnostic process, physicians will review the patient's medical history and symptoms, perform imaging tests and blood tests, and a biopsy to determine the type and stage of the cancer. Mesothelioma cancer uses a four-level classification system to classify the disease, and the classification varies according to the type of mesothelioma in a patient.

Stage 3 pleural mesothelioma

Pleural mesothelioma is the most commonly diagnosed type of cancer, accounting for 80-90% of all diagnoses. Specialists have implemented three transfer systems for this type, including the Brigham system, the Butchart system and the TNM system, which are the most common.

The TNM system examines the size and extent of mesothelioma tumors (T), lymph node involvement (N) and metastasis (M), or growth. Stage 3 malignant pleural mesothelioma is further classified in stages 3A and 3B.

Stage 3A Mesothelioma

Cancer cells are present in the pleura on one side of the breast

Nearby lymph node involvement

Possibility of spreading into the chest wall, pericardium, fascia lining or mediastinal fat

No distant metastasis

Stage 3B Mesothelioma

All components of stage 3A mesothelioma with distant lymph node involvement OR

Spreading in the chest wall, peritoneum, pleura on the opposite side of the chest, mediastinal organs, pericardium or other areas of the spine

Lymph node involvement near or far

No distant metastasis

The essential characteristic between stage 3 and stage 4 mesothelioma is that stage 3 diagnoses have spread to neighboring organs and tissues, while stage 4 diagnoses indicate metastasis to distant organs and tissues. According to the American Cancer Society, the 2-year survival rate for mesothelioma in stage 3 is about 26-30% and the 5-year survival rate is 5-8%.

Stage 3 peritoneal mesothelioma

Malignant peritoneal mesothelioma accounts for only 15 to 20% of all diagnoses. Less common than pleural mesothelioma, this type does not have its own classification system. Instead, mesothelioma specialists use the general characteristics of mesothelioma or the peritoneal cancer index (PCI), which classifies tumors in distinct areas of the abdomen and totals the scores. A score between 21 and 30 indicates stage 3 peritoneal mesothelioma.

Mesothelioma tumors are localized to the abdomen at this stage, but can spread to adjacent organs and lymph nodes. Many cases of stage 3 peritoneal mesothelioma show cancer growth in the chest wall and abdominal cavity.

Stage 3 pericardial mesothelioma

Pericardial mesothelioma represents only 1 to 2% of diagnoses. With limited case studies, specialists have not implemented a classification system for pericardial mesothelioma. Tumors of pericardial mesothelioma are often aggressive and fast-growing, and most patients are diagnosed at stage 3 or 4, or posthumously during an autopsy. At this point, the cancer probably has spread throughout the chest cavity and to neighboring organs and lymph nodes and possibly to the lungs.

Step 3 Testicular mesothelioma

Even more rare than pericardial mesothelioma, testicular mesothelioma also has no definitive staging system, and specialists rely on general staging tools to diagnose the disease. Stage 3 mesothelioma indicates that the cancer has spread outside the testicular mucosa, limiting treatment options and worsening the prognosis.

Stage 3 Symptoms of mesothelioma

In earlier stages, symptoms of mesothelioma are often minor and may not even be noticeable. But at stage 3, the symptoms are more intense and can be serious. Stage 3 patients often undergo various palliative treatments to relieve symptoms, which may involve procedures such as pleurocentesis or pleurodesis to eliminate fluid accumulation, relieve pain, and improve breathing.

Common Symptoms of Stage 3 Mesothelioma

Weight Loss                                                    Shortness of Breath (dyspnea)

Fluid Buildup                                                  Chest or Abdominal pain

Fever                                                               Chest Tightness                      

Coughing                                                        Difficulty Breathing

Fatigue

Even if the cancer has progressed to stage 3, it is still essential that patients receive medical attention as soon as possible to begin treatment before the disease progresses.

Prognosis of stage 3 mesothelioma

Patients with stage 3 malignant mesothelioma have an average life expectancy of 16 months. The prognosis is less favorable than the early stages because the disease has become more invasive and aggressive surgical treatments are generally no longer an option.

The prognosis will vary from one patient to another, each diagnosis being different. The patient's sex, age, genetics, general health, and history of smoking can affect prognosis, cell type, and type of cancer. Survival rates continue to rise as researchers and doctors in mesothelioma improve diagnostic tools and discover new treatment techniques.

Stage 3 mesothelioma Treatment

Staging is a determining factor in determining the patient's treatment plan. Stage 3 patients generally have limited options and are not able to undergo aggressive surgery or multimodal therapy.

Surgery, chemotherapy and radiotherapy can be used alone to eliminate as much cancer as possible or delay the progression of cancer. These therapies can also be applied palliatively to relieve symptoms. Palliative care is often an important part of the Stage 3 treatment plan to provide the patient with the best possible quality of life.

• Surgery: pleurodesis, paracentesis or thoracentesis are palliative surgeries that can be used to eliminate fluid build-up.

• Chemotherapy: Intraperitoneal hyperthermal chemotherapy (HIPEC) has been successful in prolonging life expectancy by at least 50% in some cases of peritoneal mesothelioma, but may be too aggressive for patients with advanced dissemination. Intravenous chemotherapy options such as pemetrexed, cisplatin and bevacizumab are used to prolong life and improve quality of life. Immunotherapy treatments have also become standard options after chemotherapy.

• Radiotherapy: Radiation therapy can be used palliatively to reduce tumors and reduce symptoms such as chest pain and breathing difficulties.

Staging is an important factor in determining which treatments a patient can follow. Accurate staging not only helps doctors understand the course of the disease, but can also provide patients with insight into treatment options.

Patients may be eligible for experimental cancer treatments and clinical trials that have improved life expectancy in some cases. Patients should discuss options with their doctor to see if they meet the criteria for participating in such treatments.