Stage 3 Mesothelioma

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In stage 3 mesothelioma, tumors have spread into tissues, organs or lymph nodes around the cancer’s original site. Mesothelioma is most frequently caught in stage 3 because this is when most symptoms arise. Median life expectancy at stage 3 is about 18 months with surgical treatment.

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What Is Stage 3 Mesothelioma?

Stage 3 is an advanced stage of mesothelioma cancer. Tumors have spread throughout the pleura (lining of the lungs) on one side of the chest and to nearby lymph nodes on the same side of the body as the main tumor.

The diaphragm, heart sac, area between the lungs (mediastinum) and layers of the chest wall near the main tumor may be affected. The biggest difference between stage 3 and stage 4 mesothelioma is that tumors have not yet spread to distant organs.

Stage 3 mesothelioma tumors spreading on the lung.

Stage 3 Mesothelioma Facts

  • Two-year survival rate is between 26% and 30%
  • Tumor-removing surgery still a possibility
  • Symptoms include frequent chest pain and difficulty breathing
  • Emerging treatments through clinical trials may extend survival

What to Do After a Stage 3 Mesothelioma Diagnosis

The most important thing a person can do after receiving a diagnosis of mesothelioma is to find a team of specialists who are well-equipped to treat the rare cancer. It is essential to seek treatment as soon as possible following a stage 3 mesothelioma diagnosis.

Working with doctors who have successfully treated mesothelioma patients through surgery and the latest therapies gives you the best chance to outlive your prognosis.

These specialists know the intricacies of mesothelioma, and they understand the challenges patients face. Not all hospitals or major metropolitan cancer centers have doctors who focus on mesothelioma.

Often, patients must travel long distances to find the best care at a specialty cancer center, but it is the smartest decision you can make when it comes to your health.

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Choosing a doctor who specializes in mesothelioma is critical to improving prognosis and finding the best treatment plan.

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Characteristics of Stage 3 Mesothelioma

Most doctors stage pleural mesothelioma using the American Joint Committee on Cancer’s TNM system. It was last updated in January 2018. According to that system, stage 3 pleural mesothelioma is divided into two parts: 3A and 3B.

  • Stage 3A: Tumors have grown into nearby structures, including the diaphragm and mediastinum on one side of the chest. The cancer has spread to nearby lymph nodes and possibly layers of the chest wall and the heart sac (pericardium). Surgery to remove all visible tumor growth is still an option.
  • Stage 3B: This category is split into two variations depending on the size of the main tumor and spread to the lymph nodes. If the cancer is contained enough to the point of origin or to nearby structures, it may be possible to remove tumors with surgery, even though it has spread to the lymph nodes. In the most advanced point of TNM stage 3, the mesothelioma has grown too extensively at the site of origin to be removed completely with surgery, even if nearby lymph nodes are not affected.

There is no formal staging system for peritoneal mesothelioma, the second-most-common form of mesothelioma. If a doctor refers to peritoneal mesothelioma as stage 3, it usually means tumors have spread throughout the lining of the abdomen and to nearby lymph nodes.

Learn More About the Four Stages of Mesothelioma

Stage 3 Mesothelioma Symptoms

By stage 3, symptoms are much more noticeable and intense compared to stage 2 mesothelioma.

The most common symptoms of stage 3 mesothelioma include:

  • Shortness of breath
  • Tightness or pain in the chest
  • Recurring dry cough

As the tumors continue to grow and spread, the symptoms will become more problematic. Symptoms vary from patient to patient depending on how the cancer is spreading.

A tumor invading the chest wall may cause increased chest pain, while tumors forming around the lung may lead to increased breathing difficulties.

How Is Stage 3 Mesothelioma Treated?

Stage 3 tumors are considered locally advanced, but surgical removal may be possible with extensive surgery.

A treatment plan using tumor-removing surgery, chemotherapy and radiation therapy has produced the best survival rates for people with stage 3 pleural mesothelioma.

Stage 3 mesothelioma patients may also benefit from emerging treatments such as immunotherapy, which can be accessed through experimental clinical trials.

Surgery

At stage 3, tumors have likely spread to surrounding tissues and lymph nodes. Pleural mesothelioma patients may be eligible for an extrapleural pneumonectomy, which removes the affected lung and its lining.

Depending on the spread of tumors, some stage 3 mesothelioma patients may qualify for the less drastic but more meticulous pleurectomy and decortication procedure. It removes the lining of the lung along with any tumor masses growing inside the chest cavity, leaving the lung intact.

Chemotherapy

Common mesothelioma surgeries show better survival rates when combined with chemotherapy.

Most patients receive combinations of chemotherapy drugs through an IV. Chemotherapy can begin as soon as a patient recovers from surgery. It may also be administered before or during surgery.

