Stage 3 mesothelioma means the cancer has spread to nearby lymph nodes or organs. About 1 in 4 people are diagnosed at this stage. With treatment, many live 16 to 26 months, and some long-term survivors have lived more than 10 years.
Medically Reviewed By: Dr. Jacques Fontaine
| Written by:
Dr. Daniel Landau
| Last Update: 07/14/2025
| 10 Min Read
Stage 3 mesothelioma is a cancer that has spread from where it started to nearby tissues, organs or lymph nodes. But it hasn’t spread to distant parts of the body. This is called a “locally advanced stage.”
Doctors use staging to learn how far mesothelioma has grown and spread. Mesothelioma staging shows the size and location of tumors, whether lymph nodes are involved and if the cancer has reached nearby tissues or organs. This information helps doctors choose the best treatment plan.
Dr. Jacques Fontaine, a thoracic surgeon at Moffitt Cancer Center in Tampa, shares more context with us. “In early stage or stage 1 mesothelioma, the patients have very little cancer, just in the lining around the lung. If the cancer has spread to some of the lymph nodes around the lung, that’s slightly more advanced, or stage 2 or 3 mesothelioma.” Fontaine said.
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Stage 3 mesothelioma can cause symptoms like shortness of breath, fatigue or fever. These symptoms often get worse as the cancer spreads to nearby tissues and lymph nodes. Many people need more help managing symptoms at this stage.
Mesothelioma symptoms may appear 20 to 60 years after asbestos exposure. As tumors grow, they can make it harder to breathe and put pressure on the chest or other organs.
Stage 3 Mesothelioma Symptoms
Fatigue
Fever
Fluid buildup
Gastrointestinal problems
Pain in the chest or abdomen
Recurring dry cough
Shortness of breath
Weight loss
Symptoms can be different for each person, depending on where mesothelioma spreads. With pleural mesothelioma, extra fluid can build up around the lungs called pleural effusions. This fluid makes it hard to breathe and causes chest pain. Tumors in the chest can also make symptoms worse.
If you have peritoneal mesothelioma, fluid can collect in your belly. This condition is called ascites or peritoneal effusions. The causes swelling and discomfort. You might also feel pain in your neck, back or shoulders, or have bloating, constipation or diarrhea.
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Stage 3 Mesothelioma Life Expectancy and Prognosis
The median life expectancy for stage 3 mesothelioma is about 16 months with treatment. This means half of patients live longer than 16 months. The average (mean) life expectancy is similar, ranging from 16 months to 19 months, depending on treatment and individual factors.
Your personal outlook, or mesothelioma prognosis, will depend on factors like cell type, your overall health and how far the cancer has spread. People who receive surgery, chemotherapy and radiation together may live longer.
Key Facts About Stage 3 Mesothelioma’s Outlook
Pleural mesothelioma median survival is about 16 months.
Peritoneal mesothelioma median survival can be up to 56 months.
Some patients are still eligible for tumor-removing surgery at this stage.
Clinical trials and multimodal therapy can improve outcomes.
Some people with stage 3 mesothelioma respond well to treatment and live well beyond their initial prognosis. New therapies and clinical trials can offer more options and help improve quality of life. For example, Russell Lamkins was first diagnosed with stage 3 pleural mesothelioma in 2014. He enrolled in a clinical trial in 2016 and shared with us how he was feeling as he surpassed the 5-year survival mark.
Russell told us, “When I was first diagnosed with stage 3 inoperable mesothelioma and told I had a year to live, I figured I’d better hurry up and finish projects I was working on. But now my goal is to make it to the 10-year mark.”
Russell Lamkins
Verified Asbestos.com Survivor
Survivor Diagnosed in Stage 3 Has Success in Clinical Trial
When Russell Lamkins was first diagnosed with stage 3 mesothelioma, he was told it was inoperable and his life expectancy was about a year. He was then able to find success participating in a transarterial chemoperfusion study at the Moffitt Cancer Center in Tampa. Russell says, “My neighbors don’t even know I’m sick. I still look and feel pretty good.”
Mesothelioma Stage 3 Survival Rates
Survival rates for stage 3 mesothelioma depend on mesothelioma type and the treatments received. With treatment, the 5-year survival rate for stage 3 peritoneal mesothelioma is about 29%, and it’s about 16% for stage 3 pleural mesothelioma.
The median survival for stage 3 pleural mesothelioma is about 16 months. For stage 3 peritoneal mesothelioma, it can be up to 26 months.
For testicular and pericardial mesothelioma, stage-specific survival rates aren’t available because there are so few cases. However, published reports show people with late-stage testicular mesothelioma tend to live about 24 months after diagnosis. Those with late-stage pericardial mesothelioma typically live around 10 months.
Some people with stage 3 mesothelioma live longer than these averages, especially if they respond well to treatments such as surgery, chemo or newer therapies. Individual prognosis depends on cancer type, cell type, overall health and response to treatment.
2-Year Survival Rate of All Stages
5-Year Survival Rate at Stage 3
Median Survival
Pleural Mesothelioma
22%
16%
16 months
Peritoneal Mesothelioma
35%
29%
26 months
Source:
SEER and various medical studies
How Lymph Nodes Affect Mesothelioma Life Expectancy
Lymph nodes are small glands that help your body fight infections. When mesothelioma spreads to the lymph nodes, it makes it harder for the immune system to fight the disease, and treatments often don’t work as well.
Because treatments like surgery usually aren’t as helpful once mesothelioma is present in the lymph nodes, people with mesothelioma in many lymph nodes usually live about 13 months. Early treatment can slow the spread and may help people live longer.
