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Stage III Mesothelioma

Stage III mesothelioma is a later stage of this rare and aggressive type of cancer. The leading cause of it is exposure to asbestos, which many people experienced on the job without knowledge of it. Unfortunately most people who have this type of cancer are diagnosed at later stages, like stage III or stage IV due to the long latency period, rarity, and difficulties if diagnosing mesothelioma.

At stage III, mesothelioma has spread throughout one side of the chest cavity and may have also spread to lymph nodes. Once cancer is in the lymph nodes, the final stage, metastasis, is not far away. At stage III symptoms will also be more severe, treatment options become more limited and survival time and prognosis is less positive.

The Importance of Staging Mesothelioma

Staging is important for any type of cancer, but for a cancer that is aggressive and moves quickly, getting the staging right is especially crucial. When a diagnosis of mesothelioma is made for a patient, the next step is to determine its stage. This means looking at imaging scans to see the original tumor and to detect any additional tumors or any areas of the body to which it has spread. It also means looking at biopsied samples and may include some exploratory surgery.

Why Most Diagnoses for Mesothelioma are Late Stage

The bad news about mesothelioma is that it is too often diagnosed after it has reached stage III or IV, when the prognosis is not good and life expectancy is limited. This happens for a number of reasons. It is a cancer that is slow to develop from exposure to asbestos to the time it can be detected in the body. Once it has developed, however, it the moves quickly.
Another issue is that mesothelioma is rare and its symptoms are similar to those of more common conditions. It is not unusual for mesothelioma to be first diagnosed as something else, like pneumonia, chronic obstructive pulmonary disorder, lung cancer, and other illnesses. Distinguishing between mesothelioma of the pleura, the tissue lining in the chest cavity, and cancer of the lungs, is particularly difficult.

Staging and Characteristics of Stage III Mesothelioma

The staging system most often used for pleural mesothelioma is the TNM system. T describes the extent of the original tumor, N describes the spread of the cancer to lymph nodes, and M describes any metastasis of the cancer. Each letter is given a number designation, such as T0, N2, or M1, to communicate and describe each of these characteristics of the cancer in an individual. Together these designations lead to a stage assignment of I, II, III, or IV.

For stage III mesothelioma, these designations may be T1 or T2, N1 or N2, and M0 or T3, N0 to N2, and M0. The first staging designation describes pleural mesothelioma with an original tumor that has grown into the pleura that lines the chest cavity and that may also have grown into the pleura around the lungs and the diaphragm, and even into the lung tissue or the diaphragm beneath the lung. It will also have spread to lymph nodes on the same side of the chest cavity as the original tumor, but has not yet metastasized.

The second staging designation for stage III mesothelioma describes an original tumor that has grown into the pleura lining the chest cavity and either into the chest wall, fatty tissues between the lungs, or the lining of the heart. The cancer may have spread to lymph nodes on the same side of the chest, but it has not metastasized.

Stage III Treatment

By stage III of mesothelioma, treatment options have become more limited. The farther a cancer spreads, the more difficult it becomes to treat. The only surgery that has a chance of curing the cancer is the most aggressive, extrapleural pneumonectomy. This is an extensive surgery that is risky and must be performed by a specialist. It involves removing all of the pleura, lung, and diaphragm from one side of the chest. Not all stage III patients are eligible for this surgery, though.

More common treatments for stage III mesothelioma is chemotherapy, radiation, or a combination of both. Either one may be used without surgery, but are also used before or after surgical procedures to reduce the size of the tumor to be removed and to kill any remaining cells after the surgery. The hope of curing or achieving remission with any of these treatment methods is unfortunately low at stage III, but they may extend the patient’s life.

Palliative Care

Another reason to pursue treatment options for stage III mesothelioma is to help a dying patient feel more comfortable. This is called palliative care and there are several options that can be used. Debulking surgery to remove part of a tumor can help a patient breathe more easily, as can procedures to drain fluid from around the lungs. These measures may also reduce pain and help patients be more mobile.

Alternative therapies can also be used at this stage to help patients cope with the consequences of having cancer and facing death. These therapies may also help reduce pain and stress and include acupuncture, massage, exercise and nutrition, yoga, meditation, and others that are guided by the patient’s medical team.

Prognosis

As the stage of mesothelioma advances, the prognosis gets worse for patients. It is highly unlikely that stage III mesothelioma can be cured, but treatments can extend the life expectancy. The median survival time for this stage is 16 months after diagnosis. This is representative of thousands of patients, though, and each individual is different. Those that are younger and healthier and able to undergo more aggressive treatments are likely to survive longer than older patients with poor health.

The prognosis is never good for mesothelioma and too many people struggling with this disease were exposed to asbestos without being aware of the dangers. Many of these people have sought compensation through lawsuits and asbestos trust funds. It cannot make the patient better, but this compensation does help cover bills and treatments and can provide a sense of justice.

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