Radiation Therapy

Radiation therapy may also be administered after surgery to prevent local recurrence. Some research reports better survival when radiation therapy is applied before surgery to shrink tumors.

Palliative Care

Stage 3 mesothelioma patients who are not in good enough health to undergo aggressive treatments have other options. They can improve their quality of life with palliative therapies.

While these treatments aren’t expected to cure your cancer, they usually can help you feel better and live longer. Palliative chemotherapy and radiation might be used to lessen cancer-related pain and extend survival. Palliative surgery drains fluid buildup around the tumor, which helps with difficulty breathing.

Learn More About Mesothelioma Treatment Options

Clinical Trials

Voluntary research studies may provide the best hope for stage 3 mesothelioma patients. Immunotherapy and gene therapy are two constantly evolving areas in cancer treatment. Neither is FDA approved for mesothelioma, but clinical trials are testing immunotherapy drugs and new therapies with promising results.

Complementary and Alternative Therapies

Complementary therapies, such as acupuncture, yoga and nutritional counseling, are often integrated with conventional mesothelioma treatments. They may improve overall health or boost the immune system.

Some late-stage patients choose to forego conventional treatments for alternative therapies. However, a 2017 study published in the Journal of the National Cancer Institute shows cancer patients who rely on alternative medicine alone have a significantly lower survival rate.

Help Covering Treatment Expenses

Treatment for mesothelioma is costly. The average price of tumor-removing surgery is estimated at around $120,000, while chemotherapy sessions can cost up to $12,000 a month. Private insurance or Medicare won’t always cover all the costs, which is why financial assistance is essential for many mesothelioma patients.

Grants are available to help cover travel expenses to top mesothelioma cancer centers. Additional compensation may be available through asbestos trust funds and legal claims. A qualified mesothelioma attorney can help answer any questions you may have and explain your options for compensation.

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Stage 3 Mesothelioma Life Expectancy & Prognosis

About 26% to 38% of stage 3 mesothelioma patients live at least two years after diagnosis.

Life expectancy for stage 3 mesothelioma depends on response to treatment and the extent of lymph node involvement.

A successful response to surgery and post-surgery therapies helps patients live longer.

Pleural Mesothelioma Stage 3 Survival Rates

2-year survival rate 5-year survival rate

26%

38%

5%

10%

Source: American Society of Clinical Oncology, 2019

How Lymph Nodes Affect Cancer

Lymph nodes play a key role in the spread of cancer. That’s because the lymphatic system can transport cancer cells to distant organs. Once this occurs, the cancer is generally considered inoperable.

That’s why beginning treatment soon after diagnosis is essential to living longer. The key is to remove as much of the cancerous growth as possible before it spreads to other areas of the body.

Patients with minor lymph node involvement often live more than two years. This compares to a 13-month average for patients with more extensive involvement of nearby lymph nodes.

Even if the cancer has not spread to the lymph nodes, surgery may not be an option for some stage 3B patients if tumors have grown too far to be removed completely.

Russell Lamkins, Diagnosed with pleural mesothelioma in 2014
Russell Lamkins Diagnosed with pleural mesothelioma in 2014

“When I was first diagnosed with stage 3 inoperable cancer and told I had a year to live, I figured I’d better hurry up and try to finish this house quickly. But now, things have changed. My goal is to make it to the 10-year mark.”

Survival Rates Don’t Tell the Whole Story

Survival statistics cannot predict how long a person will live.

All patients with stage 3 mesothelioma have varying factors that can affect prognosis and life expectancy. These factors include age, gender, cancer cell type, response to treatment and overall health.

Certain patients respond particularly well to treatment and outlive their prognosis by years.

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Registered Nurse and Patient Advocate

Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the regional director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections. She is also a member of the Academy of Oncology Nurse & Patient Navigators.

Walter Pacheco, Managing Editor at Asbestos.com
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6 Cited Article Sources

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  2. American Society of Clinical Oncology. (2019, February). Mesothelioma: Statistics.
    Retrieved from: https://www.cancer.net/cancer-types/mesothelioma/statistics
  3. American Cancer Society. (2018, November 16). Malignant Mesothelioma Stages.
    Retrieved from: https://www.cancer.org/cancer/malignant-mesothelioma/detection-diagnosis-staging/staging.html
  4. Nicholson, A.G. et al. (2018). Eighth Edition Staging of Thoracic Malignancies.
    Retrieved from: https://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2017-0245-RA
  5. Rusch, V. (2017). Update on the mesothelioma staging system.
    Retrieved from: https://www.jto.org/article/S1556-0864(16)31272-2/fulltext
  6. American Joint Committee on Cancer. Malignant Pleural Mesothelioma. In AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017: 457-468.
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Last Modified August 22, 2019

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