Sometimes, stage 3 mesothelioma can progress to stage 3B. This is when tumors grow into the diaphragm or the tissue lining the heart called the pericardium. Surgery usually isn’t an option when mesothelioma reaches stage 3B.
In stage 3 mesothelioma, tumors have grown and spread deeper to nearby tissues, organs and lymph nodes.
How Is Stage 3 Mesothelioma Treated?
Stage 3 mesothelioma treatment includes combinations of treatments, known as multimodal therapies. This can include immunotherapy, chemo, radiation and clinical trial options. The goal is to help people live longer and better, stopping or slowing the growth of mesothelioma tumors. If tumors haven’t spread too much, doctors may recommend surgery to remove them.
Most Common Treatments for Stage 3 Mesothelioma
Chemotherapy: Most patients receive 2 drugs via IV or injections in specific areas.
Immunotherapy: Opdivo (nivolumab) and Yervoy (ipilimumab) are standard options.
Palliative Care: Medicine and procedures can improve symptoms and quality of life.
Radiation Therapy: Slows growth and stops recurrence in stage 3 pleural mesothelioma.
Surgery: Can be beneficial for stage 3 or used with heated chemo for peritoneal cancer.
Targeted Therapy: May combine Avastin (bevacizumab) with chemo to extend survival.
Tumor Treating Fields: Uses electrical fields and chemo to slow tumor growth.
Dr. Daniel A. Landau, an oncologist and hematologist at the Medical University of South Carolina, tells us, “When I diagnose a patient with stage 3 peritoneal mesothelioma, it typically means the cancer has spread across the abdominal lining and into nearby lymph nodes. I’ve seen how this stage can significantly limit treatment options, which is why early detection is crucial.”
Multimodal treatment may be given to some patients where personalized therapies target the cell type, cancer stage and the location of the tumor. Clinical trials offer access to new or experimental drugs.
Stage 3 mesothelioma varies depending on where the disease begins. Pleural, peritoneal, pericardial and testicular mesothelioma each show distinct signs and patterns at this stage. These differences affect how the disease spreads and which parts of the body are involved.
Because each type behaves differently in early and later stages, doctors use different staging systems or approaches. Pleural mesothelioma has a well-established staging system, while other types rely on different methods to track progression and guide treatment.
Stage 3 Pleural Mesothelioma
Stage 3 pleural mesothelioma has two substages. In stage 3A, cancer is found in the pleura and possibly the chest wall, mediastinum or heart sac. The cancer remains on one side of the chest and has spread to lymph nodes on that side of the body. Stage 3B has two variations. In these, cancer grows into other lymph nodes or nearby structures, like the diaphragm, spine or abdominal lining.
Stage 3 Peritoneal Mesothelioma
In stage 3, cancer is found throughout the peritoneal lining and nearby lymph nodes. Spreading outside the abdomen is possible. The Peritoneal Cancer Index ranges from 0 to 39, measuring cancer across 13 parts of the abdominal lining. A score between 30 and 39 with cancer spreading into lymph nodes or beyond the abdomen indicates stage 3 peritoneal mesothelioma.
Stage 3 Pericardial Mesothelioma
Researchers haven’t defined stage 3 pericardial mesothelioma because it’s so rare. Pericardial mesothelioma is often diagnosed after the cancer has spread to the lungs or chest cavity. This shows a late stage of disease progression.
Stage 3 Testicular Mesothelioma
Testicular mesothelioma also doesn’t have a staging system because of its rarity. Doctors use staging guidelines for general testicular cancer. They may refer to stage 3 testicular mesothelioma as late-stage cancer. This describes the spread beyond the lining of the testes to other tissues, such as lymph nodes or bone.
What to Do After a Stage 3 Mesothelioma Diagnosis
After a stage 3 mesothelioma diagnosis, connect with a doctor who specializes in this cancer. Starting the right treatment for you as quickly as possible can give you the best chance of feeling better. Patient Advocates can help match you to doctors with experience treating mesothelioma cases like yours.
Following a healthy mesothelioma diet can also help. Exercise can also help you improve your overall health. Joining a mesothelioma support group is also a great way to learn from the firsthand experiences of other survivors what’s worked for them. Support groups often provide resources for improving the quality of life and mental health.
Survivor Kevin Hession shares with us that joining The Mesothelioma Center’s support group has helped him. He also shared an insight that’s been important for him personally. He tells us, “I think it’s very important to have goals. My wife wanted to go to Rome. Well, last February we went to Rome.”
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There is no mesothelioma cure for any stage of the disease. A small number of stage 3 patients are eligible for surgery, which may significantly extend survival.
What are the most common symptoms of stage 3 mesothelioma?
Symptoms of stage 3 mesothelioma may include shortness of breath, pain in the chest or abdomen, dry cough and fatigue.
How can stage 3 life expectancy be improved?
There are a number of factors affecting mesothelioma life expectancy in stage 3.
Lifestyle changes, like diet and exercise, can help stage 3 mesothelioma patients. They may extend survival for those on chemotherapy, immunotherapy or other treatments.
Are stage 3 mesothelioma patients eligible for clinical trials?
Many cancer centers in the United States offer clinical trials for stage 3 mesothelioma patients. They test new drugs and innovative therapy combinations.
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Dr. Jacques Fontaine is a thoracic surgeon at Moffitt Cancer Center in Tampa, Florida, where he heads up the Mesothelioma Research and Treatment Center. He specializes in minimally invasive robotic surgery and aggressive surgeries for mesothelioma.
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